Characteristics and outcomes of acute heart failure in sub Saharan Africa

The main objective of this thesis was to study the clinical characteristics and short-term (6 months) outcome of acute heart failure as well as determine the role of conventional biomarker BNP and the novel biomarker Gal3 in the prognostication of acute heart failure patients. To achieve this, we investigated in the first cohort; 1) the demographic and clinical characteristic of patients with AHF, 2) their echocardiographic parameters and how they predict outcome, 3) the predictors of readmission and mortality, 4) the prevalence and impact of renal dysfunction on AHF and 5) the electrocardiographic pattern in AHF. The outcome measures were worsening renal function (WRF), length of hospital stay, HF readmissions and cardiovascular death within 60 days and all cause, cardiovascular or HF death through 180 days. In the second cohort, we investigated the demographics, clinical characteristics as well as the relationship between plasma levels of BNP and galectin 3 and outcomes (cardiovascular (CV) death or HF hospitalization through week 24) as well as the relationship between the plasma levels of BNP and Gal3 and both left ventricular (LV) and right ventricular (RV) remodeling in patients with AHF

Novel admixture for improvement of foundations on tropical expansive soils

: Black cotton soils have excessive shrinkage and swelling properties with respect to changes in the moisture conditions. Thus, construction on these soils may result in foundation problems. conventionally some approaches have been used to mitigate the problem by stabilization with lime or cement and which are relatively expensive for sustainability, an alternative stabilization was experimented with terrazzo waste. The polishing process of the terrazzo tiles produces a significant amount of waste slurry that it’s disposal could pose some environmental pollution threat. Laboratory experiments were conducted to determine the suitability of terrazzo waste as admixture in the stabilization of black cotton soil. Natural moisture content, atterberg limits, maximum dry density and optimum moisture content parameters were determined using 2, 4, 6, 8 and 10% proportion of terrazzo waste admixture. The results of the parameter analysis found the natural moisture content was 23.43%, liquid limit varied from 32.8 to 56.5%, Plasticity index varied from 4.71 to 13.52%, MDD varied from 1.61 to 1.67 (g/cm3) and OMC from 8.5 to 22.6%, the CBR value was indicates unsuitability for use as a base and sub-base material. The terrazzo waste admixture produced can be used for stabilization with the potential to minimize the cost of waste disposal as well as provide substitute to the use of conventional stabilizers for use in  places such as parks or pathways

Prevalence and determinants of obesity - a cross-sectional study of an adult Northern Nigerian population

<p>Abstract</p> <p>Background</p> <p>Obesity is assuming an epidemic dimension globally. It is important to appreciate factors associated with the disease so that a holistic approach can be taken in tackling the rising burden. The objective of this study was to determine the prevalence of overweight and obesity and the factors independently associated with obesity in an urban Nigerian population.</p> <p>Methods</p> <p>A cross-sectional study of 300 healthy adult subjects was conducted in the urban city of Katsina, northern Nigeria. Relevant sociodemographic and clinical information were obtained. Screening for obesity was done using the Body Mass Index while relevant laboratory investigations were conducted. Univariate and multivariate logistic regression analyses were performed to determine the predictors of obesity.</p> <p>Results</p> <p>Overweight and obesity was found in 53.3% and 21.0% respectively with a significantly higher prevalence in females compared to males (overweight: 62.0% vs 41.9%, p < 0.001; obesity: 29.8% vs 9.3%, p < 0.001). In univariate analysis, the odds of obesity were higher in women and in the presence of hypertension, hypercholesterolaemia and hyperuricaemia. However, in multivariate analysis, factors independently associated with obesity were female sex (OR 6.119, 95% CI 2.705-13.842, p < 0.001), hypercholesterolaemia (OR 2.138, 95% CI 1.109-4.119, p = 0.023) and hyperuricaemia (OR 2.906, 95% CI 1.444-5.847, p = 0.003).</p> <p>Conclusion</p> <p>There is a high prevalence of obesity in northern Nigeria and women are significantly more affected. The high prevalence is independently associated with female sex, hypercholesterolaemia and hyperuricaemia. Public health education is urgently needed in order to reduce this burden and prevent other non-communicable cardiovascular disorders.</p

Suppressive effects of medicinal plants and their derivatives on inflammasome complex: A systematic review

Inflammasome activation is mediated by (NOD)-like receptors (NLR) proteins that respond to stimuli. Among NLRs, NACHT-LRR and PYD domains-containing protein 3 (NLRP3) senses the widest array of stimuli. NLRP3 inflammasome has an important role in the development of many inflammation disorders. Regarding the significance of inflammatory diseases, and the necessity of preventing and treating these diseases, the aim of this review article is to report medicinal plants and their nature-based derivatives that are effective on suppression of inflammasome complex. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role herbal medicine in inflammasome activation pathways from 2000 to February 2016. Sophora flavescens, Lyciumbarbarum, Impatiens textori Miq., Syneilesis palmata (Thunb.), Aloe vera, citral (3, 7-dimethyl-2, 6-octadienal), celastrol, sulforaphane, schisandrin, resveratrol, dehydrodiconiferyl alcohol (DHCA), luteoloside, Pulsatilla decoction, and Wuling San have been reported to suppression function of inflammasome. Medicinal plants and their derivatives can be useful for inflammation related disorders by suppress NLRP3 inflammasome activation. However, they should be investigated in clinical trials to help to prevent and treatment of inflammatory diseases

Ethnobotanical Survey of Medicinal Plants Used in the Treatment of Transmissible Diseases

Herbal medicine, as an ancient traditional medical method, predates the establishment of contemporary healthcare systems within human culture. Globally, several groups develop their own indigenous forms of medicine and corresponding methodologies for treating and enhancing overall well-being. The research presents a comprehensive ethnobotanical survey of medicinal plants used in the treatment of transmissible diseases in Katsina State. A random selection technique was employed in conjunction with an open-ended interview guide over the period spanning from October 2022 to June 2023. The demographic information of the respondents was ascertained using Excel 2016. Quantitatively, the documented plants were subjected to analysis based on their Relative Frequency of Citation (RFC). This study identified 26 medicinal plants used in the administration and treatment of various transmissible diseases in the northern Nigerian state of Katsina. Moringa oleifera (28%) is the most frequently reported plant, followed by Olea Europaea (24%) and Azadirachta indica (20%). Leaves were the most frequently used part of the plants (69%), common method of preparation is decoction (65%). As their popularity and recognition expanded throughout the world, plants with medical potential remain the sole hope for the future. According to the current study, people of Katsina citizens had a solid awareness of the medicinal plant. Even with the progress of contemporary medicine, the people in the area still depend on using traditional plants for medical purposes.

Modifiable cardiovascular risk factors among apparently healthy adult Nigerian population - a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Cardiovascular disease (CVD) remains a major cause of morbidity and a leading contributor to mortality worldwide. Over the next 2 decades, it is projected that there will be a rise in CVD mortality rates in the developing countries, linked to demographic changes and progressive urbanization. Nigeria has witnessed tremendous socio-economic changes and rural-urban migration which have led to the emergence of non-communicable diseases. We set out to determine the prevalence of modifiable CVD risk factors among apparently healthy adult Nigerians. This is a descriptive cross-sectional study carried out at Katsina, northwestern Nigeria from March to May 2006. Subjects for the study were recruited consecutively from local residents, hospital staff and relations of in-patients of the Federal Medical Centre, Katsina using convenience sampling. Socio-demographic information, anthropometric measurements and blood pressure were obtained from the subjects in a standardized manner. Venous samples were collected for necessary investigations and analyzed at the hospital central laboratory.</p> <p>Findings</p> <p>Three hundred subjects (129 males and 171 females) with a mean age of 37.6 ± 10.6 (range 18-75) years were studied. Prevalence of the modifiable cardiovascular risk factors screened for were as follows: generalized obesity 21.3% (males 10.9%, females 29.2%, p < 0.05), truncal obesity 43.7% (males 12.4%, females 67.3%, p < 0.05), hypertension 25.7% (males 27.9, females 24%, p > 0.05), type 2 diabetes mellitus 5.3% (males 5.4%, females 5.3%, p > 0.05), hypercholesterolaemia 28.3% (males 23.3%, females 32.2%, p < 0.05), elevated LDL-cholesterol 25.7% (males 28%, females 24%, p > 0.05), low HDL-cholesterol 59.3% (males 51.9%, females 65%, p < 0.05), hypertriglyceridaemia 15% (males 16.3%, females 14%, p > 0.05) and metabolic syndrome 22% (males 10.9%, females 30.4%, p < 0.05).</p> <p>Conclusions</p> <p>We found high prevalence of CVD risk factors among apparently healthy adult Nigerians. In order to reduce this high prevalence and prevent subsequent cardiovascular events, encouragement of a healthy lifestyle is suggested.</p

Efficacy of Personal Protective Equipment to Prevent Environmental Infection of COVID-19 among Healthcare Workers: A Systematic Review

Background: Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. Methods: A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. Results: 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. Conclusions: Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection

Differences in socio-demographic and risk factor profile, clinical presentation, and outcomes between patients with and without RHD heart failure in Sub-Saharan Africa: results from the THESUS-HF registry

Background: Rheumatic heart disease (RHD) was found in the THESUS-HF registry to be the third most common cause of acute heart failure (AHF) in Sub-Saharan Africa. Methods: One thousand six patients with AHF from 9 Sub-Saharan African countries were recruited in THESUS-HF, of which 143 (14.3%) had RHD-AHF. Clinical characteristics and outcomes in patients with RHD-AHF and non-RHD-AHF were compared. Kaplan-Meier plots for time to all-cause death and/or HF readmission according to the presence of RHD-AHF and non-RHD-AHF were performed and survival distributions compared using the log-rank test. Cox regression was used to determine the hazard ratio of death to day 180 and death or readmission to day 60 after adjusting for confounders. Results: Patients with RHD-AHF were younger, more often females, had higher rates of atrial fibrillation, had less hypertension, hyperlipidemia and diabetes, had lower BP, and higher pulse rate and better kidney function and echocardiographic higher ejection fraction larger left atria and more diastolic dysfunction. Patients with RHD-AHF had a numerically longer mean stay in the hospital (10.5 vs. 8.8 days) and significantly higher initial hospitalization mortality (9.1% vs. 3.4%). Conclusions: In conclusion, patients with HF related to RHD were younger, have higher rate of atrial fibrillation and have a worse short-term outcome compared to HF related to other etiologies in Sub-Saharan Afric

Physicochemical equivalence of generic antihypertensive medicines (EQUIMEDS): protocol for a quality of medicines assessment.

BACKGROUND: Prevention and optimal management of hypertension in the general population is paramount to the achievement of the World Heart Federation (WHF) goal of reducing premature cardiovascular disease (CVD) mortality by 25% by the year 2025 and widespread access to good quality antihypertensive medicines is a critical component for achieving the goal. Despite research and evidence relating to other medicines such as antimalarials and antibiotics, there is very little known about the quality of generic antihypertensive medicines in low-income and middle-income countries. The aim of this study was to determine the physicochemical equivalence (percentage of active pharmaceutical ingredient, API) of generic antihypertensive medicines available in the retail market of a developing country. METHODS: An observational design will be adopted, which includes literature search, landscape assessment, collection and analysis of medicine samples. To determine physicochemical equivalence, a multistage sampling process will be used, including (1) identification of the 2 most commonly prescribed classes of antihypertensive medicines prescribed in Nigeria; (2) identification of a random sample of 10 generics from within each of the 2 most commonly prescribed classes; (3) a geographical representative sampling process to identify a random sample of 24 retail outlets in Nigeria; (4) representative sample purchasing, processing to assess the quality of medicines, storage and transport; and (5) assessment of the physical and chemical equivalence of the collected samples compared to the API in the relevant class. In total, 20 samples from each of 24 pharmacies will be tested (total of 480 samples). DISCUSSION: Availability of and access to quality antihypertensive medicines globally is therefore a vital strategy needed to achieve the WHF 25×25 targets. However, there is currently a scarcity of knowledge about the quality of antihypertensive medicines available in developing countries. Such information is important for enforcing and for ensuring the quality of antihypertensive medicines

Digital forensics trends and future

Nowadays, rapid evolution of computers and mobile phones has caused these devices to be used in criminal activities. Providing appropriate and sufficient security measures is a difficult job due to complexity of devices which makes investigating crimes involving these devices even harder. Digital forensic is the procedure of investigating computer crimes in the cyber world. Many researches have been done in this area to help forensic investigation to resolve existing challenges. This paper attempts to look into trends of applications of digital forensics and security at hand in various aspects and provide some estimations about future research trends in this area