Profile, determinants and mechanisms of cerebral injury and cognitive impairment following stroke

PhD ThesisOne in three people over a life time will develop a stroke, dementia or both but little is known about stroke - related cognitive impairment despite current epidemiologic transition in sub - Saharan Africa. The CogFAST Study was established in Newcastle to unmask risk factors, pathological substrates and cellular mechanisms underlying cerebral injury and cognitive impairment following stroke. The overall aim of this thesis was to establish a comparative cohort in Nigerian African stroke survivors and explore mechanisms in post - mortem brains accrued from the Newcastle cohort. Two hundred and twenty Nigerian African stroke survivors were screened three months after index stroke out of whom 143 eligible participants underwent cognitive assessment in comparison with 74 stroke - free healthy controls. We found a high frequency (49.3%) of early vascular cognitive impairment and significant association with older age and low education. Pre-stroke daily fish intake and moderate – to - heavy physical activity were inversely associated. The frequency of vascular cognitive impairment no dementia (vCIND) in the cohort (39.9%) was relatively higher than earlier report from Newcastle (32%) but neuroimaging studies revealed significant findings of MTLA and correlative white matter changes in tandem with previous reports from the Newcastle cohort. Given these, we investigated neurodegenerative hippocampal Alzheimer pathology and synaptic changes, as well as frontal and temporal white matter abnormalities in post - mortem brain tissue from the Newcastle cohort. We found increased Alzheimer pathology in the post - stroke groups but largely this did not differ between the demented (PSD) and non - demented (PSND) sub - groups. However, we found significantly higher hippocampal expression of synaptic markers (vesicular glutamate transporter – 1 and Drebrin) but lower expression of microglial, astrocytic and axonal injury markers in PSND compared to PSD subjects. The protective effect of educational attainment, pre-stroke physical activity and fish intake have public brain health implications.ORS Award from Newcastle University, a Research Fellowship from the International Brain Research Organization (IBRO) and laboratory visit support from the International Society of Neurochemistry (ISN)

Geophysical Characterization of the Basement Rocks and Groundwater Potential Zones Using Electrical Resistivity Sounding Technique

This study characterizes the basement rocks and delineates groundwater potential zones in a basement complex terrain of Adeyemi College of Education, Ondo, Southwestern Nigeria due to its erratic and complex nature of groundwater development. Vertical Electrical Sounding (VES) technique adopting Schlumberger configuration was used to acquire the apparent resistivity data using a resistivity meter. Ten VES stations were established with 100 m spread for half-current electrode spacing. The data were subjected to partial curve matching and computer based iterative interpretations. The generated sounding curves revealed heterogeneous nature of the subsurface geological sequence; topsoil (132-467 Ωm), sandy clay (101-370 Ωm), lateritic clay (347-1133 Ωm), weathered layer (128-750 Ωm), fractured basement (554-5045 Ωm) and fresh basement (14244-24744 Ωm). The results delineated weathered and fractured basements as the aquifer units for the study area. The composite thicknesses of the aquifers were used to characterize the subsurface into high and low groundwater potential zones. VESs 2, 6, 7, 8, 9 and 10 revealed adequate overburden thicknesses (26.5-58.7 m) for groundwater storage, and they were recommended for groundwater exploitation. VESs 3 and 5 revealed low thicknesses (7.1-19.3 m) of the aquifer units, and were regarded as low groundwater potential zones. VESs 1 and 4 revealed fresh basement with thin overburden thicknesses (13.3-10.3 m) and no evidence of fractured and groundwater bearing zones. This study generally revealed high groundwater prospects, and efforts to sink boreholes had been abortive in the past due to lack of adequate knowledge as regards the heterogeneous nature of the subsurface. Keywords: Basement complex, Heterogeneous nature, Vertical Electrical Sounding, Apparent resistivity, Overburden thickness, Groundwater potentia

New trends in under-five mortality determinants and their effects on child survival in Nigeria: A review of childhood mortality data from 1990-2008

Under-five mortality in Nigeria has been reported to be on the decline, but the dynamics are yet to receive adequate attention. Thus the main objective of this study was to assess these factors and quantify their relative contributions to under-five mortality between 1990 and 2008. The Nigeria Demographic and Health Survey data for 1990, 2003 and 2008 were re-analysed to assess the trends in determinants of under-five mortality.Cox Regression model was applied to determine the relative contributions of each factor to the under-five mortality risk.The results showed there were improvements in maternal education (8.6%), childhood vaccination (17.7%), use of oral rehydration therapy (13.9%) and medical treatment of childhood illnesses(17.5%) over the 19-year period. There were declines in proportions with birth interval less than 24months (3.9%), access to improved sources of drinking water (24.2%), improved toilet facilities (9.0%) antenatal care (4.5%), skilled delivery (3.0%) while maternal age at childbirth remained unchanged. These factors increased the death hazards by 4.6% between 1990-2003 but decreased them by 12% between 2003 and 2008. It was concluded that Nigeria has recorded very minimal improvements in birth spacing and antenatal/delivery care. Poor access to potable drinking water and sewage disposal, and short birth intervals,are among the factors fueling childhood mortality risks. Further improvements in these environmental and health practices as well as other factors are recommended as strategies for promoting child survival in Nigeria

Geology and Geochemistry of Iroko-Granites Southwestern Nigeria: Implication on Provenance

The geology, geochemistry of Iroko-granites have been studied and reported in this paper. The study area has been described as of Archaean-EarlyProterozoic terrain underlain by migmatite-gneiss-quartzite complex with supracustal rocks. Large number of granites which outcrops in Iroko-Ekiti represent a typical occurrence of granitoids sporadically distributed in thebasement and are known to belong to the Older Granite suites, which are attributable to the Pan-African Orogeny (750± 150Ma). The rocks occur,mostly as flat and low lying within sparse vegetation. Structures common on and around the outcrops include quartz vein, veinlets, pegmatite dykes which trend North-south, discrete exfoliated surfaces and xenoliths of older rocks. This study reveals that the granites belong to calc-alkalic suites,demonstrate metaluminous nature, and exhibit characteristics of I-type granites. The granite is a distinctive type in that it is relatively highly potassic, has high FeO/(FeO + MgO) ratio, and high average Zr (299.75ppm)concentration with other high field strength elements. The trace elements study implicates pronounced fractional crystallization during evolution of the granites and thus petrogenetically discriminates as Syn-collision provenance

Dietary Effect of Substituting \u3cem\u3ePanicum maximum\u3c/em\u3e with \u3cem\u3eTithonia diversifolia\u3c/em\u3e Forage on Performance of Yankasa Sheep

Ruminant livestock production in Nigeria is based predominantly on native grassland (especially Panicum maximum); the nutritive value of the natural pasture varies drastically according to season (Ademosun.1992). Changes in nutritional status of these native plants result in very irregular growth and marked fluctuations in seasonal weights of farm animals. Consequently, it becomes imperative to source for alternative feed resources which are more efficient, economical and can be incorporated into ruminant’s diet with a view to reducing feed costs and hence, achieving a greater profit margin for the producer. Tithonia diversifolia is an herbaceous weed of field crops and is widely distributed in the humid and sub-humid tropical Africa. Tithonia diversifolia could be considered a higher ranking forage species considering its crude protein content that varies between 14.8 and 28.8% (Navarro and Rodriguez 1990), the average of this values compared favourably with the protein content of Gliricidia (14.7%) Leucaena (22.2%) and Peppiginna (21.4%) as reported by Rosales (1996). However, there is dearth of information on its use as ruminant feed in Nigeria. Therefore, this study was designed to evaluate the dietary effect of substituting Panicum maximum with Tithonia diversifolia forage on performance of Yankasa sheep

Assessment of Background Radioactivity of Surface Soils in Ondo City, Ondo State, Nigeria

The natural radioactivity of surface soils collected from various locations in Ondo City were measured by means of well calibrated High Purity Germanium (HPGe) detector, Canberra model coupled to a versatile Canberra Multichannel Analyzer, at the Centre for Energy Research and Development of Obafemi Awolowo University. Ile Ife. The soil samples were collected from the fourteen zones that constituted the town with four samples taken from each zone. The emission line spectra used in identifying the natural radioisotopes belong to 238U and 232Th decay series and that of naturally occurring 40K. The gamma activity obtained for 40K ranged from 212.1 Bq/kg to 895.7 Bq/kg with a mean value of 470.4 ± 26.8 Bq/kg. For 232Th, the gamma activity ranged from 30.2 Bq/kg to 72.4 Bq/kg with a mean value of 48.8 ± 8.4 Bq/kg, and from 3.6 Bq/kg to 14.2 Bq/kg with a mean value of 6.9 ± 1.2 Bq/kg for 238U. The mean absorbed dose rate in these locations amounts to 45.36 nGy/h which by approximate conversion gives an indoor annual effective dose of 0.223 mSv/year and outdoor annual effective dose of 0.056 mSv/year. These values constitute the baseline dose equivalent, which is below the 1.0 mSv/year recommended by the International Commission for Radiological Protection (ICRP, 1990) as the maximum permissible dose equivalent for members of public. The results obtained showed that the study area is free from radiological contamination. Keywords: Radioactivity, Absorbed dose, Radioisotopes, Environment

Intraligamentary Extrauterine Pregnancy Delivered at Term: A Case Report and Review of Literature

Intraligamentary pregnancy is extremely rare. Preoperative diagnosis is often difficult. We report a case of a 33 year old female who had an ectopic pregnancy in the right broad ligament. The pregnancy remained viable till term, but unfortunately resulted in a perinatal death prior delivery. Diagnosis was not made until laparotomy and a well formed still born was delivered. A high index of suspicion and prompt therapeutic intervention are necessary to prevent adverse fetal and or maternal outcome. Keywords: Intraligamentary pregnancy, Full term fetus, Nigeria

Inhibitory Effect of Aqueous Extract of Moringa oleifera and Newbuoldia laevis Leaves on Ferrous Sulphate and Sodium Nitroprusside Induced Oxidative Stress in Rat’s Testes in Vitro

Oxidative stress has been identified as one of the factors that affects fertility status. Therefore, this study sought to in-vestigate the inhibitory effect of aqueous extract of Moringa oleifera and Newbuoldia laevis leaves on FeSO4 and So-dium Nitroprusside (SNP) induced lipid peroxidation in rat testes in vitro. Incubation of the testes tissue homogenate in the presence of FeSO4 and SNP caused a significant increase in the malondialdehyde (MDA) contents of the testes. The aqueous extract from both Moringa oleifera and Newbuoldia laevis leaves caused a significant decrease in the MDA contents of the testes in a dose-dependent manner. However, aqueous extract from Moringa oleifera leaf (EC50 = 0.29 mg/ml) had a significant (P < 0.05) higher inhibitory effect on Fe2+ induced lipid peroxidation in the rat testes homoge-nate than that of Newbuoldia laevis leaf extract (EC50 = 0.58 mg/ml); while there was no significant (P < 0.05) differ-ence between the plant extracts on SNP induced lipid peroxidation in the rat testes homogenates. Therefore, part of the mechanisms through which the water extractable phytochemicals in the leaves protect the testes from oxidative stress may be through their antioxidant activity; DPPH scavenging ability, Fe2+ chelating and reducing power. Therefore, these plants have potential to prevent oxidative stress in testes and improve fertility outcomes

Contributions of uterine fibroids to infertility at Ile‑Ife, South‑Western Nigeria

Background: Uterine fibroid is the most common tumor of the female genital tract. The benign tumors often grow into large sizes and assume unsightly shapes with concomitant symptoms and signs. Being a predominantly reproductive age disease, concurrent infertility and symptomatic uterine fibroids pose management challenges. Individualization of the patient is thus essential to the success of the reproductive outcome.Objectives: This study determined the prevalence, trend, management modalities, pregnancy outcome, and exposition of factors affecting pregnancy outcome among patients presenting with uterine fibroids and infertility at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC).Materials and Methods: This is a retrospective study of case records of 106 women managed for uterine fibroids and infertility over a 5‑year period (January 1, 2012, to December 31, 2016) at the OAUTHC. The outcome measure is the pregnancy rate among those who had a myomectomy.Results: About a quarter of women with infertility had symptomatic uterine fibroids and this represents about 35%–40% of the overall number of women presenting as uterine fibroid within the study. About 84.9% had uterine size &gt;12 weeks at presentation. Two‑third of the patients had open myomectomy alone with 43.9% achieving conception thereafter. Conception rate for myomectomy with tuboplasty was 31.3% whereas myomectomy with subsequent in vitro fertilization (IVF) was 50%. Pregnancy rate decreased with increasing size of the uterus before myomectomy.Conclusion: Symptomatic fibroid was significantly prevalent among women with infertility. Myomectomy improves fertility potential and success rate of IVF. Uterine fibroid has both direct and indirect effect on infertility and pregnancy rate in this group of the patient can be improved through routine screening for uterine fibroids and early removal of the fibroids before they grow into giants size.Keywords: Infertility; myomectomy; pregnancy outcome; uterine fibroid

Burden of Stroke in Europe:An Analysis of the Global Burden of Disease Study Findings From 2010 to 2019

BACKGROUND:While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010.METHODS:The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disability-adjusted life years of stroke for the European Region as defined by the World Health Organization, with its 53 member countries (EU-53) and for European Union as defined in 2019, with its 28 member countries (EU-28), between 2010 and 2019. Results were analyzed at a regional, subregional, and country level.RESULTS:In EU-53, the absolute number of incident and prevalent strokes increased by 2% (uncertainty interval [UI], 0%–4%), from 1 767 280 to 1 802 559 new cases, and by 4% (UI, 3%–5%) between 2010 and 2019, respectively. In EU-28, the absolute number of prevalent strokes and stroke-related deaths increased by 4% (UI, 2%–5%) and by 6% (UI, 1%–10%), respectively. All-stroke age-standardized mortality rates, however, decreased by 18% (UI, −22% to −14%), from 82 to 67 per 100 000 people in the EU-53, and by 15% (UI, −18% to −11%), from 49.3 to 42.0 per 100 000 people in EU-28. Despite most countries presenting reductions in age-adjusted incidence, prevalence, mortality, and disability-adjusted life year rates, these rates remained 1.4×, 1.2×, 1.6×, and 1.7× higher in EU-53 in comparison to the EU-28.CONCLUSIONS:EU-53 showed a 2% increase in incident strokes, while they remained stable in EU-28. Age-standardized rates were consistently lower for all-stroke burden parameters in EU-28 in comparison to EU-53, and huge discrepancies in incidence, prevalence, mortality, and disability-adjusted life-year rates were observed between individual countries.<br/