Acute Exacerbation of Multiple Sclerosis in Pregnancy

Multiple sclerosis is a common neurological disease, which affects young adults. Its course is unpredictable and runs over decades. It is considered as an autoimmune disease in which there is demyelination of the brain and spinal cord. The case presented is a young adult pregnant Nigerian who had a flare up of the symptoms in pregnancy. The patient was managed conservatively during pregnancy and commenced on oxybutyllin, methylprednisolone and multivitamins shortly after delivery. The disease continued unabated till patient's death.Scl\ue9rose Multiple est une maladie neurologique ordinaire qui touche des jeunes adultes. Son \ue9volution est impr\ue9visible et deborde des d\ue9c\ue9nnies. On dirait qu'elle est une maladie autoimmune dans laquelle il y a une d\ue9my\ue9linisation du cerveau et moelle \ue9pini\ue8re. Il s'agit d'un cas d'une jeune nig\ue9riane enceinte qui avait eu le d\ue9clenchement de ces sympt\uf4mes pendant la grossesse. La patiente a \ue9t\ue9 trait\ue9e de fa\ue7on classique pendant la grossesse et a commenc\ue9 sur oxybutylline, m\ue9thypredniselone et multivitamines peu apr\ue8s accouchement. La maladie a continu\ue9 sans r\ue9pit jusqu'\ue0 la mort de la patiente

Antihypertensive Therapy Among Hypertensive Patients as Seen in the Middle Belt of Nigeria

Background: In spite of increased awareness on hypertension among Nigerians, control of blood pressure among hypertensive patients is still unacceptably poor. This study was therefore designed to assess the compliance rate to antihypertensive therapy among Nigerians and factors influencing it. Method: Two hundred and twenty four consecutive hypertensive patients were prospectively studied using a pre-tested questionnaire. Results: A total of 100 males (44.6%) and 124 females participated in the study. The age ranged between 35-82 years. Calcium channel blockers were the most frequently prescribed medication (39.3%) followed by diuretics (14.3%). Combination therapy was seen in 35.7% of the patients. B-blockers were the rarest drug as a single agent (1.8%). Using multivariate analysis, access to the hospital was the only independent predictor of Systolic Blood Pressure level. 39.3% of the respondents volunteered history of having stopped their drugs at one time or the other over a one year period for different reasons with high cost and scarcity of drugs being the most prevalent. 85.7% of the patients spent between two hundred and two thousand Naira monthly on drug procurement. Conclusion: Calcium channel blockers are rapidly gaining ground as first line antihypertensive agents in tertiary hospitals in Nigeria. This study has underscored the need to bring health care centres closer to the people in a bid to improve the control of blood pressure

High Energy X-Ray Dosimetry Using (ZnO)0.2(TeO2)0.8 Thin Filmbased Real-time X-Ray Sensor

This study reports the dosimetric response of a (ZnO)0.2(TeO2)0.8 thin film sensor irradiated with high-energy X-ray radiation at various doses. The spray pyrolysis method was used for the film deposition on soda-lime glass substrate using zinc acetate dehydrate and tellurium dioxide powder as the starting precursors. The structural and morphological properties of the film were determined. The I-V characteristics measurements were performed during irradiation with a 6 MV X-ray beam from a Linac. The results revealed that the XRD pattern of the AS-deposited thin film is non-crystalline (amorphous) in nature. The FESEM image shows the non-uniform shape of nanoparticles agglomerated separately, and the EDX spectrum shows the presence of Te, Zn, and O in the film. The I-V characteristics measurements indicate that the current density increases linearly with X-ray doses (0-250 cGy) for all applied voltages (1-6 V). The sensitivity of the thin film sensor has been found to be in the range of 0.37-0.94 mA/cm2 /Gy. The current-voltage measurement test for fading normalised in percentage to day 0 was found in the order of day 0 > day 15 > day 30 > day 1 > day 2. These results are expected to be beneficial for fabricating cheap and practical X-ray sensors

The burden of diabetes mellitus during pregnancy in low- and middle-income countries : a systematic review

Peer reviewedPublisher PD

Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria

<p>Abstract</p> <p>Background</p> <p>Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, Nigeria</p> <p>Methods</p> <p>A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan.</p> <p>Results</p> <p>Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01).</p> <p>Conclusion</p> <p>AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms.</p

Retention and mortality outcomes from a community-supported public–private HIV treatment programme in Myanmar

Introduction: There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low- and middle-income settings. This article describes a public–private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community-based non-governmental organization (International HIV/AIDS Alliance). Methods: Retrospective analysis of 2119 patient records dating from March 2009 to April 2015 was conducted. Outcomes assessed were immunological response, loss to follow-up, all-cause mortality, and alive and retained in care. Follow-up time was calculated from the date of registration to the date of death, loss to follow-up, transfer out, or if still alive and known to be in care, until April 2015. Cox proportional hazards model was used to identify predictors of loss to follow-up and mortality. Kaplan–Meier survival analysis was used to estimate survival function of being alive and retained in care. Results: The median number of patients for each of the 16 GPs was 42 (interquartile range (IQR): 25–227), and the median follow-up period was 13 months. The median patient age was 35 years (IQR: 30–41); 56.6% were men, 62 and 11.8% were in WHO Stage III and Stage IV at registration, respectively; median CD4 count at registration was 177 cells/mm3; and 90.7% were on ART in April 2015. The median CD4 count at registration increased from 122 cells/mm3 in 2009 to 194 cells/mm3 in 2014. Among patients on ART, CD4 counts increased from a median of 187 cells/mm3 at registration to 436 cells/mm3 at 36 months. The median time to initiation of ART among eligible patients was 29 days, with 93.8% of eligible patients being initiated on ART within 90 days. Overall, 3.3% patients were lost to follow-up, 4.2% transferred out to other health facilities, and 8.3% died during the follow-up period. Crude mortality rate was 48.6/1000 person-years; 42% (n=74) of deaths occurred during the pre-ART period and 39.8% (n=70) occurred during the first six months of ART. Of those who died during the pre-ART period, 94.5% were eligible for ART. In multivariate regression, baseline CD4 count and ART status were independent predictors of mortality, whereas ART status, younger age and patient volumes per provider were predictors of loss to follow-up. Probability of being alive and retained in care at six months was 96.8% among those on ART, 38.5% among pre-ART but eligible patients, and 20.0% among ART-ineligible patients. Conclusions: Effectively supported private sector GPs successfully administered and monitored ART in Myanmar, suggesting that community-supported private sector partnerships can contribute to expansion of HIV treatment and care capacity. To further improve patient outcomes, early testing and initiation of ART, combined with close clinical monitoring and support during the initial periods of enrolling in treatment and care, are required

ANTIHYPERTENSIVE THERAPY AMONG HYPERTENSIVE PATIENTS AS SEEN IN THE MIDDLE BELT OF NIGERIA

Background: In spite of increased awareness on hypertension among Nigerians, control of blood pressure among hypertensive patients is still unacceptably poor. This study was therefore designed to assess the compliance rate to antihypertensive therapy among Nigerians and factors influencing it. Method: Two hundred and twenty four consecutive hypertensive patients were prospectively studied using a pre-tested questionnaire. Results: A total of 100 males (44.6%) and 124 females participated in the study. The age ranged between 35-82 years. Calcium channel blockers were the most frequently prescribed medication (39.3%) followed by diuretics (14.3%). Combination therapy was seen in 35.7% of the patients. B-blockers were the rarest drug as a single agent (1.8%). Using multivariate analysis, access to the hospital was the only independent predictor of Systolic Blood Pressure level. 39.3% of the respondents volunteered history of having stopped their drugs at one time or the other over a one year period for different reasons with high cost and scarcity of drugs being the most prevalent. 85.7% of the patients spent between two hundred and two thousand Naira monthly on drug procurement. Conclusion: Calcium channel blockers are rapidly gaining ground as first line antihypertensive agents in tertiary hospitals in Nigeria. This study has underscored the need to bring health care centres closer to the people in a bid to improve the control of blood pressure

A Method for Solving the Voltage and Torque Equations of the Split-Phase Induction Machines

Single phase induction machines have been the subject of many researches in recent times. The voltage and torque equations which describe the dynamic characteristics of these machines have been quoted in many papers, including the papers that present the simulation results of these model equations. The way and manner in which these equations are solved is not common in literature. This paper presents a detailed procedure of how these equations are to be solved with respect to the splitphase induction machine which is one of the different types of the single phase induction machines available in the market. In addition, these equations have been used to simulate the start-up response of the split phase induction motor on no-load. The free acceleration characteristics of the motor voltages, currents and electromagnetic torque have been plotted and discussed. The simulation results presented include the instantaneous torque-speed characteristics of the Split phase Induction machine. A block diagram of the method for the solution of the machine equations has also been presented

Acute Exacerbation of Multiple Sclerosis in Pregnancy

Multiple sclerosis is a common neurological disease, which affects young adults. Its course is unpredictable and runs over decades. It is considered as an autoimmune disease in which there is demyelination of the brain and spinal cord. The case presented is a young adult pregnant Nigerian who had a flare up of the symptoms in pregnancy. The patient was managed conservatively during pregnancy and commenced on oxybutyllin, methylprednisolone and multivitamins shortly after delivery. The disease continued unabated till patient&apos;s death.Sclérose Multiple est une maladie neurologique ordinaire qui touche des jeunes adultes. Son évolution est imprévisible et deborde des décénnies. On dirait qu&apos;elle est une maladie autoimmune dans laquelle il y a une démyélinisation du cerveau et moelle épinière. Il s&apos;agit d&apos;un cas d&apos;une jeune nigériane enceinte qui avait eu le déclenchement de ces symptômes pendant la grossesse. La patiente a été traitée de façon classique pendant la grossesse et a commencé sur oxybutylline, méthypredniselone et multivitamines peu après accouchement. La maladie a continué sans répit jusqu&apos;à la mort de la patiente

Improvement of Torque Production in Single-Phase Induction Motors

Existing single phase induction motors exhibit low starting torque. Moreover, during accelerating time and at steady state, they produce a significant level of torque pulsations which gives rise to noise and vibration in the machine. As part of efforts to mitigate these problems, a performance improvement strategy using a PWM inverter to drive the existing motor is implemented in MATLAB/Simulink environment in this work. The drive supplies variable voltage and phase to the auxiliary winding with the aid of a pulse width modulation (PWM) technique and a PID controller. Simulation results show the starting torque of the motor increased by 75% under the developed drive scheme. In addition, torque pulsations reduced from 1.4 Nm peak-peak to 0.14 Nm peak-peak at steady state.&nbsp; It was observed that the accelerating time reduced by 30% compared to the accelerating time under line operation. The strategy eliminates the need for series-connected capacitors thereby potentially enhancing the reliability of the motor