Acute Kidney Injury after First Dose of AstraZeneca COVID-19 Vaccine Managed in a Nigerian Hospital.

INTRODUCTION: The association of kidney disease and COVID-19 vaccination has been reported with minimal change disease being a common presentation. CASE REPORT: Index patient is a 54-year-old female who presented with a history of reduction in urine output within 3 weeks of receiving the Oxford-AztraZeneca COVID-19 vaccine. Her serum creatinine on admission was 1,057 µmol/L with a premorbid serum creatinine of 78 µmol/L. Her vital signs were stable. She was on antihypertensive and antidiabetic medications for hypertension and diabetes mellitus, respectively. Renal biopsy was precluded by her morbid obesity and she was commenced on oral prednisolone. She had 5 sessions of hemodialysis and her serum creatinine gradually reduced to 106 µmol/L, and she is being followed up on an outpatient basis. CONCLUSION: We report a case of a female patient with acute kidney injury following COVID-19 Oxford-AztraZeneca vaccination. Further studies are required to better understand the pathogenesis of the renal affectation post-vaccination.

INTRODUCTION: L'association de la maladie rénale et de la vaccination COVID-19 a été signalée, la maladie à changement minimal est une présentation courante. RAPPORT DE CAS: La patiente à l'étude est une femme de 54 ans qui a présenté des antécédents de réduction du débit urinaire dans les 3 semaines après avoir reçu le vaccin COVID-19 d'Oxford-AztraZeneca. Sa créatinine sérique à l'admission était de 1 057 µmol/L avec une créatinine sérique prémorbide de 78 µmol/L. Ses signes vitaux étaient stables. Elle prenait des médicaments antihypertenseurs et antidiabétiques pour l'hypertension et le diabète sucré, respectivement. Une biopsie rénale était impossible à cause de son obésité morbide et elle a été mise sous prednisolone par voie orale. Elle a subi 5 sessions d'hémodialyse et son taux de créatinine sérique a progressivement à 106 µmol/L, et elle est suivie en ambulatoire. CONCLUSION: Nous rapportons le cas d'une patiente souffrant d'une lésion rénale aiguë après la vaccination par le COVID-19 Oxford-AztraZeneca. D'autres études sont nécessaires pour mieux comprendre la pathogenèse de l'affectation rénale post-vaccination. Mots-clés: Vaccin COVID-19, Événement Indésirable, Lésion Rénale Aiguë.

Psychological distress and health-related quality of life among stable patients with bronchiectasis.

BACKGROUND: Bronchiectasis is characterized by chronic symptoms and impaired physical activity. Anxiety and depression usually complicate chronic illness. Thus, underdiagnosis of psychological distress in bronchiectasis may lead to increased morbidity and mortality. AIMS: The aim of this study is to evaluate the impact of physical illness on psychological distress and its association with health-related quality of life (HRQOL). SUBJECTS AND METHODS: This is a cross-sectional study of adults with bronchiectasis. Patients completed a study questionnaire, the hospital anxiety and depression scale and the World Health Organization quality of life brief (WHOQOL-BREF) questionnaire. Physical examination was conducted on all participants. RESULTS: 103 patients were recruited for this study: 54 males (52.4%) and 49 females (47.6%). The average age of the patients was 49.12 ± 14.37 years. The most common predisposing factor for bronchiectasis amongst the patients was previous pulmonary tuberculosis (51 patients, 49.5%). Chronic productive cough, which was reported by 98 of the subjects (95.15%), was the most common symptom. 89 subjects (86.41%) reported episodes of shortness of breath, 82 (79.61%) reported at least one episode of exacerbation, while 52 subjects (50.49%) were hospitalized for bronchiectasis in the previous 12 months. 23 subjects (22.3%) had anxiety and 32 (31.1%) had depression. Anxiety and depression were significantly associated with indicators of severe disease. The subjects recorded low HRQOL scores across all domains. Psychological distress displayed a significant negative association with all the quality-of-life domains except between anxiety and social interaction. CONCLUSION: Symptoms of depression and anxiety are common among patients with bronchiectasis and these symptoms have a negative impact on HRQOL.

Etiology and Clinical Evaluation of Patients with Bronchiectasis in a Tertiary Hospital in Nigeria.

BACKGROUND: Bronchiectasis is often considered an orphan disease in developed societies. This may not be the case with low-income countries. Currently there is a paucity of data on the pattern and presentation of this condition in Nigeria. OBJECTIVE: This study was undertaken to determine the frequency and pattern of presentation of bronchiectasis in a tertiary healthcare facility in Uyo, South-South, Nigeria. METHODS: We carried out a three-year prospective study of adult patients aged between 15-85 years diagnosed with bronchiectasis in the University of Uyo Teaching Hospital in Uyo, Nigeria between 2016 and 2019. RESULTS: Eighty-two patients were identified from the clinic register. Out of these, 76 were recruited into the study; made up of 44(57.9%) males and 32 (42.1%) females. The average age of the patients was 49.7 ± 14.1 years. Sixteen (21.1%) of the patients were HIV positive. Forty-four (57.9%) patients had previously been treated for pulmonary tuberculosis. Majority of the patients; 72 (94.7%) had chronic productive cough. Sixty-four (84.2%) had at least one episode of exacerbation within the last 12 months while 36(47.4%) had a severe exacerbation requiring hospitalisation. Hospitalisation was associated with several factors with the strongest contributor being the presence of respiratory distress on physical examination (OR 15.4 p= 0.002). CONCLUSION: Bronchiectasis is not an uncommon disease amongst our patients. A previous history of pulmonary tuberculosis is the commonest associated predisposing medical condition. There is a high rate of exacerbation among these patients with respiratory distress as the strongest predictor of hospitalisation.

CONTEXTE: La bronchectasie est souvent considérée comme une maladie orpheline dans les sociétés développées.Ce n'est peut-être pas le cas dans pays à faible revenu. Actuellement, il y a une pénurie de données sur les caractéristiques et la présentation de cette maladie au Nigeria. OBJECTIF: Cette étude a été entreprise pour déterminer la fréquence et le mode de présentation de la bronchectasie dans un établissement de soins tertiaires à Uyo, dans le sud-sud du Nigeria. MÉTHODES: Nous avons mené une étude prospective sur trois ans auprès de patients adultes âgés de 15 à 85 ans chez qui on a diagnostiqué une bronchectasie dans l'hôpital universitaire d'Uyo, à Uyo, entre 2016 et 2019. Uyo, au Nigeria, entre 2016 et 2019. RÉSULTATS: Quatre-vingt-deux patients ont été identifiés à partir du registre de la clinique registre. Parmi ceux-ci, 76 ont été recrutés dans l'étude ; composés de 44 (57,9 %) hommes et 32 (42,1 %) femmes. L'âge moyen des patients était de 49,7 ± 14,1 ans. Seize (21,1 %) des patients étaient séropositifs. Quarante-quatre (57,9 %) patients avaient déjà été traités pour une tuberculose pulmonaire.La majorité des patients ; 72 (94,7%) avaient une toux productive chronique. Soixante-quatre (84,2 %) ont eu au moins un épisode d'exacerbation au cours des 12 derniers mois, tandis que 36 (47,4 %) ont eu une exacerbation sévère nécessitant une hospitalisation. L'hospitalisation était associée à plusieurs facteurs, le facteur le plus important étant la présence d'une présence d'une détresse respiratoire à l'examen physique (OR 15.4 p= 0.002). CONCLUSION: La bronchectasie n'est pas une maladie rare parmi nos patients. Un antécédent de tuberculose pulmonaire est l'état médical prédisposant le plus fréquent.ll existe un taux élevé d'exacerbation chez ces patients, la détresse respiratoire étant le facteur prédictif le plus fort d'hospitalisation. MOTS CLÉS: Étiologie, Caractéristiques cliniques, Bronchiectasie, Exacerbation, Hospitalisation.

Impact of ultrasound scanning on pregnant Women's compliance with attendance at antenatal care visits and supervised delivery at primary healthcare centres in northern Nigeria: Initial experiences.

INTRODUCTION: The world health organisation (WHO) recommends at least one ultrasound scan amidst eight antenatal care visits, however, most pregnant women in low and middle-income countries do not achieve this. This study aims to assess the impact of limited obstetrics ultrasound (LOUS) within primary healthcare centres in northern Nigeria. METHODS: A cross sectional study was conducted across selected primary healthcare centres in Bauchi and Kano States (northern Nigeria). The study protocol was approved by the Ministry of Health in each State. Within each State a total of nine primary healthcare centres were randomly selected. Information on all complete antenatal care (ANC) records of women who used the primary healthcare facility for 12 months prior to introduction of ultrasound (January 2016 to December 2016) and 12 months after (January 2018 to December 2018) were collected. Study data were analysed using descriptive (mean, standard deviations) and inferential statistics. Independent sample t-test were used to find out if there was a statistical difference between the pre and post-intervention data on women compliance to ANC visits, facility based delivery, maternal and child mortality. Data were analysed using the Statistical Package for Social Sciences and significance was set at p ≤ 0.05. RESULTS: There was a significant increase in the number of ANC visits and supervised facility delivery after introduction of ultrasound services (LOUS) in the primary healthcare centres. The number of ANC visits in Kano State was 2637.6 ± 972.0 before and 3793.0 ± 517.5 after the introduction of ultrasound services. The number of ANC visits in Bauchi State was 1866.6 ± 488.3 before and 2854.0 ± 631.3 after the introduction of ultrasound services. The number of supervised facility deliveries in Kano state was 520.1 ± 128.7 before and 1021.1 ± 217.0 after the introduction of LOUS. The number of supervised facility deliveries for Bauchi state was 553.1 ± 309.9 before and 1056.3 ± 295.4 after introduction of LOUS. A total of 2486 (11.0%) women were referred for further imaging due to equivocal ultrasound findings. A total of 2185 (9.7%) pregnant women were referred for appropriate care due to multiple gestations. CONCLUSION: This study found that LOUS, in resource scarce settings, has the potential of improving ANC visits, facility delivery rates and reduce maternal and child mortality. It also leads to change in patient management plans resulting in referrals for appropriate care. IMPLICATION FOR PRACTICE: Technological interventions using ultrasound have the potential to motivate pregnant women to attend ANC, give birth in a healthcare facility and thus reduce maternal and child morbidity and mortality. This is in line with the global drive to reduce maternal and child death by 2030 to less than 70 maternal deaths in 100,000 live births and neonatal mortality reduction to 12 in 1000 live births and under 5 mortality reduction to 25 in 1000 live births.

Protective role of Allium cepa Linn (onion) juice on maternal dexamethasone induced alterations in reproductive functions of female offspring of Wistar rats.

Maternal treatment with dexamethasone induces oxidative stress in the reproductive structures of offspring. Consumption of Allium cepa Linn improves antioxidant status. This study was designed to evaluate the protective role of Allium cepa Linn juice on maternal dexamethasone induced alterations in reproductive functions of the female offspring of Wistar rats. Twenty lactating dams (180-200 â€‹g) were randomly assigned into four groups (n â€‹= â€‹5) on the day of parturition and treated as follows during lactation for 21 days: Control (5 â€‹ml/kg BW distilled water); Dexamethasone (60 â€‹µg/kg BW); Allium cepa (5 â€‹ml/kg BW); Dexamethasone â€‹+ â€‹Allium cepa (60 â€‹µg/kg BW â€‹+ â€‹5 â€‹ml/kg BW). The female offspring were separated at birth. Days of vaginal opening and first oestrus cycle, length and frequency of estrous cycle as well as serum hormonal profiles were assessed as measure of reproductive functions. Ovarian superoxide dismutase (SOD) activity, catalase activity and malondialdehyde (MDA) level were measured as indices of oxidative stress. Oestrous cycle length, frequencies of diestrus as well as the Ovarian MDA were significantly increased (p â€‹< â€‹0.05) in dexamethasone (DEX) group relative to control group. Serum 17ß-oestradiol and corticosterone level in addition to SOD and catalase activities were significantly reduced (p â€‹< â€‹0.05) in DEX group relative to control. Co-administration of Dex with Allium cepa Linn juice reduced the oestrous length, frequency of diestrous as well as ovarian MDA. There was also a significant increase in serum 17ß-oestradiol, ovarian SOD and catalase activity. The results suggest that Allium cepa could protect against alterations in reproductive functions of offspring induced by maternal treatment with dexamethasone during lactation in Wistar rats. The flavonoid constituent of onion may also help in reducing oxidative stress in the offspring.

Comparability of serum creatinine-Based glomerular filtration rate equations in West African adult communities.

BACKGROUND: The clinical diagnosis of chronic kidney disease (CKD) is based on estimated glomerular filtration rate (GFR) using serum creatinine-based equations. Many formulas are used in estimating GFR. OBJECTIVES: We set out to determine the degree of agreement between the Cockcroft-Gault (CG), 4-variable Modification of diet in renal disease (MDRD). Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in our indigenous population. PATIENTS AND METHODS: Adult participants were recruited across all sectors of life, education, and occupation. Blood pressure, fasting blood glucose, lipid profile, urinalysis, serum creatinine, and anthropometry were measured. Estimated GFR (eGFR) was computed using CG, MDRD, and CKD-EPI equations with and without the race factor. The Lin's concordance index (rho_c) and Bland-Altman analysis were used to determine the degree of agreement between various pairs of creatinine-based eGFR equations [MDRD with the race factor (MDRDw)]; MDRD without the race factor (MDRD); CKD-EPI with race factor (CKD-EPIw); CKD-EPI without the race factor (CKD-EPI), and the CG equation. RESULTS: Two hundred and sixty-one adults, mean age 47.5 ± 9.9 years, 45.2% females participated in the study. Hypertension prevalence in the study population was 41.4 (95% CI 35.3-47.6%) while diabetes mellitus was 8.1% (95% CI 5.0-12.0%). The proportion of individuals with eGFRCKD-EPI less than 60 ml/min/1.73 m2 was 17.6 (95% CI 13.2-22.8%). All pairs of rho_c were lower than the threshold of 0.9 except for eGFRCKD-EPI versus eGFRCKD-EPw. CONCLUSION: There is significant discordance in the eGFR obtained from the various serum creatinine-based GFR equations in our population suggesting the need to validate these equations and determine the best equation for our general population.

Rheological, electrochemical, surface, DFT and molecular dynamics simulation studies on the anticorrosive properties of new epoxy monomer compound for steel in 1 M HCl solution.

A new epoxy monomer, namely, tetraglycidyl-1,2-aminobenzamide (ER), was synthesized by condensation of the amines with epichlorohydrin in a basic medium. The obtained epoxy monomer was characterized by FT-IR and 1H NMR spectroscopy. Rheological properties of this monomer were determined using an advanced rheometer. Subsequently, the synthesized ER monomer was investigated as corrosion inhibitor for carbon steel in 1 M HCl solution. The adsorption properties of ER were analyzed by electrochemical, surface investigation and theoretical computational studies using DFT and molecular dynamics (MD). Results showed a high dependence of the viscosity of ER on temperature and concentration, and also, that ER has better inhibition performance. A good agreement between the results derived from computational (MD and DFT) and experimental methods was observed. The thermodynamic parameters, along with the kinetic parameters, showed that the adsorption of ER molecules onto carbon steel surface obeyed the Langmuir isotherm model, and the adsorption at metal-electrolyte interfaces involved both chemical and physical adsorption, but predominantly chemisorption mechanism.

Loss-of-Function GRHL3 Variants Detected in African Patients with Isolated Cleft Palate.

In contrast to the progress that has been made toward understanding the genetic etiology of cleft lip with or without cleft palate, relatively little is known about the genetic etiology for cleft palate only (CPO). A common coding variant of grainyhead like transcription factor 3 ( GRHL3) was recently shown to be associated with risk for CPO in Europeans. Mutations in this gene were also reported in families with Van der Woude syndrome. To identify rare mutations in GRHL3 that might explain the missing heritability for CPO, we sequenced GRHL3 in cases of CPO from Africa. We recruited participants from Ghana, Ethiopia, and Nigeria. This cohort included case-parent trios, cases and other family members, as well as controls. We sequenced exons of this gene in DNA from a total of 134 nonsyndromic cases. When possible, we sequenced them in parents to identify de novo mutations. Five novel mutations were identified: 2 missense (c.497C>A; p.Pro166His and c.1229A>G; p.Asp410Gly), 1 splice site (c.1282A>C p.Ser428Arg), 1 frameshift (c.470delC; p.Gly158Alafster55), and 1 nonsense (c.1677C>A; p.Tyr559Ter). These mutations were absent from 270 sequenced controls and from all public exome and whole genome databases, including the 1000 Genomes database (which includes data from Africa). However, 4 of the 5 mutations were present in unaffected mothers, indicating that their penetrance is incomplete. Interestingly, 1 mutation damaged a predicted sumoylation site, and another disrupted a predicted CK1 phosphorylation site. Overexpression assays in zebrafish and reporter assays in vitro indicated that 4 variants were functionally null or hypomorphic, while 1 was dominant negative. This study provides evidence that, as in Caucasian populations, mutations in GRHL3 contribute to the risk of nonsyndromic CPO in the African population.

Synthesis and characterisation of chitin from periwinkle (Tympanotonus fusatus (L.)) and snail (Lissachatina fulica (Bowdich)) shells.

This study characterizes chitin extracted from bio-sources of snail and periwinkle using varied combinations of acid and alkali concentrations. A three level factorial design of experiment with alkali and acid concentrations was used. FTIR, XRD and SEM were used to investigate the structural changes after treatments. Results reveal that both alkali and acid concentrations significantly affect the development of the functional groups and their intensities in the extracted chitin. A certain combination of concentration of acid and alkali can be used to obtain chitin with high degree of order (Crystallinity Index (CrI)>0.9) and a degree of de-acetylation (DD>50%). This results in combined high crystallinity and degree of de-acetylation. The study also established that certain combination of acid and alkali concentrations could lead to alpha to beta transformation in chitin structure.

Occupational health problems and work practices of hairdressers in Uyo, Akwa Ibom State, Nigeria

There are several million hairdressers worldwide who are chronically exposed to various chemicals used in hairdressing business. This study aimed at determining the occupational health problems and work practices of hairdressers in Uyo, Nigeria. This was a cross-sectional descriptive study carried out in March 2017.The study participants consisted of all consenting hairdressers in Uyo metropolis, Nigeria who had been working for at least 6 months prior to the study. Data obtained was analyzed using STATA 12.1 software. Level of significance was set at 5%. A total of 429 hairdressers participated in the study. The mean age of respondents was 28.5 �7.5 years. Majority, (88.3%) were females and 63.9% were single. Ninety percent had at least secondary education, while 47.6% had worked for > 3years. Health problems reported included back pain 61.5%, tiredness 57.1%, Itching/ redness of hands 43.1%, eye itching 26.1%, catarrh 22.8% and hearing difficulty 17.7%. Injuries included needle pricks 59.0% and cuts 46.9%. Standing for > 8 hours was reported by 33% of respondents. Use of any personal protective equipment (PPE) was 67.6%. The most commonly used was glove 42.7%. Awareness about PPE increased with respondent's level of education (p<0.05).Hand lesions were significantly less among those who used gloves as 95.6% had no chemical burns and rashes, 95.1% experienced no dryness and 63.4% had no itching/redness (p<0.05). The respondents reported several health problems. Work practices included poor use of PPE and prolonged standing. Regular workplace safety training, shift duty and use of ergonomically suitable chairs are advocated for hairdressers

Clinical Utility of Urinary ß2-Microglobulin in Detection of Early Nephropathy in African Diabetes Mellitus Patients.

Background. Studies have indicated that diabetic tubulopathy may occur earlier than glomerulopathy, therefore providing a potential avenue for earlier diagnosis of diabetic nephropathy. Urinary beta-2-microglobulin (ß2m) was investigated in this study as a potential biomarker in the detection of early nephropathy in type 2 diabetics. Methods. One hundred and two diabetic subjects and 103 controls that met the inclusion criteria had data (sociodemographic, medical history, physical examination, and laboratory) collected. Urinary ß2m levels and urinary albumin concentration (UAC) were determined. Results. Elevated urinary ß2m was more frequent among the diabetics (52%, 95% CI: 42.1-61.8%) than among the controls (32%, 95% CI: 22.9-41.2%). The frequency of microalbuminuria was higher in the diabetics (35.3%, 95% CI: 25.9-44.7%) than in the controls (15.5%, 95% CI: 8.4-22.6%). There was a positive correlation between urinary ß2m and UAC (rho = 0.38, p < 0.001). Multivariate analysis showed BMI (OR: 1.23, 95% CI: 1.05-1.45), eGFR (OR: 0.97, 95% CI: 0.94-0.99), and presence of microalbuminuria (OR: 3.94, 95% CI: 1.32-11.77) as independent predictors of elevated urinary beta-2-microglobulin among the diabetics. Conclusion. Urinary ß2m may be useful, either as a single test or as a component of a panel of tests, in the early detection of diabetic nephropathy.

Association Studies and Direct DNA Sequencing Implicate Genetic Susceptibility Loci in the Etiology of Nonsyndromic Orofacial Clefts in Sub-Saharan African Populations.

Orofacial clefts (OFCs) are congenital dysmorphologies of the human face and oral cavity, with a global incidence of 1 per 700 live births. These anomalies exhibit a multifactorial pattern of inheritance, with genetic and environmental factors both playing crucial roles. Many loci have been implicated in the etiology of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in populations of Asian and European ancestries, through genome-wide association studies and candidate gene studies. However, few populations of African descent have been studied to date. Here, the authors show evidence of an association of some loci with NSCL/P and nonsyndromic cleft palate only (NSCPO) in cohorts from Africa (Ghana, Ethiopia, and Nigeria). The authors genotyped 48 single-nucleotide polymorphisms that were selected from previous genome-wide association studies and candidate gene studies. These markers were successfully genotyped on 701 NSCL/P and 163 NSCPO cases, 1,070 unaffected relatives, and 1,078 unrelated controls. The authors also directly sequenced 7 genes in 184 nonsyndromic OFC (NSOFC) cases and 96 controls from Ghana. Population-specific associations were observed in the case-control analyses of the subpopulations, with West African subpopulations (Ghana and Nigeria) showing a similar pattern of associations. In meta-analyses of the case-control cohort, PAX7 (rs742071, P = 5.10 × 10(-3)), 8q24 (rs987525, P = 1.22 × 10(-3)), and VAX1 (rs7078160, P = 0.04) were nominally associated with NSCL/P, and MSX1 (rs115200552, P = 0.01), TULP4 (rs651333, P = 0.04), CRISPLD2 (rs4783099, P = 0.02), and NOG1 (rs17760296, P = 0.04) were nominally associated with NSCPO. Moreover, 7 loci exhibited evidence of threshold overtransmission in NSOFC cases through the transmission disequilibrium test and through analyses of the family-based association for disease traits. Through DNA sequencing, the authors also identified 2 novel, rare, potentially pathogenic variants (p.Asn323Asp and p.Lys426IlefsTer6) in ARHGAP29 In conclusion, the authors have shown evidence for the association of many loci with NSCL/P and NSCPO. To the best of this knowledge, this study is the first to demonstrate any of these association signals in any African population.

Ectopic thoracic kidney and end-stage renal disease in a 38-year-old nigerian.

This patient is a 38-year-old housewife who presented with a one-month history of difficulty, in breathing, chest pain and bilateral leg swelling and had a blood pressure of 260/150 mmHg, features of malignant hypertension and hypertensive heart disease. Chest CT scan revealed a chest location of the left kidney. She also had elevated serum urea and creatinine and proteinuria (++). The right kidney was normally located with loss of corticomedullary differentiation. She is on maintenance haemodialysis and is being worked up for possible left nephrectomy.

Bioaccumulation of iron, zinc, cadmium and chromium by juvenile snail Limicolaria aurora J., fed edible mushroom Pleurotus spp from Niger Delta, Nigeria.

The effects of uptake of metals (iron, zinc, cadmium and chromium) by juvenile snail Limicolaria aurora fed edible mushroom Pleurotus spp from 3 contaminated farm sites and a laboratory grown species (control) respectively were investigated. The 120 snails were fed in plastic snaileries for 4 weeks in the laboratory. Control site was risk free. Metal uptake was low and bioaccumulation in L. aurora tissue was below FAO/WHO standard of 1 mg/kg for chromium and cadmium. Snails were considered safe for consumption.

Urban city transportation mode and respiratory health effect of air pollution: a cross-sectional study among transit and non-transit workers in Nigeria.

OBJECTIVES: To assess the respiratory health effect of city ambient air pollutants on transit and non-transit workers and compare such effects by transportation mode, occupational exposure and sociodemographic characteristics of participants. DESIGN: Cross-sectional, randomised survey. SETTING: A two primary healthcare centre survey in 2009/2010 in Uyo metropolis, South-South Nigeria. PARTICIPANTS: Of the 245 male participants recruited, 168 (50 taxi drivers, 60 motorcyclists and 58 civil servants) met the inclusion criteria. These include age 18-35 years, a male transit worker or civil servant who had worked within Uyo metropolis for at least a year prior to the study, and had no history of respiratory disorders/impairment or any other debilitating illness. MAIN OUTCOME MEASURE: The adjusted ORs for respiratory function impairment (force vital capacity (FVC) and/or FEV(1)<80% predicted or FEV(1)/FVC<70% predicted) using Global Initiative for Chronic Obstructive Lung Diseases (GOLD) and National Institute for Health and Clinical Excellence (NICE) criteria were calculated. In order to investigate specific occupation-dependent respiratory function impairment, a comparison was made between the ORs for respiratory impairment in the three occupations. Adjustments were made for some demographic variables such as age, BMI, area of residence, etc. RESULTS: Exposure to ambient air pollution by occupation and transportation mode was independently associated with respiratory functions impairment and incident respiratory symptoms among participants. Motorcyclists had the highest effect, with adjusted OR 3.10, 95% CI 0.402 to 16.207 for FVC<80% predicted and OR 1.71, 95% CI 0.61 to 4.76 for FEV(1)/FVC<70% predicted using GOLD and NICE criteria. In addition, uneducated, currently smoking transit workers who had worked for more than 1 year, with three trips per day and more than 1 h transit time per trip were significantly associated with higher odds for respiratory function impairment at p<0.001, respectively. CONCLUSIONS: Findings of this study lend weights to the existing literature on the adverse respiratory health effect of ambient air pollution on city transit workers globally. The role of other confounders acting synergistically to cause a more deleterious effect is obvious. In all, the effect depends on the mode and duration of exposure.

Heat resistance of dermatophyte's conidiospores from athletes kits stored in Nigerian University Sport's Center.

The incidence and heat resistance of conidiospores produced by dermatophytes isolated from athlete's kits (canvasses, stockings and spike shoes) stored in Nigerian University Sport's Centre were investigated. Epidermophyton floccosum, Microsporum oudouinii, Microsporum canis, Trichophyton concentricum, Trichophyton mentagrophytes and Trichophyton rubrum were isolated and their incidence on the athlete's kits varied with the species and type of kits. Among the isolates T. mentagrophytes, T. rubrum and E. floccosum with 25%, 23% and 20% prevalence rates respectively, were the most common isolates, and are often associated with tinea pedis (athletes foot). Canvasses with the highest incidence of dermatophytes (25 out of 34 fungal isolates) were the most contaminated kits and could serve as effective articles for the transmission of tinea pedis among athletes in Nigeria. The common etiological agents screened, produced asexual spores (conidiospores) that exhibited high resistance to heat treatment at 80 degrees C. Of the three isolates, E. floccosum, with a decimal reduction time (D-value) of D80 = 4.4 min was the most resistant followed by T. mentagrophytes with D80 = 4.0 min and then T. rubrum with D80 = 3.2 min. The spores elimination pattern indicates that increasing the heating duration would decrease the decimal reduction time and possibly denature the fungal propagules but may damage the skin during treatment with hot water compresses. The findings have shown that the use of hot water compresses is palliative but heat treatment especially vapour-heat treatment offers adequate preventive measures if applied for periodic treatment of contaminated kits. However, determining the correct condition for effective decontamination will require detailed understanding of the heat resistance of fungal spores. Otherwise treatment of kits with detergent and chaotropic agent such as urea and guanidinium salt is preferred to heat treatment.

Growth, keratinolytic proteinase activity and thermotolerance of dermatophytes associated with alopecia in Uyo, Nigeria.

Mycological research was conducted on the mycelial growth, keratinolytic proteinase activity and thermotolerance ofdermatophytes associated with alopecia patients in Uyo, Nigeria. The results revealed that Microsporum sp. - AP1, Epidermophyton sp. - AP2, Trichophyton rubrum - AP4, Trichophyton mentagrophytes - AP5 and a yeast Candida albicans - AP3 isolated exhibited variable growth and keratinase activity at different temperatures. Microsporum sp. - AP1 and T. mentagrophytes - AP5 survived heat treatment at 90 degrees C but exhibited best mycelial growth at 30 degrees C (with 53.41 mg/50 ml biomass dry weight) and 40 degrees C (with 61.32 mg/50 ml biomass dry weight) respectively, after incubation for 2 weeks. Trichophyton rubrum - AP4 and Epidermophyton sp. - AP2 could not survive heat treatment at 90 degrees C but grew better at 40 degrees C (with 38.52 mg/50 ml biomass dry weight) and 30 degrees C (with 48.32 mg/50 ml biomass dry weight) respectively, over the same incubation period, while C. albicans - AP3 grew better at 30 degrees C with 38.7 mg/50 ml biomass dry weight after 2 weeks, but failed to survive at 70 degrees C. All the isolates except Candida albicans - AP3 survived at 80 degrees C and exhibited great potential to elaborate keratinolytic enzymes, with T. mentagrophytes demonstrating the best potential at 30 degrees C and 40 degrees C. Higher temperatures tended to reduce keratinolytic activities and there were significant (P < 0.05) relationships between biomass weight and enzyme productivities of all the isolates except T. mentagrophytes. This indicates that in some dermatophytes keratinolytic proteinase activity is not a function of cell multiplicity. This plus the high thermostability of the enzymes are important attributes in the consideration of preventive and therapeutic methods against dermatophytes in the tropics.

Hepatotoxicity of carbon tetrachloride: protective effect of Gongronema latifolium.

The protective effect of the ethanolic extract of Gongronema latifolium (GLE) on carbon tetrachloride (CCI4) induced hepatic toxicity was studied. Liver enzymes studied included alanine aminotransferase (ALT), aspartate aminotraferase (AST), and alkaline phosphates (ALP). Hepatic injuries involved with possible necrosis which may have contributed to its possible pathogenesis was explored. Administration of toxicant only showed that the ALT level was significantly (P<0.05) increased to 345.83% when compared to control. Pretreatment with Gongronema latifolium extract (GLE) non-significantly (P<0.05) decreased to 13.08% when compared to those treated with toxicant only. Also under experimental conditions, increasing the concentration of Gongronema latifoluim extract (GLE) non-significantly (P<0.05) decreased dose-dependently the level of ALT to 18.20%. The AST level was non-significantly (P<0.05) increased to 41.55% on treatment with toxicant only. Pretreatment with GLE decreased the AST level non-significantly (P<0.05) to 25.76%. No evident increase or decrease in the level of ALP was observed. Treatments with toxicant showed liver cells filled with uniformly distributed dense small fat droplets, large nuclei, inflamed cells and evidence of necrosis and fibrosis. Pretreatment with 100mg/kg of the extract showed microvesicular fatty change with no evidence of inflammation, necrosis or fibrosis. The protective effect of the GLE was more pronounced in ALT and AST. However, the GLE has a strong modulatory effect against the hepatocellular damage induced by carbon tetrachloride.

Factors affecting the attrition of community-directed distributors of ivermectin, in an onchocerciasis-control programme in the Imo and Abia states of south-eastern Nigeria.

In areas of Nigeria where onchocerciasis is endemic, community-directed distributors (CDD) distribute ivermectin annually, as part of the effort to control the disease. Unfortunately, it has been reported that at least 35% of the distributors who have been trained in Nigeria are unwilling to participate further as CDD. The selection and training of new CDD, to replace those unwilling to continue, leads to annual expense that the national onchocerciasis-programme is finding difficult to meet, given other programme priorities and the limited resources. If the reported levels of attrition are true, they seriously threaten the sustainability of community-directed treatment with ivermectin (CDTI) in Nigeria. In 2002, interviews were held with 101 people who had been trained as CDD, including those who had stopped serving their communities, from 12 communities in south-eastern Nigeria that had high rates of CDD attrition. The results showed that, although the overall reported CDD attrition was 40.6%, the actual rate was only 10.9%. The CDD who had ceased participating in the annual rounds of ivermectin blamed a lack of incentives (65.9%), the demands of other employment (14.6%), the long distances involved in the house-to-house distribution (12.2%) or marital duties (7.3%). Analysis of the data obtained from all the interviewed CDD showed that inadequate supplies of ivermectin (P<0.01), lack of supervision (P<0.05) and a lack of monetary incentives (P<0.001) led to significant increases in attrition. Conversely, CDD retention was significantly enhanced when the distributors were selected by their community members (P<0.001), supervised (P<0.001), supplied with adequate ivermectin tablets (P<0.05), involved in educating their community members (P<0.05), and/or involved in other health programmes (P<0.001). Although CDD who were involved in other health programmes were relatively unlikely to cease participating in the distributions, they were more likely to take longer than 14 days to complete ivermectin distribution than other CDD, who only distributed ivermectin. Data obtained in interviews with present and past CDD appear vital for informing, directing, protecting and enhancing the performance of CDTI programmes, in Nigeria and elsewhere.