Silicone oil as a corneal lubricant to reduce corneal edema and improve visualization during

AIM:To evaluate the efficacy and safety of silicone oil(SO)as a corneal lubricant to improve visualization during vitrectomy.METHODS:Patients who underwent vitreoretinal surgery were divided into two groups.Group 1 was operated on with initial SO(Oxane 5700)as a corneal lubricant.Group 2 was operated on with initial lactated ringer’s solution(LRS)and then replaced with SO as required.Fundus clarity was scored during the surgery.Fluorescein staining was performed to determine the damage to corneal epithelium.RESULTS:Totally 114 eyes of 114 patients were included.Single SO use maintained a clear cornea and provided excellent visualization of surgical image.In group 1,the fundus clarity was grade 3 in 41/45 eyes and grade 2 in 4/45 eyes.In group 2,corneal edema frequently occurred after initial LRS use.The fundus clarity was grade 3 in 19/69 eyes,2 in 37/69 eyes and 1 in 13/69 eyes(P<0.05).SO was applied in 29 eyes of initial LRS use with subsequent corneal edema,which eliminated the corneal edema in 26 eyes.Corneal fluorescein staining score in group 1 was 0 in 28 eyes,1 in 11 eyes and 2 in 6 eyes,and 40,20 and 9,respectively,in group 2(all P>0.05).CONCLUSION:The use of SO as a corneal lubricant is effective and safe for preserving and improving corneal clarity and providing clear surgical field during vitrectomy.

The Effects of Cigarette Smoking on Serum Carboxyhemoglobin and Calcium Levels in Apparently Healthy Male Smokers in Benin City, Nigeria

The aim of this study is to determine the effects of cigarette smoking on carboxylhaemoglobin (COHb) and calcium levels in apparently healthy male cigarette smokers in Benin City, Nigeria. Thirty active cigarette smokers and thirty healthy, non-smokers within the same age range participated in this study. Serum COHb level was estimated using ELISA reagent from Calbiotech, USA, while calcium concentration was estimated spectrophotometrically with commercially purchased kit from Randox, UK. Results showed higher concentration of COHb but lower concentration of calcium level among the cigarette smokers when compared with the non-smokers. There were no statistically significant differences observed in COHb levels between smokers with regard to smoking duration (<5 yrs vs. ≥5 yrs;p = 0.893) and number of sticks of cigarette per day (<5 sticks/day vs. ≥5 sticks/day;p = 0.256). In contrast, significantly higher mean COHb level was found in subjects who smoked “always” compared with those who smoked “occasionally” (p = 0.04) and those who smoked “rarely” (p = 0.006). On the other hand, the smokers’ serum calcium level was not affected by smoking duration, frequency and number of sticks consumed. In conclusion, the present study confirms that cigarette smoking contributes to abnormally high COHb levels, which is associated with adverse health consequences from carbon-monoxide poisoning in the body. In addition, cigarette smoking may interfere with the mechanisms responsible for the absorption of calcium in the gastro-intestinal tract, thus leading to poor absorption as well as low levels of calcium in the body.

Seroprevalence, Type-Specific of Herpes Simplex Virus and Associated Risk Factors among Women of Child Bearing Age in Kogi State, Nigeria

Background: Viruses of the Herpes viridae family infect 90% of the Earth’s population. Humans are the hosts of at least nine unique herpes viruses. Aim: This study is aimed at evaluating the seroprevalence of type specific herpes simplex virus infection and the associated risk factors in a cross-section of asymptomatic healthy women of childbearing age in Kogi state, Nigeria. Methodology: A total of 330 females of child bearing age (15 - 49 years) participated in this study. They were recruited from various local government areas of three Senatorial districts of Kogi state. Blood samples were collected from participants and analyzed for HSV-1 and HSV-2 antibodies (IgG) quantitatively with ELISA kit. Results: The overall prevalence of HSV was 76.7%. Data further show that majority (96.4%) of the population studied had HSV-1, while 77% had HSV-2 infections. Results also showed that the young adults indicated prevalence of 95.7% for HSV-1 and 74.7% for HSV-2, while in the middle aged, the prevalence were 98.6% for HSV-1, and 84.9% for HSV-2. 99.2% of the married women were positive for HSV-1, while 86.9% were positive for HSV-2. 94.5% of the unmarried women were positive for HSV-1, while 70.5% were positive for HSV-2. The risk of HVS-1 or VS-2 infections was not associated with age, age of first sexual exposure and number sex partners before marriage. Married women were at greater risk for HSV-1 (p = 0.03) and HSV-2 (p ≤ 0.001) infections compared to the unmarried women. Conclusion: The prevalence of the HSV-1 and HSV-2 infections was high among asymptomatic healthy women of childbearing age in Kogi state, Nigeria. Efforts should be made to increase the awareness of HSV infection among the child bearing populace.

The Risk of Islet Cell and Insulin Autoantibodies and Their Predictive Strength as Markers of Type-1 Diabetes in a Cross-Section of Nigerian Population

Aim: We demonstrated the risk of developing islet autoantibodies-Insulin Autoanti-bodies (IAAs) and Islets cell Autoantibodies (ICAs)-in type-1 diabetic relatives and newly diagnosed type-1 patients compared to non-diabetic controls. We also aimed to determine the predictive strengths of both autoantibodies in the development of type-1 diabetes mellitus, and which of the two autoantibodies is a better predictive marker of type-1 diabetes mellitus among Nigerian adults. Methodology: A total number of four hundred and fifty five (455) subjects (211 (46%) males, and 244 (54%) females) aged between 35 - 76 years were recruited for the study. IAA and ICA levels were estimated using ELISA reagents from Biomerica Inc. Other parameters such as fasting blood sugar, urine glucose, and urine protein were assessed using standard biochemical techniques. Results: Relatives of type-1 diabetic patients and newly diagnosed type-1 diabetic patients were at greater risk (p < 0.05) of testing positive for more than one autoantibody (ICA and IAA) compared to non-diabetic controls. In addition, IAAs appeared to be better predictors or markers of type-1 diabetes mellitus compared to ICAs. Conclusion: The present study indicated a greater risk of autoim-mune destruction of the insulin producing beta cells of the pancrease of the type-1 relatives and newly diagnosed type-1 patients and suggests the need for periodic re-cruitment of individuals in the general population, siblings and relatives of type-1 diabetic patients for planned intervention trials. In addition, IAAs appeared to be better autoimmune markers of type-1 diabetes compared to ICAs.

Seroprevalence of <i>Helicobacter pylori</i>Infection and Risk Factors among Asymptomatic Subjects in Delta State, Nigeria

Aim: The study aimed at evaluating the seroprevalence of H. pylori infection and its associated risk factors in a cross-section of asymptomatic adult population in Niger-Delta, Nigeria. Methodology: 408 apparently healthy volunteers, aged between 18 - 87 years were recruited for this study. Blood samples were collected from participants and analyzed for H. pylori antibody (IgG) qualitatively with Combo rapid kits and quantitatively with Accu-Bind ELISA Kits. Results: The overall prevalence of Helicobacter pylori colonization in 408 asymptomatic adults was 52.5% (n = 214) and 48.3% (n = 197) by qualitative (Combo rapid kits) and quantitative (Accu-Bind ELISA Kits) serological test methods respectively. H. pylori infection did not differ statistically between genders (p = 0.962) and among age groups (p = 0.185). In addition, multivariate logistic regression indicated that sex and age were not associated with risk of H. pylori. However, participants from Delta Central were at greater risk (OR = 1.89;p = 0.014) of H. pylori infection compared with those from Delta South, but those from Delta North were not at greater risk of infection compared with those from Delta South (p = 0.476). Conclusion: This study indicated an intermediate seroprevalence of H. pylori among asymptomatic adults in Delta state, Nigeria. The prevalence of H. pylori infection was linked to geographical regions but not with sex and age.

The Level of CD4⁺T Cell Count among Reproductive Age Women Coinfected with Human Immune Virus, Hepatitis Surface Antigen and Herpes Simplex Virus in Kogi State, Nigeria

Background: There are pockets of evidence to show the existence of co-infections of viral particles in humans. Aim: The study aimed at evaluating the CD4+ T cell count among women of reproductive age co-infected with human immune virus, hepatitis surface antigen and herpes simplex virusin Kogi state, Nigeria. Methodology: 342 females of reproductive age within the ages of 15 - 49 years participated in this study. They were recruited from various local government areas of three Senatorial districts of Kogi state. Blood samples were collected from participants and analyzed for HSV1/HSV2, HIV, HBsAg and CD4 using different scientific methods and procedures. Results: There was no significant differences in mean CD4+ T cell counts between subjects who tested positive and those who tested negative for only HSV1 (p = 0.61), HSV2 (p = 0.95), HIV (p = 0.48) and co-infection for HSV1, HSV2, HIV (0.68). In contrast, mean CD4+ T cell count was significantly higher in those who tested positive compared with those who tested negative for HBsAg alone (p = 0.03) and those co-infected with HSV1, HSV2, HBsAg (p = 0.01). Analysis of variance (ANOVA) indicated no significant differences in CD4+ T cell counts among the different classes of infections. Conclusion: This study shows no decline in the count of CD4+ T cell on the co-infections of HSV1, HSV2 and HIV, but higher significant difference in those co-infected with HSV1, HSV2 and HBsAg was recorded among the women of child bearing age in Kogi state.

Comparative Analysis of Amino Acid Composition in the Head, Muscle and Tail of Fresh African Cat Fish (Clarias gariepinus)

Consumption of seafood has increased globally over the past 50 years, from an average of 9.9 kg per capital in the 1960s to over 20 kg in 2016. In Nigeria, African catfish (Clarias gariepinus) has gained more attention in terms of farming and consumption compared to other seafood. This project was carried out to determine the level of amino acid composition in the head, muscle and tail of catfish so as to enlighten the public about their choice on the part of catfish to be eaten. Eight different sets of fresh catfish with a mean ± standard deviation of 15.6 kg ± 1.89, which were collected from a local fish pound in Ado-Ekiti, Nigeria, were used for the analysis. Extraction and evaluation of the amino acid composition were carried out using standard analytical techniques. The results obtained showed that high values of amino acids were observed in the fresh catfish (g/100g protein): 13.27 - 13.87 (Glu), 8.76 - 10.39 (Asp), 7.20 - 9.15 (Leu), 7.00 - 8.26 (Lys) and a low value in (Cys), 1.27 - 1.38. The total amino acids had a range of 89.16 - 92.12 g/100g. The coefficient of variation percent (CV %) for all the parameters determined were all generally low with values of 0.74 (observed for Ser) and 39.41 (observed for Pro). Total essential amino acid with histidine values ranged from 38.64 - 42.91 g/100g (CV % = 5.66). It was also observed that the concentrations (g/100g) of amino acids in the muscle of fresh catfish (92.12) are higher than that of the tail (91.98) and that of the head (89.16). There is no appreciable variation in the amino composition of the head, muscle and tail of catfish as the values observed were found to be statistically insignificant (p > 0.05). Therefore, it could be posited that the amino acid in the muscle, tail and head of African catfish would therefore be enough to prevent malnutrition in children and in adults who feed solely on any part of this fish as a main source of protein.

Decision-Aiding Transit-Tracker Methodology for Bus Scheduling Using Real Time Information to Ameliorate Traffic Congestion in the Kathmandu Valley of Nepal

The bustling urban environment of Kathmandu Valley is characterized by unprecedented traffic congestion. Due to its bowel-shaped geography, gusty winds rarely remove vehicular emissions from the urban atmosphere, making Kathmandu one of Asia’s most polluted cities, 100th city in global pollution index. Over 500,000 vehicles travel daily on over 1600 km of roads covering over 675 sq&middot;km urban area. Thousands of low occupancy vehicles are added each year to the urban public transit system (UPTS). Kathmandu faces worse and unreliable traffic from the current UPTS mostly with low occupancy vehicles. Around 4.5 million urban denizens, both permanent and transient residents, suffer from unreliable UPTS. Traffic rules and daily transportation schedules are rarely followed, resulting in frequent traffic jams and accidents. Once experienced, visitors try avoiding the UPTS. Tourism, annually contributing almost 8 percent to Nepal’s total annual GDP, also suffers from poor UPTS. Planners, policy makers, and politicians (P-actors) are seeking ways to improve sustainable UPTS to ameliorate stresses to family life and working hours for the urban majority. Aiming to help P-actors, we propose a transit-tracker model that uses real time information (RTI) in mobile phones and web-embedded devices to inform travelers, drivers, government authorities, and sub-admins. We argue that unreliability in the UPTS motivates urban elites to add more low occupancy vehicles, which in turn reduces already shrunken urban spaces and contributes more per capita air pollution than multi-occupancy vehicles. Since mobile and smart phones are capable of processing RTI to generate meaningful information and inform various stakeholders in communicable languages, we argue that replacing low occupancy vehicles with multi-occupancy buses within a Bus Rapid Transit (BRT) system, on main roads with fixed schedules and strict traffic rules, would not only improve UPTS, but also reduce pollution in the Kathmandu Valley.

Effects of Cardiac Rehabilitation Exercise Protocols on Physical Function in Patients with Chronic Heart Failure: An Experience from a Resource Constraint Nation

Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p p > 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO2 max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO2 max (10.3 ± 0.5 mL/kg/min) (p p > 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.

Bivariate Logistic Regression of Knowledge as Predictor of the Practice of Female Genital Mutilation in Ekiti State,Nigeria

Female genital mutilation/cutting(FGM/C)is a harmful traditional practice with severe health implications among women and girls.This study determined whether knowledge reduced the practice of female genital mutilation and identified the socio-demographic factors that predicted the practice of female genital among parents in Ekiti State,Nigeria.A cross-sectional quantitative research method was employed among 600 selected parents in the three senatorial districts of Ekiti-State,Nigeria between March and June 2019.A pretested structured questionnaire was used to collect data.Our analysis revealed that 468(78%)of the respondents believed that the practice was high as against 132(22%)who said the practice was low.Female is two times more likely to practice FGM than male(OR=1.614,B=0.479,p<0.05,CI=1.088-2.394).Respondents with low knowledge were significantly 11 times likely to practice female genital mutilation compared with respondents with high knowledge(OR=10.597,B=2.361,p<0.05,CI=6.813-16.483).Those who lived in rural areas were two times significantly(OR=1.690,B=0.525,p<0.05,CI=3.246-13.197)likely to practice female genital mutilation than the urban dwellers.The study concluded that respondents’knowledge,location(urban/rural),sex,age,and ethnicity were strong predictors of the practice of FGM/C in Ekiti-State,Nigeria.With these findings in mind,the community institutions would play a great role in changing the community through spreading information about the health implications of FGM/C for the practice to be drastically reduced.

Assessment of Renal Biomarkers of Renal Function in Commercial Automobile Workers in Benin City, Edo State, Nigeria

Background: Blood-urea nitrogen, creatinine, uric acid and electrolytes are important biomarkers of renal function which could be considered as suitable prognostic indicators of renal dysfunction. Aim: The aim of this work was to assess renal biomarkers of renal function in commercial automobile workers in Benin City, Edo State, Nigeria. Methodology: A total of 158 males within the ages of 18 - 60 years participated in this study, 50 of which are control subjects. They were recruited for this study from various workshops in Benin City, while controls are unexposed volunteers. Results: It was observed that serum uric acid, urea, creatinine, chloride and bicarbonate levels in all the exposed groups were significantly higher (p Conclusion: This study indicated greater levels of some renal biomarkers in automobile workers compared with the controls. In addition, blood urea levels were elevated above normal range of values. These findings suggest that the occupationally exposed automobile workers may be at risk of renal diseases. This calls for urgent need for policy formulation that will prevent the vulnerable groups from kidney damage.

Serum Levels of Prostate Specific Antigen Parameters among Male Patients with Lepromatous Leprosy in Edo State, Nigeria

Aim: This study is aimed at determining the total PSA (tPSA), free PSA (fPSA) concentrations and free to total PSA ratio (f/tPSA) and their utility in prostate cancer (PCa) risk stratification among male lepromatous leprosy patients in Edo state, Nigeria. Methods: Forty participants and thirty controls participated in this study. A structured questionnaire was administered to each participant to elicit details such as their personal data, age, sex, residence, medications, alcohol consumption, smoking habit, length of time of diagnosis, sexual activities, as well as the history of any other underlying diseases. Blood samples were collected from the participants. Total and free PSA concentrations in the samples were measured using ELISA method. Results: Significantly (p = 0.042) higher serum fPSA among the leprosy patients (0.22 ± 0.12 ng/ml) compared with the healthy controls (0.17 ± 0.09 ng/ml). There were no significant (p = 0.055) difference in the mean tPSA between the leprosy patients (2.69 ± 2.25 ng/ml) compared with the control (1.95 ± 0.69 ng/ml). Similarly, no significant (p = 0.548) difference was observed in PSA ratio between the control (0.08 ± 0.04) and the leprosy patients (0.09 ± 0.03). Conclusion: Our study indicated no significant differences in tPSA and f/tPSA between the leprosy patients and their healthy control. Elevated tPSA as well as f/tPSA levels that fell within the high risk zones of PCa were more prevalent among patients aged ≥ 70 years, not married, who rarely had sexual intercourse and those with longer disease duration.

<i>Loa loa</i>microfilaremia in a blood donor—A case report

We report a case of Loa loa microfilaremia in a healthy blood donor. The potential for transfusion-transmitted infection and the possibility of transfusion-associated allergic reactions calls for stringent donor requirements. We recommend that all blood products be additionally screened for possible hemoparasites.

Impact of metformin on the therapeutic effect of radiotherapy

Objective:To explore the effect of metformin on therapeutic outcomes in cancer patients undergoing radiotherapy.Methods:A literature search of the electronic databases was conducted to retrieve articles that investigated the effect of metformin on radiotherapy.Timeframe of electronic search ranged from the inception of each database to May 2020.These databases include PubMed,Embase and Scopus.Results:From an initial search of 142 articles,and after the removal of duplicates as well as applying the inclusion and the exclusion criteria,20 articles were finally included in this systematic review.Results from the reviewed clinical studies showed promising therapeutic effect of the combination of metformin with radiotherapy.Metformin has promising therapeutic effects as an adjuvant with radiotherapy.Conclusions:The use of metformin as an adjuvant with radiotherapy should be treated with caution,as further studies investigating its optimal dose as well as molecular mechanisms are still needed.