Baseline CD4+ T lymphocyte cell counts, hepatitis B and C viruses seropositivity in adults with Human Immunodeficiency Virus infection at a tertiary hospital in Nigeria

Background: Ekiti State of Nigeria is known to have the lowest prevalence of HIV in Nigeria. University Teaching Hospital (UTH), Ado Ekiti was recently upgraded to serve as one of the three centres for HIV/AIDS referral, diagnosis and treatment in Ekiti State. We evaluated the baseline immunologic and biochemical parameters of patients presenting at the ART clinic of University Teaching Hospital, Ado Ekiti, Ekiti State. Methods: All HIV seropositive patients not yet on antiretroviral therapy, who presented at the ART Clinic within the study period had at the first visit to the clinic, their blood sample taken for CD4 cell counts estimation, HBsAg and anti- HCV screening, ALT, AST as well as hemoglobin estimation as part of the routine workup to assess their disease health status and need for antiretroviral therapy. Statistical significance was taken as p< 0.05. Results: A total of 273 patients comprising 79 (28.9%) males and 194 (71.1%) females were included in the study (F:M = 2.46: 1). The mean age of the study population was 36.21± 10.20 years with mean age of males (39.52 ± 9.95years) significantly higher than females (34.88 ± 10.02; p=0.001). The overall prevalence of HBsAg in the study population was 6.6% with a sex specific prevalence of 8.1% and 6% for males and females, respectively. No statistically significance difference in the mean serum alanine transaminase, serum aspartate transaminase, hemoglobin and CD4+ T- Lymphocytes cell count of those who had HBsAg negative status compared to those who had HBsAg positive status. Two (0.7%) of the patients had positive serum anti HCV antibodies. The CD4+ T- Lymphocytes cell count ranged between 5 – 1050 cells/Hl with a mean of 286.19 ± 233.31 cells/Hl. The majority of patients (71.8%) had a CD4+ T- Lymphocytes cell count < 350 cells/Hl. Conclusion: At the time of presentation, majority of our patients had a CD4+ T- Lymphocytes cell count less than 350 cells/Hl consistent with significant immune-suppression. More sustained and vigorous awareness campaigns still need to be done in Ekiti State to diagnose this disease early. There is also a need to accelerate the integration of hepatitis B virus screening and treatment programme into HIV/AIDS programme because of the morbidity and mortality implication of HBV and HIV co-infection.Key words: HIV AIDS infection, CD4+ T-lymphocyte cell counts, Hepatitis B virus infectio

Biochemical and Heamatological Indices of Broiler Chickens fed Differently Processed Legume Seed Meals

This study was designed to investigate the implications of feeding broiler chickens with mucuna beans processed by simple domestic methods on the performance, haematological and biochemical parameters. Differently processed bean meals namely dehulling (DUMM), dehulling and cooked (DCMM), soaked and cooked (SCMMI) prolonged soaking and cooking (SCMMII) and toasting (TMM) mucuna meals were fed to two hundred and seventy 1 – day old broiler chicks of Anak strain. The birds were divided into six groups of 45 birds per group. Each group was further sub divided to 3 replicates of 15 birds and allocated to six dietary treatments in a completely randomized design. Maize – soybean meal served as control diet. Processed mucuna meal was added to the diet 200g/kg of feed at the expense of soybean meal in the control diet. All diets formulated were isocaloric and iso-nitrogenous. Feed intake was not influenced by the dietary treatments (P>0.05). Average daily gain (ADG) was significantly (P<0.05) influenced by the dietary treatments. Growth was depressed in birds fed dehulled mucuna meal compared to other dietary treatments. Compared with DUMM, there was significant improvement in ADG in bird fed heat treated mucuna meal. Feed conversion efficiency was significantly improved (P<0.05) in birds fed aqueous heated meals (DCMM, SCMMI and SCMMII) compared with those that received DUMM and TMM diets. Dietary treatments significantly (P<0.05) affect blood cellular components. The PCV, Hb, and RBC of broilers chickens fed DUMM were reduced with increased MCV and MCH values compared to other treatments. Serum total protein and globulin were affected by the dietary treatments (P<0.05). Values obtained in birds fed SCMMI, SCMMII, DCMM and TMM were similar and significantly lower than those that received the control and DUMM diets. The result of this study revealed that aqueous heat treatment (cooking) was more effective in improving the nutritive values of mucuna bean meals compared to dehulling and toasting.Keywords: Mucuna bean, Processing, Performance, Haematology, Biochemica

Myasthenia gravis following chicken pox infection in a Nigerian primary school girl

We report a case of myasthenia gravis occurring post Chicken pox infection in a 9 year old Nigerian girl. The girl was growing and seeing normally until 2weeks after a chicken pox infection when she observed progressive drooping of both upper eye lids which worsens as the day progresses and has persisted for more than one year. There was good response to Neostigmine

Coagulation / flocculation process in the removal of trace metals present in industrial wastewater

Attempts were made in this study to examine the effectiveness of polymer addition to coagulation process during treatment of a beverage industrial wastewater to remove some of its trace metals content such as lead, cadmium, total iron, total chromium, nickel and zinc. Experiments were conducted using the standard Jar test procedure to determine the performance of both ferric chloride and organic polymer (a non-ionic polyacrylamide) individually and ferric chloride-polymer combination. The dosages used for ferric chloride ranged from 0 to 500mg/l, whereas polymer dosages varied between 0 and 100mg/l. The (optimal) removal efficiency for total chromium in the wastewater was obtained at 300mg /l for ferric chloride and 65mg/l for polymer. Whereas for zinc and total iron, the optimal removal efficiencies were obtained at 500mg/l for ferric chloride and 65mg/l for polymer. Addition of ferric chloride resulted in significant removal of the metals reaching up to 91%, 72% and 54% of total chromium, zinc and total iron respectively while addition of polymer achieved 95%, 87% and 88% of total chromium, zinc and total iron respectively. Ferric chloride produced more voluminous and more compacted sludge than polymer. Combinations of ferric chloride and polymer at different ratio achieved better removal efficiencies of the metals in the range 84-97% for total chromium, 69-90% for zinc and 69-92% for total iron, also less sludge was produced. Lead, cadmium and nickel were not detected in the raw wastewater. Journal of Applied Sciences and Environmental Management Vol. 10(3) 2006: 159-16

Identification and Characterisation of Major Hydrocarbons in Thermally Degraded Low Density Polyethylene Films

The vast application of Low Density Polyethylene (LDPE) in packaging, greenhouses, homes etc has led to its huge accumulation as a municipal solid waste with monumental health, economic and environmental consequences. Since these are non-biodegradable and their photodegradation occurs only over a very long period, their economic conversion to energy products through pyrolysis is the thrust of this study. LDPE sample collected from the University of Ilorin Community was thermally degraded in a pyrolyser at temperatures ranging from 203 – 400 oC. The products of pyrolysis were in three (3) states of matter and both the liquid and solid products were analysed using FTIR to determine the functional groups and GC- MS for the hydrocarbons present in the products. For the GC-MS analysis, the peaks that had 90% above quality when compared with the compounds in the installed NIST11 library were reported. There were alkanes, alkenes, halogenated alkanes, and very few aromatics in the liquid product and, the hydrocarbons were observed to range between C10 - C27. The FTIR and GC-MS results show the potential of the oil obtained as renewable source of energy while that for residue shows its inherent energy content. The liquid product was refluxed over molecular sieve catalyst (US 2882244A) and the calorific value was found to increase from 13,974 kJ/kg to 15,815.52 kJ/kg and this is found to be comparable to the range for lignite and dry wood. Key words: environmental pollution, solid wastes, LDPE, pyrolysis, hydrocarbons, Calorific value

Coverage, Adherence and Costs of Intermittent Preventive Treatment of Malaria in Children Employing Different Delivery Strategies in Jasikan, Ghana

BACKGROUND: Intermittent preventive treatment of malaria in children (IPTc) involves the administration of a course of anti-malarial drugs at specified time intervals to children at risk of malaria regardless of whether or not they are known to be infected. IPTc provides a high level of protection against uncomplicated and severe malaria, with monthly sulphadoxine-pyrimethamine plus amodiaquine (SP&AQ) and sulphadoxine-pyrimethamine plus piperaquine being the most efficacious regimens. A key challenge is the identification of a cost-effective delivery strategy. METHODS: A community randomized trial was undertaken in Jasikan district, Ghana to assess IPTc effectiveness and costs using SP&AQ delivered in three different ways. Twelve villages were randomly selected to receive IPTc from village health workers (VHWs) or facility-based nurses working at health centres' outpatient departments (OPD) or EPI outreach clinics. Children aged 3 to 59 months-old received one IPT course (three doses) in May, June, September and October. Effectiveness was measured in terms of children covered and adherent to a course and delivery costs were calculated in financial and economic terms using an ingredient approach from the provider perspective. RESULTS: The economic cost per child receiving at least the first dose of all 4 courses was US$4.58 when IPTc was delivered by VHWs, US$4.93 by OPD nurses and US$5.65 by EPI nurses. The unit economic cost of receiving all 3 doses of all 4 courses was US$7.56 and US$8.51 when IPTc was delivered by VHWs or facility-based nurses respectively. The main cost driver for the VHW delivery was supervision, reflecting resources used for travelling to more remote communities rather than more intense supervision, and for OPD and EPI delivery, it was the opportunity cost of the time spent by nurses in dispensing IPTc. CONCLUSIONS: VHWs achieve higher IPTc coverage and adherence at lower costs than facility-based nurses in Jasikan district, Ghana. TRIAL REGISTRATION: ClinicalTrials.gov NCT00119132

The contributions of muscarinic receptors and changes in plasma aldosterone levels to the anti-hypertensive effect of Tulbaghia violacea

Background: Tulbaghia violacea Harv. (Alliaceae) is used to treat various ailments, including hypertension (HTN) in South Africa. This study aims to evaluate the contributions of muscarinic receptors and changes in plasma aldosterone levels to its anti-hypertensive effect. Methods: In the acute experiments, methanol leaf extracts (MLE) of T. violacea (30–120 mg/kg), muscarine (0.16 -10 μg/kg), and atropine (0.02 - 20.48 mg/kg), and/or the vehicle (dimethylsulfoxide (DMSO) and normal saline (NS)) were respectively and randomly administered intravenously in a group of spontaneously hypertensive (SHR) weighing 300 to 350 g and aged less than 5 months. Subsequently, T. violacea (60 mg/kg) or muscarine (2.5 μg/kg) was infused into eight SHRs, 20 min after atropine (5.12 mg/kg) pre-treatment. In the chronic (21 days) experiments, the SHRs were randomly divided into three groups, and given the vehicle (0.2 ml/day of DMSO and NS), T. violacea (60 mg/kg/day) and captopril (10 mg/kg/day) respectively into the peritoneum, to investigate their effects on blood pressure (BP), heart rate (HR), and plasma aldosterone levels. Systolic BP and HR were measured using tail-cuff plethysmography during the intervention. BP and HR were measured via a pressure transducer connecting the femoral artery and the Powerlab at the end of each intervention in the acute experiment; and on day 22 in the chronic experiment. Results: In the acute experiments, T. violacea, muscarine, and atropine significantly (p < 0.05) reduced BP dose-dependently. T. violacea and muscarine produced dose-dependent decreases in HR, while the effect of atropine on HR varied. After atropine pre-treatment, dose-dependent increases in BP and HR were observed with T. violacea; while the BP and HR effects of muscarine were nullified. In the chronic experiments, the T. violaceatreated and captropril-treated groups had signicantly lower levels of aldosterone in plasma when compared to vehicle-treated group. Compared to the vehicle-treated group, significant reduction in BP was only seen in the captopril-treated group; while no difference in HR was observed among the groups. Conclusion: The results obtained in this study suggest that stimulation of the muscarinic receptors and a reduction in plasma aldosterone levels contribute to the anti-hypertesive effect of T. violacea.IS

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030