Slower Rise and Smaller Peak Level of Blood Glucose in Healthy Young Male Adults Pre-Fed Moringa Oleifera Seed Powder

Ingestion of food with high glycaemic index is known to stress the insulin release mechanism that can produce Insulin resistance and eventually Diabetes Mellitus. How fast the end product of digestion of carbohydrate glucose surges into the bloodstream and the peak level attained are equally important for the glucose control mechanism of the body and ultimately the health of the individual involved. This study aims at exploring the effect of Moringa oleifera seed on the post-prandial rate of absorption of glucose and the peak glucose level attainable. Five healthy young male adult (18-35) volunteers had their Oral Glucose Tolerance Test (OGTT) conducted the first day as a control group followed the next day by a second OGTT with a pre-treatment with Moringa oleifera seed powder in a fix dose of 0.0175 gram per Kilogram body weight as the test/case group. The results indicate that it takes 60 minutes for the blood glucose to reach the peak concentration of 118.6 mg/dl in treatment group as against 30 minutes in the control group reaching 135mg/dl optimal concentration. The difference in this concentration and rate of surge are significant (p<0.05) A slower rise and a smaller optimal concentration of glucose are demonstrated as response to Moringa oleifera powder ingestion, a potentially clear beneficial effect. Keywords: Moringa Oleifera, Seed, Slower, Smaller, Glucose, Insulin-resistanc

Foreign bodies in the ear, nose and throat at the federal teaching hospital, Gombe-north-eastern, Nigeria

Foreign bodies (FBs) are common ENT emergencies all over the world. Children have been found to be commonly affected due to their curiosity and desire to explore their environment. Objective: To evaluate the clinical presentations, management and the outcomes of ear, nose and throat foreign bodies in a tertiary hospital setting. Method: This a three-year retrospective study of patients presented with foreign bodies to the ENT department. The demographic information, sites and sides of foreign bodies, nature of foreign bodies, management and outcomes were extracted from their records and analysed. Results: There were 34 (45.9%) males and 40 (54.1%) females with Male to Female ratio of 1: 1.8. Inanimate objects 60 (81%) were the common FBs aspirated, while 4 (5.4%) were animate FBs aspirated. In 28.4% of the patients presented to the hospital in the first three days of aspiration. The symptoms include sensation/ discomfort, accidental finding, Otalgia, ear discharge, bleeding among others. Lodgment is more common in the left nostril 9 (56.2%), throat 11 (55.0%) and right ear 19 (50.0%) among those with nasal, throat and ear foreign bodies respectively. The complications included infection, bleeding among others. Conclusion: FBs aspiration was found to be commoner among children than in adults due to the fact that children explore their environment

Detection of African swine fever virus (ASFV) antibodies in pigs in Taraba state north east Nigeria

A serological study was conducted between 2011 and 2013 to detect the presence of antibodies to African swine fever virus (ASFV) in Pigs in Taraba State, north eastern Nigeria. Sixty (60) pig farms were studied. Questionnaires (N=885) consisting of sections related to the farmer and the animal were distributed and blood samples taken to analyze for the African swine fever virus antibodies. All the 60 questionnaires were answered by the farmers, while 885 were retrieved for the individual pig studied. Of the 60 famers, only 13 (21.7%) were aware of the disease while 47 (78.3%) were ignorant (P<0.05). Out of the 885 pigs examined, none (0%) was infected nor showed any clinical signs of the infection. However, 117 (13.2%) out of the 885 sera samples analyzed for the three year period were positive for ASFV antibodies. The results obtained in 2013 (22.5%) was significantly higher (P<0.05) those in 2011 (12.9%) and 2012 (4.0%). Although male pigs recorded higher sero-prevalence (13.7%) than the females (12.9%), this was no statistically significant (P>0.05). The highest sero-prevalence (16.3%) was  recorded in the Northern zone in 2011, followed by 10.0% and 5.0% in Southern and Central zones  respectively. In the year 2012, no ASFV antibody was detected from the 100 and 99 pigs examined from Central and Northern zones respectively. However, the Central zone recorded a sero-prevalence of  12.0%. In 2013, the sero-prevalence in Southern (29.0%) and Central zones (24.0%) is significantly higher (P<0.05) than in the Northern zone. The sero-prevalence obtained may pose a great risk in the study area, it is therefore recommended that adequate veterinary services, proper sanitary measures and monitoring of pig movement be instituted to avert an outbreaks.Keywords: African swine fever virus, Antibodies, ELISA, Pigs, Taraba State, North eastern Nigeri

The role of anaesthetist in the management of patients due to insurgency in the North-eastern Nigeria.

The roles played by the team of Anaesthetists in the management of patients due to insurgency are enormous and very vital in the survival of the patients and indeed in the reduction of the possible morbidities and mortalities due to injuries from the insurgency. Objective: This study is aimed at giving an overview of the role of Anaesthetist in important areas of patient's management due to insurgency and to suggest ways of improvement. Method: This is a prospective study of 1,339 patients managed for various injuries sustained due to insurgency in the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria, for the period of five years (January, 2010 and December, 2014). Results: One thousand three and thirty nine (1,339) patients who were injured directly due to the insurgency were included in the study during the period under review. Their ages ranged from 1 month to 80 years with the mean age of 38.6±18.3 years. Most of the injuries occurred among the age group 18 - 35 years. Patients were resuscitated, had anaesthesia for surgeries and also had intensive care management. Conclusion: The roles played by the Anaesthetist are so vital in the survival of the patients due to insurgency. However, there is a need for an increase in the number of Anaesthesia manpower and for the training and re-training of these Anaesthetists in the management of mass casualties

Preparing for and executing a randomised controlled trial of podoconiosis treatment in Northern Ethiopia: the utility of rapid ethical assessment

Background Community-based randomized controlled trials are often complex pieces of research with significant challenges around the approach to the community, information provision, and decision-making, all of which are fundamental to the informed consent process. We conducted a rapid ethical assessment to guide the preparation for and conduct of a randomized controlled trial of podoconiosis treatment in northern Ethiopia. Methods A qualitative study was carried out in Aneded woreda, East Gojjam Zone, Amhara Regional State from August to September, 2013. A total of 14 In-depth Interviews (IDIs) with researchers, experts, and leaders, and 8 Focus Group Discussions (FGDs) involving 80 participants (people of both gender, with and without podoconiosis), were conducted. Interviews were carried out in Amharic. Data analysis was started alongside collection. Final data analysis used a thematic approach based on themes identified a priori and those that emerged during the analysis. Results Respondents made a range of specific suggestions, including that sensitisation meetings were called by woreda or kebele leaders or the police; that Health Extension Workers were asked to accompany the research team to patients’ houses; that detailed trial information was explained by someone with deep local knowledge; that analogies from agriculture and local social organisations be used to explain randomisation; that participants in the ‘delayed’ intervention arm be given small incentives to continue in the trial; and that key community members be asked to quell rumours arising in the course of the trial. Conclusion Many of these recommendations were incorporated into the preparatory phases of the trial, or were used during the course of the trial itself. This demonstrates the utility of rapid ethical assessment preceding a complex piece of research in a relatively research-naive setting

Multi-center survey of House officers’ choice of Medical specialties in Nigeria: preferences and determining factors

The objective of the study was to determine preferences and factors influencing the choice of medical specialties by House officers.  Questionnaires were distributed to House-officers in 4 tertiary hospitals namely: the National hospital, Abuja, the University of Port-Harcourt, the Jos University, and the University of Uyo Teaching Hospitals. The data were simultaneously collected and analyzed using SPSS 20.0 version. Of the 150 questionnaires distributed, 129(86%) were duly filled. The mean age was 22.4 years (range 21-40 years), 79(61.2 %) of the respondent were male. Fifty-nine(45.7%) chose training within the country while 32(24.8%)  preferred outside as 107(86%) chose training in Teaching Hospitals. Teachers, Resident doctors and parents influenced choices in 34(26.3%), 17(13.1%) and 16(12.4%) respectively. Thirty-four(26.3%), 28 (21.7%), 13(10.1%) and 15(11.6%) preferred obstetrics, surgery, internal medicine and paediatrics respectively. Seventy (46.7%) chose specialties for personal likeness and 17(11.3%) for role models in that specialty. House officers preferred to pursue medical specialty in teaching hospitals within the country and they are motivated by personal fulfilment, independence of practice and role models while more prefer to specialize in more Obstetrics/ Gyaenocology and surgery

Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Background Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.</p

Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.

BACKGROUND: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. METHODS: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. FINDINGS: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0). INTERPRETATION: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. FUNDING: Medical Research Council of South Africa.Medical Research Council of South Africa