Wernicke’s Encephalopathy in a Nigerian with Schizophrenia

While Wernicke’s encephalopathy (WE) is a well-characterized syndrome in alcoholism and malnutrition, little is written of its prevalence or presentation in patients with psychiatric illness. We present a case of a 37-year-old Nigerian male with schizophrenia and malnutrition who presented with delirium and ophthalmoplegia. The clinical diagnosis was supported by dramatic reversal of the symptoms and signs following the administration of intravenous thiamine. Owing to the high rate of mortality and morbidity, WE should be considered in the evaluation of any patient with unexplained nystagmus, gaze palsies, gait ataxia, or confusion, especially if a condition associated with malnutrition is present. This is particularly important in psychiatric patients where the clinical history and syndrome may be obscured and treatment delaye

Hyponatraemia during Low-Dose Carbamazepine Therapy

We report the syndrome of inappropriate antidiuresis as a much earlier side-effect of carbamazepine administration in a 29-year Nigerian female patient with generalized tonic-clonic seizures. Although asymptomatic, the biochemical abnormality improved after discontinuation of carbamazepine.Hyponatraemia developed after rechallenge with controlled release carbamazepine. The authors suggest that serum sodium levels be carried out before commencement of carbamazepine and caution be used inprescribing carbamazepine to patients with low or borderline low sodium value

Wernicke's Encephalopathy in a Nigerian with Schizophrenia

While Wernicke's encephalopathy (WE) is a well-characterized syndrome in alcoholism and malnutrition, little is written of its prevalence or presentation in patients with psychiatric illness. We present a case of a 37-year-old Nigerian male with schizophrenia and malnutrition who presented with delirium and ophthalmoplegia. The clinical diagnosis was supported by dramatic reversal of the symptoms and signs following the administration of intravenous thiamine. Owing to the high rate of mortality and morbidity, WE should be considered in the evaluation of any patient with unexplained nystagmus, gaze palsies, gait ataxia, or confusion, especially if a condition associated with malnutrition is present. This is particularly important in psychiatric patients where the clinical history and syndrome may be obscured and treatment delayed.Bien que l'enc\ue9phalopathie de Wernicke (WE) est un syndrome bien caract\ue9ristique de l'alcoolisme et de la sous-alimentation. Il y a peu d'\ue9crits \ue0 propos de sa fr\ue9quence ou pr\ue9sentation chez des patients atteints de la maladie psychiatrique. Nous pressentons un cas d'un homme nig\ue9rian \ue2g\ue9 de 37 ans atteint de la schizophr\ue9nie et de la sous-alimentation qui s'est pr\ue9sent\ue9 avec delirium et ophtalmologie. Le diagnostic clinique a \ue9t\ue9 appuy\ue9 par le renversement spectaculaire de sympt\uf4mes et signes \ue0 la suite de l'administration intraveineuse de la thiamine. En raison de taux \ue9lev\ue9 de mortalit\ue9 et de morbidit\ue9, le WE devraient \ueatre consid\ue9r\ue9e dans l'\ue9valuation de tous les patients avec une nystagmus inexpliqu\ue9e, regard palsie, giat ataxie, ou la confusion surtout si une condition li\ue9e \ue0 la sous alimentation est pr\ue9sent. Cela est particuli\ue8rement important chez des patients psychiatriques o\uf9 l'histoire clinique et syndrome peuvent \ueatre obscur et traitement retard\ue9

Optimization of Transesterification Parameters of Biodiesel Produced from Sword Bean (Cavalia gladiate) Seed Oil

The subject of this study was to optimize the transesterification parameters of biodiesel produced from sword bean (C. gladiate) using Response Surface Methodology (RSM). Four transesterification parameters (Reaction temperature 55 0C, Catalyst concentration 0.4 wt%, Methanol to oil ratio 4:1 and reaction time 60 min) were optimized. Data obtained revealed that the optimum reaction conditions for the transesterification of C. gladiata seed oil resulted in 92.88% biodiesel yield. Multiple regression analysis produced a quadratic polynomial equation for methylester and a linear relationship was recorded between the observed and predicted value (R2 = 0.9647) with a significant molar ratio and temperature.  The interaction terms of methanol to oil, molar ratio and temperature with reaction time exhibited a positive effect on the methylester yield. The response surface methodology was found to be a suitable technique for optimizing transesterification process and producing biodiesel that meets the ASTM standard

Approximation of the Cox survival regression model by MCMC Bayesian hierarchical Poisson modelling of factors associated with childhood mortality in Nigeria

The need for more pragmatic approaches to achieve sustainable development goal on childhood mortality reduction necessitated this study. Simultaneous study of the influence of where the children live and the censoring nature of children survival data is scarce. We identified the compositional and contextual factors associated with under-five (U5M) and infant (INM) mortality in Nigeria from 5 MCMC Bayesian hierarchical Poisson regression models as approximations of the Cox survival regression model. The 2018 DHS data of 33,924 under-five children were used. Life table techniques and the Mlwin 3.05 module for the analysis of hierarchical data were implemented in Stata Version 16. The overall INM rate (INMR) was 70 per 1000 livebirths compared with U5M rate (U5MR) of 131 per 1000 livebirth. The INMR was lowest in Ogun (17 per 1000 live births) and highest in Kaduna (106), Gombe (112) and Kebbi (116) while the lowest U5MR was found in Ogun (29) and highest in Jigawa (212) and Kebbi (248). The risks of INM and U5M were highest among children with none/low maternal education, multiple births, low birthweight, short birth interval, poorer households, when spouses decide on healthcare access, having a big problem getting to a healthcare facility, high community illiteracy level, and from states with a high proportion of the rural population in the fully adjusted model. Compared with the null model, 81% vs 13% and 59% vs 35% of the total variation in INM and U5M were explained by the state- and neighbourhood-level factors respectively. Infant- and under-five mortality in Nigeria is influenced by compositional and contextual factors. The Bayesian hierarchical Poisson regression model used in estimating the factors associated with childhood deaths in Nigeria fitted the survival data.Publisher PDFPeer reviewe

Molecular identification and prevalence of Mycobacterium tuberculosis complex amongst people living with HIV in Osun state, Nigeria.

Human immunodeficiency virus (HIV) infection has created a special niche for Mycobacterium tuberculosis complex in humans as a result of the defect/reduction in cell mediated immunity. M. tuberculosis still responsible for most cases of death due to infectious diseases after HIV. In this study, prevalence of M. tuberculosis was determined in people living with HIV in Osun state of Nigeria with identification of culture positive isolates by polymerase chain reaction. A total of 160 samples were collected from people living with HIV with mean age of 36.8 years old of age (Median -34; age range 16 – 68; 95% confidence interval – 2.49) after seeking ethical approval from the Ministry of Health, Osun State. The result of the microscopy by ZN stain showed that 40 (25%) of the 160 samples were positive for acid fast bacilli while culture on Lowenstein-Jensen (LJ) medium revealed that 30 (18.75%) of the samples processed, grew organism that conformed to the characteristics of M. tuberculosis complex. Polymerase chain reaction for IS6110 was used to confirm the identity of the colonies on LJ slope as M. tuberculosis complex while the PCR for 260 bp of Rv1255c was used in identifying M. tuberculosis. M. tuberculosis represented 92% of the M. tuberculosis complex. The prevalence of M. tuberculosis among people living with HIV was found to be 15% after PCR identification. The effects of socio-demographic factors on the prevalence of TB were analysed. Occupation was found to be associated with the proportional distribution of TB in people living with HIV (X2 = 14.85; p < 0.05). The study concluded that PCR should be integrated into the schema for identification of tuberculosis in reference laboratories in developing countries.Key words: Molecular identification, Polymerase chain reaction, Mycobacterium tuberculosis complex; Mycobacterium tuberculosis, Prevalence, HIV, Nigeri

Mineral Profile of \u3ci\u3ePanicum maximum\u3c/i\u3e var. Ntchisi as Influenced by Organic Nitrogen Rate and Age at Harvest

The study was aimed at profiling the mineral contents of Panicum maximum var Ntchisi as influenced by organic (poultry) nitrogen rate and age at harvest. The study was carried out at the organic research farm of the Federal University of Agriculture, Abeokuta, Nigeria in 2016. The experiment was laid in a 4 x 3 factorial arrangement in a split plot design with four (4) organic nitrogen rate (0, 100, 200 and 300 kgNha-1) as the main plot and three (3) age at harvest (4, 8 and 12 weeks after cutback) as the subplot which amounts to twelve (12) treatment combinations with four replicates. The macro mineral contents were significantly (P\u3c 0.05) influenced by the nitrogen rate. The calcium (Ca) content was up to 4.35 gkg-1DM for the grass at 0 KgNha-1 which was the highest value. The magnesium (5.59 – 8.43 gkg-1DM) content had a linear increment with increased nitrogen rate. The potassium content ranged from 15.58 to 30.80 gkg-1 DM with the grass fertilized at 0 KgNha-1 having the highest K content. The phosphorus was linearly (P\u3c 0.05) influenced with the grass fertilized at 300 KgNha-1 with the highest (1.78 gkg-1DM) content. The micro mineral contents were significantly (P\u3c 0.05) influenced by the nitrogen rate though without a definite pattern. The macro and micro mineral contents were significantly (P\u3c 0.05) influenced by age at harvest except for the copper content. The macro mineral contents decreased with advancement in age at harvest. It was concluded that the grass harvested at younger age will make a good feed resource in terms of mineral requirement of ruminants in the tropics

Synthesis and Characterization of Graphene-Cu Composite Via Hydrothermal Method

In this paper, graphene-copper composite was synthesized via hydrothermal method using different compositions from 5 to 25%. The grain size and copper composition are observed to decrease proportionally to increase in band gap. The effect of composition fluctuate the peaks shift. The peak increased linearly with increasing temperature for each composition. The band gap reduces with increasing temperature for each composition. Short calcined duration on samples is observed to cause a little lower band gap value than that of longer duration. The thermal treatment of graphene oxide (GO) has been observed to cause changes in its quality, size and shape. &nbsp

Comparison of Two Hospital Stroke Scores with Computerized Tomography in Ascertaining Stroke Type Among Nigerians

Background: Stroke, a major cause of morbidity and mortality is on the increase in Nigeria, routine Computerized Tomography (CT) for all Nigerians with stroke is not available to most doctors, and this poses management problems. We compared two available clinical scores with brain CT for the differential diagnosis of cerebral ischemia and hemorrhage among adult Nigerians with first-ever acute stroke. Methods: The study was conducted at the State Specialist Hospital Maiduguri. Ninety-five adult Nigerians presenting with first-ever acute stroke onset within 48 hours were evaluated with the Siriraj Hospital Stroke (SHS) score on presentation and the Guy's Hospital Stroke (GHS) score 24 hours after admission. CT brain scan was considered as gold standard. These two stroke scores were compared with the results of CT brain and sensitivity, specificity; positive predictive and negative values were calculated. Results: Applying the recommended optimum cut-off points for the 2 scores, diagnoses were classified by the Guy's Hospital Stroke and Siriraj Hospital Stroke score as probable hemorrhagic strokes (49% and 25% respectively) and probable ischemic (40% and 65% respectively). The remainder were classified as "uncertain." The prevalence of hemorrhage diagnosed by gold standard (CT) was 29.5% while the prevalence of ischemic stroke diagnosed by CT was 54.7%. The CT brain was normal in 15.8%. Sensitivity, specificity, positive predictive value and negative predictive value for cerebral hemorrhage was 0.64, 0.48, 0.4 and 0.71 for Guy's Hospital Stroke score and 0.35, 0.73, 0.4 and 0.68 for Siriraj Hospital Stroke score. Conclusion: It is evident from the study that these clinical scoring systems alone are not sufficient and one has to employ the use of computerized tomography scan in establishing stroke type in Nigerians with stroke.Fond: La course, une cause importante de la morbidit\ue9 et la mortalit\ue9 est en augmentation du Nig\ue9ria, la tomographie automatis\ue9e par routine (CT) pour tous les nig\ue9riens avec la course n'est pas \ue0 la disposition de la plupart des m\ue9decins, et ceci pose des probl\ue8mes de gestion. Nous avons compar\ue9 deux points cliniques disponibles au cerveau CT pour le diagnostic diff\ue9rentiel de l'isch\ue9mie et de l'h\ue9morragie c\ue9r\ue9brales parmi des nig\ue9riens d'adulte avec la premi\ue8re course aigu\ueb. M\ue9thodes: L'\ue9tude a \ue9t\ue9 entreprise \ue0 l'h\uf4pital Maiduguri de sp\ue9cialiste en \ue9tat. Quatre-vingt-quinze nig\ue9riens d'adulte se pr\ue9sentant avec le premier d\ue9but aigu de course dans un d\ue9lai de 48 heures ont \ue9t\ue9 \ue9valu\ue9s avec les points de la course d'h\uf4pital de Siriraj (SHS) sur la pr\ue9sentation et les points de la course de l'h\uf4pital du type (GHS) 24 heures apr\ue8s admission. Le balayage de cerveau de CT a \ue9t\ue9 consid\ue9r\ue9 comme \ue9talon or or. Ces points de deux courses ont \ue9t\ue9 compar\ue9s aux r\ue9sultats du cerveau de CT et de la sensibilit\ue9, sp\ue9cificit\ue9 ; des valeurs pr\ue9dictives et n\ue9gatives positives ont \ue9t\ue9 calcul\ue9es. R\ue9sultats: Appliquant les points optima recommand\ue9s de coupure pour les 2 points, des diagnostics ont \ue9t\ue9 classifi\ue9s par les points de course de l'h\uf4pital du type et de course d'h\uf4pital de Siriraj en tant que les courses h\ue9morragiques probables (49% et 25% respectivement) et isch\ue9mique probable (40% et 65% respectivement). Le reste ont \ue9t\ue9 classifi\ue9s comme \uab incertain. \ubb La pr\ue9dominance de l'h\ue9morragie diagnostiqu\ue9e par l'\ue9talon or or (CT) \ue9tait 29.5% tandis que la pr\ue9dominance de la course isch\ue9mique diagnostiqu\ue9e par CT \ue9tait 54.7%. Le cerveau de CT \ue9tait normal dans 15.8%. La sensibilit\ue9, la sp\ue9cificit\ue9, la valeur pr\ue9dictive positive et la valeur pr\ue9dictive n\ue9gative pour l'h\ue9morragie c\ue9r\ue9brale \ue9taient 0.64, 0.48, 0.4 et 0.71 pour les points de course de l'h\uf4pital du type et 0.35, 0.73, 0.4 et 0.68 pour des points de course d'h\uf4pital de Siriraj. Conclusion: Il est \ue9vident de l'\ue9tude que ces seuls syst\ue8mes de notation cliniques ne sont pas suffisants et on doit utiliser l'utilisation du balayage automatis\ue9 de tomographie en \ue9tablissant la course saisissent des nig\ue9riens avec la course

Effect of Nitrogen Source and Age at Harvest on the \u3cem\u3ein vitro\u3c/em\u3e Digestibility of Oba Super II Maize Fodder

This experiment was carried out in the Pasture Section of the Directorate of University farms and the laboratory of Department of Pasture and Range Management, Federal University of Agriculture, Abeokuta, Nigeria, to evaluate the effect of nitrogen source (Swine manure, N.P.K. 15:15:15 as well as the control) and age at harvest on the in vitro gas production and digestibility of Oba Super II maize fodder. The experiment was in a split plot design. The nitrogen source was applied at the rate of 120 kgN/ha two weeks after planting. Maize was harvested at 8, 10 and 12 weeks after planting, oven dried and milled. Samples were taken to laboratory for in vitro analysis. Data collected was subjected to analysis of variance (ANOVA) using General Linear Model (GLM). The result of this study showed that nitrogen source and age at harvest significantly influenced (p \u3c 0.05) the volume of gas produced throughout the period of incubation. Oba super II maize fertilized with swine manure harvested 12WAP had the highest dry matter digestibility value to be 84.80 %. It was concluded that Oba Super II maize fertilized with swine manure and harvested 12 weeks after planting had the highest gas volume and can be recommended as a potential source of nutrient for ruminant animals