Effect of Climate on Yam Tuberization in the Guinea Savanna Ecological Zone of Nigeria: The Case Study of Kwara State

The response of yam tuber development to its micro-climate was monitored at the National Centre for Agricultural Mechanization (NCAM) for two yam growing seasons. The micro climate data measured include air temperature, rainfall, number of rain days, relative humidity, soil temperature at intervals of 5cm, 20cm, 30cm and 40cm and soil moisture with depths at 0-15cm, 15-30cm and 30-45cm. Measurement of yam tuber circumference and length were taken on monthly basis from the period of tuber initiation (34 WAP) to period of tuber maturity (50 WAP) using thread and measuring tape. Monthly means of weather elements from research plot was calculated, grouped and summarized using descriptive statistics of mean and percentages. Dependency of yam tuber development on meteorological factors was examined through statistical analysis of correlation and regression. Based on this, the period of tuber development in Kwara State was identified and categorized. The growth in yam tuber responds positively more to rainfall frequency than rainfall amount. Again soil temperature at 5cm depth was identified to be more critical for efficient yam tuberization. Farmers in the study area are advised to improve on the materials used for mulching to increase yam yield

Greywater reuse for toilet flushing at a university academic and residential building

Interest in water reuse is increasing all over the world and particularly in South Africa, because of its potential to supplement scarce freshwater resources in the face of increased demand and aridity. If water reuse is to be implemented, it must be done sustainably. This study: (i) describes the perceptions of beneficiaries before and after greywater reuse (GWR) implementation; (ii) determines the attributes of greywater that were important to beneficiaries when reusing greywater and their willingness to pay for these attributes; and (iii) undertakes an economic analysis of the implemented GWR systems. To this end, two GWR systems for toilet flushing were installed. The first was installed at a university academic building at the University of the Witwatersrand, Johannesburg, and the second at a university residence at the University of Johannesburg. Perceptions highlighted included respondents’ preference to reuse greywater for toilet flushing rather than irrigation, and the greater preference for GWR for toilet flushing expressed for the university academic relative to the university residential building. In sequence, ‘smell’, ‘colour’ and ‘greywater tariff’ emerged as the attributes of greywater that were important to respondents. In terms of payback period, net present value and benefit-cost ratio, both systems generated a net loss and were economically unfeasible.Keywords: greywater reuse for toilet flushing, perceptions, economic

Microbial Contamination of Locally Produced Cheese and Determination of their Antimicrobial Potential in Nigeria

The high consumptionrate of soft cheese and manner of cheese production in Nigeria prompted the need to determine the microbial quality and  antimicrobial properties of locally produced cheese in Nigeria. A total of 20 cheese samples were obtained from different points in 4 cities in southern Nigeria, 5 cheeses per city. They were investigated for some physico-chemical properties, isolation and microbial counts and determination of antimicrobial potential. There was no significant variation in the  composition of physic-chemical properties of cheese samples from various cities except for the acidity of cheese sample obtained from Ilorin. All the 20 samples (100%) yielded low level of lactic acid bacteria (LAB) with counts ~ 103. Escherichia coli or Klebsiella species were constantly isolated in all the cheese samples. Similarly, yeast and Aspergillus species were isolated either alone or in a mixed culture. The result showed increase in total bacteria count from the point of production to the hawkers.  Antimicrobial potential was not found in cheese against the  microorganisms used in the study. The study identified local cheese (‘wara’) as a high risk food in Nigeria due to the high rate of contamination since they are ready-to-eat food item and no antimicrobial property detected in the soft cheese.Key Words: Cheese; Bacteria; Fungi; Nigeria, Susceptibility Le taux de fromage à pâte molle et les modalités de production de  fromage au Nigeria à forte consommation a incité la nécessité de déterminer la qualité microbienne et propriétés antimicrobiennes de  fromage produit localement au Nigeria. Un total de 20 échantillons de fromage ont été obtenues à partir de différents points dans 4 villes au sud du Nigeria, 5 fromages par ville. Ils ont été étudiés pour certaines  propriétés physico-chimiques, l'isolement et les numérations microbiennes et détermination du potentiel antimicrobien. Il n'y avait aucune variation significative dans la composition des propriétés physico- chimiques des échantillons de fromage à partir de différentes villes à l'exception de l'acidité de l'échantillon obtenu à partir de fromage de la ville d’Ilorin. Tous les 20 échantillons (100%) ont donné un faible niveau de bactéries lactiques (LAB) avec environs 103 espèces. Escherichia coli ou Klebsiellaont été constamment isolés dans tous les échantillons de fromage. De même, des espèces de levures et d'Aspergillus ont été isolés soit seuls, soit dans une culture mixte. Le résultat a montré l’augmentation des bactéries totales compté du point de production aux colporteurs. Potentiel antimicrobien n'a pas été trouvé dans le fromage contre les micro-organismes utilisés dans l'étude. L'étude a identifié fromage local (' wara ‘) comme un aliment à haut risque au Nigeria en raison du taux élevé de contamination, car ils sont prêts à consommer l'aliment et aucune  propriété antimicrobienne détecté dans le fromage à pâte molle.Mots clés: Fromage; bactéries; champignons; Nigeria, sensibilit

Effect of Hepatitis-B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients

Background: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function.Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy- naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver  enzymes were determined using standard techniques.Results: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co- infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/μl were significantly higher than those with count ≥ 200 cells/μl. (pvalue of <0.01). The mean ALT and  AST of the co - infected patients and all patients with CD4 count <200 cells/μl were higher than the normal reference range.Conclusion: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count <200 cells/μl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/μl should be given non-hepatotoxic antiretroviral drug.Keywords: HIV, Hepatitis B, CD4 count, liver function, co-infectio

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

Acute kidney injury from herbal vaginal remedy in Ilorin: a case report

The use of traditional herbal remedy is very common worldwide, and it is associated with complications such as acute kidney injury. Herbal remedy accounts for 35% of acute kidney injury in Africa. As with orthodox medicines, herbal remedies are administered orally in the majority of cases but other routes such as topical and rectal administrations may be used. Vaginal route of administration is a rare practice used as arbortifacients in some parts of southern Africa. One case of AKI that resulted from vaginal administration of a herbal product used as a treatment of infertility has been reported previously in Nigeria. We describe a similar case of a young female who developed AKI three days after vaginal insertion of a herbal remedy for treatment of secondary infertility. She was managed conservatively and recovered full renal function. The case suggests that the unusual socio-cultural practice of vaginal herbal therapy leading to AKI may be underreported and therefore the need for surveillance and public awareness of the harmful effect of this practice, and the use of unstandardized herbal products.Key words: Acute kidney injury, herbal vaginal remedy, nephrotoxins, Nigeri

Profile and causes of mortality among elderly patients seen in a tertiary care hospital in Nigeria

Background: Old age is one of the factors associated with increased risk of dying when admitted to hospital. Therefore, aim of this study was to&nbsp; examine causes and pattern of death among elderly patients managed in a tertiary care hospital in Nigeria with scanty mortality records.Materials and Methods: This prospective study was on deaths that occurred in patients 60 years and above admitted to University of Ilorin Teaching Hospital (UITH), Ilorin, between January 2005 and June 2007. Excluded were all brought-in-dead during the study period. Information obtained included demographic data, duration on admission, and diagnosis. Causes of death were determined from clinical progress notes and diagnosis.Results: A total of 1298 deaths occurred during the study period, of which 297 occurred in persons 60 years and above with crude death rate of&nbsp; 22.8%. The mean age at death was 68 &plusmn; 9 years (ranged 60-100 years). This consisted of 59% males and 41% females. Mean age at death for females was 69.7 &plusmn; 8.7 years and for males 68.1 &plusmn; 9.8 years (P=0.05).Mean values of serum chemistry were sodium 137 &plusmn; 8 mMol/l, potassium 3.6 &plusmn; 1 mMol/l, urea 11 &plusmn; 8 mMol/l, and creatinine 126 &plusmn; 91 &mu;mol/l. The value of mean haemogram concentration was 10.5 &plusmn; 3 gm/dl and white&nbsp; cell count was 12 &plusmn; 2 &times; 109/ mm3. The three most common diagnoses at deaths were stroke (19.8%), sepsis (16.5%), and lower respiratory tract disease (8.1%). Infectious diseases accounted for 38.2% of all diagnoses. Collective mean length of hospital stay (LOS) at death was 6.8 &plusmn; 8.6&nbsp; (ranged 15 minutes-60 days). Close to 27.4% of the deaths occurredwithin 24 hours and neurological disorder had shortest hospital stay (4.6 &plusmn;&nbsp; 6.3 days), followed by endocrine disorders (6.8 &plusmn; 8.4 days) and respiratory diseases (8.4 &plusmn; 5.6 days) [P=0.001].Conclusion: Hospital mortality is high amongst older people. Stroke and infectious diseases are leading causes of death. Efforts should be geared toward reducing risk for cardiovascular diseases and improvement on level of personal and community hygiene