Sexual networking, STDs and HIV/AIDS in four urban gaols in Nigeria

Truck drivers, female hawkers and prostitutes are generally regarded as high-risk groups because they have a high rate of partner change, run abnormally high risks of being infected with sexually transmitted diseases (STDs) including HIV/AIDS, and are capable of transmitting them to the general population who live around them (Orubuloye, Caldwell and Caldwell 1993; Orubuloye 1995). Recent experience has shown that the prison population runs a high risk of being engulfed by AIDS. By late 1992, HIV-positive prisoners had been detected in at least one of the prisons in Nigeria and there was beginning to be concern for the safety of the prison population. Therefore a study of the prison population was planned as part of a larger continuing research program of the Ondo State University, Ado-Ekiti, Nigeria, on Sexual Networking, STDs and HIV/AIDS Transmission, supported by a grant from the Swedish Agency for Research Cooperation with Developing Countries (SAREC). The aim of the prison study was to investigate the attitudes and activities that are likely to facilitate the spread of sexually transmitted diseases, HIV and AIDS; and to develop an intervention program for the prison population and any population that may be in a similar situation

Histological Study of Lumbosacral Spinal Cord of Mice Embryos who’s Mothers were Administered Retinoic Acid

The usefulness of retinoic acid (RA) in reproduction, embryonic and fetal development, growth and tissue maintenance has been established. Excess/low consumption of RA by pregnant rat also leads to congenital malformations affecting the musculoskeletal system and nervous system. The aim of this study was to investigate the histological changes of the lumbosacral spinal cord in mice embryos whose mothers were administered RA on day 8 post coitum (dpc). Twenty pregnant albino mice were divided into two groups of 10 each. The experimental group received a single dose (70mg/kg) of RA dissolved in vegetable oil by gastrointestinal route, delivered by gavage on gestational day 8, while the control group received only vegetable oil by the same route on gestational day 8. The animals were all sacrificed on gestational day 14 and their embryos harvested and studied. Gross malformations were observed around the lumbosacral region. Microscopic observations revealed reduction in left and right anterior horn thickness (diameter) of the lumbosacral spinal cord region of experimental group (0.01885mm ± 0.00045mm and 0.01872mm ± 0.00054mm) against control (0.02015mm ± 0.00065mm and 0.02002mm ± 0.00054mm) P<0.05. Quantification of left and right lumbosacral anterior horn cell density revealed reduction in cell density of experimental group (354.4 ±4.77493 and 351.6 ± 6.542) P<0.05 against control (366.0 ± 6.245 and 366.4 ± 7.056). This study showed that one dose of 70mg/kg RA administered through the gastrointestinal route by gavage to pregnant mice on 8dpc caused neural tube defect such as spina bifida occluta, reduction in embryonic neural cell proliferation, reduction of lumbosacral anterior grey horn density and thickness. Key Words: Administration, Embryonic, Gestational, Malformation, Spina bifida

Pitfalls in diagnosis of Hepatitis B Virus infection among adults Nigerians

Objective: Hepatitis B virus infection is common in Nigerians and its diagnosis is necessary for effective treatment and eradication. This study is aimed at highlighting the serological factors jeopardizing the diagnosis and treatment of the infection among Nigerians adults. Patients and Methods: Three studies were carried out. The first study involved 56 Nigerian adults and it compared the assay ofHBsAg byHaemagulationMethod (HMA)with Enzyme linked immunoassay (ELISA). The second study was a comparison of Glaxo Welcome HB rapid test(GWHB) with ELISA in sero-assay of HBsAg and HBeAg among 25 Nigerian subjects while the third study was on the assay of the sera of HBsAg positive patients forHBeAg and anti-HBe in forty twoNigerian patients byELISA. Results: The sero - prevalence rates of HBsAg were 41.8% and 61.8% by HM and ELISA respectively with false HBsAg sero-positives and sero-negatives by HM of 5.4% and 25.5% respectively. Similarly, there was sero-detection of HBsAg in 84% and 80% by ELISA and GWHB respectively in 25 Nigerian adults. In addition, 19% and 64% of the 42 patients with HBsAg sero-positivity were also positive for HBeAg and anti- HBe respectively,while 31%of the patientswere bothHBeAg and anti-HBe sero-negative. Conclusion: Sero-diagnosis of HBsAg and other serological markers of infectivity in patients with HBV should be carried out by ELISArather than HMAamong adult Nigerians. Furthermore, high infectivity of the virus abounds among Nigerians with HBV infection.  Keywords: Pitfalls, diagnosis, HBV, Adults Nigerians, ELISA.

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Background Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI. Methods This randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecified a sensitivity analysis that excluded patients with a GCS score of 3 and those with bilateral unreactive pupils at baseline. All analyses were done by intention to treat. This trial was registered with ISRCTN (ISRCTN15088122), ClinicalTrials.gov (NCT01402882), EudraCT (2011-003669-14), and the Pan African Clinical Trial Registry (PACTR20121000441277). Results Between July 20, 2012, and Jan 31, 2019, we randomly allocated 12 737 patients with TBI to receive tranexamic acid (6406 [50·3%] or placebo [6331 [49·7%], of whom 9202 (72·2%) patients were treated within 3 h of injury. Among patients treated within 3 h of injury, the risk of head injury-related death was 18·5% in the tranexamic acid group versus 19·8% in the placebo group (855 vs 892 events; risk ratio [RR] 0·94 [95% CI 0·86-1·02]). In the prespecified sensitivity analysis that excluded patients with a GCS score of 3 or bilateral unreactive pupils at baseline, the risk of head injury-related death was 12·5% in the tranexamic acid group versus 14·0% in the placebo group (485 vs 525 events; RR 0·89 [95% CI 0·80-1·00]). The risk of head injury-related death reduced with tranexamic acid in patients with mild-to-moderate head injury (RR 0·78 [95% CI 0·64-0·95]) but not in patients with severe head injury (0·99 [95% CI 0·91-1·07]; p value for heterogeneity 0·030). Early treatment was more effective than was later treatment in patients with mild and moderate head injury (p=0·005) but time to treatment had no obvious effect in patients with severe head injury (p=0·73). The risk of vascular occlusive events was similar in the tranexamic acid and placebo groups (RR 0·98 (0·74-1·28). The risk of seizures was also similar between groups (1·09 [95% CI 0·90-1·33]). Interpretation Our results show that tranexamic acid is safe in patients with TBI and that treatment within 3 h of injury reduces head injury-related death. Patients should be treated as soon as possible after injury. Funding National Institute for Health Research Health Technology Assessment, JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and Wellcome Trust (Joint Global Health Trials scheme)

Mortality rate in Sickle Cell Disease Patients in Crisis at a Haematology Day Care Unit (HDCU) in Nigeria

The Haematology Day Care Unit (HDCU) of the University College Hospital, Ibadan, Nigeria was established in 1975 with the main goal of providing immediate and specialized care to haematological emergencies, particularly sickle cell disease (SCD) patients. Since inception, a systematic analysis of its effectiveness has not been done, hence this study. A retrospective study of all registered patients attending the Haematology Day Care Unit of the University College Hospital, Ibadan, over a one-year period was conducted and analyzed. Demographic data, diagnosis, treatment received, outcome of such treatment as well as laboratory parameters were extracted from HDCU register and the data were then analysed using descriptive statistics. A total of 890 patients were seen during the period, January and December 2001, out of which 520 were sickle cell disease patients (HbSS accounted for 508 (92.7%) cases and HbSC, 40 (7.3%) cases). The mean age of the SCD patients was 25.8years, the median, 23years and the mode, 18years. The mean PCV was 21.2%, median, 21.0% and mode, 20%. Majority (246 or 47.3%) of the patients were between 20 and 30 years, the lowest frequency being in the >50years group (14 or 2.7%). One patient died during the period under review (31year old female with HbSC disease), giving a mortality rate of 2 per 1000 patients. . Keywords: Haematology Day Care Unit, mortality rate, haematological emergencies, HbSS disease, HbSC disease Nigerian Journal of Health and Biomedical Science Vol. 6 (1) 2007: pp. 63-6

Survival advantage in female patients with sickle cell anaemia

(East African Medical Journal: 2001 78(7): 373-375

Venous thromboembolism in Ibadan: A five year experience (1986-1990)

No Abstract. NQJHM Vol. 8 (2) 1998: pp. 80-8