Level of blood pressure control among hypertensive patients receiving treatment at federal medical centre Nguru Yobe state North Eastern Nigeria

Hypertension remains the most readily identifiable and reversible risk factor for cardiovascular diseases (CVD) and is the leading cause of death worldwide. Despite the avalanche of medications for the management of elevated blood pressure, adequate control of systemic hypertension has largely remained enigmatic. Previous studies from African countries including Nigeria have shown that blood pressure (BP) control still remained poor. The objective of this study therefore was to determine the level of blood pressure control among hypertensive patients on treatment and identify associated factors Methodology: The study was an observational, cross-sectional study of consecutive hypertensive patients attending the general outpatient, cardiac, endocrine and renal clinics at the Federal Medical Centre Nguru, in northeastern Nigeria; conducted over a period of six months from June 2016 to December 2016. Result: A total of two hundred and ninety-one (291) consecutive subjects, comprising 134(46.1%) males and 157(53.9%) females were recruited. The mean age of the study population was 56.15±12.72. There was no difference in the mean age of subjects with controlled and uncontrolled hypertension 57.13±12.97 and 55.48±12.54 respectively with P = 0.275. One hundred and nineteen (40.9%) subjects had controlled hypertension while the remaining 172(59.1%) had uncontrolled hypertension. There was a significant difference in the mean systolic and diastolic blood pressure of subjects with controlled and uncontrolled hypertension (116.22± 12.14 and 153.14±18.17) P = 0.001 and (73.78±8.02 and 89.53±11.12) P = 0.001 respectively. The predominant pattern of uncontrolled hypertension among the study population was combined systolic and diastolic hypertension. Conclusion: Our study revealed that blood pressure control among hypertensive on medication was not optimal, decreased glomerular filtration rate, low anti-hypertensive medication adherence and use of NSAID were found to be responsible for the inadequate blood pressure control observed in this study. Poverty and ignorance were major contributing factors for low medication adherence

Synthesis and Characterization of Graphene-Cu Composite Via Hydrothermal Method

In this paper, graphene-copper composite was synthesized via hydrothermal method using different compositions from 5 to 25%. The grain size and copper composition are observed to decrease proportionally to increase in band gap. The effect of composition fluctuate the peaks shift. The peak increased linearly with increasing temperature for each composition. The band gap reduces with increasing temperature for each composition. Short calcined duration on samples is observed to cause a little lower band gap value than that of longer duration. The thermal treatment of graphene oxide (GO) has been observed to cause changes in its quality, size and shape. &nbsp

Predictive value of spot urine albumin-to-creatinine ratio for echocardiography-based left ventricular hypertrophy among newly diagnosed hypertensive patients

Objective: Studies have reported high prevalence of left ventricular hypertrophy (LVH) among patients with microalbuminuria. Both left ventricular hypertrophy and microalbuminuria (MA) are associated with increased risk of cardiovascular morbidity and mortality. The study aimed to determine the predictive value of spot urine albumin-to-creatinine ratio (ACR) for echocardiography-based LVH in newly diagnosed hypertensive patients.Methods: LVH was defined as left ventricular mass index (LVMI) of >115g/m2 in males and >95g/m2 in females. Microalbuminuria was defined as ACR >30 mg/g and diagnostic value of MA for LVH assessed using X2 2by2 table and the Receiver Operating Characteristics (ROC) curve plot.Results: Sixty six (48.5%) males and 70(51.5%) females with a mean age of 44.8(10.5 %) years were studied. Left ventricular hypertrophy was observed in 36.8% while 42.7% had MA. The prevalence of MA in those with LVH was 66%. Microalbuminuria showed a sensitivity of 64% and specificity of 70% for echocardiography (echo) detected LVH, while the positive predictive value (PPV) and negative predictive value (NPV) were 55% and 77% respectively. Diagnostic accuracy of MA for echo LVH was 68% with an odd ratio of 4.1. ROC curve plot revealed an area under the curve of 0.73 at ACR of 36mg/g, improving the sensitivity and NPV to 85.7% and 83.8% respectively.Conclusion: Microalbuminuria predicts LVH in treatment naïve Nigerian hypertensive patients. This can be used as a surrogate for LVH in outpatient settings, providing vital information for comprehensive management of patients.Keywords: Hypertension, microalbuminuria, albumin-to-creatinine ratio, left ventricular hypertroph

Evaluation of Environmental Effect of Shiroro Hydropower Dam on the Downstream Communities of Shiroro Local Government Area, Niger State, Nigeria

This study evaluates the environmental effect of Shiroro hydropower dam on the downstream communities. The main objective of this study is to investigate the environmental effects of Shiroro hydropower dam on the downstream communities. A suitable conceptual framework was formulated and obtained data on the environmental impacts of dam on downstream communities, followed by a comprehensive literature review for viable information on the study. Three communities were used as case studies and quantitative method was  used as an appropriate research paradigm such as structured questionnaire survey (with predominantly quantitative questions) and  relevant data was obtained from the study area. Subsequently the data was analysed using descriptive, factor analysis and Kruskal-Wallis test as well construct reliability and validity analysis. From a broad range of environmental impacts, core environmental impacts were determined. The core impacts include changes in riparian vegetation, changes in river water quality, changes to channel shape and changes in floodplains among others. Similarly, control techniques were identified to lessen the effect of the impact and the result revealed that watershed management, water pollution control, management of water releases, fishing regulation, fish hatcheries and fish passage facilities were the core control techniques. The result of Kruskal-Wallis test revealed that majority of the environmental impacts affecting the communities under study is significantly and statistically different while the Cronbach alpha for internal consistencies of the constructs of the questionnaire was 0.745, hence high enough for generalising the result. Keywords: Environment, Effects, Hydroelectric, Dam, Downstream DOI: 10.7176/JEES/9-3-11 Publication date:March 31st 201

Prevalence of microalbuminuria in untreated Nigerian hypertensive patients

The burden of cardiovascular disease imposed by hypertension is a result of target organ damage. Microalbuminuria (MA) is the first clinical expression of nephropathy and has become acardiovascular and/or renal disease prognostic indicator for hypertensive subjects. Objectives: To establish the prevalence of MA among newly diagnosed hypertensive patients using thesimple spot urine Albumin-Creatinine Ratio (ACR). Method: : One hundred and eighty six newly diagnosed hypertensive patients were enrolled for assessment of MA using spot urine ACR. Those with overt proteinuria, diabetes mellitus, overt kidney disease and other potential causes of albuminuria were excluded. Spot urine was obtained for measurement of albuminand creatinine. Anthropometric variables were measured and body mass index calculated. All patients had echocardiographic assessment. Statistical analysis was performed using SPSS version 11.0 software. Multiple regression analysis was used in determining predictors of MA. A p-value of ≤ 0.05 was considered significant. Results: Results of 136 patients comprising of 66(48.53%) males and 70(51.47%) females was considered. The overall prevalence of microalbuminuria was 42.65%. Males had a prevalence of 51.52% compared to 34.27% for the females (p=0.29). Weight, BMI, LVM, LVMI, UAE, and ACR were significantly higher in patients with MA, whereas those without MA had a significantly higher urinary creatinine. Multiple regression analysis identified DBP, MAP, LVM and LVMI as significant predictors of increased urinary albumin excretion Microalbuminuria showed significant positive correlation with LVM and LVMI. Conclusion: The prevalence of microalbuminuria is high among untreated Nigerian hypertensive patients. The spot urine ACR provides a simple, accurate and cost effective way of identifying this high risk group of hypertensive patients, allowing for more aggressive treatment to reduce cardiovascular outcomes

Association between HindIII (rs320) variant in the lipoprotein lipase gene and the presence of coronary artery disease and stroke among the Saudi population

Lipoprotein Lipase (LPL) is known to be a key enzyme for lipid metabolism specifically in an enzymatic glycoprotein which provide tissues without fatty-acids and eliminates triglycerides (TG) by the circulation. Mutations in LPL were proven to cause alteration in fractions within lipoprotein, causing the development of atherosclerosis which predispose to weakening coronary artery disease (CAD) and stroke. We examined the linkage between genetic variant HindIII in LPL on lipoprotein fractions, stroke occurrences and CAD. In this case-control study, we have recruited 315 CAD cases and 205 age-matched controls. A total of 520 genomic DNA was digested with the purified PCR products for restriction fragment length polymorphism with HindIII restriction enzyme. The distribution of genotypes in a decreasing order were TT, 148 (47%), GT 135 (42.9%) and GG 32 (10.2%) in CAD groups of the study while the pattern in controls were GT 91 (44.4%), TT 86 (42%) and GG 28 (13.7%). None of all the allele or genotype frequencies were found to be significant in our study (p greater than 0.05), while the biochemical levels for both TG and LDL-c were shown to be prone in CAD patients when compare with the controls. Furthermore, the occurence of strokes were more in CAD groups vs. controls: 72 (22.9%) vs. 7 (3.4%) [p 0.000]. This could indicate the influence of HindIII variant on plasma lipid levels, and the possibility of considering it a risk factor for atherosclerosis leading to CAD and stroke occurrence

A spatio-temporal analysis of trends in rainfall from long term satellite rainfall products in the Sudano Sahelian zone of Nigeria

Rainfall and its variability drive the rural economies across the Sudano-Sahelian zone of northern Nigeria, where drought strategies largely determine crop yields. The increasing scarcity of rain gauges in West Africa generally limits assessments of the degree and spatial extent of hardship arising from rainfall deficiency. However, the improved availability and robustness of satellite-based rainfall products since the early 1980s, offers an alternative source of rainfall data which is spatially, and often temporally, more complete than rain gauges. This research evaluates four satellite-based rainfall products for their ability to represent both long term rainfall trends such as recovery from decadal droughts, and trends in seasonal rainfall variables relevant to crop yield prediction. The Climate Hazards group Infrared Precipitation with Stations (CHIRPS) rainfall product at 5 km resolution, was observed to be consistently most representative of ground station rainfall across northern Nigeria over a 35-year period 1981–2015, followed by TARCAT. CHIRPS was found to give a good overall prediction of rainfall amounts at dekadal, monthly and seasonal time scales, and was therefore used in the study to represent the typical performance of satellite rainfall datasets. The CHIRPS-observed increase in growing season length since the 1970s and 80s drought decades, was accompanied by significant rainfall increases in the later part of the growing season, especially marked in northern and northeastern states. This is especially important for the main subsistence crops sorghum and millet as the risk of late drought impedes swelling of the grain, affecting dry weight production. The CHIRPS data also indicate a significant decrease in dry spells in the northwest and southern parts of the study area, which would have favourable outcomes for crop production in the densely populated rural hinterlands of the cities of Sokoto, Jos and Abuja. In view of the continued intra-and inter-annual rainfall variability across northern Nigeria, and amid rapid rural population growth recently, a return to the rainfall levels of the drought decades, would require informed response. The study suggests that satellite rainfall estimates can offer such information, especially since we observed high spatial variability in rainfall distributions and trends

CD4+ T-lymphopenia in HIV negative tuberculous patients at King Khalid University Hospital in Riyadh, Saudi Arabia

Tuberculosis (Tb) is a chronic infectious disease in which the cellular immunity (specifically CD4+ and CD8 lymphocytes) provides the most important defense in controlling infection. CD4 lymphopenia is a well-defined risk factor for the development of active tuberculosis in patients infected with Human Immunodeficiency Virus. In HIV - negative patients, CD4 and CD8 cell count suppression has been associated with Tb infection. Our study was designed to deter mine the baseline and post-treatment values of CD4 and CD8 in HIV negative patients diagnosed with active Tb in Saudi Arabian patients. We recruited twentyeight, non-HIV patients with tuberculosis for the study group comprising 16 males and 12 females with either disseminated or localized active Tb infection. Two control groups were selected - one of twenty one matched healthy controls and the second of fortytwo subjects from pool of controls of an ongoing study in same population for normal CD4 and CD8 counts. The baseline pre-treatment CD4 and CD8 counts in the study group were significantly lower than either control group. Specifically the mean ± SD of CD4 counts were 556.79 ± 298.81 in the study group vs 1,132.38 ± 259.90 in control group 1 and 1,424.38 ± 870.98 in control group 2 (p 0.000). Likewise the CD8 counts in the study group were 1,136.00 ± 512.06 vs. 1,461.90 ± 367.02 in control group 1 and 1,495.90 ± 565.32 in control group 2 (p 0.000) respectively. After treatment of tuberculosis, the study patients experienced a significant increase in their mean ± SD CD4 and CD8 cell counts, from 556.79 ± 297.81 to 954.29 ± 210.90 for CD4 cells (p 0.005) and 1136.00 ± 512.06 to 1,316.54 ± 286.17 for CD8 cells (p 0.002). Analysis of study patients with disseminated disease found significantly lower CD4 cells (but not lower CD8 cells) compared to study patients with localized disease, both at baseline and after treatment. The mean ± SD baseline CD4 cells were 247.60 ± 187.80 with disseminated vs 728.56 ± 186.32 for localized disease (p = 0.000) which rose to 842.30 ± 93.55 vs 1016.50 ± 233.51 (p = 0.033) respectively. We conclude that tuberculosis may be associated with CD4 and CD8 lymphopenia even in patients without human immunodeficiency virus infection, there was the tendency of recovery towards normality especially of the CD4 and CD8 counts after treatment, and that disseminated disease is associated specifically with profound CD4 lymphopenia

Antibiotics modulate biofilm formation in fish pathogenic isolates of atypical Aeromonas salmonicida

Atypical Aeromonas salmonicida causes furunculosis infections of non‐salmonid fish, which requires antibiotic therapy. However, antibiotics may induce biofilm in some bacteria, which protects them against hostile conditions while allowing them to persist on surfaces, thus forming a reservoir for infection. The aim of this study was to determine whether atypical isolates of A. salmonicida increased biofilm in the presence of two antibiotics, florfenicol and oxytetracycline. A microtitre plate assay was used to quantify biofilm in the presence and absence of each antibiotic. Fifteen of 28 isolates formed biofilms under control conditions, while 23 of 28 isolates increased biofilm formation in the presence of at least one concentration of at least one antibiotic. For oxytetracycline, the most effective concentration causing biofilm to increase was one‐quarter of that preventing visible bacterial growth, whereas for florfenicol it was one‐half of this value. This is the first study to demonstrate that a bacterial pathogen of fish increases biofilm in response to antibiotics. Biofilm formation may increase the risk of re‐infection in culture systems and this lifestyle favours the transmission of genetic material, which has implications for the dissemination of antibiotic‐resistance genes and demonstrates the need for enhanced disease prevention measures against atypical A. salmonicida

Catalytic Transformations of Alkynes via Ruthenium Vinylidene and Allenylidene Intermediates

NOTICE: This is the peer reviewed version of the following book chapter: Varela J. A., González-Rodríguez C., Saá C. (2014). Catalytic Transformations of Alkynes via Ruthenium Vinylidene and Allenylidene Intermediates. In: Dixneuf P., Bruneau C. (eds) Ruthenium in Catalysis. Topics in Organometallic Chemistry, vol 48, pp. 237-287. Springer, Cham. [doi: 10.1007/3418_2014_81]. This article may be used for non-commercial purposes in accordance with Springer Verlag Terms and Conditions for self-archiving.Vinylidenes are high-energy tautomers of terminal alkynes and they can be stabilized by coordination with transition metals. The resulting metal-vinylidene species have interesting chemical properties that make their reactivity different to that of the free and metal π-coordinated alkynes: the carbon α to the metal is electrophilic whereas the β carbon is nucleophilic. Ruthenium is one of the most commonly used transition metals to stabilize vinylidenes and the resulting species can undergo a range of useful transformations. The most remarkable transformations are the regioselective anti-Markovnikov addition of different nucleophiles to catalytic ruthenium vinylidenes and the participation of the π system of catalytic ruthenium vinylidenes in pericyclic reactions. Ruthenium vinylidenes have also been employed as precatalysts in ring closing metathesis (RCM) or ring opening metathesis polymerization (ROMP). Allenylidenes could be considered as divalent radicals derived from allenes. In a similar way to vinylidenes, allenylidenes can be stabilized by coordination with transition metals and again ruthenium is one of the most widely used metals. Metalallenylidene complexes can be easily obtained from terminal propargylic alcohols by dehydration of the initially formed metal-hydroxyvinylidenes, in which the reactivity of these metal complexes is based on the electrophilic nature of Cα and Cγ, while Cβ is nucleophilic. Catalytic processes based on nucleophilic additions and pericyclic reactions involving the π system of ruthenium allenylidenes afford interesting new structures with high selectivity and atom economy