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Background: The computerised classification and prediction of heart disease can be useful for medical personnel for the purpose of fast diagnosis with accurate results. This study presents an efficient classification method for predicting heart disease using a data-mining algorithm. Methods: The algorithm utilises the weighted support vector machine method for efficient classification of heart disease based on a binary response that indicates the presence or absence of heart disease as the result of an angiographic test. The optimal values of the support vector machine and the Radial Basis Function kernel parameters for the heart disease classification were determined via a 10-fold cross-validation method. The heart disease data was partitioned into training and testing sets using different percentages of the splitting ratio. Each of the training sets was used in training the classification method while the predictive power of the method was evaluated on each of the test sets using the Monte-Carlo cross-validation resampling technique. The effect of different percentages of the splitting ratio on the method was also observed. Results: The misclassification error rate was used to compare the performance of the method with three selected machine learning methods and was observed that the proposed method performs best over others in all cases considered. Conclusion: Finally, the results illustrate that the classification algorithm presented can effectively predict the heart disease status of an individual based on the results of an angiographic test.

In this study, a simple, sensitive and reproducible spectrophotometric technique has been developed and validated for the determination of caffeine and vitamin B6 in beverages, energy/soft drinks and herbal products. The determination of caffeine and vitamin B6 in the respective samples were carried out at maximum (λmax) absorbance of 272 and 290 nm respectively. The method was validated in terms of linearity, sensitivity (limit of Detection (LOD) and limit of Quantification (LOQ), accuracy (% Recovery), precision (relative standard deviation). The method was linear from (4-20 µg/ml and 50 - 250 µg/ml with r 2 of 0.9991 and 0.9996 for vitamin B6 and caffeine respectively. The accuracy of the method ranged from 99.48 - 101.42% for caffeine and 99.94% - 102.35% for vitamin B6. The detection limit and quantification limit were 0.192 µg/ml and 0.640 µg/ml for vitamin B6 while 0.0155 µg/ml and 0.0518 µg/ml was obtained for caffeine. The method for the two analytes was found to be precise as the percentage relative standard deviation was below 5%. Therefore, the method proposed in this study is rapid, suitable and can be used as a quality control index for caffeine and vitamin B6 in beverages, energy/soft drinks and herbal products in industries. Keywords: Caffeine, Vitamin B6, Beverages, Energy/Soft drinks, Herbal products, Spectrophotometry

Surgical repair of Tetralogy of Fallot has excellent outcomes, with over 90% of patients alive at 30 years. The ideal time for surgical repair is between 3 and 11 months of age. However, the symptomatic neonate with Tetralogy of Fallot may require earlier intervention: either a palliative intervention (right ventricular outflow tract stent, ductal stent, balloon pulmonary valvuloplasty, or Blalock-Taussig shunt) followed by a surgical repair later on, or a complete surgical repair in the neonatal period. Indications for palliation include prematurity, complex anatomy, small pulmonary artery size, and comorbidities. Given that outcomes after right ventricular outflow tract stent palliation are particularly promising – there is low mortality and morbidity, and consistently increased oxygen saturations and increased pulmonary artery z-scores – it is now considered the first-line palliative option. Disadvantages of right ventricular outflow tract stenting include increased cardiopulmonary bypass time at later repair and the stent preventing pulmonary valve preservation. However, neonatal surgical repair is associated with increased short-term complications and hospital length of stay compared to staged repair. Both staged repair and primary repair appear to have similar long-term mortality and morbidity, but more evidence is needed assessing long-term outcomes for right ventricular outflow tract stent palliation patients.

A Fontan circulation requires a series of three-staged operations aimed to palliate patients with single-ventricle CHD. Currently, the most frequent technique is the extracardiac total cavopulmonary connection, an external conduit connecting the IVC and right pulmonary artery, bypassing the right side of the heart. Fontan candidates must meet strict criteria; they are assessed utilising both cardiac catheterisation and cardiac magnetic resonance. Postoperatively, treatment protocols prioritise antibiotic prophylaxis, diuretics, angiotensin-converting enzyme inhibitors, anticoagulation, and oxygen therapy with fluid restriction and a low-fat diet. These measures aim to reduce length of stay in the ICU and hospital by preventing acute complications such as infection, venous thromboembolism, low cardiac output, pleural effusion, and acute kidney injury. Late complications of a Fontan procedure include circulation failure, protein-losing enteropathy, plastic bronchitis, and Fontan-associated liver disease. The definitive management is cardiac transplantation, with promising innovations in selective embolisation of lymphatic vessels and Fontan-specific ventricular assist devices. Further research assessing current protocols in the perioperative management of Fontan patients would be beneficial for standardising current practice and improving outcomes.

Performance and other parameters of broiler chickens could be influenced by the environment (feeds, housing, climate) and genetic potentials (breeds). Three hundred (300) broiler chicks comprising of one hundred each of the three breeds designated as A, B and C were used in a completely randomized design experiment which lasted for 56 days. Each breed represents a treatment with 5 replicates of 20 birds each. The birds were fed ad libitum with the same commercial starter and finisher diets throughout the period of the study; and water supplied free of choice. Average final body weight, average daily feed intake, average daily weight gain, feed conversion ratio, cost/kg feed and cost of feed/kg live weight gains at the starter and finisher phase were the performance parameters measured. Carcass, serum and haematological indices of these birds were also investigated. Proximate composition of the experimental starter and finisher diets indicated that both were adequately formulated for birds in the tropics under which the study was carried out. Results of the performance parameters showed that the values were similar for the starters and finishers except for highest (P

ObjectiveThe aim of this study was to repeat a previous audit, performed from 2009 to 2013, for the cohort of 2018 to determine how the resistance rates in urinary pathogens in women over 18 years of age have changed. A secondary aim of the study was to use resistance data from a different UK hospital in the same year to compare differences in resistance rates across different geographic locationsStudy designThis was a retrospective study of all positive urine cultures grown from female patients attending two different hospitals in the year 2018. Resistance patterns were analysed.ResultsThe resistance rate to co-amoxiclav continues to increase with amoxicillin retaining high resistance patterns. There are some significant differences in resistance patterns between the different locations.ConclusionAntimicrobial resistance is a significant problem in the UK particularly in antibiotics used to treat UTI. These patterns can vary across different geographical locations and over time; therefore, up-to-date knowledge of local anti-biotic resistance is essential when making an appropriate prescription choice.

OBJECTIVE: Clinical trials evaluating pharmacological and non-pharmacological treatment of COVID-19, either excluded pregnant women or included very few women. Unlike the numerous systematic reviews on prevalence, symptoms and adverse outcomes of COVID-19 in pregnancy, there are very few on the effects of treatment on maternal and neonatal outcomes in pregnancy. We undertook a systematic review of all published and unpublished studies on the effects of pharmacological and non-pharmacological interventions for COVID-19 on maternal and neonatal pregnancy outcomes. DATA SOURCES: We performed a systematic literature search of the following databases: Medline, Embase, Cochrane database, WHO (World Health Organization) COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 1 December 2020. STUDY ELIGIBILITY CRITERIA: Studies were only included if they involved pregnant or postnatal women who were exposed to pregnancy specific interventions like the mode of delivery and type of anaesthesia, pharmacological or non-pharmacological interventions. STUDY APPRAISAL AND SYNTHESIS METHODS: We first screened the titles and abstracts of studies and then assessed the full text of the selected studies in detail for eligibility. Data on study design, population, type of screening for COVID-19, country, hospital, country status (high or low and middle income), treatment given (mode of delivery, type of anaesthesia, type of pharmacological and non-pharmacological treatment was extracted. The pre-defined maternal outcomes we collected were mode of delivery (vaginal or by caesarean section), severe or critical COVID-19 (as defined by the authors), symptomatic COVID-19, maternal death, maternal hospital admission, ICU admission, mechanical ventilation, ECMO and maternal pneumonia. The pre-defined neonatal outcomes we extracted were preterm birth (

This is a case of a patient prenatally diagnosed with ccTGA. Immediately after birth, postnatal transthoracic echocardiography diagnosed ccTGA with concomitant Ebstein’s anomaly of the tricuspid valve, without a ventricular septal defect (VSD). Initially, this dysplastic tricuspid valve had mild tricuspid regurgitation. However, by 12 months follow up, the patient was becoming symptomatic, and their tricuspid regurgitation had become severe. Due to the patients worsening symptoms and regurgitation, clinical intervention was pursued. The patient had Cardiovascular Magnetic Resonance performed to assess for myocardial fibrosis and to measure the size of each ventricle. After imaging and MDT discussion, the patient was deemed suitable for a double switch operation, a form of anatomical repair. However, since this patient did not have pulmonary stenosis (PS), they required a pulmonary artery (PA) band before anatomical repair. This procedure has dual benefits: to retrain the morphological left ventricle (mLV) to cope with systemic pressures, and to induce a septal shift, which can reduce the severity tricuspid regurgitation. At 18 months of age, this patient had their PA band placed. The patient immediately had a reduction in the severity of their tricuspid regurgitation. In the future, this patient will have cardiac catheterisation performed to measure mLV pressures and assess when the patient is ready for anatomical repair. The morphology of this patient is rare, as most patients with ccTGA have an associated VSD. This case describes a potential management pathway for a ccTGA patient without VSD and an Ebstenoid tricuspid valve. It also demonstrates the benefits of PA banding in a ccTGA patient with this morphology. This is a unique contribution, due to the rarity of this specific morphology and the limited evidence and guidance for its successful management.

Objective To determine if postnatal transfer or birth in a non-tertiary hospital is associated with adverse outcomes. Design Observational cohort study with propensity score matching. Setting National health service neonatal care in England; population data held in the National Neonatal Research Database. Participants Extremely preterm infants born at less than 28 gestational weeks between 2008 and 2015 (n=17 577) grouped based on birth hospital and transfer within 48 hours of birth: upward transfer (non-tertiary to tertiary hospital, n=2158), non-tertiary care (born in non-tertiary hospital; not transferred, n=2668), and controls (born in tertiary hospital; not transferred, n=10 866). Infants were matched on propensity scores and predefined background variables to form subgroups with near identical distributions of confounders. Infants transferred between tertiary hospitals (horizontal transfer) were separately matched to controls in a 1:5 ratio. Main outcome measures Death, severe brain injury, and survival without severe brain injury. Results 2181 infants, 727 from each group (upward transfer, non-tertiary care, and control) were well matched. Compared with controls, infants in the upward transfer group had no significant difference in the odds of death before discharge (odds ratio 1.22, 95% confidence interval 0.92 to 1.61) but significantly higher odds of severe brain injury (2.32, 1.78 to 3.06; number needed to treat (NNT) 8) and significantly lower odds of survival without severe brain injury (0.60, 0.47 to 0.76; NNT 9). Compared with controls, infants in the non-tertiary care group had significantly higher odds of death (1.34, 1.02 to 1.77; NNT 20) but no significant difference in the odds of severe brain injury (0.95, 0.70 to 1.30) or survival without severe brain injury (0.82, 0.64 to 1.05). Compared with infants in the upward transfer group, infants in the non-tertiary care group had no significant difference in death before discharge (1.10, 0.84 to 1.44) but significantly lower odds of severe brain injury (0.41, 0.31 to 0.53; NNT 8) and significantly higher odds of survival without severe brain injury (1.37, 1.09 to 1.73; NNT 14). No significant differences were found in outcomes between the horizontal transfer group (n=305) and controls (n=1525). Conclusions In extremely preterm infants, birth in a non-tertiary hospital and transfer within 48 hours are associated with poor outcomes when compared with birth in a tertiary setting. We recommend perinatal services promote pathways that facilitate delivery of extremely preterm infants in tertiary hospitals in preference to postnatal transfer.

Introduction Anatomical knowledge is an essential part of surgical practice. However, its delivery lacks a standardised approach across medical school curricula. A student-led anatomy programme was implemented at a single institution, using near-peer teaching and Anatomage virtual dissection. This study aims to describe the methodology of this programme and determine the benefit of a near-peer taught anatomy course. Method The programme was organised by senior medical students, utilising Anatomage virtual dissection and techniques in line with Bigg’s constructive alignment. Attendees were asked to complete questionnaires with Likert scales (0-10) and open answer text to determine learners’ benefit. Both quantitative and qualitative analyses are presented. Results 73 students attended eight sessions from January to March 2020. Students reported a statistically significant (p Conclusions This study demonstrates how virtual dissection technology and near-peer teaching can derive significant benefit to undergraduate students, in line with previously published data.

To appreciate congenital heart disease fully, a detailed understanding of the anatomical presentation, as well as the physiology, is required. This is often introduced at an advanced stage of training. Professor Anderson has been influential in the Clinical Anatomy Intercalated BSc programme at the University of Birmingham, in particular in his teaching on Sequential Segmental Analysis. This article describes the experiences of the latest cohort of students on this programme, who undertook varying research projects using the Birmingham Cardiac Archive, with the guidance of Professor Anderson. The projects outlined include various aspects of isomerism, encompassing both the cardiac and abdominal manifestations, as well as details of congenitally corrected transposition of the great arteries and prenatally diagnosed right aortic arch and double arch. These studies all aimed to increase the knowledge base of their respective cardiac malformations and provide a basis for further research.

ObjectiveTo describe temporal changes in inhaled nitric oxide (iNO) use in English neonatal units between 2010 and 2015.DesignRetrospective analysis using data extracted from the National Neonatal Research Database.SettingAll National Health Service neonatal units in England.PatientsInfants of all gestational ages born 2010–2015 admitted to a neonatal unit and received intensive care.Main outcome measuresProportion of infants who received iNO; age at initiation and duration of iNO use.Results4.9% (6346/129 883) of infants received iNO; 31% (1959/6346) were born 34 weeks of gestation. Between epoch 1 (2010–2011) and epoch 3 (2014–2015), there was (1) an increase in the proportion of infants receiving iNO: 34 weeks (4.5% vs 5.0%), (2) increase in postnatal age at iNO initiation: ConclusionsBetween 2010 and 2015, there was an increase in the use of iNO among infants admitted to English neonatal units. This was most notable among the most premature infants with an almost fourfold increase. Given the cost of iNO therapy, limited evidence of efficacy in preterm infants and potential for harm, we suggest that exposure to iNO should be limited, ideally to infants included in research studies (either observational or randomised placebo-controlled trial) or within a protocolised pathway. Development of consensus guidelines may also help standardise practice.

Objective To determine the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed coronavirus disease 2019 (covid-19). Design Living systematic review and meta-analysis. Data sources Medline, Embase, Cochrane database, WHO COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 27 April 2021, along with preprint servers, social media, and reference lists. Study selection Cohort studies reporting the rates, clinical manifestations (symptoms, laboratory and radiological findings), risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed covid-19. Data extraction At least two researchers independently extracted the data and assessed study quality. Random effects meta-analysis was performed, with estimates pooled as odds ratios or risk difference and proportions with 95% confidence intervals. All analyses are updated regularly. Results 435 studies were included. Overall, 9% (95% confidence interval 7% to 10%; 149 studies, 926 232 women) of pregnant and recently pregnant women attending or admitted to hospital for any reason were diagnosed as having suspected or confirmed covid-19. The most common clinical manifestations of covid-19 in pregnancy were fever and cough (both 36%). Compared with non-pregnant women of reproductive age, pregnant and recently pregnant women with covid-19 were less likely to report symptoms of fever, dyspnoea, cough, and myalgia. The odds of admission to an intensive care unit (odds ratio 2.61, 95% confidence interval 1.84 to 3.71; I 2 =85.6%), and invasive ventilation (2.41, 2.13 to 2.71; I 2 =0%) were higher in pregnant and recently pregnant than non-pregnant women of reproductive age. Overall, 970 pregnant women (0.2%, 123 studies, 179 981 women) with confirmed covid-19 died from any cause. In pregnant women with covid-19, non-white ethnicity, increased maternal age, high body mass index, any pre-existing maternal comorbidity including chronic hypertension and diabetes, and pregnancy specific complications such as gestational diabetes and pre-eclampsia, were associated with serious complications (severe covid-19, admission to an intensive care unit, invasive ventilation, and maternal death). Compared to pregnant women without covid-19, those with the disease had increased odds of maternal death (odds ratio 6.09, 95% confidence interval 1.82 to 20.38; I 2 =76.6%), of admission to the intensive care unit (5.41, 3.59 to 8.14; I 2 =57.0%), caesarean section (1.17, 1.01 to 1.36; I 2 =80.3%), and of preterm birth (1.57, 1.36 to 1.81; I 2 =49.3%). The odds of stillbirth (1.81, 1.38 to 2.37, I 2 =0%), and admission to the neonatal intensive care unit (2.18, 1.46 to 3.26, I 2 =85.4%) were higher in babies born to women with covid-19 versus those without covid-19. Conclusion Pregnant and recently pregnant women with covid-19 attending or admitted to the hospitals for any reason are less likely to manifest symptoms such as fever, cough, dyspnoea, and myalgia, but are more likely to be admitted to the intensive care unit or needing invasive ventilation than non-pregnant women of reproductive age. Pre-existing comorbidities, non-white ethnicity, chronic hypertension, pre-existing diabetes, high maternal age, and high body mass index are risk factors for severe covid-19 outcomes in pregnancy. Pregnant women with covid-19 versus without covid-19 are more likely to deliver preterm and have an increased risk of maternal death and of being admitted to the intensive care unit. Their babies are more likely to be admitted to the neonatal intensive care unit. Systematic review registration PROSPERO CRD42020178076. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This version is update 2 of the original article published on 1 September 2020 ( BMJ 2020;370:m3320), and previous updates can be found as data supplements ( https://www.bmj.com/content/370/bmj.m3320/related#datasupp ). When citing this paper please consider adding the update number and date of access for clarity.

The covid-19 pandemic has presented unique challenges to medical school applicants.1 These changes have particularly affected students from widening access backgrounds—that is, young people from under-represented groups such as those of a lower socioeconomic …

In this study, the effects of some clinical variables on the survival times of patients with bladder cancer were examined. The effects of these variables on sub-distribution of the failure types were determined using the proportional sub-distribution hazards regression model described in Fine and Gray (1999). Published dataset on 294 bladder cancer patients with four clinical outcomes were analyzed using Cumulative Incidence Function approach. The four outcomes included 184 (64%) patients that experienced recurrence of bladder cancer after receiving chemotherapy treatments. Two patients died of bladder cancer while 27 patients died of other causes and the remaining 76 patients did not experienced any of these three outcomes, and as a result, were considered censored. Among the covariates considered, only the patients’ initial number of tumors and initial size of tumor were incorporated into our analysis due to high proportion of missing observations in others. Results from this work showed that, patients with tumour recurrence have highest risk of dying than those from other causes. Further results showed that, the number of tumor was positively associated with the recurrence of cancer of the bladder. However, the size of the tumor did not demonstrate a significant effect on the patients’ survival time. It can therefore, be concluded that patients with tumor recurrence have low probability of survival from bladder cancer than patients that experienced other events. Above all, number, but not size of tumor could adversely affect the survival time of bladder cancer patients, especially those with tumor recurrence after bladder cancer treatment.

The methanol extract of Russelia equisetiformis (MRE), which exhibited significant antiinflammatory activity, was evaluated for the possible mode of action by studying its antioxidant potential in adjuvant- induced arthritic rats. 1, 1 diphenyl-2-picrylhydrazyl (DPPH) radical scavenging effect was determined by spectrophotometric method. The enzymatic activity of the superoxide dismutase, glutathione peroxidase, showed a significant increase, while the lipid peroxide content was found to decrease to a large extent in MRE and indomethacin-treated rats. There was also significant and concentration-dependent increase in the percentage inhibition of DPPH, comparable to that of vitamin E and butylated hydroxyanisole (BHA) which are natural and synthetic antioxidants, respectively. The results obtained in the present study indicate that MRE possesses free radical scavenging and antioxidant properties.

A protease enzyme was isolated and partially purified from the pulp ofThaumatococcus daniellii fruit by gel filtration on sephadex G-75 followed by ion-exchange column chromatography on DEAE-cellulose. The enzyme showed a specific activity of 4.75 × 10-1 unit/mg protein and 6.93 × 10-1 unit/mg protein, respectively after each purification procedure. The purified enzyme had a Km andVmax of 2.0 × 10-4 M and 1.53 mol/min, respectively, using casein as substrate. The enzyme had an optimum temperature of 35°C and functioned best at pH 7.0 with some residual activity at alkaline pH. Key words: Protease, isolation, characterization, Thaumatococcus danielii.

e18563Background: There is great need to study the morphologic outcome of bone marrow aspiration done in our center for generation of baseline data and planning. Methods: Record of bone marrow aspi...

Introduction Wilson disease is rarely reported among African children. This report describes the second case report of a Nigerian child with Wilson disease in three decades. Case presentation An eight-year-old African boy presented with generalized oedema and ascites and proteinuria. Over the next three weeks he developed conjugated hyperbilirubinaemia, severe coagulopathy and prominent extrapyramidal features consisting of rigidity, tremors at rest and in action, shuffling gait, slurred speech and emotional lability. Slit-lamp examination of his eyes revealed Kayser-Fleischer rings and sunflower cataracts. His serum caeruloplasmin level was 5mg/dL. Using the scoring system proposed by the 8th International Meeting of Wilson Disease and Menkes Disease, a diagnosis of Wilson disease was made. Conclusions Wilson disease does occur in African children, although the diagnosis is rarely made. A diagnosis of Wilson disease should be entertained in the evaluation of African children presenting with liver dysfunction and/or extrapyramidal neurological features.

The oestrogen effect of soyprotein on female rabbits, fed for a period of 6 weeks, was investigated. Results indicate significant increase ( P r =0.808, P P P P

Activities of human hepatic drug metabolizing enzymes N-acetyl transferase (NATS) had earlier been recognized as a cause of inter-individual variation in the metabolism of drugs. Therefore acetylation of many drugs in human exhibit genetic polymorphism. The aim of the study was to investigate if acetylator status predispose diabetic mellitus patients more to the complications of renal disease, One hundred and twenty (120) diabetics consisting of (50) Type 1 (T(1)) and 70 Type 2 (T(2)) diabetes mellitus patients and 100 healthy individuals as controls were classified as slow or rapid acetylator using sulphamethazine (SMZ) as an in vivo probe. The percentage acetylation, recovery of SMZ, creatinine clearance and presence of urinary albumin were determined. A significant difference (P 0.05) was observed in the percentage of SMZ acetylated between slow and rapid acetylators in control, T(1) and T(2) subjects. The ratios of slow to rapid acetylators for T(1), T(2) and control subjects were 1:4, 3:2 and 2:3 respectively. No significant differences were observed in the percentage of SMZ recovered in the urine of slow and rapid acetylators that are diabetics. The difference in creatinine clearance of slow and rapid acetylators in T(1) and T(2) were significant (P 0.05). 29% out of 120 (24.2%) diabetics (T(1) and T(2)) exhibited albuminuria out of which 25 (86.2%) had slow acetylator status. These findings suggest that slow acetylator status in diabetes mellitus could be a predisposing factor in the development of renal complications. This underscores the need for a rapid pharmacogenetic testing and therapeutic drug monitoring in such patients. However this inference could be further validated with a larger sample size.

The study investigated the effect of chronic tea intake (1.76g/kg bwt/ day/ rat for 42 days) on blood pressure, body weight and blood lipid profile (total cholesterol, triglycerides, high density lipoprotein (HDL)-cholesterol and low density lipoprotein (LDL)-cholesterol levels). At the end of the study, the tea-treated rats (n=6) had lower systolic (102.8±1.9 c.f. 111.8± 1.6mmHg; P NQJHM Vol. 15 (1) 2005: pp. 38-41

Animal studies have shown that steroid sex hormones such as estrogen may be helpful in the regulation of several pathophysiologic stages that are involved in wound healing. This study therefore investigated the effects of topical estradiol on wound healing and haemato-biochemical changes in West African dwarf (WAD) goats. Ten WAD goats were used for the study and randomly divided into two equal groups of five animals each; the first group served as the control while the second group was treated topically with estrogen. Healing process was compared between the two groups, haematology and serum biochemistry werecarried out at each phases of the healing process. The result showed significant improved wound contractions in the estrogen treated by day 12, 15 and 17. Haematology and serum analyses revealed significantly (P

The study investigated the effect of chronic tea intake (1.76g/kg bwt/ day/ rat for 42 days) on blood pressure, body weight and blood lipid profile (total cholesterol, triglycerides, high density lipoprotein (HDL)-cholesterol and low density lipoprotein (LDL)-cholesterol levels). At the end of the study, the tea-treated rats (n=6) had lower systolic (102.8±1.9 c.f. 111.8± 1.6mmHg; P NQJHM Vol. 15 (1) 2005: pp. 38-41

The study was designed to investigate the effect of chronic tea consumption (1.76g/kg b wt/day/rat for 42 days) on blood pressure (BP), heart rate (HR) and cardiovascular responses to bilateral carotid occlusion (BCO), coupled with some associated mechanisms. Five experiments were performed in paired weight matched groups of rats (n = 5). In the first experiment, group 2 (kept on normal feed; NF and tea drink) had lower systolic, diastolic and mean arterial pressure (MAP) (P < 0.005) compared with group 1 (kept on NF and normal drinking water), with little change in HR and cardiovascular reflex. Experiments 2 to 5 were used to investigate some mechanisms responsible for the hypotensive effect of tea using appropriate pharmacologic blockers. In experiment 2, group 3 (kept on NF and furosemide solution) had similar BP as group 4 (kept on furosemide, NF and tea). In experiment 3, group 5 (kept on NF and captopril solution) had similar BP as group 6 (kept on captopril, NF and tea). In experiment 4, group 7 (kept on NF and nifedipine solution) had similar BP as group 8 (kept on nifedipine, NF and tea). In experiment 5, group 9 (kept on NF and indomethacin solution) also had similar BP as group 10 (kept on indomethacin, NF and tea). The results suggest that chronic tea consumption lowers BP in rats with little change in HR and cardiovascular reflex. The hypotensive effect of tea may be attributed to the following mechanisms: the prostanoids, sodium/potassium transport, calcium transport and the RAS (producing the least contribution). KEY WORDS: Blood pressure (BP), heart rate (HR), rats, tea. Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 131-135

OZET AMAC: Tum tuberkuloz vakalarini tariyacak tek bir tani yontemi yoktur. Bu nedenle tani birkac gun veya hafta surebilir, pahali, invazif ve karmasiktir. YONTEM: Ibadan, Nijerya’da Jericho Gogus klinigi’nde takip edilen 100 klinik tanili almis tuberkuloz hastasi (Deney grubu) ve tuberkulozu olmayan 100 saglikli kisi (Kontrol grubu) calismaya alindi. Immun kromatografik stripler uzerinde hareketsizlestirilmis antijenlere dayanan hizli serolojik test kontrol ve deney grubundaki tum deneklere uygulandi. Kontroller klinik muayene ve rie grafi, mikroskopi ve bakteri kulturu yapilarak secildi. Tuberkuloz hastalarinin da pozitifligi ayni sekilde dogrulandi. BULGULAR: Gercek pozitif sayisi 78 (%78) ve yanlis positif sayisi 8 (%8) iken gercek negatifler 92 (%92) ve yanlis negatifler 22 (%22) idi. Serolojik yontemin sensitivite, spesifite, negatif prediktif deger ve positif prediktif degerleri sirasiylasoyleydi: %78,0, %92,0, %80,7 ve %90,7. SONUC: Bu sonuclar serolojik yontemi tani ve ozellikle fakir ve gelismekte olan ulkelerde tuberkulozun idaresi noktasinda rutin uygulamaya sokmak icin dusuktur. Ayrica, hizli serolojik tani icin coklu antijene dayali immunkromatografik kitlerin daha fazla umut verici oldugu soylenebilir.

Background There had been conflicting reports with levels of markers of iron metabolism in HIV infection. This study was therefore aimed at investigating iron status and its possible mediation of severity of HIV- 1 infection and pathogenesis. Method Eighty (80) anti-retroviral naive HIV-1 positive and 50 sero-negative controls were recruited for the study. Concentrations of serum total iron, transferrin, total iron binding capacity (TIBC), CD4+ T -lymphocytes, vitamin C, zinc, selenium and transferrin saturation were estimated. Results The mean CD4+ T-lymphocyte cell counts, serum iron, TIBC, transferrin saturation for the tests and controls were 319 ± 22, 952 ± 57 cells/μl (P < 0.001), 35 ± 0.8, 11.8 ± 0.9 μmol/l (P < 0.001), 58.5 ± 2.2, 45.2 ± 2.4 μmol/l (P < 0.005) and 68.8 ± 3.3, 27.7 ± 2.2%, (P 4+ T-lymphocyte cell count had a positive correlation with levels of vitamin C (r = 0.497, P < 0.001), zinc (r = 0.737, P < 0.001), selenium (r = 0.639, P < 0.001) and a negative correlation with serum iron levels (r = −0.572, P < 0.001). Conclusion It could be inferred that derangement in iron metabolism, in addition to oxidative stress, might have contributed to the depletion of CD4+ T cell population in our subjects and this may result in poor prognosis of the disease.

Methylene chloride (MeCl2) is a clear colorless volatile sweet smelling lipophilic solvent used as a constituent of wood vanishes and paints. Human exposure is mainly due to inhalation and its biotransformation by the hepatic mixed function oxidases (MFO) leads to formation of carbon monoxide (CO). Simultaneous exposure to MeCl2 and increased ambient CO results in undesirably increased carboxyhemoglobin (COHb) formation, which predisposes to carboxyhemoglobinaemia with the central nervous system as the primary target organ of toxicity. In this study, ambient CO levels were determined using a CO personal monitor in different pasts of Ibadan Nigeria and work place microenvironment of 50 Cabinet makers (test group) and 50 volunteer (control) in non-furniture making occupations. Mann Whitney U and Kruskaal Wallis were the statistical methods of analysis used. Questionnaires were administered to both groups carboxyhaemoglobin levels were determined in venous blood drawn from individuals in the two groups by differential spectrophotometric method. Ambient CO levels in Ibadan were observed to be between 4 and 52 ppm with a mean of 20 ppm. Work environment CO levels were significantly higher in test subjects than controls at 5.2 ± 1.08 ppm and 2.08 ± 0.91 ppm respectively (P 0.05). It is therefore imperative to substitute MeCl2 for safer chemicals in wood vanish and paints and the use of protective gas masks and adequate ventilation should be mandatory whenever MeCl2 is used.

105 promigravidae aged 16 or under who received inadequate antenatal care were compared with 95 who had received adequate care (defined as 5 clinic visits or more following the 13th week of pregnancy). A control group was 100 primigravidae aged 22 years who had also received adequate care. About 3/4 of the teenagers had fathers or husbands in the lower income groups; 64% of the controls were in the lower income groups while 18% were in Group 2 which includes most professional men. 3.8% of the teen-agers given inadequate prenatal care had mild preeclampsia 6.7% severe and 2.9% eclampsia. Among those given adequate care the rates were 12.6% 4.2% and 1.0%. Only 3 cases of mild preeclampsia were found in the 22-year-olds. 35.2% of the teen-agers given inadequate care and 22.1% of those receiving adequate care had iron deficiency anemia compared with 45% of controls. 23.6% of the inadequate care gound and 12.6% of the adequate care group had babies weighing 2.5 gm or less; 8% of controls did. Variations in duration of labor and blood loss were not significant. The higher weight of babies in the adequate care groups may have been due to control of malaria and other diseases. The higher incidence of mild preeclampsia in the teen-agers receiving adequate care may be due to greater hospital awareness of the condition. Severe preeclampsia and eclampsia were more common in the in adequately managed group.

Background Globally, radon is a natural contaminant that affects indoor air quality. Several epidemiological studies have implicated high radon levels in the causality of lung cancer. The study therefore determined the environmental level of radon in selective offices in the Obafemi Awolowo University, Ile-Ife. The study employed a descriptive cross-sectional design. A Pro 3-series radon detector was used to determine the radon levels in randomly selected offices. The instrument was set-up in each office and after 48 h, reading was taken and recorded on a proforma data sheet. The structural characteristics of the offices were also assessed by observation. Results The result revealed that the radon level obtained in the sampled offices ranged from 0.0 to 5.3 pCi/L (196 Bq/m3). The median concentration of radon obtained from sampled offices was 0.9 pCi/L. Almost all (95 %) of the offices had radon levels within the ‘permissible’ reference level recommended by World Health Organization. Radon levels also showed a statistically significant decline with height of office building with the mean concentration of radon in offices located on the basement, ground floor and first floor being 1.54 ± 1.32, 0.99 ± 0.56, 0.63 ± 0.41 pCi/L respectively, (F statistic 5.8, p

Guinea-worm eradication has been progressing internationally and efforts at case containment have begun in most endemic countries. Case containment rests on the assumption that in previous phases of eradication most if not all endemic settlements have been identified. Experiences in the predominantly Yoruba communities of Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, however, have shown that the settlements of ethnic minority groups may be overlooked during initial case searches and subsequent programmes of village-based reporting. The migrant cattle-herding Fulani are found throughout the savannah and sahel regions of West Africa. Nearly 3000 live in 60 settlements in Ifeloju. An intensive case search identified 57 cases in 15 settlements. The assumption that village-based health workers (VBHWs) in neighbouring Yoruba farm hamlets would identify cases in the Fulani settlements, known as gaa, proved false. Only 5 endemic gaa were located next to a Yoruba hamlet that had a VBHW, and even then the VBHW did not identify and report the cases in the gaa. Efforts to recruit VBHWs for each endemic gaa are recommended, but only after LGA staff improve the poor relationship between themselves and the Fulani, whom they view as outsiders. The results also imply the need for Guinea worm eradication staff in neighbouring LGAs, states and countries to search actively for the disease among their minority populations.

At the start of the United Nations International Drinking Water Supply and Sanitation Decade in the 1980s, guinea worm disease was targeted as the major indicator of the success of the Decade's efforts to promote safe water. By the late 1980s, most of the guinea worm endemic countries in Africa and South Asia had established guinea worm eradication programmes that included water supply as one of their main technical strategies. By surveying the water supply situation in Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, in June 1996, as a case study, it was possible to determine the role that water supply has played in the eradication effort. Although two major agencies, the former Directorate for Food, Roads and Rural Infrastructure and UNICEF, provided hand dug and bore-hole wells respectively in many parts of the LGA, coverage of the smaller farm hamlets has been minor compared to efforts in the larger towns. This is ironic because the farm hamlets served as a reservoir for the disease in the 1980s, such that when the piped water system in the towns broke down, guinea worm was easily reintroduced into the towns. The survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of the people still drink only pond water. Another 11.3% have wells that have become dysfunctional. Only 14.4% of this rural population has access' to functioning wells. Guinea worm was eliminated from 107 of the hamlets mainly by the use of cloth filters and chemical treatment of ponds. While this proves that it is possible to eradicate guinea worm, it fails to leave behind the legacy of reliable, safe water supplies that was the hope of the Water Decade.The 1980s were designated by the UN as the International Drinking Water Supply and Sanitation Decade, and guinea worm disease was targeted as the major indicator of the campaign's success. The campaign conceptualized guinea worm disease as a symbol of the isolation of poor rural residents from national development programs such as water supply, education, and health care. The Nigerian Guinea Worm Eradication Program, launched in 1987, committed to provide drinkable treated water to areas with endemic guinea worm disease. However, less expensive interventions such as monofilament nylon cloth filters were given priority over water supply provision. This article examines the eradication program in Ifeloju Local Government Area in Oyo State, Nigeria. The former Directorate for Food, Roads, and Rural Infrastructure provided hand-dug wells in several settlements, but made no provisions for maintenance and repairs. UNICEF assisted in the drilling of bore-hole wells, but restricted this intervention to settlements with more than 250 people. A 1996 survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of residents drank only pond water. Another 11.3% had wells that had become dysfunctional. Only 14.4% of these rural residents had access to functioning wells. Guinea worm was eliminated from 107 of the hamlets, chiefly through use of cloth filters and chemical treatment of ponds. These results show a striking lack of commitment to the eradication of guinea worm disease through the safe water strategy. In 1995, only 43% of Nigeria's population had access to safe water. There is a need for financial investment in less expensive and more appropriate hamlet-level technologies, as well as community mobilization to dig and maintain hand-dug wells.

Background Petroselinum crispum, a bright green biennial shrub is widely used traditionally as a food additive and herbal remedies for many ailments. This study therefore aimed to assess the toxic effects of its leaf extract using some biochemical, haematological parameters. Methods The toxic effects were assessed by quantifying liver enzymes such as serum aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase (ALP), total serum protein and liver weight. Effects on haematological parameters were assessed by analysis of parked cell volume (PCV), red blood cell count (RBC), white blood cells (WBC) and haemoglobin (Hb) concentrations. Histopathological studies were done on the liver and kidneys. Results The extract caused significant increase in serum activity of alanine amino transferase and blood urea nitrogen (BUN) levels at the dose of 1000 mg/kg. Other biochemical and haematological parameters were not affected at lower doses. Conversely, the liver weight was not affected after eight weeks of treatment at the dose levels studied. The organs obtained for pathological study, were structurally unchanged under histopathological evaluation at lower doses but inflammatory and necrotic features were observed at doses ≥ 1000 mg/kg. Conclusion The results indicate that the leaf ethanol extract of Petroselinum crispum was hepatotoxic and nephrotoxic at continued oral doses equal to or more than 1000 mg/kg, but no obvious toxicity when used at lower doses. Therefore, there should be caution in its administration to avoid overdosing and known interaction with some medications. In addition, the plant should be kept away from pets and domestic animals and should not be cultivated on soil irrigated with waste water due to their ability to bio-accumulate toxic metals.

The kinetics of the thermal decompositions of X·C6H4·CHClCH3 into olefin and hydrogen chloride (X =p-Me, m-Me, p-F, H, p-Cl, p-Br, and p-CN) are reported and shown to be homogeneous unimolecular reactions. Arrhenius parameters are listed, together with the rates relative to the unsubstituted compound at 308°. The logarithms of these latter quantities when plotted against σ+ yield a straight line of slope –1·4. It is concluded that a moderate degree of charge separation is involved in the transition states of these reactions. An appendix reports and discusses the rate of pyrolysis of 2-phenylethyl chloride and bromide at 425·5° and 385·5° respectively.