Subcutaneous Injection of Adalimumab Trial compared with Control (SCIATiC):a randomised controlled trial of adalimumab injection compared with placebo for patients receiving physiotherapy treatment for sciatica

Background Biological treatments such as adalimumab (Humira®; AbbVie Ltd, Maidenhead, UK) are antibodies targeting tumour necrosis factor alpha, released from ruptured intervertebral discs, which might be useful in sciatica. Recent systematic reviews concluded that they might be effective, but that a definitive randomised controlled trial was needed. Usual care in the NHS typically includes a physiotherapy intervention. Objectives To test whether or not injections of adalimumab plus physiotherapy are more clinically effective and cost-effective than injections of saline plus physiotherapy for patients with sciatica. Design Pragmatic, parallel-group, randomised controlled trial with blinded participants and clinicians, and an outcome assessment and statistical analysis with concurrent economic evaluation and internal pilot. Setting Participants were referred from primary care and musculoskeletal services to outpatient physiotherapy clinics. Participants Adults with persistent symptoms of sciatica of 1–6 months’ duration and with moderate to high levels of disability. Eligibility was assessed by research physiotherapists according to clinical criteria for diagnosing sciatica. Interventions After a second eligibility check, trial participants were randomised to receive two doses of adalimumab (80 mg and then 40 mg 2 weeks later) or saline injections. Both groups were referred for a course of physiotherapy. Main outcome measures Outcomes were measured at the start, and after 6 weeks’ and 6 months’ follow-up. The main outcome measure was the Oswestry Disability Index (ODI). Other outcomes: leg pain version of the Roland–Morris Disability Questionnaire, Sciatica Bothersomeness Index, EuroQol-5 Dimensions, 5-level version, Hospital Anxiety and Depression Scale, resource use, risk of persistent disabling pain, pain trajectory based on a single question, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia and adverse effects. Sample size To detect an effect size of 0.4 with 90% power, a 5% significance level for a two-tailed t-test and 80% retention rate, 332 participants would have needed to be recruited. Analysis plan The primary effectiveness analysis would have been linear mixed models for repeated measures to measure the effects of time and group allocation. An internal pilot study would have involved the first 50 participants recruited across all centres. The primary economic analysis would have been a cost–utility analysis. Results The internal pilot study was discontinued as a result of low recruitment after eight participants were recruited from two out of six sites. One site withdrew from the study before recruitment started, one site did not complete contract negotiations and two sites signed contracts shortly before trial closure. In the two sites that did recruit participants, recruitment was slow. This was partly because of operational issues, but also because of a low rate of uptake from potential participants. Limitations Although large numbers of invitations were sent to potential participants, identified by retrospective searches of general practitioner (GP) records, there was a low rate of uptake. Two sites planned to recruit participants during GP consultations but opened too late to recruit any participants. Conclusion The main failure was attributable to problems with contracts. Because of this we were not able to complete the internal pilot or to test all of the different methods for primary care recruitment we had planned. A trial of biological therapy in patients with sciatica still needs to be done, but would require a clearer contracting process, qualitative research to ensure that patients would be willing to participate, and simpler recruitment methods

Evapotranspriation levels at Owerri, Imo State, Nigeria

No Abstract.International Journal of Natural and Applied Sciences Vol. 4 (3) 2008: pp. 168-17

Estimation of Solar Radiation in South Eastern Nigeria

Knowledge of global solar radiation is of fundamental importance for all solar energy conversion systems. In this work is presented the Sayigh equation for estimating the global solar radiation, analyzing data from 1972 to 2004 in the Southeastern Nigeria using Umudike (lat. 5.29oN, long. 7.33oE) as a case study. The levels of the global solar radiation within the region was noted to range from 1.99 kWh to 6.75 kWh, showing that the method was in agreement with those of earlier authors in this area of research, indicating that the method could be used for reproducing signatures of global solar radiation in the region when actual measurements are not available. The results highlight the potential of using photovoltaic systems as viable energy option within the region. Keywords: Estimate, Photovoltaic systems, Sayigh, Solar Radiation, Southeastern Nigeria International Journal of Natural and Applied Sciences, 5(3): 223-228, 200

Mean air surface temperature anomalies in the humid south – south zone of Nigeria

The concept of regional climate is very important in understanding global climate change. Changes in surface air temperature are primary measures of global climate change. In this work, the analyses of the mean air surface temperature dynamics from 1901 to 2000 in six cities located in the South- South humid zone of Nigeria, which comprised four ecological zones namely; coastal barrier island, mangrove swamp forest, fresh water swamps and lowland rainforest were presented. The analyses showed that at climatological scale of 33 years, that there were some slightly elevated temperatures, which remained nearly stable over the entire period of study, grouped into three climatological scales. The results showed that an anomaly of 4.5oC was recorded in 1932, 1935 and 1983 in the first, second and third climatological scales respectively. Also observed in 1936 and 1942 were the mean air surface temperature that recorded 4.5oC respectively as maximum on its warming trend, whereas on its cooling trend a minimum of -2.5oC in the first and second climatological scale and -1.5oC in the third climatological scale were observed. Keywords: Temperature, climate change, climatological scale, humid zone, Nigeria International Journal of Natural and Applied Sciences, 6(4): 428 - 431, 201

Development of an uninterrupted solar powered traffic light from locally accessed materials

Advances in transport technology have brought benefits, but growing vehicular traffic and increased fossil fuel use have created problems. In view of these, the need to address the shortage of important infrastructures such as traffic light systems in most cities of Nigeria is imperative. This paper aims at designing, constructing and testing an uninterrupted solar powered traffic light that could operate at a T-junction to reduce traffic jam and risks around the area. The design made use of an Atmel series of 89S51 Microcontroller Unit (MCU), a Vero board, resistors, transistors, diodes, capacitors, Light Emitting Diodes (LED) and battery charged with a solar powered photovoltaic module. The testing of the traffic light was carried out at the pre-implementation and post-implementation stages of the construction as well as subsequent tests carried out on the complete system for precision.Keywords: Traffic light systems, vehicular traffic, fossil fuel, solar photovoltaic International Journal of Natural and Applied Sciences, 6(4): 482 - 487, 201