Role of diverse fermentative factors towards microbial community shift in ruminants.

Besides the liver, rumen is one of the most important components of metabolism in ruminants. However, the microbes residing in the rumen are influenced by several complex factors such as diet, which result in fluctuations in the rumen pH. Rumen pH affects feed intake and feed digestibility, subsequently causing microbial shift in the individual members of microbial community residing in the foregut and hindgut. This in turn causes an increase in lipopolysaccharide concentration, among other factors, in the gut fluid and animal blood. Irrespective of diet fed to animals, Firmicutes would probably be the most dominant in high grain diet while Bacteroidetes are dominant in hay diet, and both have a relative abundance of about 80% or more at times. The shift in microbial population is not limited to adult ruminants alone but also occur in calves. Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria were the most abundant in both hay and concentrate diet of newly weaned calves. Prolonged, depressed pH, causes subacute ruminal acidosis. This leads to compromise in the integrity of both foregut and hindgut of ruminants, eventually causing structural changes in the gut physiology. Furthermore, diet containing C-12:0 and C-14:0, which are medium-chain fatty acids, were toxic to rumen protozoa. Phytochemical content in some plant residues when fed to animals also causes shift in microbial population. Therefore, foregut and hindgut pH stability is important for ruminant health and for optimal productivity.

Prevalence of Fasciola species in ruminants under extensive management system in Ibadan southwestern Nigeria.

BACKGROUND: Fasciolosis is a zoonotic trematode of ruminants and a common parasite in cattle in Nigeria. With the increasing numbers of small household cattle herds kept under extensive management system as well as the more usual small ruminants, there is a possibility therefore that parasites common to these ruminants but better adapted to cattle such as Fasciola may also be on the increase within the small ruminant population as they graze freely over the same wide area and sometimes freely mix. AIM: The aim of the study is to determine the prevalence of Fasciola spp in sheep, goats and cattle in Ibadan during the short wet season, (August-October 2011). METHODS: Faecal samples were collected per rectum from 440 each of goats and sheep and 291 cattle. Helminth ova were recovered using sedimentation technique for faecal examination. RESULTS: A total of 40 goats (9.1%), 53 sheep (12.0%) and 158 cattle (54.3%) were positive for Fasciola ova which reflects an increase in prevalence in small ruminants. CONCLUSION: This implies that the entire Ibadan is endemic for Fasciola spp and small ruminants may serve as an important link in the epidemiology of Fasciola spp infection. More so, this has implications for the scavenging household animals which receive little or no medical attention and man that may acquire this trematode by inadvertently eating vegetables with encysted Fasciola metacercariae.

Non-glaucomatous optic neuropathy in ibadan: extrapolations to healthcare funding in Nigeria.

BACKGROUND: Optic neuropathy is not a diagnosis in itself, as potential aetiologies are myriad. A pilot study conducted in the Eye Clinic, University College Hospital, Ibadan, between September 2007 and November 2009, showed that 46.8% of new cases presenting to the neuroophthalmology unit, had non-glaucomatous optic neuropathy (NGON) in which, the precise aetiology of optic neuropathy was never diagnosed. METHODS: All cases of NGON, seen in the neuro-ophthalmology unit, between September 2007 and June 2014 were analyzed to determine common aetiologies and identify the difficulties encountered in their investigation or management. RESULTS: There were 159 cases of NGON. The age range was 6 months to 87 years (mean 39.0, SD 21.3). Male: Female ratio was 1.2: 1, and the commonest diagnosis was optic atrophy of unknown aetiology. Challenges identified included difficulty obtaining recommended radiological and serological investigations, as well as no access to genetic studies and high loss to follow-up. CONCLUSION: There are major constraints in the investigation of patients presenting with optic nerve disease in Ibadan, despite the prevalence of NGON as a major cause of visual disability among neuro-ophthalmic patients in this setting. Diagnostic constraints must be addressed, to facilitate neuroophthalmology patient care, within our limited resources.

Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria.

BACKGROUND: Metabolic syndrome (MetS) is an important cause of morbidity and mortality. Nigeria is currently undergoing rapid epidemiological transition. The objective was to study whether urbanization is associated with increased prevalence of MetS between native rural Abuja settlers and genetically related urban dwellers. MATERIALS AND METHODS: It was a cross-sectional study. Three hundred and forty-two urban native Abuja settlers and 325 rural dwellers were used for the study. Fasting blood lipid, glucose, waist circumference, blood pressure, and body mass index were determined. MetS was defined according to three standard criteria. SPSS 16.0 was used for statistical analysis. P<0.05 was used as statistically significant. RESULTS: Obesity, hypertriglyceridemia, and hypertension were commoner among urban dwellers than rural dwellers. MetS was associated more with the female gender. Urbanization significantly increases the frequency of MetS using the three standard definitions. The prevalence of MetS using International Diabetes Federation, World Health Organization, and National Cholesterol Education Program Adult Treatment Panel III among rural versus urban dwellers were 7.7% vs. 14.9%, P<0.05; 0% vs. 0.9%, P>0.05; and 3.7% vs. 13.7%, P<0.05, respectively. CONCLUSION: This study shows that MetS is a major health condition among rural and urban Nigerians and that urbanization significantly increases the prevalence of MetS. This can be explained on the basis of higher prevalence of dyslipidemia, obesity, and hypertension in urban setting, possibly as a result of stress, diet, and reduction in physical activity. Effective preventive strategy is therefore required to stem the increased risk associated with urbanization to reduce the cardiovascular risk associated with MetS among Nigerians.

Dyslipidaemia among Nigerian oil workers with type 2 diabetes mellitus.

BACKGROUND: Nigerians working in the oil industry appear to maintain a 'westernised' lifestyle and thus may be at increased risk for diabetes mellitus and related disorders. There are several reports on lipid profile in type 2 DM among Nigerians (non-oil workers) in the general population from different parts of the country. However the lipid profile of Nigerian oil workers with type 2 DM has not been previously reported. OBJECTIVE: To determine the serum lipid profile of Nigerian oil workers with or without type 2 diabetes mellitus. METHODS: Hospital records of Nigerian oil workers with type 2 diabetes mellitus were retrieved for the study. Data extracted included the patient's age, sex, weight, height, waist circumference, blood pressure and fasting lipid profile. Hospital staff without DM served as controls. RESULTS: There were 52 Nigerians with type 2 DM and 99 controls. Serum triglyceride levels were significantly higher in diabetics than in controls (1.91±1.10 vs 1.27 ±0.58mmol/l, p<0.001). The other lipid fractions were comparable in both diabetics and non-diabetics. High-density lipoprotein cholesterol abnormality was found in 32.7% of diabetic subjects. Serum total cholesterol dyslipidaemia, triglyceride dsylipidaemia and low-density lipoprotein cholesterol dyslipidaemia were found in 26.9%, 19.2% and 9.6% of the diabetic subjects respectively. CONCLUSION: Dyslipidaemia in Nigerian oil workers with T2DM is common and consists mainly of hypertriglycendaemic and low HDL cholesterol. Measures should be instituted to reduce the lipid levels in these patients in order to minimize the risk of cardiovascular events.

Glycaemic response to some commonly eaten fruits in type 2 diabetes mellitus.

BACKGROUND: It is not known which of the commonly consumed fruits in Nigeria are suitable for persons with diabetes mellitus especially with regards to the attendant plasma glucose response (PGR) to consumption of such fruits. OBJECTIVES: To determine and compare the PGR to commonly eaten fruits in patients with diabetes mellitus. METHODS: Ten persons with type 2 diabetes mellitus were studied. Fifty-gram portions of five fruits containing 50 g carbohydrate [ banana, Musa paradisiaca; orange, Citrus sinensis; pineapple, Ananus comosus; mango, Magnifera indica; pawpaw, Carica papaya], and glucose were randomly fed to the study subjects at one-week intervals. Blood samples were collected in the fasting state and half-hourly over a 2- hour period post-ingestion of the fruits or glucose for plasma glucose determination. Plasma glucose responses were assessed by the peak plasma glucose concentration (PPPG), maximum increase in postprandial plasma glucose (MIPG), two-hour postprandial plasma glucose level (2hPG) and incremental area under the glucose curve (IAUGC). RESULTS: The mean ± SEM PPPG in mmol/L were: banana, 9.0± 1.6; orange, 8.1± 0.8; pineapple, 9.2±1.1; mango, 8.0 ± 1.1; and pawpaw, 7.8±0.9. The mean ±SEM IAUGC in mmol.min/L were: banana, 131.7±53.4; orange, 108.7±29.8; pineapple, 115.3±33.2; mango, 101.6 ± 28.7; and pawpaw, 124.1± 46.1. However, mango showed the least MIPG (1.8 ± 0.5 mmol/l) followed by orange and pawpaw. The IAUGC also followed this pattern. There were no significant differences among the glycaemic indices of the fruits. Glucose load produced a significantly higher IAUGC than the fruits (orange, pineapple, mango, pawpaw, p<0.005; banana, p<0.025). CONCLUSION: The plasma glucose response to consumption of Nigeria fruits are similar. The PGR indices to all fruits were less than the PGR after an equivalent carbohydrate load of glucose. It appears safe to recommend these Nigerian fruits to persons with diabetes within the prescribed daily total calorie intake.

Underweight, overweight and obesity in adults Nigerians living in rural and urban communities of Benue State.

OBJECTIVE: To assess the prevalence of underweight, overweight and obesity among Nigerians aged 18-45 years, living in urban and rural settlements in one state in Nigeria. MATERIALS AND METHODS: Four hundred and thirty-five subjects between 18 and 45 years of age were recruited for height, weight and waist circumference (WC) measurements. Body mass index (BMI) was calculated (weight/height 2, kg/m 2 ); WHO criteria determined BMI and WC categories. RESULTS: Based on BMI, about 2% of the study population was underweight, 22% was overweight and 4% was obese. There were more normal weight persons in rural than in urban settlement. About 40 and 30% of females in urban and rural settlement, respectively, were either overweight or obese. Based on WC of the sample population, 10.34% had increased risk for metabolic syndrome [action level I (defi ned as WC ≥94 cm in men and ≥80 cm in women)] and 2.8% had substantially increased risk [action level II (defi ned as WC ≥102 cm in men and ≥88 cm in women)]. At action level II, there was no obese male. CONCLUSION: This study revealed that underweight, overweight and obesity exist in young adults, but overweight and obesity are more prevalent. Therefore, concerted efforts should be made to control this in young adults for their present well-being and to possibly avoid the risk of disease later in life.

Postprandial glucose response to selected tropical fruits in normal glucose-tolerant Nigerians.

BACKGROUND AND OBJECTIVES: The glycemic response to commonly eaten fruits in Nigeria has not been reported. Therefore, this study assessed the plasma glucose response to selected fruits in Nigeria. PATIENTS AND METHODS: Ten normal glucose-tolerant subjects randomly consumed 50 g carbohydrate portions of three fruits: banana (Musa paradisiaca), pineapple (Ananus comosus), and pawpaw (Carica papaya), and a 50-g glucose load at 1-week intervals. Blood samples were collected in the fasting state and half-hourly over a 2-h period post-ingestion of the fruits or glucose. The samples were analyzed for plasma glucose concentrations. Plasma glucose responses were assessed by the peak plasma glucose concentration, maximum increase in plasma glucose, 2-h postprandial plasma glucose level, and incremental area under the glucose curve and glycemic index (GI). RESULTS: The results showed that the blood glucose response to these three fruits was similar in terms of their incremental areas under the glucose curve, maximum increase in plasma glucose, and glycemic indices (GIs). The 2-h postprandial plasma glucose level of banana was significantly higher than that of pineapple, P < 0.025. The mean ± SEM GI values were as follows: pawpaw; 86 ± 26.8%; banana, 75.1 ± 21.8%; pineapple, 64.5 ± 11.3%. The GI of glucose is taken as 100. The GI of pineapple was significantly lower than that of glucose (P < 0.05). CONCLUSION: Banana, pawpaw, and pineapple produced a similar postprandial glucose response. Measured portions of these fruits may be used as fruit exchanges with pineapple having the most favorable glycemic response.

Pattern of thyroid disorders in the southwestern region of Nigeria.

OBJECTIVE: Thyroid disorders were thought to be rare in Africans in the early 1960s. However the 1970s witnessed an upsurge in reported cases of thyroid disorders in Africans. In endocrinology clinics in Nigeria, thyroid disorders are the second most common endocrine disorders seen. This study attempts to describe the patterns of thyroid disorders, clinical features, and complications as seen in Nigerians. DESIGN/SUBJECTS: This is a descriptive study that took place from June 2004 to August 2005 in the Department of Medicine of the Lagos State University Teaching Hospital, Ikeja, Nigeria. The demographic data, anthropometric indices, clinical features and associated complications of thyroid disorders were documented. Patients were categorized into three broad groups according to symptoms and biochemical profile as being euthyroid, thyrotoxic and hypothyroid. RESULTS: The total number of patients with thyroid disorders seen in a 15-month period was 78. The female:male ratio was 5:1. The mean (standard deviation) age of all the subjects studied was 40 (12.4) years. The female:male ratio of those with thyrotoxicosis was 5.6:1. Cardiovascular complications of thyrotoxicosis, namely heart failure and atrial fibrillation, were the most common reasons for prolonged morbidity and hospitalizations. Hypothyroidism was present in five (7%), Graves disease/hyperthyroidism in 63 (84%), and euthyroid in 10 (9%). Obstructive symptoms were documented in eight (13%) of the subjects with palpable goiters. CONCLUSION: Thyroid disorders in Nigerians are a significant cause of cardiovascular morbidity. Public awareness of thyroid disorders and their potential complications could lead to improved diagnostic and therapeutic facilities.

An assessment of the disease burden of foot ulcers in patients with diabetes mellitus attending a teaching hospital in Lagos, Nigeria.

The major part of the burden of people with diabetes mellitus (DM) is their impaired quantity and quality of life. This is due to acute and chronic complications of which diabetic foot ulceration (DFU) takes the greatest toll. Most studies on the disease burden of DFU were carried out in developed countries, and to date, no indigenous study has addressed the burden of foot ulceration in Nigerians with DM. This study attempted to determine the disease burden of this important DM complication. The study was carried out at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. The working definition of disease burden encompassed prevalence, morbidity, mortality, and the direct economic costs of diabetes mellitus foot syndrome (DMFS). For determination of the estimates of prevalence, the "capture-recapture" and intensive case-counting methods were used, mortality and morbidity were determined from records of admissions, and associated deaths over a 3-year period (1998-2000). The direct economic costs of foot ulceration were derived from the costs incurred from in-patient days, tests, drugs/medications, surgery, and other miscellaneous units of services. The total number of people with DM seen in LUTH from 1998 to 2000 was 1500, the hospital prevalence of DFU using the capture-recapture method being 9.5%. A total of 7253 medical admissions were made in this 3-year period, and of this number 827 (11.4%) were DM related. DFU-related admissions were 97 in number, and this made up 1.3% and 11.7% of the total medical and diabetes admissions, respectively. During this period, a total of 61 lower limb amputations were carried out and 26 (42.6%) of these were DM related. The proportion of medical deaths due to DMFS deaths was greater than the proportion of medical admissions due to DFU (P = .007). The case fatality of individuals with DFU was approximately 53%. A total number of 20 patients with DM foot ulcers were hospitalized during a 1-year period of the study (2003-2004). The majority had type 2 DM. A large majority (65%) of these patients had some form of surgery in addition to medical management of their condition. Mean costs for successfully treating a patient with DMFS was Nigerian Naira (NGN) 180,581.60. The total costs incurred ranged from NGN 20,400.00 to NGN 278,029.00. Drugs or medications accounted for the majority of the total costs incurred by the patients (46.9%).

Prevalence and determinants of erectile dysfunction among people with type 2 diabetes in Ilorin, Nigeria.

STUDY OBJECTIVES: To determine the prevalence and determinants of Erectile Dysfunction (ED) among men with Type 2 diabetes mellitus. MATERIALS AND METHODS: Seventy-seven adult men with Type 2 Diabetes Mellitus were assessed for Erectile Dysfunction using the 'IIEF-5' questionnaire. They were also assessed for the presence of certain clinical factors in other to determine their degree of correlation with ED. RESULTS: The mean age of the study subjects was 56.8(+/-2.4) years. Almost all (96.1%) were married. Forty-four (56.4%) men volunteered a history of Erectile Dysfunction. When assessed with the 'IIEF - 5' questionnaire, the prevalence of any degree of ED was 74% while moderate to severe ED was found in 39(51%) of the patients. The only clinical variables that had statistically significant correlation with ED were the age of the patients (p=0.04) as well as the duration of diabetes (p=0.04). CONCLUSION: - Erectile Dysfunction is a very common condition among men with Type 2 Diabetes mellitus in Ilorin, Nigeria and should therefore be routinely sought for by the clinicians. The two clinical factors that confer significant risk to development of ED, from this study are non-modifiable. More emphasis should therefore be placed on treatment rather than the prevention of this condition.