Atorvastatin improves sputum conversion and chest X-ray severity score.

BACKGROUND: We report the results of a phase IIB study investigating the safety and effectiveness of atorvastatin use with standard anti-TB drugs.METHODS: In this multicentre, open-labelled study, we recruited treatment-naÏve patients with uncomplicated pulmonary TB aged at least 18 years. Participants were randomly assigned to standard-of-care or standard-of-care plus oral dose of atorvastatin (40 mg) daily for 2 months. Primary end points were safety measured by the number of participants with severe adverse events and effectiveness measured by the number of participants with negative sputum culture. Secondary endpoint was chest X-ray (CXR) severity score.RESULTS: Of the 185 participants screened, 150 were enrolled and equally assigned to the standard-of-care and atorvastatin groups. Adverse event severity was similar in the two groups. There was increased frequency of muscle pain in the trial group (12/75, 16% vs. 4/75, 5%). For efficacy analysis, respectively 64 (97%) and 57 (85.1%) patients in the trial and control groups had culture-negative results (P = 0.02) and experienced a reduction in CXR severity score of respectively 37% and 22%, with a mean difference of 1.4-4.9%.CONCLUSION: Atorvastatin is safe and associated with improved microbiological and radiological outcomes in TB.

New method to estimate femoral head size from the trochanteric length of the femur.

INTRODUCTION: Preoperative planning is an important step before any joint replacement surgery. In developing countries standardised radiographs and planning tools might not be available but nevertheless hemiarthroplasties are performed in certain trauma cases. An equation should be devised to allow a preoperative estimation of the expected femoral head size dimensions in those situations. MATERIALS AND METHODS: 35 lower limbs of human cadavers were studied. The estimated femoral head (EFH) size of each femur was obtained by measuring the trochanteric length (TL) (in cm) and using the equation 'EFH = 16 + (0.7 × TL)'. The hip joint was dissected, and the actual size of the femoral head (AFH) was measured on the specimen. RESULTS: There was a correlation between the EFH and AFH (p = 0.0001). Accepting a range of ±3 mm the femoral head size was predicted correctly in 31 hips (89%), for ±4 mm in 33 hips (94%) and for ±5 mm in 35 hips (100%), respectively. CONCLUSIONS: A simple tape measurement and the equation Femoral head size = {16 + (0.7 × Trochanteric Length)} ±5 mm gives a rather reliable guess for the expected femoral head size. It might be useful as pre-operative planning tool if no standardised radiographs are available.

Propensity of Tagetes erecta L., a Medicinal Plant Commonly Used in Diabetes Management, to Accumulate Perfluoroalkyl Substances.

It has been extensively demonstrated that plants accumulate organic substances emanating from various sources, including soil and water. This fact suggests the potentiality of contamination of certain vital bioresources, such as medicinal plants, by persistent contaminants, such as perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorobutane sulfonate (PFBS). Hence, in this study, the propensity of Tagetes erecta L. (a commonly used medicinal plant) to accumulate PFOA, PFOS, and PFBS was determined using liquid chromatography/tandem mass spectrometry (LC⁻MS/MS-8030). From the results, PFOA, PFOS, and PFBS were detected in all the plant samples and concentration levels were found to be 94.83 ng/g, 5.03 ng/g, and 1.44 ng/g, respectively, with bioconcentration factor (BCF) ranges of 1.30 to 2.57, 13.67 to 72.33, and 0.16 to 0.31, respectively. Little evidence exists on the bioaccumulative susceptibility of medicinal plants to these persistent organic pollutants (POPs). These results suggest that these medicinal plants (in particular, Tagetes erecta L., used for the management of diabetes) are also potential conduits of PFOA, PFOS, and PFBS into humans.

Biochemical characteristics of a free cyanide and total nitrogen assimilating Fusarium oxysporum EKT01/02 isolate from cyanide contaminated soil.

Sustainability of nutrient requirements for microbial proliferation on a large scale is a challenge in bioremediation processes. This article presents data on biochemical properties of a free cyanide resistant and total nitrogen assimilating fungal isolate from the rhizosphere of Zeamays (maize) growing in soil contaminated with a cyanide-based pesticide. DNA extracted from this isolate were PCR amplified using universal primers; TEF1-α and ITS. The raw sequence files are available on the NCBI database. Characterisation using biochemical data was obtained using colorimetric reagents analysed with VITEK® 2 software version 7.01. The data will be informative in selection of biocatalyst for environmental engineering application.

Vigna subterranea ammonium transporter gene (VsAMT1): Some bioinformatics insights.

Ammonium transporters (AMTs) play a role in the uptake of ammonium, the form in which nitrogen is preferentially absorbed by plants. Vigna subterranea (VsAMT1) and Solanum tuberosum (StAMT1) AMT1s were characterized using molecular biology and bioinformatics methods. AMT1-specific primers were designed and used to amplify the AMT1 internal regions. Nucleotide sequencing, alignment and phylogenetic analysis assigned VsAMT1 and StAMT1 to the AMT1 family. The deduced amino acid sequences showed that VsAMT1 is 92% and 89% similar to Phaseolus vulgaris PvAMT1.1 and Glycine max AMT1 respectively, while StAMT1 is 92% similar to Solanum lycopersicum LeAMT1.1, and correspond to the 5th-10th trans-membrane domains. Residues VsAMT1 D23 and StAMT1 D15 are predicted to be essential for ammonium transport, while mutations of VsAMT1 W1A-L and S87A and StAMT1 S76A may further enhance ammonium transport. In addition to nitrogen uptake from the roots, VsAMT1 may also contribute to interactions with rhizobia.

Respiratory symptoms and lung function patterns in workers exposed to wood smoke and cooking oil fumes (mai suya) in Nigeria.

BACKGROUND: 'Mai suya' is a common job in the most northern Nigeria in which there is significant exposures to wood smoke and oil fumes. The respiratory impact of these dual exposures on workers engaged in this work has not been previously documented, hence this study was carried out. AIM: The aim is to study the prevalence, patterns and respiratory function assessment among this group. SUBJECT AND METHODS: This is a case controlled study involving mai suya and workers who are not exposed to wood smoke and oil fumes in an occupational setting. All consenting mai suya and matched controls were recruited. Both groups underwent an interviewer administered questionnaire followed by on spot spirometric test measuring forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR). Results are presented using descriptive statistics. Chi square was used to test for association between respiratory symptoms and the job categories. Student's t-test was used to compare values of continuous variables. Odd ratios were determined for the risk of respiratory symptoms and exposure to wood smoke and oil fumes. RESULTS: Both groups are similar in their demographic characters except in their smoking status, so current smokers were excluded from further analysis. The test group had significantly increased occurrence of chest tightness: 59% (19/32), nasal congestion: 37% (12/32), cough: 32% (10/32), and wheeze: 12% (4/32) compared with the control group, odds ratio (OR) 3.1, 95% confidence interval CI (0.1-5.8), P value 0.04, OR 1.2,95% CI (1.04-1.8), P value = 0.02, OR 0.9 95% CI (0.9-1.4), P value = 0.3, and OR 1.2,95% CI (1-1.3), P value = 0.04, respectively. Occurrences of some respiratory symptoms were associated with duration on the job, while a positive family history of asthma is not associated with increased occurrence of symptoms. The mean (SD) FEV1 and FVC were significantly lower among the test group compared with the control group; 2.5L/s (0.55) versus 3.02L/s (0.51), P value = 0.007 and 2.7L (0.7) versus 3.16L (0.51), P value = 0.04. CONCLUSION: Mai suya' have increased risk of respiratory symptoms and altered pulmonary functions. There is a need for protective equipment and periodic evaluation.

Assessment of preventive oral health knowledge and practices among rural and urban mothers in Lagos state.

AIMS AND OBJECTIVES: To evaluate students' performance and its predictors in the preclinical examinations at the College of Health Sciences, Ladoke Akintola University of Technology Ogbomoso Nigeria. MATERIALS AND METHODS: A cross section of students' records admitted into medical programme in 1999/2000 sessions was studied. RESULTS: Younger students performed consistently better than the older ones in all the three subjects taken at the MBBS1. It was also noticed that the male students performed better, a statistically significant mean difference in score was observed in Biochemistry P>0.05. Students with better Ordinary level aggregate grade of (5-15) in the five core subjects at SSCE, consistently had better results in all the subjects taken at MBBS1 examination compared to their counter-part with aggregate SSCE grade of (16-30). Students that were admitted through JAMB performed better in all the three subjects than those that were admitted through pre-degree programme and the transferred students. However, the mean difference was statistically significant P<0.05 in Biochemistry only. CONCLUSION: Better performance at MBBS1 was found in younger age group, those with aggregate grade of (5-15) in SSCE and those admitted through JAMB. Ordinary level requirement irrespective of the mode of admission should not be compromised. Schools that admit students through pre-degree, transfer or direct entry will have to be more conscious of the quality of students they admit and also operate such system with utmost transparency and with a principle of promoting good academic standard.

Predictors of students'performance in the pre-clinical MBBS programme in a Nigerian University.

AIMS AND OBJECTIVES: To evaluate students' performance and its predictors in the preclinical examinations at the College of Health Sciences, Ladoke Akintola University of Technology Ogbomoso, Nigeria. MATERIALS AND METHODS: A cross section of students' records admitted into medical programme in 1999/2000 sessions was studied. RESULTS: Younger students performed consistently better than the older ones in all the three subjects taken at the MBBS1. It was also noticed that the male students performed better, a statistically significant mean difference in score was observed in Biochemistry P<0.05. Students with better Ordinary level aggregate grade of (5-15) in the five core subjects at SSCE, consistently had better results in all the subjects taken at MBBS1 examination compared to their counter-part with aggregate SSCE grade of (16-30). Students that were admitted through JAMB performed better in all the three subjects than those that were admitted through pre-degree programme and the transferred students. However, the mean difference was statistically significant P<0.05 in Biochemistry only. CONCLUSION: Better performance at MBBS1 was found in younger age group, those with aggregate grade of (5-15) in SSCE and those admitted through JAMB ordinary level requirement irrespective of the mode of admission should not be compromised. Schools that admit students through pre-degree, transfer or direct entry will have to be more conscious of the quality of students they admit and also operate such system with utmost transparency and with also operate such system with utmost transparency and with a principle of promoting good academic standard.

Autosomal Dominant Pattern of Inheritance in Type 2 Diabetes in Nigeria

We investigated 212 patients attending 3 diabetic clinics centres in Lagos; Nigeria; and recorded family history; age of onset of diabetes; and body mass index. Analysis of family pedigrees showed that 3of sibships followed an autosomal dominant pattern of inheritance. The mean age of diabetes onset among the dominant group was 25 years and obesity was uncommon. This suggests that these patients may have Maturity Onset Diabetes of the Young (MODY)

Seasonal and temporal variations in the population and biting habit of mosquitoes on the Atlantic coast of Lagos, Nigeria.

OBJECTIVES: To determine the hourly density of vector mosquitoes in coastal Nigeria, compare seasonal human-biting and sporozoite rates in the vector density, locate breeding sites of mosquitoes, and determine larval population at breeding sites. MATERIALS AND METHODS: Indoor and outdoor mosquitoes of a coastal Nigerian community were caught during early and late wet seasons and in the harmattan period, a time of dusty wind from the Sahara on the western coast of Africa. Larvae were collected from various locations during the study period. The mosquitoes were physically characterized and their salivary glands dissected for sporozoite rate. Larvae density was calculated. Human-biting rate was calculated for Anopheles gambiae complex. RESULTS: Of the 4,317 female A. gambiae complex collected during the night bait catches, 3,543 (82.1%) were from outdoors and 774 (17.9%) from indoors during the three seasons. The maximum human-biting rate approached 25/h and the sporozoite rate was almost 3.0%. These vector mosquitoes were mainly outdoor biting and midnight feeding. Of the 1,269 Anopheles mosquitoes collected with pyrethrum spray catches, 1,245 (98.1%) were A. gambiae complex. There was no significant difference in the entomological inoculation or sporozoite rates during the three seasons of study. There was a preponderance of A. gambiae complex larvae from larval collection. CONCLUSION: Findings from this study should be useful in the implementation of Integrated Vector Management for the control of malaria in coastal and noncoastal areas of Nigeria.

Plasma selenium concentration and glutathione peroxidase activity in HIV-1/AIDS infected patients: a correlation with the disease progression.

AIMS AND OBJECTIVES: To find a correlation, if any, between the concentration of plasma selenium and erythrocyte activity in HIV-infected patients with the progression of the disease. MATERIALS AND METHODS: Plasma selenium concentration and erythrocyte glutathione peroxidase (GSH-Px) activity were measured in 62 HIV-1 seropositive patients before commencing antiretroviral drug. Thirty (30) age-matched and apparently healthy HIV-1/11 seronegative subjects were recruited as control subjects. HIV-1 seropositive patients were classified according to the Centre for Disease Control and Prevention (CDC) Criteria. RESULTS: The mean plasma selenium concentrations of 0.53+/-0.06_mol/L and 0.71+/-0.10_mol/L were significantly reduced (P<0.001) in HIV- 1 patients with CD4+ count of <200 lym/mm3 and that of 200-499 lym/mm3 respectively when compared with the controls which is 1.01+/-0.10_mol/L. The mean erythrocyte GSH-Px activity of 15.1+/-2.4 U/g Hb and 20.7+/-3.7U/g Hb of HIV-1 seropositive patients with CD4+ count of <200 lym/mm3 and 200-499 lym/mm3 respectively were significantly reduced (P<0.001) compared with 31.5+/-4.5 U/g Hb for the control. Our results clearly show that there is reduced scavenging antioxidant i.e Selenium and GSH-Px which will lead to oxidative stress in the HIV-1 patients when compared with controls, and decrease significantly with the progression of disease, i.e. AIDS

Limitations to Access and Use of Antiretroviral Therapy (ART) Among HIV Positive Persons in Lagos, Nigeria.

The study was designed to examine the knowledge and perception of HIV positive persons about the antiretroviral therapy (ART) program and to determine their ability to pay for ART and the treatment of other opportunistic infections in Nigeria. This is aimed at identifying factors that may impede effective delivery and utilization of ART in the country. One hundred and twenty-five HIV positive persons seeking ART at the Nigerian Institute of Medical Research (NIMR) clinic, Lagos, were studied using questionnaires. Respondents' average monthly income was N11,253.00 (US$90.00). Almost 26% (25.6%) were unwilling to seek ART at the nearest hospital because of fear of stigmatization. While 9% wanted the therapy for free, the majority was willing to pay N500.00 (US$4.00) per month. The average affordable price based on the subjects' assessment was N905.00 (US$7.24), while the median was N500.00 (US$4.00) per month. Eighty-eight percent believed ART would prolong their lives. The ART drugs need to be affordable and building on the positive perceptions of ART is imperative.

Willingness to seek HIV testing and counseling among pregnant women attending antenatal clinics in Ogun State, Nigeria.

HIV counseling and testing (CT) is slowly being introduced as one of several key components of the comprehensive package of HIV/AIDS prevention and care in Nigeria, particularly in the prevention of mother-to-child transmission of HIV (PMTCT). A cross-sectional survey of 804 women attending antenatal clinics (ANC) in Ogun State, Nigeria was done using questionnaires to assess their willingness to seek and undergo CT and know the determinants. Focus group discussions were also held in the general community: 84.3% of respondents believed in AIDS reality, while 24.3% thought they were at risk of HIV infection. Only 27% knew about MTCT, while 69.7% of 723 who had heard of HIV/AIDS did not know about CT. Only 71 (8.8%) had thought about CT and 33 (4.5%) mentioned HIV testing as one of antenatal tests. After health education on CT, 89% of the women expressed willingness to be tested. Their willingness for CT was positively associated with education (p < 0.05), ranging from 77% (no education) to 93% (post-secondary). More of those with self-perceived risk expressed willingness to test for HIV (p < 0.05). Those willing to be tested had a higher knowledge score on how HIV spreads than those not willing. Multiple regressions identified four key factors that were associated with willingness for CT: increasing educational level; not fearing a blood test; perception that the clinic offered privacy; and perceptions of higher levels of social support from relatives and peers. Those unwilling or undecided about CT expressed strong fear of social stigma/rejection if tested positive. The results provided insights for planning promotional programs and showed that not only are IEC efforts needed to boost knowledge about HIV/AIDS, but that change in clinic setting and community are imperative in creating supportive environment to encourage uptake of CT services.

Plasma magnesium in adult asthmatics at the Lagos University Teaching Hospital, Nigeria.

OBJECTIVE: To determine the plasma magnesium levels in adult asthmatics. DESIGN: Case control study. SETTING: Lagos University Teaching Hospital, Lagos, Nigeria. SUBJECTS: Forty stable asthmatics and thirty five apparently healthy controls. METHODS: Detailed history including drug history was obtained from patients and controls. Fasting venous blood was collected into heparinized tubes from both patients and controls. Plasma magnesium, albumin, calcium and phosphorus were measured using spectrophotometric end point methods. RESULTS: Mean (SD) plasma magnesium concentration of 0.93(0.24) mmol/L in the asthmatics was significantly lower compared to the controls which was 1.15(0.28) mmol/L, p<0.001. There was no significant difference in the plasma albumin, calcium and phosphorus levels between the patients and controls. Plasma magnesium levels correlated with the plasma albumin level (r=0.62) but did not correlate with the duration of disease, peak flow rate and age of patients. There was no gender difference in plasma magnesium levels in the asthmatics. CONCLUSION: Adult Nigerian asthmatics have lower plasma magnesium concentrations compared to healthy controls. This may be of use in future therapeutic management of asthma. A large scale multi-centre study needs to be carried out since this study was done in one hospital.

MICA, HLA-B haplotypic variation in five population groups of sub-Saharan African ancestry.

The human major histocompatibility complex (MHC) class I chain-related gene A (MICA), located 46 kb centromeric to HLA-B, encodes a stress-inducible protein, which is a ligand for the NKG2D receptor. In addition to its primary role in immune surveillance, data suggest that MICA is involved in the immune response to transplants and in susceptibility to some diseases. In this study, 152 subjects from the Yoruba (n=74), Efik (n=32), and Igbo (n=46) tribes of southern Nigeria, 39 nationwide African-American stem cell donors, and 60 African-American individuals residing in the metropolitan Boston area were studied for MICA, HLA-B allelic variation, haplotypic diversity, and linkage disequilibrium (LD). MICA and HLA-B exhibited a high degree of genetic diversity among the populations studied. In particular, MICA allele and HLA-B-MICA haplotype frequencies and LD in the Efik and Igbo tribes were significantly different from the other study groups. HLA-B and MICA loci demonstrated significant global LD in all five populations (P-values &<0.00001). LD also varied in a haplotype-specific manner. A novel MICA allele was detected in the Boston population. These findings are important from an anthropologic perspective, and will inform future HLA-linked disease association studies in related ethnic groups of African-derived ancestry.

Effects of Ocimum gratissimum L essential oil at subinhibitory concentrations on virulent and multidrug-resistant Shigella strains from Lagos, Nigeria.

Ocimum gratissimum leaf extracts have been extensively demonstrated to be effective against the various aetiologic agents of diarrhoea, including Shigellae. However, the mechanism of the shigellocidal action of this plant remains to be understood. This study investigated the effects of O. gratissimum essential oil (EO) at subinhibitory concentrations of 0.75 and 1.0 microg/ml on virulence and multidrug-resistant strains of 22 Shigella isolates from Nigeria. Compared with untreated Shigella strains, O. gratissimum EO caused significant decreases (p<0.01) in extracellular protease activity, o-lipopolysaccharide rhamnose content and incidence of invasiveness mediated as keratoconjunctivitis in guinea pig. The disparity in extracellular protease activity and o-lipopolysacharide rhamnose between the two treatment groups was also found to be significant (p<0.05), suggesting greater anti-virulent effects of O. gratissimum oil at 1.0 microg/ml. Antibiotic susceptibility testing revealed that the EO of O. gratissimum reduced the MICs of antibiotics to which Shigellae showed resistance by 9.8-53.1% and fluoroquinolones by 18.2-45.5%. The results of this study strongly suggest inhibition of extracellular protease and expression of O-LPS rhamnose in Shigellae by O. gratissimum EO. The future use of O. gratissimum- antibiotic combinations as a therapeutic measure against shigellosis is discussed.

Laboratory assessment of three glucometers.

The study was designed to assess the technical performance of three common glucometers (Glucometer Elite, Accutrend Alpha, One Touch Basic) marketed in Nigeria. This is with a view to assessing their suitability for use in this environment and to provide an informed opinion on the selection option. Venous blood, capillary blood, serum and plasma were assayed during the study. Precision, accuracy, linearity and effect of haemolysis and haematocrit were carried out on each glucometer. Simultaneous analysis using the laboratory reference method was also carried out where necessary. Intra-assay precision was between 1.4% (Glucometer Elite)-11% (One Touch Basic) while the interassay precision was best for the Accutrend Alpha with a CV of 1.9%. All three glucometers correlated excellently with laboratory values and the %deviation from laboratory values was 0.2-10.5%. The Glucometer Elite was the most portable and used the least volume of blood (5 ul). One Touch Basic Glucometer was the least affected by haemolysis. Haematocrit values less than 50% did not have any effect on the three glucometer readings. The technical performance of these three glucometers were found to be acceptable and are recommended for use by diabetic patients, emergency and intensive care units and antenatal clinics, subject to periodic assessment and calibration.

Shigellocidal properties of three Nigerian medicinal plants: Ocimum gratissimum, Terminalia avicennoides, and Momordica balsamina.

The prevalence of multidrug-resistant shigellae is an important concern in the treatment of shigellosis in many developing countries, and other therapies, including herbal agents, may provide an important alternative to antimicrobial agents. In this study, three Nigerian medicinal plants: Ocimum gratissimum, Terminalia avicennoides, and Momordica balsamina were investigated for their activities against multidrug-resistant Shigella species isolated from patients with bacilliary dysentery in Lagos. Decoctions of O. gratissimum and concoctions of O. gratissimum and T. avicennoides at crude concentration of 3,000 micrograms/mL markedly inhibited the growth of all isolates tested. Zones of inhibition indicating susceptibilities of the organisms varied from 18.3 to 21.5 mm for Shigella dysenteriae, 15.3 to 16.3 mm for S. flexneri, 18.8 to 19.3 mm for S. sonnei, and 16.5 mm for S. boydii. Except S. flexneri, minimum inhibitory concentration and minimum bactericidal concentration revealed a higher shigellocidal property of O. gratissimum/T. avicennoides concoction than other extracts in S. dysenteriae (300-515.6 vs 337.5-1,312.5 micrograms/mL), S. sonnei (309.4-543.8 vs 403.1-1,312.5 micrograms/mL), and S. boydii (243.8-337.5 vs 253-1,312.5 micrograms/mL). O. gratissimum showed a greater shigellocidal effect against the S. flexneri isolates, while extracts of M. balsamina possessed low shigellocidal potential. The results suggest that aqueous extracts of O. gratissimum and T. avicennoides as decoctions and concoctions could be useful in the treatment of shigellosis and should be clinically evaluated specially in Nigerian region.

Application of polymerase chain reaction to the prenatal diagnosis of sickle cell anaemia in Nigeria.

Although sickle-cell disease is very common in Nigeria, control by prenatal testing is lacking. The polymerase chain reaction-based technology combined with chorionic villi sampling has enabled us to offer prenatal diagnosis of sickle cell disease to 50 pregnant women who were at risk of bearing children with sickle cell anaemia. DNA was extracted from the villus and subjected to either PCR and restriction enzyme (Dde I) analysis (36 samples) or to PCR-ARMS procedure (12 samples) or to both procedures when the results by the first procedure were equivocal (2 samples). The genotypic distribution was 13AA, 25AS and 11SS. In one case, it was not possible to determine the genotype of the villi by both methods. A post delivery genotype analysis confirms the correctness of prenatal diagnosis in all the 42 subjects that has so far reported. The results clearly demonstrate the usefulness of the PCR method in the prenatal diagnosis of sickle-cell anaemia in this environment.