Early-onset developmental impairments among infants attending the routine immunization clinic at the University College Hospital, Ibadan, Nigeria.

Developmental disorders are frequently overlooked in the developing countries, particularly in sub-Saharan Africa. Early identification of developmental delays (DDs) is critical to optimal outcomes. This study set out to determine the proportion of children who are at risk of DDs among infants attending immunization clinics at the University College Hospital, Ibadan, Nigeria. Infants 6 weeks to 12 months of age (median age 6 months) who presented for routine immunization were screened for DDs using the Ages and Stages Questionnaire. A total of 587 infants [312 (53.2%) males] were enrolled. A total of 198 (33.7%) children showed signs of DDs. For the domains of communication skills, fine motor skills, gross motor skills, problem solving/cognition skills and personal/social skills, the prevalences of DDs were 7.5%, 15.0%, 10.7%, 14.1% and 14.8%, respectively, and 14.3% had global DDs. Factors that significantly predicted DDs included prematurity (odds ratio [OR] 2.64 [95% confidence interval {CI} 1.45 to 2.05]) and a history of perinatal asphyxia (OR 1.74 [95% CI 1.77 to 2.49]). There is a need to incorporate routine developmental screening into the Nigerian healthcare system for timely recognition of DDs and prompt interventions.

A numerical investigation of the heat transfer characteristics of water-based mango bark nanofluid flowing in a double-pipe heat exchanger.

In this study, the heat transfer characteristics of a new class of nanofluids made from mango bark was numerically simulated and studied during turbulent flow through a double pipe heat exchanger. A range of volume fractions was considered for a particle size of 100 nm. A two-phase flow was considered using the mixture model. The mixture model governing equations of continuity, momentum, energy and volume fraction were solved using the finite-volume method. The results showed an increase of the Nusselt number by 68% for a Reynolds number of 5,000 and 45% for a Reynolds number of 13 000, and the heat transfer coefficient of the nanofluid was about twice that of the base fluid. In addition, the Nusselt number decreased by an average value of 0.76 with an increase of volume fraction by 1%. It was also found that there was a range of Reynolds numbers in which the trend of the average heat transfer coefficient of the nanofluid was completely reversed, and several plots showing zones of higher heat transfer which if taken advantage of in design will lead to higher heat transfer while avoiding other zones that have low heat transfer. It is hoped that these results will influence the thermal design of new heat exchangers.

Knowledge Regarding Organ Donation and Willingness to Donate among Health Workers in South-West Nigeria.

BACKGROUND: Organ transplantation program in developing countries is still significantly dwarfed. Health workers are undeniably important in the success of transplantation. OBJECTIVE: To assess the knowledge and attitude of health workers toward organ donation in South-West Nigeria with a view to explaining reasons for these shortcomings. METHODS: In a cross-sectional study conducted on 850 health care workers, self-administered questionnaires were used to obtain information from participants. RESULTS: Of 850 participants, 766 (90.1%) returned their completed questionnaires. The mean±SD age of participants was 36.7±9.2 years. Majority (93.3%) of participants had heard of organ donation; 82.5% had desirable knowledge. Only 29.5% and 39.4% would be willing to donate and counsel potential organ donors, respectively; 36.5% would consider signing organ donation cards. Only 19.4% believed that organ transplantation is often effective and 63.4% believed they were permitted by their religion to donate. Permission by religion (OR 3.5; 95% CI 2.3 to 5.3), good knowledge (OR 2.9; 95% CI 1.4 to 5.7), readiness to sign donation cards (OR 2.6; 95% CI 1.7 to 3.8), discuss organ donation (OR 2.7; 95%CI 8.0 to 63.8), and knowing somebody who had donated (OR 2.9) independently influenced willingness to donate organ. CONCLUSION: There is disparity in knowledge of organ donation and willingness to donate among health care workers. Efforts should be intensified to give comprehensive and appropriate education to health care workers about organ donation to bridge this gap.

Alpha-1-antitrypsin levels and prevalence of Pi variant phenotypes in adult Nigerian asthmatics.

Alpha-1-antitrypsin (A1AT) phenotypes and serum levels were determined in 99 asthmatic patients and 100 control subjects. The phenotypes encountered were PiMM 74% in asthmatics, 98% in controls; PiMZ 19% in asthmatics, 1% in controls; PiMW 3% in asthmatics, 0% in controls; and PiLM 2% in asthmatics, 1% in controls. There was one asthmatic patient with the homozygous deficient phenotype ZZ. The result revealed that there were more deficient heterozygous phenotypes in the asthmatic group than the control group. There was also a positive correlation between the number of patients with deficient phenotypes and the severity of asthma (P less than 0.02). Analysis of the serum A1AT levels revealed that as a group the asthmatic patients had significantly lower A1AT levels (1.97 +/- 0.18 g/l) than the control group (2.21 +/- 0.15 g/l) (P less than 0.01). However, there was no statistically significant difference in the A1AT serum levels of patients with P1MM phenotype and the control of the same phenotype. Statistical analysis could not be done for the other phenotypes because of the small number of subjects. Apart from the patient with PiZZ the A1AT serum levels encountered in the study were not low enough to justify replacement therapy with alpha-1-proteinase inhibitor in our asthmatic patients.

Alpha-1-antitrypsin and chronic bronchitis in adult Nigerians.

Alpha-1-antitrypsin (A1AT) serum levels and phenotypes were determined in 49 Nigerians with chronic bronchitis and 100 normal controls. The A1AT phenotypes encountered were PiMM, 69% in chronic bronchitics, 98% in controls; PiMZ, 23% in chronic bronchitics, 1% in controls; PiLM, 2% in chronic bronchitics, 1% in controls. There were three patients (6%) with the homozygous-deficient phenotype PiZZ. Spirometry confirmed obstructive ventilatory pattern in the patients with chronic bronchitis, and the difference in the values obtained between the patients and controls was statistically significant (P less than 0.01). Serum A1AT levels were within the normal range of 1.4-2.7 g/l in all except the three patients with PiZZ. There was no significant difference in the A1AT serum levels between patients with chronic bronchitis and control subjects with the PiMM phenotype; tests of significance were not possible for the other phenotypes because of the small number of subjects. The observation of PiZZ in 6% of our patients with chronic bronchitis is in support of screening of this category of patients. Replacement therapy with alpha-1-antitrypsin inhibitor is currently under investigation and may be worthwhile in these patients if detected early.

Effects of the timing of antigen stimulation on parasitaemia profile and subsequent immunodepression in an experimentally induced Trypanosoma brucei infection.

The influence of administering sheep red cells (SRC) as antigens, either after or before a trypanosome challenge, on parasitaemia profile and antibody response was assessed in albino Wistar rats. High levels of parasitaemia associated with significantly depressed antibody response and packed cell volume (PCV) values were observed when trypanosome challenge preceded antigen stimulation. In contrast, a clear delay in the onset and development of parasitaemia occurred when antigen priming preceded trypanosome challenge. At the beginning, PCV values and antibody response to the antigen were in the range of levels found in control rats. However, as infection progressed, parasitaemia rose and significant immunological hyporesponsiveness developed which at least reached levels found in rats that had received trypanosome challenge prior to antigen stimulation. These findings should be taken into consideration when evaluating serological tests used for assessing responses to specific vaccinations, or for the diagnosis of infections based on rising antibody titres in the host.