Comparative evaluation of maize, sorghum, millet and biscuit waste meal as dietary energy sources for laying Japanese quails in a derived savannah zone of Nigeria

An eight-week feeding trial was conducted to compare the potential of maize, sorghum, millet and biscuit waste meal (BWM) as energy sources in diets of laying Japanese quails. One hundred and forty four layingquails (15 weeks old) were divided into 4 dietary treatment groups and each group replicated thrice with 12 quails each. Quails on dietary treatment group I were fed maize based diet while groups 2, 3 and 4 were fed sorghum, millet and BWM based diets respectively. Results showed significant differences in daily feed intake, hen-day production and feed conversion ratio. Quails fed millet and BWM based diets had the highest feed consumption while those on millet had the highest kg feed per dozen egg laid. Quails on BWM and sorghum based diets recorded the highest (p<0.05) hen day production. Daily weight gain, egg weight and feed cost per dozen egg revealed no significant (p>0.05) variations among dietary treatments. Data on egg quality traits indicated non-significance (p>0.05) among most parameters measured except for yolk color and shell  thickness where quails fed millet and biscuit meal recorded highest egg yolk color. Quails fed biscuit and maize diets had thicker shells thanthose fed with sorghum or millet based diets. The findings indicated that BWM, millet and sorghum proved to be tolerable in the diets of laying Japanese quail in a derived savannah zone of Nigeria

Do Knowledge and Cultural Perceptions of Modern Female Contraceptives Predict Male Involvement In Ayete, Nigeria?

Male involvement is crucial to female contraceptive use. This study examined how male knowledge and cultural perceptions of modern female contraceptives influence involvement in contraceptive use. A cross-sectional survey of 389 men from Ayete, Nigeria was used to regress a continuous male involvement score on demographic variables, knowledge of at least one method of modern female contraception and a scored male perception variable using Ordinary Least Squares regression. Controlling for perception, the knowledge of at least one method of modern female contraception was not significantly associated with a change in male involvement (p=0.264). Increasing positive perception was associated with higher male involvement scores (p=0.001). Higher educated males, those with a current desire to have children and males whose partners were currently using a method had greater male involvement scores (p<0.05). Policy and intervention efforts should be focused on changing cultural perceptions, in addition to providing in-depth knowledge of contraceptive methods. Keywords: Partner involvement, Family Planning, Nigeria, Contraception, CultureCette étude a examiné comment la connaissance par les hommes des méthodes contraceptives féminines modernes et leurs perceptions culturelles influencent la participation à la contraception féminine. Une enquête transversale de 389 hommes de Ayete, l'État d'Oyo, au Nigeria a été utilisé pour régresser un score continu de participation des hommes, sur les variables démographiques, la connaissance d'au moins une méthode de contraception féminine moderne et une variable de la perception masculine classée par les modèles de la régression ordinaire des moindres carrés. Le contrôle pour la perception, la connaissance d'au moins une méthode de la contraception féminine moderne n’était pas significativement associé à un changement dans la participation des hommes (p = 0,264). L’accroissement de la perception positive a été associé à des scores plus élevés de la participation des hommes (p = 0,001). Les hommes hautement instruits, ceux qui ont un désir actuel d'avoir des enfants et les hommes dont les partenaires actuellement se servaient d’une méthode avaient plus des scores masculins de participation (p <0,05). La politique et les efforts d'intervention devraient être axés sur l'évolution des perceptions culturelles, en plus de fournir une connaissance approfondie des méthodes contraceptives. Mots-clés: participation des hommes, contraception féminine, perception culturelle, planification familiale, Nigeri

The efficacy of tramadol in the prevention of post spinal anaesthesia shivering in caesarean deliveries

Shivering associated with subarachnoid block in obstetric patients is a cause of discomfort in this group of patients. Tramadol, a synthetic weak opioid that acts centrally at the mu receptors has been found to be effective in the treatment of shivering after general anaesthesia, but will it be effective in prevention of post spinal shivering also? Objective: The study is aimed at investigating the efficacy of intravenous 1mg/kg tramadol in the prevention of post spinal shivering for Caesarean delivery. Methodology: In a double blinded clinical trial, one hundred (100) healthy obstetric patients who were scheduled for elective or emergency Caesarean section under spinal anaesthesia were randomised into two groups. Immediately after the delivery of the foetus, fifty (50) patients received 1mg/kg tramadol diluted to 2ml with sterile water and fifty (50) patients received 2ml of sterile water. The incidence and intensity of shivering, level of sedation and other complications were recorded. The Statistical Package for Social Sciences (SPSS) version 16 was used for analysis of statistical data. The data was presented as frequencies, proportions and means. The demographic numeric data was compared using students't' test. The incidence of shivering and side effects was tested by Chi square test. P < 0.05 was considered as statistically significant. Results: The incidence of shivering was significantly lower in patients who received tramadol than those who received placebo, 18% versus 72% (P < 0.001). In the placebo group 17 (34%) and 19 (38%) patients had grade one and grade two shivering respectively as compared to 7 patients (14%) with grade one shivering and 2 patients (4%) with grade two shivering in the study group. The severity of shivering was significantly higher in the placebo group (P < 0.001). There were no significant differences in the sedation scores and other complications, but nausea and vomiting was significantly higher in the study group (P = 0.004 and 0.005respectively). Conclusion: Intravenous tramadol 1mg/kg is effective in the prevention of shivering following spinal anaesthesia for Caesarean section; however it is associated with nausea and vomiting

Effect of Spinal Anaesthesia on Hearing Threshold

Background: Hearing loss following spinal anaesthesia is a known yet uncommonly reported complication. This study was aimed at determining the incidence and type of hearing loss (HL) following spinal anaesthesia (SA) and the relationship with the size of spinal needle.Methods: A prospective study of patients scheduled for spinal anaesthesia for surgery at the Operating room and Otorhinolaryngology department in a tertiary centre was undertaken. The audiometry was done and the pre- and post – anaesthesia results were compared.Results: Ninety – four ears of 47 patients, 16 males and 31 females, age range between 21 and 63 years (mean + SD= 41± 5) were included. The duration of anaesthesia was between 90 and 150 minutes (mean ± SD= 116+9). HL was seen in 9 ears of 7 patients (15%) and tinnitus in 14 ears. The preoperative and postoperative BC PTA were 10 – 45dB (mean ± SD= 26± 5) and 25 – 65dB (mean ± SD=38±5) respectively, (P= 0.02) while the preoperative and postoperative AC PTA in the early frequency range (0-100Hz) were between 5 – 45dB (mean ± SD= 20± 5) and 25 – 50dB (mean ± SD=25±7) respectively, (P= 0.08). There was significant difference in the mean BC PTA between those who had procedure less than 1 hour, 37.2dB and those greater than 1 hour 38.4dB, (P=0.004). According to the Quincke needle sizes, the mean BC PTA among those who had 26G and 27G were 37.4dB and 38.1dB respectively (P=0.2).Conclusion: HL complicating SA is significant and associated with duration of procedure thus should be included in informed consent for medico-legal and ethical reasons and measures must be taken to avoid the leak of cerebrospinal fluid

Intensive Care Management of Organophosphate Poisoned Patient: A Test of Critical Care Services in Nigeria

The management of organophosphate poisoning is challenging, more so in the setting of poor critical care facilities. The management requires the administration of atropine, an antidote (oxime) and supportive care often provided in the ICU. We report a 35year old male who presented with a history of ingestion of an organophosphate insecticide and features of cholinergic and central nervous system affectation. The patient was managed with intravenous atropine, pralidoxime, ventilator support and other supportive care. This paper highlights those challenges associated with the management of organophosphate poisoning in our environment.Keywords: Poisoning; organophosphate; ICU; Developing countries

Normal kidney size and its influencing factors - a 64-slice MDCT study of 1.040 asymptomatic patients

<p>Abstract</p> <p>Background</p> <p>Normal ultrasound values for pole-to-pole kidney length (LPP) are well established for children, but very little is known about normal kidney size and its influencing factors in adults. The objectives of this study were thus to establish normal CT values for kidney dimensions from a group of unselected patients, identify potential influencing factors, and to estimate their significance.</p> <p>Methods</p> <p>In multiphase thin-slice MDCTs of 2.068 kidneys in 1.040 adults, the kidney length pole to pole (LPP), parenchymal (PW) and cortical width (CW), position and rotation status of the kidneys, number of renal arteries, pyelon width and possible influencing factors that can be visualized, were recorded from a volume data set. For length measurements, axes were adjusted individually in double oblique planes using a 3D-software. Analyses of distribution, T-tests, ANOVA, correlation and multivariate regression analyses were performed.</p> <p>Results</p> <p>LPP was 108.5 ± 12.2 mm for the right, and 111.3 ± 12.6 mm for the left kidney (p < 0.0001 each). PW on the right side was 15.4 ± 2.8 mm, slightly less than 15.9 ± 2.7 mm on the left side (p < 0.0001), the CW was the same (6.6 ± 1.9 mm). The most significant independent predictors for LPP, CW, and PW were body size, BMI, age, and gender (p < 0.001 each). In men, the LPP increases up to the fifth decade of life (p < 0.01). It is also influenced by the position of the kidneys, stenoses and number of renal arteries (SRA/NRA), infarctions suffered, parapelvic cysts, and absence of the contralateral kidney; CW is influenced by age, position, parapelvic cysts, NRA and SRA, and the PW is influenced in addition by rotation status (p < 0.05 each). Depending on the most important factors, gender-specific normal values were indicated for these dimensions, the length and width in cross section, width of the renal pelvis, and parenchyma-renal pyelon ratio.</p> <p>Conclusions</p> <p>Due to the complex influences on kidney size, assessment should be made individually. The most important influencing factors are BMI, height, gender, age, position of the kidneys, stenoses and number of renal arteries.</p

HIV treatment is associated with a twofold higher probability of raised triglycerides: pooled analyses in 21 023 individuals in sub-Saharan Africa

Background Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations. Methods Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models. Findings Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies. Interpretation Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SS

Pressure Ulcers in Critically Ill Patients

No Abstract

Evaluation of a modified APACHE II Scoring System in the Intensive Care Unit of a Tertiary Hospital in Nigeria

Background: The use of the Acute Physiological And Chronic Health Evaluation (APACHE) II scoring system for critically ill intensive care unit (ICU) patients has not been evaluated in the ICU of the University College Hospital (UCH) Ibadan, due to lack of arterial blood gases. This study evaluated the predictive value of a modified APACHE II (MAPA II) in our patient population.Patients and Methods: This prospective study was conducted over a 12 month period in the ICU of UCH, Ibadan. MAPA II format was designed from the APA II. The APA II score consists of 12 sets of acute physiological variables (A), age points (B) and chronic health points (C). Total APACHE II score of 71 was generated by adding A, B and C. (Appendix I). MAPA II score was generated by adding A, B and C but substituting PaO2 with SaO2 under A (Appendix 2). MAPA II scores were assigned to all the patients to calculate their observed and predicted risk of mortality which was compared with APA II.Results: Total number of ICU admission was 282, of which 60 patients were studied. There were 39 (65%) survivors and 21 (35%) non-survivors, with MAPA II scores of 9.6 &plusmn; 7.1 (range 0-31) and 22.4 &plusmn; 11 (range 6-36) respectively. The demographic and other results are as shown on Tables I-IV. Interpretation &amp; Conclusion: The MAPA II is a simple and objective tool for mortality prediction in ICU patients.Key words: Modified APACHE II, mortality prediction, ICU evaluatio

ICU Utilization by Cardio-Thoracic Patients in a Nigerian Teaching Hospital: Any Role for HDU?

Background: The underlying pathological conditions in cardiothoracicpatients, anesthetic and operative interventions often lead to complex physiological interactions that necessitate ICU care. Our objectives were to determine the intensive care unit (ICU) utilization by cardio-thoracic patients in our centre, highlight the common indications for admission; and evaluate the interventions provided in the ICU and the factors thatdetermined outcome.Materials and Methods: The intensive care unit (ICU) records of University College Hospital, Ibadan for a period of 2 years (October 2007 to September 2009) were reviewed. Data of cardio-thoracic patients were extracted and used for analysis. Information obtained included the patientdemographics, indications for admission, interventions offered in the ICU and the outcome.Results: A total of 1, 207 patients were managed in the ICU and 206 cardio-thoracic procedures were carried out during the study period. However, only 96 patients were admitted into the ICU following cardiothoracic procedures, accounting for 7.9% of ICU admissionsand 46.6% of cardio-thoracic procedures done within the reviewperiod. The mean length of stay and ventilation were 5.71 ± 5.26and 1.30 ± 2.62 days. The most significant predictor of outcomewas endotracheal intubation (P = 0.001) and overall mortalitywas 15%.Conclusion: There is a high utilization of the ICU by cardio-thoracic patients in our review and post-operative care was the main indication for admission. Some selected cases may be managed in the HDU to reduce the burden on ICU resources. We opine that when endotracheal intubation is to continue in the ICU, a 1:1 patient ratio should be instituted.Keywords: Cardio-thoracic surgery, hospital, intensive care unit, Nigeria, teaching, utilizatio