Abdominal Tuberculosis in Surgical Practice in Northern Nigeria

Background: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV, tuberculosis has become a major public health problem particularly in developing countries. Methods: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria - Nigeria, between January1975 to December 2006.Results: There were 68 males and 49 females, aged 12-70 years (mean 28.6yrs 11yrs). While paroxysmal dry cough was present in about 20 patients, abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14%). The findings at Surgery in 66 patients are presented in fig.2. Multiple deposits on the peritoneum and omentum were the commonest findings (48.7% and 26.2%) respectively. Conclusion: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol.Keywords: Abdominal Tuberculosis, Nigeria

Preliminary study of Hepatitis B surface antigen on mental health care workers at federal neuropsychiatric hospital Barnawa, Kaduna Nigeria

Background: This study was designed to determine retrospectively, HBsAg status, marker of HBV infection, among Mental Health Care Workers (MHCWs) at Federal Neuropsychiatric Hospital (FNPH), Barnawa Kaduna, North West, Nigeria. Two hundred and fifty one, apparently healthy HBV vaccine naïve, MHCWs, who voluntarily participate prior to HBV-vaccination. Materials and Methods: The screening was carried out using atlas latex haemagglutination test kit, between the months of December, 2000 through March, 2001. The MHCWs were categorized into senior and junior staff. Their ages, years of service, occupation, and department were obtained from year 2000 staff nominal roll. Prior to the study ethical approval was obtained from the hospital ethical committee. Two hundred and fifty one, participant were tested for HBsAg in a pre-HBV-vaccination exercise. Results: The number and percentages of participants by gender were 127 (50.6%) males and 124 (49.4%) females, respectively. The age range was 19-60 years with a mean age of 37 ± 2 years. The Number and percentages of junior and senior staff were 163 (65.0%) and 88 (35.0%), respectively. The incidence of HBsAg was 72 (28.7%). Incidence rates was highest among the males 41 (32.3%) compared to females 31(25.0%) and51-60yrs (50.0%), the incidence among Junior Staff was 52 (31.9%), while in Senior staff was 20 (22.7%) respectively. MHCWs who served between 26-30 years were 2 (66.7%) and those within 21-25 years were 6 (26.1%). Medical Record Staff were 3 (60.0%) and staff from other departments were Pharmacy 3 (50.0%), Artisans 7 (46.7%), Security 15(42.9%), Occupational Therapy Staff 2 (40.0%), Account Staff 6 (30.0%), Social Welfare 1 (25.0%), Hospital Maids 14 (23.7%), Administration Staff 11 (23.4%), Nurses 8 (17.0%), Medical Laboratory Staff 0 (0.0%), respectively. Statistical analysis obtained using Chisquare (x2) test showed no statistically significant association (p >0.05) between incidence of HBV-infection and years of service, Sex, Age, Cadre and Occupation. Conclusions: Due to a high prevalence of HbsAg, a marker of HBV infection, among MHCWs, Pre-vaccination screening should be instituted in Nigeria’s mental health facilities for early detection of HBV-infection and selective treatment. Key words: Hepatitis B virus; HbsAg; neuropsychiatric; vaccination; screening; Barnawa; Kaduna; Nigeria

Dapagliflozin and Kidney Outcomes in Hospitalized Patients with COVID-19 Infection:An Analysis of the DARE-19 Randomized Controlled Trial

Background and objectives: Patients who were hospitalized with coronavirus disease 2019 (COVID-19) infection are at high risk of AKI and KRT, especially in the presence of CKD. The Dapagliflozin in Respiratory Failure in Patients with COVID-19 (DARE-19) trial showed that in patients hospitalized with COVID-19, treatment with dapagliflozin versus placebo resulted in numerically fewer participants who experienced organ failure or death, although these differences were not statistically significant. We performed a secondary analysis of the DARE-19 trial to determine the efficacy and safety of dapagliflozin on kidney outcomes in the overall population and in prespecified subgroups of participants defined by baseline eGFR. Design, setting, participants, & measurements: The DARE-19 trial randomized 1250 patients who were hospitalized (231 [18%] had eGFR <60 ml/min per 1.73 m2) with COVID-19 and cardiometabolic risk factors to dapagliflozin or placebo. Dual primary outcomes (time to new or worsened organ dysfunction or death, and a hierarchical composite end point of recovery [change in clinical status by day 30]), and the key secondary kidney outcome (composite of AKI, KRT, or death), and safety were assessed in participants with baseline eGFR <60 and ≥60 ml/min per 1.73 m2. Results: The effect of dapagliflozin versus placebo on the primary prevention outcome (hazard ratio, 0.80; 95% confidence interval, 0.58 to 1.10), primary recovery outcome (win ratio, 1.09; 95% confidence interval, 0.97 to 1.22), and the composite kidney outcome (hazard ratio, 0.74; 95% confidence interval, 0.50 to 1.07) were consistent across eGFR subgroups (P for interaction: 0.98, 0.67, and 0.44, respectively). The effects of dapagliflozin on AKI were also similar in participants with eGFR <60 ml/min per 1.73 m2 (hazard ratio, 0.71; 95% confidence interval, 0.29 to 1.77) and ≥60 ml/min per 1.73 m2 (hazard ratio, 0.69; 95% confidence interval, 0.37 to 1.29). Dapagliflozin was well tolerated in participants with eGFR <60 and ≥60 ml/min per 1.73 m2. Conclusions: The effects of dapagliflozin on primary and secondary outcomes in hospitalized participants with COVID-19 were consistent in those with eGFR below/above 60 ml/min per 1.73 m2. Dapagliflozin was well tolerated and did not increase the risk of AKI in participants with eGFR below or above 60 ml/min per 1.73 m2

A note on the utilization of urea by Sudan Desert sheep

Sixty-four young male Sudan Desert lambs were group-fed for 87 days on four diets, all containing approximately 10% crude protein. The four diets contained 0, 1.3, 1.7 and 2.7% urea, respectively. Average daily gains were 0.15, 0.14, 0.14 and 0.13 kg; feed conversion ratios (kg of feed required to produce 1 kg liveweight gain) were 7.26, 8.14, 8.92 and 7.92; dressing percentages were 43.6, 42.1; 44.1 and 42.3. Digestibility trails with lambs fed on diets with 0 or 2.7% urea gave higher digestibility coefficients for crude fiber and nitrogen-free extract for the urea-supplemented lambs. Crude protein digestibility and nitrogen retention values were lower for urea-supplemented lambs