Anomalous renal artery is potential cause of resistant hypertension in a 53 year old patient: case report

Background: Drug-resistant hypertension can be attributable to secondary hypertension and other causes. Anomalous renal artery is uncommon but can be a potential cause of resistant hypertension.Case Report: We highlight the challenges in management of resistant hypertension and describe its unusual association with renal artery anomaly in 53 years old man who was referred to our nephrology clinic from a peripheral general hospital on account of poorly controlled hypertension. At presentation, BP was severely elevated at 208/100mmHg but no remarkable findings in the rest of the examination. Several investigations done including abdominal ultrasound scan and Computerised Tomography (CT) Renal angiogram revealed a Left anomalous renal artery. Patient declined all suggested urologic interventions and he was then managed conservatively.Conclusion: We found that anomalous renal arteries can be a potential cause of resistant hypertension. We therefore recommend ultrasound scan of the abdomen as a screening modality due to its being non-invasive.Keywords: Renal artery, anomalous, resistant hypertension, stenosi

Assessment of Post Fire Structural Strengths of Normal Strength Concrete Subjected to Cyclic Thermal Loadings

Concrete is a composite construction material consisting basically of a binder, aggregates, water and with or without admixture to modify either or both its physical and chemical properties. The rate at which concrete structures especially buildings are gutted by fire hazards is on the increase and this has adverse effect on the strength, hence, the need to  assess the post fire structural strengths of Normal Strength Concrete(NSC). NSC of grade 50 was produced and cast into specimens of sizes 150mm cubes and 100mm x 100mm x 500mm reinforced concrete beams. The concrete cubes and beams were subjected to elevated cyclic thermal loadings after 7, 14 and 28 days of curing, while the rate of heating was maintained at 1oC/min until the target temperature of (100, 130, 160, 200 and 250)o C where attained and this was maintained for one hour and then allowed to cool at 1oC/min to room temperature of 32oC.         Unstressed Residual Uniaxial Compressive Test (URUCT and Flexural Strength Test (FST) were conducted on the cubes and reinforced concrete beams, respectively. Direct Tensile Strength Test (DTST) was performed on the high yield (460N/mm2) steel reinforcement. The result showed that the residual compressive strengths of concrete cubes decreases with increase thermal loadings. The expected strengths of 0.69 and 0.97 of the 28 days strength for 7 and 14 days respectively were met. The flexural strengths decrease with increase in thermal loadings. The flexural strength of the concrete beams at 28 days of 15.25N/mm2 at thermal loading of 32oC was reduced to 8.16/mm2 at thermal loading of 160oC; while the strength at 14 days of 12.19 N/mm2 at thermal loading of 32oC was reduced to 7.62N/mm2 at thermal loading of 160oC and finally, the strength at 7 days of 10.13N/mm2 at thermal loading of 32oC was reduced to 5.82N/mm2 at thermal loading of 160oC. All the results met the specification for high yield steel of 12% elongation at fracture. It was concluded that within the thermal loading range adopted, the tensile strength of the reinforcement was not impaired beyond the limit specified by the code. Keyword: Normal Strength Concrete, Thermal loadings, Unstressed Residual  Strength Test, Fire hazard

Roll out of a successful antimicrobial stewardship programme in Lagos University Teaching Hospital Nigeria using the Global-Point Prevalence Survey

Background: Antimicrobial resistance (AMR) has become a public health emergency with increasing rates and spread globally. Antimicrobial stewardship (AMS) has been advocated to reduce the burden of antimicrobial resistance, promote rational and appropriate use of antibiotics and improve clinical outcomes. Education and training are one of the AMS interventions to improve antimicrobial use. We present the roll out of a successful AMS programme with education and training using the Global-PPS as data collection tool to measure AMS interventions and impact.Methodology: This was a cross sectional study on the implementation of an AMS programme at the Lagos University Teaching Hospital. Global PPS was conducted in 2015 to collect baseline data which was used to identify targets for quality improvement in AMS and was repeated in 2017 and 2018 to measure impact of AMS interventions. AMS interventions included education, feedback of Global-PPS result and writing of the hospitalwide antibiotic policy based on the baseline data.Results: Out of the 746 inpatients surveyed, 476 (68.3%) had received at least one antimicrobial on the days of Global-PPS. The antimicrobial prescribing rates reduced significantly over the three time periods. In 2015, 82.5% were placed on antimicrobials, 65.5% in 2017 and 51.1% in 2018 (p<0.00001). The documentation of indication for treatment significantly improved from 53.4% in 2015 to 97.2% in 2018 (p<0.0001). Stop review date also significantly improved from 28.7% to 70.2% in 2018 (p<0.00001). Surgical prophylaxis for more than 24 hours reduced significantly from 93.3% in 2015 to 65.7% in 2018 (p=0.002) even though the prevalence was still high. The three most commonly administered antimicrobial groups were third generation cephalosporins, imidazole derivatives and quinolones. The most commonly prescribed antibiotics for surgical prophylaxis were ceftriaxone and metronidazole in 2015 and ceftriaxone in 2017.Conclusion: The use of education and training as AMS intervention in a limited resource setting clearly made impact on antimicrobial prescribing patterns in the hospital. Global-PPS is useful to set quality improvement targets and for monitoring, evaluation and surveillance of an AMS programme. Keywords: Antibiotic, Stewardship, Resistance, Education, Global-PP

Assessing efficacies of insect pest management methods to preserve nutritional composition of bagged maize in storehouses located in markets in Nigeria

Maize needs to be stored using effective and safe postharvest management measures to prevent physical insect damage as well as ensure stability of nutritional quality during storage. In this study, conducted in February–December 2016, insect pest management methods for bagged maize preservation in storehouses located in markets in Nigeria were evaluated for their ability to preserve nutritional quality. Study locations were inthree grain markets, namely Eleekara market in Oyo town and Arisekola market in Ibadan, Oyo State, South West Nigeria, and Ago market in Ilorin, Kwara State, North Central Nigeria. Treatments comprised Piper guineense (Botanical), Bularafa diatomaceous earth (DE), permethrin powder (Rambo™) (Permethrin), PICS bags (hermetic) and ZeroFly® bags (non-hermetic). The study also had negative control (Control) comprising untreated maize in polypropylene bags. In general, as a result of insect infestation, protein content increased in all treatments except PICS which had the least infestation. After 11 months of storage, Permethrin and PICS treatments had the lowest insect infestation levels and the highest energy levels. Energy level in the Botanical treatment was also high and similar to levels in Permethrin and PICS treatments most likely due to fats and essential oils in P. guineense being adsorbed and/or absorbed by kernels. Fat content was lower in the Control and DE treatments likely due to the Control having the highest insect infestation and the DE adsorbing and/or absorbing fat from kernels. During storage carbohydrate content decreased in all treatments except the Control. However, even in the Control, there was a clear trend of decrease in carbohydrate content. Because the Control had the highest insect (Sitophilus zeamais) infestation and insect damaged kernels (IDK), this trend in decrease in carbohydrate content may be insect related. Ash content increased in the ZeroFly treatment, was unchanged in Botanical, Control, and PICS treatments, and decreased in DE and Permethrin treatments. Nutritional quality variables in this study were within or close to the known value ranges for maize. Therefore, use of maize that had been fumigated well and had a relatively low initial grain MC (9.1%), in addition to the effects of the treatments most likely slowed down population growth of the several insect species that were found and contributed to preserving nutritional quality. The relatively low insect populations in all treatments, including the Control, during the February–September period probably reduced the clarity of effects of infestation onnutritional composition reported in this study

Sugarcane germplasm expedition of southeastern Nigeria

Sugarcane germplasm expedition was undertaken to the southeastern states of Nigeria in order to identify the available local sugarcane in this region. Fifty-three accessions were identified and collected. Phyto-geographical diversity in cane accessions was observed across the rainforest to the coastal swamp. Most of the clones differ in major morphological traits such as stalk height, girth and internodes colouration. Unlike the accessions which has been reported from the northern part of Nigeria, most of the accessions from the south-east are hard rinded and more resistant to smut and stem borer which are the most economically important disease and pest of sugarcane in Nigeria. They therefore have a great potential for breeding improved sugarcane varieties for sugar industries in Nigeria. These diverse and important breeding values confer on them a great potential as parent materials for use in the development of improved cane varieties for local growers and sugar estates. [Niger Agric. J. 33 (2002): 143-145

Farmer preferences and market vaues of cattle breeds of west and central Africa

World agriculture is based on a small number of animal species and a decreasing number of breeds within each species. Several breeds of West African shorthorn cattle (Bos taurus brachyceros) are now at high risk of extinction due to interbreeding. The West African shorthorn breeds are particularly important resources because of their superior abilities to resist diseases, particularly trypanosomosis, and be productive under high humidity, heat stress, water restriction and with poor quality feed. A study was undertaken in the derived savanna area of southwest Nigeria to determine the prospects for conservation through use and possible improvement of the Muturu, a West African shorthorn breed known to be in decline throughout southern Nigeria. An analysis of farmers' breeding practices and breed preferences confirmed a strong trend away from Muturu and identified the traits farmers find least desirable about the Muturu relative to other breeds. An analysis of cattle market prices found small, but significant, price differences by breed. The best hopes for increased utilization likely in other areas of West Africa, such as southeast Nigeria, where the Muturu is better suited to the farming systems and there is a large market for this breed

The Hazards of Non-Ionizing Radiation of Telecommunication Mast in an Urban Area of Lagos, Nigeria

The health hazards of non-ionizing radiation from telecommunication mast on the exposed community were assessed using a descriptive cross-sectional survey. The socio-demographic pattern and hazard profile of the respondent were documented. The results of the data showed that majority of respondents (60.8%) were youth within age range of 20 – 30 years. Hazard profile showed majority (62%) having different symptoms with headache being the most frequent (51.6%), similar to other established findings. There is a significant synergistic relationship between high voltage cable and telecom mast on the health effect, with p value < 0.05. It was also shown that proximity and duration of exposure to mast radiation is directly proportional to hazard effect, with p value < 0.05. This study therefore establishes that there are health implications of exposure to mast radiation and minimizing them will go a long way to improve healthy living

Livestock production pattern of agropastoralists in peri-urban centres of south-west Nigeria

. . . The remarkable reduction of tsetse fly and its vector disease trypanosomosis in the South West zone of Nigeria has led to the development of agropastoralism in the zone. This study was carried out by administration of structured questionnaires to farmers in three towns (Oyo, Ogbomosho and Saki) in order to highlight some of the factors influencing production in the area. It was found that in all the three towns animals were maintained on free range grazing, browsing and offer of crop residues. The most favoured breed kept is the Bunaji and Ogbomoso had the highest concentration (52.16%) of this breed. Labour allocation among agropastoralists was based on sex. Diarrhoea was the prevalent disease among the adult animals in wet and dry seasons while sand eating was common among the calves. In all the centres, cattle constituted the major ruminant in stock (77%) while sheep and goats accounted for 15% and 8% respectively. A preponderance of female cattle over the male for all the breeds was recorded in all the towns. But Saki had the highest number of cattle in stock and Oyo the lowest. Feed supplements offered all year round were salt lick and grains. Most of the agropastoralists depended on the use of local herbs and such other orthodox methods of combating diseases affecting the herd. Keywords: Livestock production, agropastoralism, peri-urban, SouthWest, Nigeria

Reducing self--medication with anti-infective agents in Lagos, nigeria: a community-based intervention study

Background: Self-medication with anti-infective agents is a global public health concern particularly in the developing countries. In this study, the rate and pattern of self-medication with anti-infective agents and effectiveness of an educational intervention programme in reducing the practice were investigated. Method: This was designed as a community-based pre and post-intervention survey of 328 participants. A structured questionnaire was used to collect data from the respondents. Educational intervention was conducted on the subjects after the interview. Another community in Lagos state served as the control population without educational intervention. Prevalence of self-medication of the anti-infective agents was assessed pre- and postintervention. The main outcome measure was reduction in the rate of self-medication of anti-infective agents after the intervention. Result: Three hundred and twenty eight (328) respondents in the study group were comprised of 165 (50.8%) males and 163 (49.2%) females. The rate of self-medication of anti-infective agents was 44.5% pre intervention while post intervention was 14.8% among the respondents. The most prevalent factors influencing selfmedications of this class of drugs were: previous experience of treating similar illness (25.3%), to save time and cost (23.6%), for emergency use (17.3%) and to avoid visiting a doctor (14.2%). Ampicillin/cloxacillin (20.2%) and co- trimoxazole (10.9%) were the most commonly self-medicated anti-infective agents. After the educational intervention, there was a significant reduction in the rate of self-medication of the anti-infective agents in the postintervention group compared to the pre-intervention [(44, 4.8%) versus (145,44.5%), p&lt; 0.001]. Conclusion: There is a high rate of anti-infective agents' self-medication in among healthy adults population in Lagos, Nigeria. Educational intervention significantly reduced the practice in this survey. Keywords: Anti-infective agents, Antibiotics, Antimicrobial stewardship, Antibiotic resistance, Self-Medication, interventionResume Contexte: L'automédication avec des agents anti-infectieux est un problème mondial en matière de santé publique, en particulier dans les pays en développement. Dans cette étude, le taux et les caractéristiques de l'automédication de ces agents anti-infectieux ainsi que l'efficacité d'un programme d'intervention éducative visant à réduire cette pratique ont été examinés. Méthode: cette étude a été conçue comme une enquête communautaire avant et après-intervention auprès de 328 participants. Un questionnaire structuré a été utilisé pour collecter les données auprès des répondants. Une intervention éducative a été menée sur les sujets après l'entrevue. Une autre communauté de l'État de Lagos a servi de population témoin sans intervention éducative. La prévalence de l'automédication des agents antiinfectieux a été évaluée avant et après l'intervention. La principale mesure de résultat a été la réduction du taux d'automédication des agents anti-infectieux après l'intervention. Résultat: Trois cent vingt huit (328) répondants du groupe d'étude étaient composés de 165 (50,8%) hommes et de 163 (49,2%) femmes. Le taux d'automédication des agents anti-infectieux était de 44,5% parmi les répondants. Les principaux facteurs ayant influencé l'automédication des agents anti-infectieux étaient les suivants: expérience antérieure de traitement d'une maladie similaire (25,3%), gagner du temps et de l'argent (23,6%), utilisation en urgence (17,3%) et éviter de visiter à un médecin ( 14,2%). L'Ampicillin/cloxacillin (20,2%) et le cotrimoxazole (10,9%) étaient les agents anti-infectieux les plus couramment utilisés pour l'automédication dans cette étude. Après intervention, il y a eu une réduction significative du taux d'automédication des agents antiinfectieux après intervention par rapport ceux avant l'intervention: 44 (14,8%) contre 145 (44,5%), p = 0,00001. Conclusion: le taux d'automédication de la part d'agents anti-infectieux est élevé à Lagos, dans le sud-ouest du Nigeria. L'intervention éducative a réduit la pratique dans cette enquête. Mots clés: antibiotiques, intendance antimicrobienne, résistance aux antibiotiques, automédication, interventionWest Afr. J. Pharmacol. Drug Res. Vol. 32 January – December 2017; 37 - 4