EFFECTIVE DOSE AND RISK ESTIMATES IN ADULT PATIENTS FROM FOUR RADIOLOGICAL PROCEDURES EXTRAPOLATED OVER TWO POPULATIONS AT SOME SELECTED CENTERS IN LAGOS STATE, NIGERIA.

In this study, risk of exposure to adult patients in some common radiological procedures was estimated at selected diagnostic centers in Lagos State, Nigeria using estimated average effective doses. The results showed that pelvis lateral (LAT) examination with the lowest estimated mean effective dose level (2.61) recorded the highest probability of cancer incidence and mortality occurrences, while lumbar anteroposterior (AP) had the lowest (3.61). A high sum total of probability of fatal cancers and the total weighted probability of non-fatal cancer in a single exposure to low-dose ionizing radiation were recorded in pelvic procedure among others. Also, a high-percentage mortality increase of solid cancers was recorded in chest PA examination (53.7%), while the lowest was in lumbar spine radiography (with lumbar AP = 0.14%, lumbar LAT = 0.15%). The data obtained suggested the possibility of having higher percentage mortality and cancer-related incidence in the chest.

A review of nutritional and toxicological implications of castor bean (Ricinus communis L.) meal in animal feeding systems.

The nutrient-rich defatted castor meal has been tested as a potential source of protein in diets of many livestock species but has limitation due to challenges of toxins. This review was conducted to compile the relevant research information on advances in the use of raw and differently processed castor seed meal in animal feed. In this article, distribution and uses of castor and its products were identified. Research findings on the nutrients profile, principal toxins, various detoxification strategies, nutritional value and toxicity on common livestock species were compiled and reviewed. The defatted seed meal had crude protein range of 32-48%, gross energy of about 3200 kcal/kg. Ricin content was 9.3 mg/g seed, and the average RCA content was 9.9 mg/g. The meal had high activity of lectin, which produced agglutination at about 4.70 mg/ml minimum assays. Reports of detoxification strategies showed varying degrees of success but high pH, moist heating and microbial techniques appeared to exert greater effect on deactivating ricin. Detoxification strategy for the allergen component is inconclusive. Tannins and the phenolic contents were present at trace level and did not constitute notable threat. It was concluded that castor seed holds great potential as feedstuff when upgraded but such upgrading must be safe, cost-effective and labour efficient for commercial acceptability.

Use of wound drains following open reduction and internal fixation of femoral shaft fractures.

OBJECTIVE: To determine if routine use of closed suction wound drainage is justified following open reduction and internal fixation of femoral-shaft fractures. METHOD: Patients undergoing reduction and internal fixation of 75 femoral shaft fractures were prospectively randomised into two groups: one receiving closed-suction drainage (CSD) and one no wound drainage (NWD). The state of the wound dressing at 24 and 48 hours post-surgery, blood transfusion requirements, status of the wound (presence of hyperaemia, surgical site infection, undue wound tenderness, presence of induration at the wound edge and wound healing) at days 7, 14, 28 and 90 postoperatively, and duration of wound healing, were assessed. RESULTS: A total of 65 patients, with 75 femoral shaft fractures, completed the study: 37 fractures in CSD group and 38 in the NWD group. No significant difference was observed between the two groups in terms of the state of wound dressing at 24 hours (p=0.192) or 48 hours (p=0.365). There was no statistically significant difference in the incidence of wound infection (X2=3.339, df=2, p=0.188) or duration of wound healing (X2=3.168, df=1, p=0.075) between the two groups. However, more patients in the CSD group had blood transfusions than in the NWD group (21.6% vs 15.8%), although this was also not statistically significant (p=0.181). CONCLUSION: No benefit was observed in the routine use of wound drains following open reduction and internal DECLARATION OF INTEREST: There were no external sources of funding for this study. The authors have no additional conflicts of interest to declare.

Outcome of non-operative management of femoral shaft fractures in children.

BACKGROUND: Femoral shaft fractures are common injuries in childhood. There is paucity of information on their presentation and outcome of the available treatment methods in the African population. This study evaluated the outcome of non-operative methods of treatment of femoral shaft fractures in our centre. PATIENTS AND METHODS: A retrospective review of the database of children aged 14 years and below with femoral shaft fractures treated non-operatively over a 10-year period. RESULTS: A total of 134 patients with 138 fractures met the study criteria. This consisted of 71 boys (mean age = 6.1 years ± SD) and 63 girls (mean age = 6.5 years ± SD). Pedestrian vehicular accident was the most common cause of femoral shaft fractures in the study population. The midshaft was the most common site of fractures. There were associated injuries to other parts of the body (especially head injury) in 34.3% of the patients. The commonest mode of treatment was skin traction only (87.7%). The mean time to fracture union was 4.9 weeks ± SD (range = 3-15 weeks). The mean length of hospitalisation was 6.7 weeks ± SD (range = 5 days-11 weeks). There was a fairly strong positive correlation between the length of hospitalisation and the presence of associated injuries, especially head injury, upper limb fractures and bilaterality of the fractures. The mean total cost of treatment was #7685 (Naira) or $51.2 (range = $14.2-$190). At the last follow up, 97.8% of the fractures united without significant angulation or shortening. CONCLUSION: The outcome of non-operative treatment of femoral shaft fractures in our setting is comparable to the results of other workers. Methods of treatment that shorten the length of hospitalisation without unduly increasing cost should be encouraged.

Femoral bifurcation with ipsilateral tibia hemimelia: early outcome of ablation and prosthetic fitting.

Femoral bifurcation and tibia hemimelia are rare anomalies. Hereby, we present a case report of a 2-year-old boy who first presented in our orthopedic clinic as a 12-day-old neonate, with a grossly deformed right lower limb from a combination of complete tibia hemimelia and ipsilateral femoral bifurcation. Excision of femoral exostosis, knee disarticulation and prosthetic fitting gives satisfactory early outcome.

Outcome of non-operative management of femoral shaft fractures in children

Background: Femoral shaft fractures are common injuries in childhood. There is paucity of information on their presentation and outcome of the available treatment methods in the African population. This study evaluated the outcome of non-operative methods of treatment of femoral shaft fractures in our centre. Patients and Methods: A retrospective review of the database of children aged 14 years and below with femoral shaft fractures treated non-operatively over a 10-year period. Results: A total of 134 patients with 138 fractures met the study criteria. This consisted of 71 boys (mean age = 6.1 years ± SD) and 63 girls (mean age = 6.5 years ± SD). Pedestrian vehicular accident was the most common cause of femoral shaft fractures in the study population. The midshaft was the most common site of fractures. There were associated injuries to other parts of the body (especially head injury) in 34.3% of the patients. The commonest mode of treatment was skin traction only (87.7%). The mean time to fracture union was 4.9 weeks ± SD (range = 3-15 weeks). The mean length of hospitalisation was 6.7 weeks ± SD (range = 5 days-11 weeks). There was a fairly strong positive correlation between the length of hospitalisation and the presence of associated injuries, especially head injury, upper limb fractures and bilaterality of the fractures. The mean total cost of treatment was #7685 (Naira) or $51.2 (range = $14.2-$190). At the last follow up, 97.8% of the fractures united without significant angulation or shortening. Conclusion: The outcome of non-operative treatment of femoral shaft fractures in our setting is comparable to the results of other workers. Methods of treatment that shorten the length of hospitalisation without unduly increasing cost should be encouraged

Response of laying hens and growing broilers to the dietary inclusion of mango (Mangifera indica L.) seed kernel meal.

Studies were carried out to assess the nutritive value and utilization of mango (Mangifera indica L.) seed kernel (MSK) in the diets of layer and broiler chickens. The physical component of mango seeds was found to consist of 678 g/kg kernel, 292 g/kg shell and 30 g/kg testa. Meal from the seed kernel contained 61.6 g crude protein, 136.2 g ether extract, 22.3 g ash, 46.4 g crude fibre, 673.5 g nitrogen-free extract and appreciable mineral content. In the layers trial, MSK replaced maize weight for weight at 0, 50, 100, 150, 200 and 250 g/kg. Results indicated a significant decrease (p < 0.05) in feed intake, rate of lay, egg mass and feed efficiency with increase in MSK. Layers on 150, 200 and 250 g/kg MSK exhibited the highest body weight losses. Except for lower shell thickness (p < 0.05) in hens fed MSK at 200 and 250 g/kg, the internal egg quality characteristics were comparable. In the broiler experiment, MSK was incorporated at levels of 0, 50, 100, 150 and 200 g/kg at the expense of maize but with slight adjustments to the soybean meal so as to achieve isonitrogenous diets. Body weight and body weight gains increased significantly (p <0.05) up to 100 g/kg and then decreased. MSK at 150 or 200 g/kg had no significant effects (p >0.05) on feed intake and feed efficiency when compared with control diet. Organ weights with the exception of liver and lung were unaffected by dietary MSK. Haematological indices were not influenced (p > 0.05) by dietary MSK except haemoglobin and mean cell haemoglobin, which were higher (p<0.05) in broilers fed 100 g/kg MSK. Neutrophils, lymphocytes and albumin/ globulin ratio were similar on all diets. The results indicated that at higher weight for weight levels, MSK cannot readily substitute maize in layer diets, whereas a marginal improvement was recorded in the broiler diet, albeit with nutrient supplementation.

COMT haplotypes suggest P2 promoter region relevance for schizophrenia.

A recent study found, in a large sample of Ashkenazi Jews, a highly significant association between schizophrenia and a particular haplotype of three polymorphic sites in the catechol-O-methyl transferase, COMT, gene: an IVS 1 SNP (dbSNP rs737865), the exon 4 functional SNP (Val158Met, dbSNP rs165688), and a downstream SNP (dbSNP rs165599). Subsequently, this haplotype was shown to be associated with lower levels of COMT cDNA derived from normal cortical brain tissue, most likely due to cis-acting element(s). As a first step toward evaluating whether this haplotype may be relevant to schizophrenia in populations other than Ashkenazi Jews, we have studied this haplotype in 38 populations representing all major regions of the world. Adding to our previous data on four polymorphic sites in the COMT gene, including the Val158Met polymorphism, we have typed the IVS 1 rs737865 and 3' rs615599 sites and also included a novel IVS 1 indel polymorphism, yielding seven-site haplotype frequencies for normal individuals in the 38 globally distributed populations, including a sample of Ashkenazi Jews. We report that the schizophrenia-associated haplotype is significantly heterogeneous in populations worldwide. The three-site, schizophrenia-associated haplotype frequencies range from 0% in South America to 37.1% in Southwest Asia, despite the fact that schizophrenia occurs at roughly equal frequency around the world. Assuming that the published associations found between the exon 4 Val158Met SNP and schizophrenia are due to linkage disequilibrium, these new haplotype data support the hypothesis of a relevant cis variant linked to the rs737865 site, possibly just upstream in the P2 promoter driving transcription of the predominant form of COMT in the brain. The previously described HindIII restriction site polymorphism, located within the P2 promoter, varies within all populations and may provide essential information in future studies of schizophrenia.

Haplotypes and linkage disequilibrium at the phenylalanine hydroxylase locus, PAH, in a global representation of populations.

Because defects in the phenylalanine hydroxylase gene (PAH) cause phenylketonuria (PKU), PAH was studied for normal polymorphisms and linkage disequilibrium soon after the gene was cloned. Studies in the 1980s concentrated on European populations in which PKU was common and showed that haplotype-frequency variation exists between some regions of the world. In European populations, linkage disequilibrium generally was found not to exist between RFLPs at opposite ends of the gene but was found to exist among the RFLPs clustered at each end. We have now undertaken the first global survey of normal variation and disequilibrium across the PAH gene. Four well-mapped single-nucleotide polymorphisms (SNPs) spanning approximately 75 kb, two near each end of the gene, were selected to allow linkage disequilibrium across most of the gene to be examined. These SNPs were studied as PCR-RFLP markers in samples of, on average, 50 individuals for each of 29 populations, including, for the first time, multiple populations from Africa and from the Americas. All four sites are polymorphic in all 29 populations. Although all but 5 of the 16 possible haplotypes reach frequencies >5% somewhere in the world, no haplotype was seen in all populations. Overall linkage disequilibrium is highly significant in all populations, but disequilibrium between the opposite ends is significant only in Native American populations and in one African population. This study demonstrates that the physical extent of linkage disequilibrium can differ substantially among populations from different regions of the world, because of both ancient genetic drift in the ancestor common to a large regional group of modern populations and recent genetic drift affecting individual populations.

Comparison of the supplemental effects of Saccharomyces cerevisiae and antibiotics in low-protein and high-fibre diets fed to broiler chickens.

Two experiments were completed to compare the supplemental effects of yeast Saccharomyces cerevisiae and sub-therapeutic antibiotics in high-fibre and low-protein diets for broiler chicks. In experiment 1, yeast was added at 1.5, 3.0 and 6.0 g kg-1 while penicillin, tylosin or neoterramycin were added at 150 mg kg-1 into different batches of a high-fibre diet containing 250 g kg-1 palm kernel meal. Saccharomyces cerevisiae and antibiotics increased BW, BWG, FCR, feed intake, carcass and breast weights above the control. Small intestine weight was reduced by antibiotics, while yeast caused a lower deposition of abdominal fat. Liver weights of different treated broilers were similar. The performance indices were superior on penicillin and 3.0 g kg-1 yeast compared to other supplements evaluated. In the second experiment, 1.5 and 3.0 g kg-1 of yeast, and 0.75 mg kg-1 of procaine penicillin, zinc bacitracin and tylosin were separately added to a 180 g kg-1 crude protein diet. Performance of the chicks with additives was compared with unsupplemented negative and positive controls containing 180 and 210 g kg-1 crude protein respectively. Broilers fed with supplements had superior BW, BWG, FCR and feed intake compared to the negative control, but carcass data were similar. Dietary penicillin increased BW, BWG, feed intake more than other supplements, but yeast stimulated higher FCR. Data from both studies indicated that Saccharomyces cerevisiae comparatively increased growth and carcass weight and reduce abdominal fat, therefore, it can serve as a natural substitute for antibiotics in broiler diet.

Nutritive value of hot water- or cocoa-pod ash solution-treated cocoa bean cake for broiler chicks.

1. The effectiveness of boiling (90 degrees C for 75 min) in water and alkali (cocoa-pod ash CPA solution) treatments for reducing the antinutritional factor (theobromine) in cocoa bean cake (CBC) and the influence of these treatments on the chemical composition, gross energy and metabolisable energy (ME) of CBC to the broiler chicken were examined. 2. Boiling did not affect crude protein content but resulted in lower ash, crude fibre, ether extract and gross energy values, and a 56% reduction in theobromine, while the use of increasing concentrations of cocoa-pod ash solution decreased crude protein, ether extract, theobromine and gross energy. 3. Mineral elements were significantly affected both by boiling and by cocoa-pod ash solution treatments. 4. There were no significant effects of hot water-treated or 5 g CPA/kg treated CBC on ME or MEn. However, efficiency of energy utilisation was improved. 5. Nutritional evaluation showed that there was a general decrease in performance at high dietary concentrations of CBC (treated or untreated). However, both forms of treatment (hot water-treated and 5 g CPA/kg treated CBC) significantly improved food utilisation and retention of nitrogen and dry matter.

Evaluation of the roll over test as predictor of gestational hypertension in African women.

Fifty-six primigravid women at 28-32 weeks gestation were studied prospectively to assess the roll over test (ROT) as a predictor of gestational hypertension in African women. Blood pressures were measured continuously in the supine and left lateral positions using an automated accutor machine. ROT was positive in only two women (3.6%). These two women later developed gestational hypertension but so did 18 others who had negative ROT. Measures that may be useful in increasing the predictive value of the ROT in these women are suggested.

Does standing up improve the predictive value of the supine pressor test for gestational hypertension?

Fifty-six primigravid women at 28-32 weeks' gestation were studied prospectively to compare the roll-over test with the stand-up pressor test in the prediction of gestational hypertension. Blood pressures were measured in the different positions continuously using an automated machine. Twenty patients developed gestational hypertension; two of these were accurately predicted by roll-over test and six by stand-up pressor test (P less than .001). However, there was no significant difference between the tests in the rates of false negatives, specificity, and negative and positive predictive values. Concomitant measurement of blood pressures in the standing position may increase the sensitivity of the roll-over test for the prediction of gestational hypertension.