An evaluation of intra-operative and post-operative blood loss in total knee arthroplasty at the National Orthopaedic Hospital, Lagos.

Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this study was to evaluate blood loss after total knee replacement. Patients and Methods: A prospective study of blood loss after Total Knee Arthroplasty in 53 patients in the National Orthopaedic Hospital, Lagos. Consecutive patients with established indications, presenting for total knee arthroplasty were recruited into the study after obtaining their consent. Results: The mean intra-operative blood loss was 342.4 mls, with a range of 50 - 1500 mls. The mean post-operative blood loss and total blood loss were 603.6 mls and 940.3 mls respectively, showing a strong positive correlation (r = 0.884, p < 0.01). The average pre-operative and post-operative haemoglobin concentration were 12.5 ± 1.2 g/dl and 9.8 ± 0.9 g/dl, respectively. The mean haemoglobin loss was 2.6 ± 1.2 g/dl (r = 0.46, p < 0.001). Conclusion: Post-operative blood loss as measured by suction drainage, is a good predictor of total blood loss, showing a strong and positive correlation.

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.

Antimicrobial potential of Dialium guineense (Wild.) stem bark on some clinical isolates in Nigeria.

CONTEXT: The persistent increase in the number of antibiotic-resistant strains of microorganisms has led to the development of more potent but also more expensive antibiotics. In most developing countries of the world these antibiotics are not readily affordable, thus making compliance difficult. This calls for research into alternative sources of antimicrobials. Dialium guineense is a shrub of the family Leguminosae. Its stem bark is used for the treatment of cough, toothache, and bronchitis. AIMS: Despite the acclaimed efficacy of D guineense, there is no scientific evidence in its support. This work was carried out to assess the antimicrobial activity of D guineense in vitro against some clinical isolates. MATERIALS AND METHODS: D guineense stem bark was collected and 50 gm of air-dried and powdered stem bark of the plant was soaked for 72 hours in 1 l of each of the six solvents used in this study. Each mixture was refluxed, agitated at 200 rpm for 1 hour, filtered using Whatman No. 1 filter paper and, finally, freeze dried. The extracts were then tested for antimicrobial activity using the agar diffusion method. RESULTS: The highest percentage yield of 23.2% was obtained with ethanol. Phytochemical screening showed that D guineense contains anthraquinone, alkaloids, flavonoids, tannins, and saponins. The antimicrobial activity of the extracts revealed a broad spectrum of activity, with Salmonella typhi and Staphylococcus aureusa showing the greatest zones of inhibition (18.0 mm). Only Candida albicans among the fungi tested was inhibited by the extract. The greatest zone of inhibition among the fractions was 16.0 mm. D guineense exhibited bactericidal activity at the 7th and 9th hours against Streptococcus pneumoniae and S. aureus 25923 while the 10th hour against S. typhi and C. albicans. The greatest activity was noted against S pneumoniae, where there was reduced viable cell count after 6 hours of exposure. CONCLUSION: Stem bark extract of D guineense (Wild.) has the potential to be developed into an antimicrobial agent.

Astrovirus infection in children in lagos, Nigeria.

A preliminary investigation was conducted to screen for astrovirus in Lagos. Two hundred and fifteen (215) faecal samples collected from children under 5 years old with diarrhoea (161) and without diarrhoea (54) admitted at paediatric clinics in Lagos State were studied. The stool specimens were examined for the presence of human astrovirus antigen using a monoclonal antibody-based ELISA (Astrovirus RIDASCREEN(®) r-Biopharm, Germany) technique. Astrovirus was detected in 40.4 percent (65/161) of the diarrhoeal stools compared to 11.1 percent (6/54) of the control specimens. Astrovirus was found to infect younger children and about three quarter of the children infected was under 12 months of age. The prevalence of infection decreases with age group and was statistically significant (P = 0.0470). Although, prevalence of infection is more in males than females but this is not significant. This study shows that astrovirus is an important agent of acute gastroenteritis among children in Lagos state.

Astrosvirus infection children in Lagos, Nigeria

A preliminary investigation was conducted to screen for astrovirus in Lagos. Two hundred and fifteen (215) faecal samples collected from children under 5 years old with diarrhoea (161) and without diarrhoea (54) admitted at paediatric clinics in Lagos State were studied. The stool specimens were examined for the presence of human astrovirus antigen using a monoclonal antibody-based ELISA (Astrovirus RIDASCREEN® r-Biopharm, Germany) technique. Astrovirus was detected in 40.4 percent(65/161) of the diarrhoeal stools compared to 11.1 percent (6/54) of the control specimens. Astrovirus was found to infect younger children and about three quarter of the children infected was under 12 months of age. The prevalence of infection decreases with age group and was statistically significant (P = 0.0470). Although, prevalence of infection is more in males than females but this is not significant. This study shows that astrovirus is an important agent of acute gastroenteritis among children in Lagos state

Elemental analysis of limestone samples from Obajana and Mfamosing limestone deposits, Nigeria, using nuclear techniques.

Six limestone samples were picked from three different points at the Obajana and Mfamosing limestone deposits. The limestone samples were subjected to elemental analysis by Proton-Induced X-Ray Emission (PIXE) analysis. The samples were irradiated by a 4mm diameter beam of protons with energy of 2.5 MeV and beam current of 0.2nA for 0.9 ms. The analysis was carried out with the 1.7MV Tandem accelerator at the Centre for Energy Research and Development (CERD), Ile-Ife, Osun State, Nigeria. The NIST geology standard NIST 278 was analysed for quality assurance. The elemental composition and concentration of 14 elements were determined in the two locations. Ten elements were found at the Obajana deposit while 13 elements were found at the Mfamosing deposits. The elements: Mg, Al, Ca and Mn do not differ much at both deposits while others differ. The major elements (Ca, Fe, Al, Si and K) present in the limestones were also found in airborne particulate matter studied by earlier researchers. These observations suggest that all particulate emissions and wastes from the Limestone deposit should be closely monitored to reduce their cumulative effects on both health and the environment.

Activated charcoal-a potential material in glucoamylase recovery.

The potential of activated charcoal in the purification of fungal glucoamylase was investigated. Various concentrations of activated charcoal (1-4% w/v) were used to concentrate crude glucoamylase from Rhizopus oligosporus at different temperature values (30-50°C). Effects of pH (3.0-6.0) and contact time (0-60 min) on enzyme purification were also monitored. Activated charcoal (3% w/v) gave a 16-fold purification in a single-step purification at 50°C for 20 min and pH 5.5. The result of SDS-PAGE analysis of purified glucoamylase showed two major protein bands with corresponding molecular weight of 36 kDa and 50 kDa. The method is inexpensive, rapid, and simple which could facilitate downstream processing of industrial enzyme.

The effects of a soluble activin type IIB receptor on obesity and insulin sensitivity.

BACKGROUND: Myostatin, also known as Growth and Differentiation Factor 8, is a secreted protein that inhibits muscle growth. Disruption of myostatin signaling increases muscle mass and decreases glucose, but it is unclear whether these changes are related. We treated mice on chow and high-fat diets with a soluble activin receptor type IIB (ActRIIB, RAP-031), which is a putative endogenous signaling receptor for myostatin and other ligands of the TGF-beta superfamily. RESULTS: After 4 weeks, RAP-031 increased lean and muscle mass, grip strength and contractile force. RAP-031 enhanced the ability of insulin to suppress glucose production under clamp conditions in high-fat fed mice, but did not significantly change insulin-mediated glucose disposal. The hepatic insulin-sensitizing effect of RAP-031 treatment was associated with increased adiponectin levels. RAP-031 treatment for 10 weeks further increased muscle mass and drastically reduced fat content in mice on either chow or high-fat diet. RAP-031 suppressed hepatic glucose production and increased peripheral glucose uptake in chow-fed mice. In contrast, RAP-031 suppressed glucose production with no apparent change in glucose disposal in high-fat-diet mice. CONCLUSION: Our findings show that disruption of ActRIIB signaling is a viable pharmacological approach for treating obesity and diabetes.

Application, effectiveness, and limitations of the electrophysiological diagnosis of neurotoxic effects of chronic environmental mycotoxins in humans.

An extensive body of data demonstrates that diverse groups of mycotoxins can alter the structure and function of the nervous system in a variety of ways with notable human health consequences. Myconeurotoxicity refers to any adverse effects of exposure to mycotoxins or byproducts of primary and secondary mold metabolism, including volatile organic compounds (VOCs) on the structural or functional integrity of the developing or adult nervous system. Neuromycotoxic effects may involve a spectrum of biochemical, morphological, behavioral, and physiological abnormalities whose onset can vary from immediate to delayed action, following exposure to a mycotoxin, and whose duration may be transient or persistent and result in disability, while some may have life-threatening consequences. Myconeurotoxicity may result from effects of the mycotoxins acting directly on the elements of the nervous system or acting on other biological systems, which then adversely affect the nervous system. This paper reviews the application, effectiveness, and limitations of the electrophysiological diagnosis of myconeurotoxic effects of chronic environmental exposure to mycotoxins. The systemic targets of mycotoxic effects were reviewed for greater understanding as to why different neurophysiological test techniques have different levels of outcomes. Thus, nerve conduction velocity, sensory, motor, and evoked potentials, electroencephalographic techniques were evaluated using previously published papers and our clinical experience. Although, neuromycotoxic disorders can be established using clinical electrophysiological diagnosis, there is always the possibility of false positive and false negative results in some patients, which may be due to a multi-factorial etiopathogenesis of neuromycotoxicity. Detection of nervous system toxicity and other measures of toxicity could be achieved using a combination of these neurodiagnostic techniques.

Health impacts of frequent heavy automobile traffic on children and adolescents.

This paper assesses the extent to which particulate, elemental and organic carbon emissions from heavy traffic in urban city roads affect the health of children and the adolescent health. Although the health effects of exposures may be cumulative, it is in the adolescence that the manifestations are realized. This paper therefore, assesses the best way forward for monitoring and preventing the environmental health impacts of heavy traffic on children and adolescents who live within the vicinity of urban city transportation systems. Major urban cities such as Houston, New York, and California are cited as examples of cities where health-related problems have already been reported. The particulate, elemental and organic carbon emissions are reviewed as the sources by which heavy traffic and the hazardous chemical emissions affect the health of the populace. The role of accessory loading and engine speed on idling emissions in direct health risks of children and adolescents is evaluated. The association of particulate, elemental, and organic carbon emission with respiratory effects (including, allergies and asthma), and the related behavior problems in children and the adolescents are discussed. The best strategies in preventing the effects of heavy traffic in the urban cities are suggested by introducing new effective monitoring techniques and exposure assessment methods. It is visualized that a more comprehensive research is needed to develop robust regulatory systems that would control the efficiency of automobiles and prevent the adverse health effects relating to heavy traffics in urban city roads. Strong city environmental health authorities-community partnerships relevant to exposure information should be encouraged.

The neurological significance of abnormal natural killer cell activity in chronic toxigenic mold exposures.

Toxigenic mold activities produce metabolites that are either broad-spectrum antibiotics or mycotoxins that are cytotoxic. Indoor environmental exposure to these toxigenic molds leads to adverse health conditions with the main outcome measure of frequent neuroimmunologic and behavioral consequences. One of the immune system disorders found in patients presenting with toxigenic mold exposure is an abnormal natural killer cell activity. This paper presents an overview of the neurological significance of abnormal natural killer cell (NKC) activity in chronic toxigenic mold exposure. A comprehensive review of the literature was carried out to evaluate and assess the conditions under which the immune system could be dysfunctionally interfered with leading to abnormal NKC activity and the involvement of mycotoxins in these processes. The functions, mechanism, the factors that influence NKC activities, and the roles of mycotoxins in NKCs were cited wherever necessary. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40 degrees C (104 degrees F), cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures. Although sleep is commonly considered a restorative process that is important for the proper functioning of the immune system, it could be disturbed by mycotoxins. Most likely, mycotoxins exert some rigorous effects on the circadian rhythmic processes resulting in sleep deprivation to which an acute and transient increase in NKC activity is observed. Depression, psychological stress, tissue injuries, malignancies, carcinogenesis, chronic fatigue syndrome, and experimental allergic encephalomyelitis could be induced at very low physiological concentrations by mycotoxin-induced NKC activity. In the light of this review, it is concluded that chronic exposures to toxigenic mold could lead to abnormal NKC activity with a wide range of neurological consequences, some of which were headache, general debilitating pains, fever, cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, and seizures.

Biochemical changes in the serum of patients with chronic toxigenic mold exposures: a risk factor for multiple renal dysfunctions.

This paper analyzes and presents the biochemical abnormalities in the sera of patients presenting with chronic mycosis in order to investigate the relationship with the risks of multiple renal disorders. The study population (n = 10) consisted of six females and four males (mean age 36.3 years) exposed by toxic molds in their homes and offices for an average of 2.8 years. The control group comprised ten people, five males and five females (mean age 35.9 years) without any known exposures to toxic molds. Blood samples were obtained from both the patients and the controls and were processed using specific biochemical methods that included enzyme-linked immunoabsorbent assay (ELISA). There were biochemical abnormal concentrations in creatinine, uric acid, phosphorus, alkaline phosphotase, cholesterol, HDH, SGOT/AST, segmented neutrophils, lymphocytes, total T3, IgG and IgA immunoglobulins with significant differences between patients and controls. These abnormalities were consistent with multiple renal disorders. The major complaints of the mycosis patients were headaches, pulmonary symptoms, allergic reactions, memory loss, skin rashes, blurred vision symptoms, fatigue, and runny nose. These findings were depictive of a strong association of chronic mycosis with abnormal renal indicators. It was concluded that, although this research was a pilot investigation, based on the overall results, people exposed to chronic indoor environmental toxic molds were at risk of multiple renal complications.

Evaluation of the most current and effective methods in the analysis of chlorinated dioxins in ground beef.

Chlorinated dioxins are the group of environmental pollutants consisting of 210 chlorinated dibenzo-p-dioxins and dibenzofurans. They are highly toxic and persistent. They are lipophilic and can easily biomagnify in the food chain, hence posing a serious threat to human health. The daily consumption of low-level contaminated food, mainly of animal origin, leads to the accumulation of dioxins in the human body. The exposures of the general human population to dioxins and the specific issues of a risk assessment of dioxin pose serious concerns in public environmental and nutritional health. This paper reviews the analysis of chlorinated dioxins in ground beef. The sources of contamination of chlorinated dioxins in ground beef are first reviewed to form a basis for a clear understanding of the health implications of chlorinated dioxins in the human food chain and why it is necessary to monitor the level of dioxins in animal food products, especially ground beef. The methods of collection, sampling, and processing of ground beef, and the methods of sample clean up prior to the analysis, are reviewed. Emphasis is laid on the new techniques that are available and that might be effective in the analysis of chlorinated dioxins in ground beef. Among these new methods and techniques are: the synergistic combination of ELISA/GC/MS, direct sample introduction to /GC/MS-MS, automated clean-up method, and the supercritical fluid extraction methods. The possible treatments of results from each method and technique are discussed and their respective efficiencies are compared. Finally, quality control and quality assurance parameters are evaluated for levels of accuracy, reproducibility, and precision.

Calotropis procera (Sodom apple)--a potential material for enzyme purification.

A simple method based on precipitation with Calotropis procera latex was developed for the purification of crude enzyme from fermentation broth. C. procera latex (10(-2) dilution) clarified and concentrated the crude amylase of Aspergillus oryzae 4-fold with 97% recovery of the initial amylase activity in the filtrate in a single step operation. The latex was stable at pH < or = 4.5 and there was no significant difference (P < or = 0.05) in the purification potential of the latex at 4 and 28 degrees C. This method could prove useful to developing economies of the tropics where ambient temperature is around 28 degrees C.

Human ecology and parasitic infections. 1. The effect of occupation on the prevalence of parasitic infections in Calabar, Nigeria.

One thousand six hundred people belonging to three different occupational groups were randomly selected. Blood, urine and stool specimens were collected from them and processed for the detection of any parasitic infections. The results show 28.5% infection rate with one or more species of intestinal parasites; 50.7% in the school children, 17.3% among the farmers, and 12% among the soldiers. Results of blood examination showed 5.3%, 8.0% and 2.0% infection rates for P. falciparum in the school pupils, farmers and soldiers respectively, while 31.3% of the three groups were infected with the microfilaria of Dipetalonema perstans, and Loa loa. These were found in 60.7% of the farmers and none at all in the other two groups. Urine examination yielded no positive cases of urinary schistosomiasis and only one case of Trichomonas vaginalis. These results reflect the endemicity of the respective parasites, the degree of their sanitary awareness and their exposure frequencies to the pathogens as a result of their daily activities.