A Review of Causes of Mortality in an Acute Medicine of the Elderly and Acute Stroke Service

The information recorded in medical certificates of cause of death (MCCD) can influence population-based mortality and statistical reviews. Data retrieved from MCCD based studies can inform certain aspects of public health planning, health service delivery and evaluation, and could potentially impact health resource allocation. This study retrospectively reviews a total of 173 consecutive MCCD counterfoil records. This included 71 deaths from an acute stroke unit/ward (ASU), and 102 deaths from acute medicine of the elderly (acute MoE) wards of a tertiary referral hospital in a developed country. Disease/condition classification was based upon the International Statistical Classification of Diseases and Related Health Problems (Tenth Revision) (ICD-10, WHO). We describe the top five ICD-10 categories of diseases/conditions documented in Parts 1 and 2 of the MCCD during the study period. We also describe the top five underlying primary medical conditions recorded on the MCCD. A review of some other notable diseases/conditions recorded during the study period is also presented.Keywords: Cause of Death; Death Certificate; ICD-10; Medicine of the Elderly; Mortality; Strok

Acute and Sub-acute Toxicity Profile of Aqueous Leaf Extract of Nymphaea lotus Linn (Nymphaeaceae) in Wistar Rats

Purpose: To evaluate the acute and sub-acute toxicity profile of the aqueous leaf extract of Nymphaea lotus L in Wistar rats.Methods: Acute toxicity study was performed by administering a single oral dose of 5000 mg/kg body weight of the extract to 5 rats while distilled water was given to another 5 rats (control), and the animals were observed for 14 days. Thereafter, 50, 100 and 200 mg/kg doses of the extract were administered to different groups of 5 rats each daily for 28 days while control received distilled water. At the end of the experiment, the animals were sacrificed and the serum obtained was used for the assessment of haematological and biochemical parameters. Histological examination was also performed on the liver and kidney of the rats.Results: The concentrations of alanine aminotransferase (42.56 U/L), aspartate aminotransferase (126.01 U/L) and alkaline phosphatase (183.33 U/L) significantly decreased while creatinine (0.64 mg/dL) and chloride ions (94.50 mmol/L) were significantly elevated (p < 0.05) compared to those of control following the extract treatment. Haematological parameters were not significantly different (p > 0.05) from those of control except white blood cell count (7.80 × 109/L), lymphocytes (5.20 %) and monocytes (2.72 %) which were significantly elevated (p 0.05) in the 100 and 200 mg/kg treated groups. Histopathology did not reveal any sign of lesions or pathological changes in the organs that could be attributed to treatment with the plant extract.Conclusions: These results suggest that the aqueous leaf extract of Nymphaea lotus may be safe for use at the doses tested.Keywords: Nymphaea lotus, Toxicity, White Blood Count, Alkaline Phosphatase, Histolog

Weight reduction with improvement of serum lipid profile and ratios of Sesamum radiatum leaves diet in a non-obese Sprague Dawley rats

Development of novel natural dietary adjunct/agent with significant therapeutic effects on metabolic disease conditions such as obesity and heart disease raises concern in recent times. We studiedchronic toxicity of the combined active ingredients present in the sesame leaves and their interaction on the fasting serum lipid profiles with their ratios in thirty adult male non-obese Sprague Dawley (SD)rats. Such that, both treated groups received 14.0 and 28.0 mg/kg body weight doses of aqueous leaves extract of Sesamum radiatum respectively on a daily basis via gastric gavage, while, the controlreceived equal volume of normal saline daily for six weeks. Significant (P < 0.05) weight loss observed in the treated groups was associated with significant (P < 0.05) reductions in both serum cholesteroland triglycerides (TG). The effect on the serum lipoprotein cholesterol components and ratios were significant in a dose related manner, such that increase in HDL accompanied a corresponding decreasein both LDL and LDL/HDL ratio. In addition, to increased in TG/HDL ratio. However, no significant differences in the relative reduction level of VLDL and triglycerides in the treated groups were found compared to control. Thus, LDL/HDL ratio is significantly a better indicator than the TG/HDL ratio in assessing the impact of sesame treatment with evidence of weight loss and hypolipidaemia especially in hypertensive heart diseases

Case Report: Pneumomediastinum and Subcutaneous Emphysema Complicating Acute Exacerbation of Bronchial Asthma

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The Relationship Between Cholelithiasis And Laboratory Indices Of Haemolysis In Nigerian Patients With Sickle Cell Anaemia

The relationship between the occurrence of cholelithiasis (gall stones) and laboratory indices of haemolysis in sickle cell anaemia (Hbss), was examined by determining the level of foetal haemoglobin, steady state haematocrit, reticulocyte count and serum bilirubin, in sicklers with and without ultrasonographic evidence of cholelithiasis. One hundred and forty-six (146) unselected, consecutive Hb ss patients, comprising 66 males and 80 females, aged between 5 and 30 years and attending both paediatric and adult sickle cell clinics of the Lagos University Teaching Hospital, Nigeria were studied. All the subjects were screened for gall stones by ultrasonography. Sickle cell anaemia patients without gall stones served as controls. Cholelithiasis was diagnosed in 24 of the 146 subjects representing a prevalence rate of 16.4%. There were no significant differences in mean steady state haematocrit, foetal haemoglobin, serum bilirubin and reticulocyte counts between the test and control subjects. Foetal haemoglobin, haematocrit, serum bilirubin and reticulocyte count are not associated risk factors for cholelithiasis in sickle cell anaemia patients (Hbss). Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 209-21