Medical causes of death in a teaching hospital in South‑Eastern Nigeria: A 16 year review

Background: Most developing regions of the world are undergoing gradual epidemiological transition resulting in high burden of both communicable and noncommunicable diseases. This affects the pattern of death in this region.Objective: The objective of this study is to determine the causes of death in the medical wards of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, South‑East Nigeria from 1995 to 2010.Materials and Methods: Data were collected retrospectively from January 1995 to December 2010.Statistical Analysis Used: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL, USA) version 17.0 was used. Simple descriptive statistics were done. Student’s t‑test was used to compare means of continuous variables, while Chi‑square test was used to test significance of differences between two proportions.Results: The mortality rate was 22.8% (6250/27,514) admissions. The male to female ratio was 1.7:1. Infections (20.2%) were the most common cause of death. However, chronic kidney disease was the single most common disease entity causing death (12.3%). Other important causes of death in order of prevalence were cerebrovascular accident (10.5%), acquired immune deficiency syndrome and tuberculosis either alone or as co‑infection (10.3%), heart failure (8.8%), chronic liver disease (7.0%), septicemia (6.5%), respiratory failure (5.3%), diabetes mellitus (4.6%), cardiac arrhythmias (2.9%), and primary liver cell carcinoma (2.7%). There were few deaths from tetanus, malaria, typhoid fever, and coronary artery disease.Conclusion: Mortality is high in our medical wards and reflects the emerging trend of mixed disease spectrum comprising communicable and noncommunicable diseases.Keywords: Chronic kidney disease, infections, medical wards, mortality, Nigeri

Pattern of cancer deaths in the medical wards of a teaching hospital in South East Nigeria

Background: Cancers are emerging public health problems in developing countries like Nigeria. The epidemiological shift and aging population make cancers a challenge.Objective: We set out to describe the pattern of death due to cancer in our medical ward. The hospital is one of the premier hospitals covering the South East zone of Nigeria.Materials and Methods: We retrospectively reviewed the case notes and death certificates of all who died of cancer in our adult medical wards for 16 years (January 1995 to December 2010).Statistical Analysis Used: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL) version 17.0 was used.Results: Twenty seven thousand, five hundred and fourteen patients were admitted into the medical wards. Six thousand, two hundred and fifty died. Out of the 6250 deaths, cancers accounted for 7.6%. Male to Female ratio was 2.4:1. The mean age at death was 43.7 ± 17.4 years. The mean age at death in both sexes was similar (42.9 ± 17.5 for men and 45.7 ± 17.0 years for women), P = 0.109. Primary liver cell carcinoma was the most common cause of death among men (40.8%), while cancer of hematopoietic organ was the most common in women (48.7%). The overall fatality rate was 1.7% (477/27 514) of medical admissions. Younger and middle age groups were most commonly affected in both sexes. Conclusion: Since the most productive age groups were affected, governments in developing countries should as a matter of urgency put in place adequate cancer preventive and curative services.Keywords: Cancer, mortality, medical wards, South East NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Analisis Rawan Kekeringan Lahan Pertanian Tanaman Pangan Dengan Memanfaatkan Citra Quickbird Dan Sistem Informasi Geografis Kabupaten Bantul Tahun 2012

Penelitian ini berjudul “Analisis Rawan Kekeringan Lahan Pertanian Tanaman Pangan dengan Memanfaatkan Citra Quickbird dan Sistem Informasi Geografis Kabupaten Bantul Tahun 2012”. Tujuan dari penelitian ini adalah: (1) memetakan agihan tingkat rawan kekeringan lahan pertanian tanaman pangan di Kabupaten Bantul; (2) faktor dominan apakah yang dapat mempengaruhi tingkat rawan kekeringan lahan pertanian tanaman pangan di Kabupaten Bantul. Penelitian ini menggunakan Sistem Informasi Geografi (SIG) sebagai alat bantu untuk menghasilkan data dan informasi rawan kekeringan. Metode yang digunakan adalah dengan pendekatan berjenjang (skoring). Parameter yang dalam penelitian ini yaitu ketinggian muka air tanah, jenis irigasi, kebutuhan air tanaman pangan, permeabilitas, ketinggian tempat, dan curah hujan. Klasifikasi yang digunakan pada penelitian ini adalah mengacu pada Puslitanak Bogor tahun 2002. Potensi tingkat rawan kekeringan dihasilkan dari penjumlahan skor tiap parameter berpengaruh. Kelas kerawanan kekeringan tersebut dibedakan menjadi 4 kelas kerawanan yaitu, tinggi, sedang, rendah, dan sangat rendah.Hasil penelitian menunjukkan bahwa terdapat empat kelas kerawanan kekeringan lahan pertanian yaitu “tinggi” sebesar 3%, “sedang” sebanyak 87%, “rendah” 10%, dan 0% untuk kerawanan kelas “sangat rendah”.Kecamatan yang memiliki tingkat kerawanan kekeringan lahan pertanian tanaman pangan yang tinggi adalah Kecamatan Dlingo, Banguntapan, Piyungan dan Pleret dengan luas area pertanian yang tercakup adalah 183,25ha. Kecamatan yang termasuk dalam kelas kekeringan sedang ini adalah Kecamatan Bambanglipuro 1.102,47 ha, Banguntapan 1324,18 ha, Bantul 906,38 ha, Imogiri 1.544,51 ha, Jetis 1.283,57, Kasihan 765,85 ha, Pajangan 392,58 ha, Pandak 994,79 ha, Piyungan 1.003,23 ha, Pleret 650,48 ha, Pundong 985,6 ha, Sanden 974,96 ha, Sedayu 1074,52 ha, Sewon 1.395,82 ha, dan Srandakan 637,99 ha. Daerah dengan tingkat rawan kekeringan rendah sebagian besar berada di Kecamatan Bantul dengan luas 583,98 ha dan Jetis seluas 279,89 ha. Peta-peta dan informasi mengenai kerawanan kekeringan lahan pertanian tanaman pangan disajikan dalam bentuk laporan tertulis dan peta cetak

In vitro effects of metals and pesticides on dehydrogenase activity in microbial community of cowpea (Vigna unguiculata) rhizoplane

Effects of heavy metals and pesticides on cowpea (Vigna unquiculata) rhizoplane microbial community  were assessed in vitro via dehydrogenase activity. The microbial community was exposed to various concentrations of heavy metals and pesticides in a nutrient broth-glucose-2,3,5-triphenyl chloride (TTC) medium. At 0.2 mM, iron and cadmium stimulated the dehydrogenase activity of the microbialcommunity. For all the metal ions, there was progressive inhibition with each successive increase in the concentration of metal ion, reaching near 100% at 0.6, 0.8, 1.2, 0.12 and 12 mM for cobalt, cadmium,iron, mercury and nickel, respectively. Between 0.2 and 0.4 mM, zinc sharply inhibited dehydrogenase activity and at concentration above 0.4 mm, inhibition of dehydrogenase activity became lesspronounced. The order of toxicity is Hg2+ > Co2+ > Cd2+ > Zn2+ > Fe2+ > Ni2+. The herbicides Cotrazine (Atrazine 80W) and Northrin®10EC stimulated dehydrogenase activity of the microbial community at 0.2% and inhibited it at higher concentrations. The median inhibitory concentrations (IC50s) of Cotrazine(Atrazine 80W) and Northrin®10EC were 0.552 ± 0.028 and 0.593 ± 0.051%, respectively. The dehydrogenase activity varied significantly (p < 0.05) with the type and concentrations of metals orpesticides. The result indicates that the heavy metals and pesticides are potentially toxic to V. unquiculata root surface microorganisms. In soil, this toxicity may affect nitrogen fixation processes and by extrapolation affect crop yield

The liver is a common non-exocrine target in primary Sjögren's syndrome: A retrospective review

BACKGROUND: The autoimmune destruction of exocrine glands that defines primary Sjögren's syndrome (1°SS) often extends to non-exocrine organs including the liver. We aimed to determine the prevalence of liver disease in patients with 1°SS and to evaluate the association of this complication with other non-exocrine features and serologic markers of autoimmunity and systemic inflammation. METHODS: We reviewed 115 charts of patients with 1°SS and further analyzed the 73 cases that fulfilled the European Epidemiology Center Criteria, seeking evidence for clinical and subclinical liver disease. RESULTS: Liver function tests had been determined in 59 of the 73 patients. Of those, 29 patients (49.1%) had abnormal liver function tests including 20.3% with clinically overt hepatic disease. Liver disease was the most common non-exocrine feature in this cohort. Risk factors for abnormal liver function tests were distributed similarly between the patients with and without liver disease. In 60% of patients with abnormal liver function tests no explanation for this complication was found except for 1°SS. Liver involvement was significantly more common in 1°SS patients who also had evidence of lung, kidney and hematological abnormalities. Patients with abnormal liver function tests were also more likely to have an elevated sedimentation rate and a positive anti-ENA during the course of their disease. CONCLUSION: Liver involvement is a common complication in 1°SS. Its presence correlates with systemic disease. We consider that this complication should be routinely sought in patients with 1°SS, especially when a positive anti-ENA or evidence of systemic inflammation is found

The Transcriptome of the Nosocomial Pathogen Enterococcus faecalis V583 Reveals Adaptive Responses to Growth in Blood

gains access to the bloodstream and establishes a persistent infection is not well understood.. infections

Case fatality among hypertension-related admisssions in Enugu, Nigeria

No Abstract

Production of Escherichia coli heat – Labile Enterotoxin (LT) in some artificial media and commercially available baby foods

The production of thermolabile (LT) enterotoxin on some artificial media and commercially available baby foods was studied. Staples medium, Casamino-acids-yeast extract (CA-YE) medium, Tryticase soy broth (TSB) and Syncase medium were evaluated for their ability to support the production of LT toxin. Also, nine commercially available baby foods were evaluated as substrate for LT – toxin production. Rabbit toxicity indices (RTI) showed that the staples medium served as the best artificial medium for toxin production (RTI=1.9) followed by CA-YE (RTI=1.2). Three (NA, CER and BOC), out of nine baby food brands examined supported LT-toxin production with NA giving the highest yield of toxin (RTI=2.2) determination of the electrolyte content of aspirated diarrhoeal fluid showed significant secretion of sodium (Na +) and potassium (K +) electrolytes into the fluid. These results suggest that some baby foods, when prepared and stored under non-hygienic conditions could permit growth of, as well as toxin production by toxin production bacteria and pose a health hazard for the infant population. Bio-Research Vol. 3(1) 2005: 56-6