Sonografski prikaz dimenzija bubrega u bolesnika s esencijalnom hipertenzijom u sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi u Nigeriji

Introduction: Hypertension is one of the commonest non-communicable diseases worldwide; it is the second most common cause of end-stage renal disease. Objective: To evaluate the renal dimensions and volume of essential hypertension patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi and to compare the dimensions with that of apparently healthy volunteers. Materials and Methods: A total of two hundred and eleven individuals (comprising 121 females and 90 males) with essential hypertension attending an outpatient clinic in Abubakar Tafawa Balewa University Teaching Hospital Bauchi, and an equal number of healthy volunteers (comprising of 172 females and 49 males) were studied as controls. Both the healthy volunteers and the Hypertensive patients’ renal length, renal width, antero-posterior diameter, and parenchymal thickness were assessed. Statistical Package for Social Sciences (SPSS version 20.0) was used for data analysis. Results: Study show the mean renal length for hypertensive patients to be 9.1 ± 0.79 cm and 9.1 ± 0.73 cm, the mean renal width of 3.5 ± 0.48 cm and 3.8 ± 0.68 cm, and mean renal volume of 87.22 ± 19.58 cm3 and 95.08 ± 22.93 cm3 for the right and left kidneys respectively. Results equally show statistically significant difference in anteroposterior diameter (p<0.05), parenchymal thickness (p<0.05) and renal volume (p<0.05) between the hypertensive group and the volunteer group for both right and left kidneys. Conclusion: This study has established baseline renal dimensions for hypertensive in our population (Bauchi Metropolis). The hypertensive subjects showed a decrease in renal anteroposterior diameter, parenchymal thickness and volume compared to control group.Uvod: Hipertenzija je jedna od najčešćih nezaraznih bolesti u svijetu; drugi je najčešći uzrok završnog stadija bubrežne bolesti. Cilj: Procijeniti dimenzije bubrega i bubrežni volumen kod hipertenzivnih bolesnika u Sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi i usporediti ih s dimenzijama kod naizgled zdravih ispitanika koji su se dobrovoljno javili za sudjelovanje u istraživanju. Materijali i metode: Uzorak se sastojao od dvjesto jedanaest ispitanika (121 žena i 90 muškaraca) koji boluju od esencijalne hipertenzije i na ambulantnom su liječenju u Sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi i jednakog broja zdravih ispitanika (172 žene i 49 muškaraca), koji su bili kontrolna skupina. Proučavana je duljina i širina bubrega, anteroposteriorni promjer i debljina parenhima kod ispitanika s hipertenzijom i kod zdravih ispitanika. Za analizu podataka primijenjen je statistički paket za društvene znanosti (SPSS verzija 20.0). Rezultati: Studija pokazuje da je prosječna dužina bubrega kod hipertenzivnih bolesnika 9,1 ± 0,79 cm i 9,1 ± 0,73 cm, prosječna bubrežna širina 3,5 ± 0,48 cm i 3,8 ± 0,68 cm, a prosječni bubrežni volumen 87,22 ± 19,58 cm3 i 95,08 ± 22,93 cm3 za desni i lijevi bubreg pojedinačno. Rezultati također pokazuju statistički značajnu razliku u anteroposteriornom promjeru (p < 0,05), debljini parenhima (p < 0,05) i bubrežnom volumenu (p < 0,05) između hipertenzivne skupine i kontrolne skupine za desni i lijevi bubreg. Zaključak: Ovom su studijom utvrđene osnovne bubrežne dimenzije kod hipertenzivnih bolesnika u populaciji grada Bauchi, glavnog grada Savezne države Bauchi u Nigeriji. Kod ispitanika koji boluju od hipertenzije ustanovljeno je smanjenje anteroposteriornog promjera bubrega, debljine parenhima i bubrežnog volumena u usporedbi s kontrolnom skupinom

Water use and grain yield response of rainfed soybean to tillage-mulch practices in southeastern Nigeria

Despite the agronomic, economic and food values of soybean (Glycine max L. Merrill), there is still dearth of information on the tillage need and the implications of surface mulch for the crop in the eastern part of the forest-savanna transition zone of Nigeria. This study was therefore carried out on a sandy loam Ultisol at Nsukka with a sub-humid climate, during 2006 and 2007 cropping seasons. Our objective was to devise an appropriate tillage method for the crop from evaluated effects of no-till (NT), conventional tillage (CT) and mulch on selected key agronomic indices. Each of the NT and the CT was either unmulched (U) or mulched (M) in a split-plot, giving four treatments/tillage methods (NTU, NTM, CTU and CTM) randomized in four blocks. Rainfall was more favorable in the first than in the second season. The mean seasonal soil water storage (range, 99-109 mm) within 0.5-m soil layer differed among the treatments (NTU < CTU < NTM = CTM). However, for the first and second seasons, both water use (582-616 and 667-709 mm respectively) and grain yield (0.71-0.81 and 1.22-1.91 Mg ha-1 respectively) were not different. Mulch lowered the crop water use but had no influence on grain yield. Water use efficiency was enhanced with mulch only in the second season. Although either of the two mulch treatments (NTM/CTM) would be suitable for growing soybean especially in years of unfavorably distributed rainfall, NTM is a more rational choice than CTM. Rainfall adequacy at the critical reproductive stage of the crop showed to be a more important yield factor than the tested tillage methods

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding: Bill & Melinda Gates Foundation

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

EFFECT OF DIFFERENT CRYOPROTECTIVE AGENTS ON SKIM MILK AND DIMITROPOULUS EXTENDER FOR STALLION SEMEN CRYOPRESERVATION

s to assess different CPAs on stallion semen cryopreservation. Skim milk (SM) and Dimitropoulos(DV) were the extenders used in this study; each was added by glycerol (Gly), combination of ethyleneglycol-glycerol (EG+Gly) or dimethilformamide (DMF). Each semen sample was evaluated and dividedequally into six tubes; semen in the three tubes was diluted 1:1 with (SM), while in the remaining tubesthe semen was diluted 1:1 by DV. After being diluted, all tubes were centrifuged at 1006xg for 10minutes. The supernatan discarded, the pellet was rediluted by SM trehalosa or DV trehalose, and addedby G, EG+Gly, or DMF to reach the final sperm concentration of 200x106/ml. The extended semen wasindividually packed in 0.3 ml minitube, equilibrated at 4oC for 2 hours, frozen in liquid nitrogen vaporfor 10 minutes, and then was stored in liquid nitrogen container at -196 oC. After 24 hours, the semenwas thawed at 37 oC for 30 second. There were no significantly different (p&gt;0.05) on the percentages ofmotile and viable sperm in SMT (21.7% and 43.4%, respectively) compared with those extended withDV T extender (26.9% and 50.8%, respectively). DMF demonstrated better results as CPA compared tothe others; and DVTDMF combination had the best protection during cryopreservation in this study