Seroprevalence of infectious bursal disease virus in local chickens in Udu Local Government Area of Delta State, South East Nigeria.

Infectious Bursal Disease Virus (IBDV) poses a great global threat to the poultry industry. Knowledge of the occurrence of the disease is important in the design and implementation of a control program, therefore this study determines the seroprevalence of IBDV in local chickens in Udu Local Government Area of Delta State. 250 chickens were bled by exsanguination and sera obtained were screened using Agar Gel Immunodiffusion (AGID) test. The seropositivity was 51.6%, which is indicates endemicity of the disease. Biosecurity and good sanitary measures are recommended. Molecular characterization of the strains should be carried out for inclusion in generic vaccines.

Prevalence of Newcastle Disease Antibodies in Local Chicken in Federal Capital Territory, Abuja, Nigeria.

Newcastle disease is a contagious disease of birds and is the greatest constraint to the development of rural poultry production in Nigeria and most developing countries. The only effective means of control is vaccination which is not properly carried out in Nigeria. Therefore, this project determined the prevalence rate of Newcastle disease virus (NDV) in local chicken in the Federal Capital Territory, Abuja, Nigeria. About 5 mL of blood was collected from each of 200 chickens at the point of sale by exsanguination and sera obtained were analyzed using Haemagglutination Inhibition (HI) test to determine the prevalence of NDV. Of the 200 samples screened 34 were positive for HI antibody to NDV giving a prevalence rate of 17%. The prevalence rate obtained in this study is significant (P < 0.05) and indicates endemicity of the disease. There was no statistically significant (P > 0.05) difference in the seroprevalence of NDV antibodies among the four markets studied. Further studies are required to determine the strains circulating for appropriate preventive and control measures.

Mechanical thrombectomy of an infected deep venous thrombosis: a novel technique of source control in sepsis.

A young i.v. drug abuser presented with an extensive iliofemoral deep vein thrombosis and signs of severe sepsis. Subsequent investigations revealed multiple septic emboli in his lungs originating from infected thrombus in his leg. Despite systemic anti-coagulation and appropriate parenteral antibiotics, he continued to show signs of worsening acute infection. Percutaneous mechanical thrombectomy was performed successfully and resulted in an immediate improvement in his condition. In this report, we discuss the novel use of this technique for source control in a patient with septic shock secondary to infected thrombus.

Brachial plexopathy as a complication of induced hypothermia following cardiac arrest.

Induced hypothermia following cardiac arrest is a common treatment in the critical care unit. Topical cooling measures are easy to initiate and widely utilised. We report a case of brachial plexopathy occurring in association with topical cooling measures and discuss the diagnosis, management and avoidance of such complications.

Serologic and virologic surveillance of avian influenza in Nigeria, 2006-7.

Since January 2006, H5N1 avian influenza has affected Nigeria's poultry population causing enormous loss of resources. The current circulating virus is a potential candidate for pandemic influenza which may severely affect the human and animal population worldwide especially in the resource-poor countries. In this study, we report on our field and laboratory surveillance efforts in Nigeria. A total of 1,821 tissue samples, 8,638 tracheal swabs, 7,976 cloacal swabs and 7,328 avian sera were analysed over a period of two years, with 312 positive results [corrected] We recovered 299 isolates of highly pathogenic avian influenza virus H5N1 mainly from the diagnostic samples of poultry kept in backyard, small scale and free range farms. This finding emphasised the role played by these farming systems in the dissemination of avian influenza in Nigeria and highlights the need for a continued surveillance in humans since human-animal interaction is a key feature in Africa. Furthermore, there is a need for the strengthening of border controls. Since October 2007, there has been no reported and confirmed outbreak of avian influenza in Nigeria.

Control versus no control: options for avian influenza H5N1 in Nigeria.

In January 2006, an outbreak of a highly pathogenic avian influenza (HPAI) was recorded in Nigeria for the first time. This present work describes an estimation of possible costs associated with a vaccination-based control policy added to other measures to restrict HPAI H5N1 virus infections. The evaluations used epidemiological and production data, including budgets necessary for the vaccine acquisition, distribution and administration in arriving at the final costs. Using decision tree and cost benefit analysis the economical benefits for Nigeria and countries with similar veterinary infrastructures, biosecurity and farming systems are calculated. The result indicated that a halting in the continued spread of the virus through effective control measure will be 52 times better than taking no action. This should help policy makers in deciding in favour of vaccination combined with other tools as an effective means of controlling avian influenza H5N1. * Control of HPAI H5N1 will best be understood by policy makers in financial terms. * Effective control through vaccination of poultry is much cheaper and reduces the chances of human zoonoses. * Poultry vaccination combined with other control measures will be the most effective means of control in most developing economies.

Surgical vs wire-guided cricothyroidotomy: a randomised crossover study of cuffed and uncuffed tracheal tube insertion.

Using an airway mannequin and artificial lung model, we compared surgical cricothyroidotomy with a 6.0-mm cuffed Portex tracheostomy tube with wire-guided cricothyroidotomy using a 5.0-mm cuffed Melker or 6.0-mm uncuffed Melker tube. The trial was carried out by 27 anaesthetists using a randomised, crossover design. Surgical cricothyroidotomy proved significantly faster (mean (SD) time to first breath 44.3 (12.5) s for Portex surgical, 87.2 (21.6) s for cuffed Melker, 87.8 (19.2) s for uncuffed Melker, p < 0.001). With a standardised ventilator model, the cuffed tubes provided more effective ventilation (mean (SD) tidal volume 446 (41) ml Portex, 436 (52) ml cuffed Melker, 19 (5) ml uncuffed Melker, p < 0.001). Fourteen of the participants preferred the wire-guided system. We conclude that, in this model, a cuffed device is preferable when cricothyroidotomy is needed. In addition, the surgical method is quicker than a wire-guided approach.

Survival after massive bleeding into the airway in a patient at risk from "can't intubate, can't ventilate".

A patient survived massive bleeding into the airway due to blowout of the right internal jugular vein associated with a failed free-flap graft for pharyngeal malignancy. A recently decannulated "covering tracheostomy" could not be easily re-established. Direct laryngoscopy and mask ventilation were inappropriate because the pharyngeal mucosal wound opened spontaneously and progressively and bleeding was dramatic. Positive pressure ventilation via a facemask risked widespread surgical emphysema and further wound disruption and because bleeding was from the internal jugular vein, there would also have been a risk of air embolism. The clinical situation evolved rapidly so time management and consideration of hierarchy of mortality risks was critical. It was eventually possible to re-establish the previous tracheostomy site as a result of close co-operation between the surgical and anaesthetic teams. In difficult intubation where the problems are anticipated, the notion of responsive contingency planning is suggested to be of more general relevance than the current standard of considering alternative fallback options. The limitations of conventional capnography in this situation are also noteworthy.