A Review of Causes of Mortality in an Acute Medicine of the Elderly and Acute Stroke Service

The information recorded in medical certificates of cause of death (MCCD) can influence population-based mortality and statistical reviews. Data retrieved from MCCD based studies can inform certain aspects of public health planning, health service delivery and evaluation, and could potentially impact health resource allocation. This study retrospectively reviews a total of 173 consecutive MCCD counterfoil records. This included 71 deaths from an acute stroke unit/ward (ASU), and 102 deaths from acute medicine of the elderly (acute MoE) wards of a tertiary referral hospital in a developed country. Disease/condition classification was based upon the International Statistical Classification of Diseases and Related Health Problems (Tenth Revision) (ICD-10, WHO). We describe the top five ICD-10 categories of diseases/conditions documented in Parts 1 and 2 of the MCCD during the study period. We also describe the top five underlying primary medical conditions recorded on the MCCD. A review of some other notable diseases/conditions recorded during the study period is also presented.Keywords: Cause of Death; Death Certificate; ICD-10; Medicine of the Elderly; Mortality; Strok

RELATIONSHIP OF DAM MILK OFFTAKE AND LAMB’S STRONGYLE EGG COUNT, HAEMATOLOGICAL, BIOCHEMICAL AND PHYSIOLOGICAL PARAMETERS IN WEST AFRICAN DWARF AND YANKASA SHEEP

Milk offtake of dam, strongyle egg count, haematological, biochemical and physiological parameters of lambs were examined in West African Dwarf and Yankasa sheep. Rectal temperature, pulse rate and respiratory rate were also determined.  The West African Dwarf (WAD) lambs had higher haemoglobin concentration (9.12g/dl), lymphocytes (54.93%), glucose content (48.80mg/l), serum glutamate oxaloacetate transaminase (65.97ul/L), pulse rate (65.90beats/minute) and rectal temperature (38.340C) while the Yankasa lambs had higher packed cell volume (28.93%), white blood cell (15540Cumm3), red blood cell (10.03x106mm), total protein (69.96g/l), serum glutamate pyruvate transaminase (18.12ul/L) and  respiratory rate (38.90breath/minute). The West African Dwarf Dams had higher value of milk offtake and their lambs had lower percentage of strongyle egg count. Milk offtake  was significantly correlated with lamb’s white blood cells (r=0.84) and lymphocytes (r=0.55) in WAD sheep while it was significantly correlated with red blood cells (r=0.65) and neutrophils (-0.61) in Yankasa sheep.  There was a significant but negative correlation between milk offtake of dams and strongyle egg count (r= -0.48) in Yankasa sheep. White blood cell was superior to other blood parameters in estimating milk offtake in WAD sheep. Therefore, the West African Dwarf dams and lambs could be selected for milk production and better future performance because of the lower strongyle burden. High milk producing Yankasa ewes tends to confer immunity against strongyle burden in their lambs.Â

COVID-19 vaccination: a possible trigger for Addisonian crisis in a patient with Addison’s disease

Infection with COVID-19 disease is caused by the SARS-CoV-2 virus. Following its identification, the pursuit of the rapid development of effective vaccines became a pandemic-period international public health priority. This report describes the case of an older woman with Addison’s disease who developed acute clinical symptoms and signs indicative of an Addisonian crisis following each of two consecutive doses of the Pfizer BioNTech Covid-19 vaccines. Both presentations (with nausea, vomiting, hypotension, tachycardia, and transient hypoglycaemia) occurred within 24 hours of receipt of the vaccines. In each instance, she responded well to treatment with intravenous fluids, and temporarily changing her maintenance oral steroid regimen to higher dose intravenous steroids. She successfully completed a period of rehabilitation and was discharged home. Some pharmacokinetic and pharmacodynamic considerations of the Pfizer BioNTech COVID-19 vaccines are discussed. An overview is presented of Addison’s disease and Addisonian crisis. The discussion also applies two causality assessment systems to derive a classification of ‘probable’ adverse drug reactions for the index case report

QUALITY BASED ASSESSMENT FOR CONTEMPORARY LEADERSHIP – THE CASE OF STEVE JOBS

In this paper, the authors discuss different reasons for the choice of Steve Jobs as a leader. It summarizes several primary concepts that shape matter about who is a leader? In addition, it attempts to provide collaborative evidence into argument about Leadership. Overall, it is about an exhibition of leadership. The methodology is to present, evaluate and analyze several qualities of a Leader that have been identified by some scholars. Conclusively, it asserts that it is expedient to concentrate on lessons learnt from various leaders and apply such lessons in a subsequent engagement with the subject of leadership

A Tale of Five Bridges; the use of GNSS for Monitoring the Deflections of Bridges

The first Bridge Monitoring surveying was carried out in 1996 by the authors, through attaching Ashtech ZXII GPS receivers onto the Humber Bridge’ parapet, and gathering and further analysing the resulting 1Hz RTK GPS data. Various surveys have subsequently been conducted on the Humber Bridge, the Millennium Bridge, the Forth Road Bridge, the Severn Suspension Bridge and the Avonmouth Viaduct. These were all carried out using survey grade carrier phase/pseudorange GPS and later GNSS receivers. These receivers were primarily dual frequency receivers, but the work has also investigated the use of single frequency receivers, gathering data at 1Hz, 10Hz, 20Hz and even 100Hz. Various aspects of the research conducted are reported here, as well as the historical approach. Conclusions are shown in the paper, as well as lessons learnt during the development of this work. The results are compared to various models that exist of the bridges’ movements, and compare well. The results also illustrate that calculating the frequencies of the movements, as well as looking at the magnitudes of the movements, is an important aspect of this work. It is also shown that in instances where the magnitudes of the movements of the bridge under investigation are small, it is still possible to derive very accurate frequencies of the movements, in comparison to the existing models.Humber Bridge Board, the Forth Estuary Transport Authority and Arup for the Millennium Bridge wor

ASSESSMENT OF STRENGTH PROPERTIES OF CASSAVA PEEL ASH-CONCRETE

Basic conventional building materials like cement and aggregates are becoming increasingly expensive due to high cost incurred in their processes, production and transportation. The utilization of locally available materials such as cassava peel ash that can either reduce or replace the conventional ones is being considered. This paper investigated the effect of partial replacement of cassava peel ash with ordinary Portland cement at 5, 10, 15, 20 and 25%. The cassava peel ash was obtained by calcinations of cassava peel to 7000 c temperature. Cube samples of size 150 x 150 x 150 were prepared for concrete grade 30 and cured in water for 7, 14, 28, 90, 120 and 180 days after which they were subjected to compressive strength, tensile strength, durability, porosity, water absorption, slump, compact factor and shrinkage tests. The results showed that partial replacement of 10 and 15% gave compressive strength comparable to the control with 0% replacement and optimum replacement is 10%. It was discovered that the cassava peel ash contains all the main chemical constituents of cement though in lower percentage compared with OPC which shows that it can serve as a suitable replacement if the right percentage is used. However, its durability and sulphric acid resistance improved considerably at 10% replacement of cement with cassava peel ash. The study recommends that concrete made with cassava peel ash can be used for light construction works where high strength is not major requirement but where durability is a major concern

Association between cholera treatment outcome and nutritional status in children aged 2–4 years in Nigeria

SETTING: Cholera can aggravate or precipitate malnutrition, and children with severe acute malnutrition (SAM) have a higher incidence and longer duration of diarrhoea. OBJECTIVE: To describe 1) characteristics of and treatment outcomes in children aged 2–4 years with cholera, 2) the case fatality rate (CFR) in all children treated, and 3) the associations between nutritional status, hydration status, treatment administered and hospital outcomes. DESIGN: An observational cohort study of children admitted to one cholera treatment centre in Maiduguri, Nigeria, with a focus on children aged 2–4 years. CFRs were examined by cross tabulation and mean length of stay (LOS) using analysis of variance. RESULTS: SAM was identified in 24% of children aged 2–4 years. The CFR for children aged 2–4 years was 1.4%. As the sample size was small, we did not find any association between nutritional status and death due to cholera. The proportion of children discharged within 2 days was 79%, and the longest stay was 8 days. In general, health facility LOS increased with severity of malnutrition. CONCLUSION: Our study found that nutritional status affected the LOS, but was unable to find an association between malnutrition and fatality among children aged 2–4 years.publishedVersio

ANALYSES OF COPPER CONCENTRATIONS IN PALM KERNEL CAKE FROM THREE INDUSTRIAL PALM KERNEL OIL MILLS.

Palm kernel cake, a by-product of palm kernel seed oil processing was analysed for its metallic contamination as livestock feed without modification or Zinc supplementation. Metalloid analysis of cake from industrial output revealed Copper II ion (Cu2+) concentration in quantities dangerous to livestock. Samples of Palm kernel cake, De-oxidised cake and Palm kernel oil products from industrial lines were analysed to determine sources of contamination in the cake using flame photometry, flame emission spectroscopy and Atomic Absorption Spectrometry. The sources of contamination were traced to the feed quality, materials of construction of the expeller section and degree of purification of bye-product and waste discharged. Preliminary investigation in fresh fruit showed that copper was a component, in the range of 14.43±0.4 and 17.03±0.6 (µg/g) but  higher copper content was later found associated with by–products at higher concentrations along the  process lines, especially at the crushing and solvent extraction stages. To take care of high copper concentrations and obtain less contaminated cake from industrial practices with a good inventory mechanism with free and dried kernel with concerns to the materials of construction to enhance continuous usage of cake as livestock feed supplement was proposed

Factors Affecting Effective use of Safety Wears among Construction Site Operatives: Lessons from Indigenous Firms in South Western Nigeria

Work related hazard is not a new phenomenon but its frequent occurrence on sites remain a major setback towards successful projects delivery. The study assessed factors affecting effective use of safety wears on construction sites. Based on snowball and random sampling technique, 128 copies of questionnaire were administered to participants with years of experience on construction management. The outcome of the study revealed that the top aspect of safety practices currently explored by the indigenous construction firms on sites include: provision of temporary fence, provision of accidents prevention procedure and development and frequently review of Safety Policy for building projects. The result of Independent Samples T-test showed the top three factors preventing effective use of safety wears on construction sites are: inadequate engagement of Safety Managers on sites, lack of proper training on effective use of safety wears and workers failure to adapt with safety practices as it was against their traditional training. This paper concluded that effective use of audio and visual displaying gadgets on site, conducting in-house safety training for the workers and ensure one Safety Manager is employ on every construction sites will go a long way in improving workers safety practices on sites

Ocimum gratissimum Ameliorates Gentamicin-Induced Kidney Injury but Decreases Creatinine Clearance Following Sub-Chronic Administration in Rats

The effects of aqueous extract of Ocimum gratissimum leaf (AOGL) on the renal function of rats with gentamicin-induced nephrotoxicity were investigated. This study involved the use of forty five (45) adult male Wistar rats (housed in separate metabolic cages) such that graded doses of OAGL were administered to the experimental groups (p.o.) for 28 days after exposure to gentamicin toxicity (100 mg/kg i.p.) for 1 week. At the end of the study, comparisons of some indices of renal function as well as antioxidant status (GSH and TBARS) were made between the control, toxic and AOGL-treated groups at P < 0.05. The result showed that gentamicin treatment caused significant increase (P < .05) in urine output, urea, creatinine, total protein, relative kidney weight, and TBARS, as well as significant decrease (P < .05) in urine creatinine and GSH levels. Post-treatment with graded doses of AOGL caused significant increase in food consumption, GSH, urine, and plasma creatinine, as well as significant decrease (P < .05) in relative kidney weight, TBARS, and urine total protein. There was an appreciable difference in the kidney histology of the AOGL-treated groups when compared with the toxic control. Hence, the extract has therapeutic potential in the management of gentamicin-induced kidney injury, although a risk profile of renal dysfunction is not unlikely from 28 days of administration as evident by the decrease in creatinine clearance