Determination of standardised ileal digestibility of amino acids in high-fibre feedstuffs and additivity of apparent and standardised ileal amino acids digestibility of diets containing mixtures of maize, sorghum, and soybean meal.

1. Two experiments were conducted to determine the coefficients of standardised ileal amino acid digestibility for selected high-fibre feedstuffs (Expt.1) and to assess the additivity of coefficients of apparent (cAIAAD) and standardised (cSIAAD) ileal amino acid digestibility for diets containing combinations of sorghum, maize and soybean meal.2. In Expt. 1, broiler chickens (324) were allocated to 54 metabolism cages (nine diets with six replicates). In Expt. 2, broiler chickens (315) were allocated to 63 metabolism cages (seven diets with nine replicates). The diets in Expt. 1 were a nitrogen-free diet plus eight semi-purified diets in which soybean meal (SBM), low-protein SBM (LPSBM), soybean hull, wheat bran, maize bran, rice bran, dried sugarbeet pulp or maize gluten feed were the only sources of protein in the respective diets. In Expt. 2, the seven diets were a nitrogen-free diet, and six semi-purified diets consisting of individual feedstuffs (SBM, maize, or sorghum) or combinations (maize and SBM; sorghum and SBM; or maize, sorghum, and SBM) as the only sources of protein.3. In both experiments, all the broiler chickens received the same maize-SBM diet formulated to meet nutrient requirements according to the breeder's recommendations from d 0 to 16. Allocated experimental diets were provided on d 16, and ileal digesta were collected on d 21.4. In Expt. 1, SBM and LPSBM had greater (P < 0.01) cSIAAD for indispensable and dispensable amino acids than the other feedstuffs. The rice bran had greater (P<0.01) cSIAAD values than wheat bran and maize bran, except for Leu, Cys, and Pro.5. In Expt. 2, predicted cAIAAD values for maize-SBM and maize-sorghum-SBM were generally lower (P<0.01) than actual values. The actual and predicted cSIAAD values for maize-SBM, sorghum-SBM and maize-sorghum-SBM combinations were not significantly different.6. It was concluded that the standardised amino acid digestibility of sorghum, when combined with other feedstuffs, was additive and that approximately three-quarters of total amino acids in the assayed high-fibre feedstuffs, except for dried sugarbeet pulp and maize gluten feed, were digestible.

Childhood intussusception: a multicentre study in a middle-income country.

BACKGROUND: The outcome in infants and young children of intestinal obstruction due to intussusception is well documented in high-income countries. Our aim was to investigate the current pattern of presentation, management and outcome of childhood intussusception in a middle-income country using a multicentre approach. METHODS: Records of children managed for intussusception in three centres in South West Nigeria were retrospectively reviewed and analysed. RESULTS: One hundred and ninety children managed for intussusception were analysed. The male-to-female ratio was 1.8:1. The median age was 7 months with a peak age incidence of 3-6 months. Peak incidence was recorded during the dry season. Passage of bloody stool, vomiting, abdominal pain and fever were the most common presenting features. Seventy-three (38.4%) of the patients presented with the classic triad. The median duration of symptoms was three days and only 19 (10.1%) patients presented in less than 24 hours. Ileocolic intussusception was the most common anatomic type, occurring in 166 (87.4%) patients, and was significantly associated with age. Twenty-two (56.4%) had successful hydrostatic reduction, while 165 (88.2%) required surgery. Forty (21.1%) patients suffered postoperative complications. Eleven (5.8%) of the patients died. The median duration of hospital stay was six days, and this correlated with the duration of symptoms and the length of hospital stay. CONCLUSION: Delayed presentation is a persisting challenge in the management of childhood intussusception in Nigeria. Prompt referral to a paediatric surgeon may reduce the surgery rate, associated morbidity and the length of hospital stay.

Dietary composition modulates impact of food-added monosodium glutamate on behaviour, metabolic status and cerebral cortical morphology in mice.

Effects of food-added monosodium glutamate (MSG) on neurobehaviour, serum biochemical parameters, malondialdehyde (MDA) levels, and changes in cerebral cortex, liver and kidney morphology were assessed in mice fed standard diet (SD) or high-fat diet (HFD). Animals were assigned to 8 groups [SD control, HFD control, and six groups fed MSG plus SD or HFD at 0.1, 0.2 and 0.4 g/kg of feed]. Animals were fed for 8 weeks, behavioural tests were conducted, and blood was taken for estimation of biochemical parameters and MDA level. Whole brain was homogenised for neurochemical assays, while the cerebrum, liver and kidneys were processed for histology. In groups fed MSG/SD, there was a decrease in weight gain, increase in food-intake, an increase in locomotion, a decrease in rearing/grooming, and a decrease in anxiety-response. Also observed were derangements in biochemical parameters, increased MDA, and alteration of renal morphology. Compared to HFD, MSG/HFD groups had reduction in weight gain, food-intake, grooming and anxiety-response, an increase in locomotion, and improved memory. Protection against biochemical derangements and HFD-induced organ injuries were also observed. In conclusion, the findings suggest that possible interactions that may occur between dietary constituents and MSG are determinants of the effects of food-added MSG in mice.

Subchronic ketamine alters behaviour, metabolic indices and brain morphology in adolescent rats: Involvement of oxidative stress, glutamate toxicity and caspase-3-mediated apoptosis.

Ketamine is a dissociative anaesthetic agent whose recreational use amongst adolescents and young adults is reaching epidemic proportions in a number of countries. While animal studies have examined the long-term detrimental effects of early-life ketamine exposure, there is a paucity of information on the immediate effects of ketamine following subchronic administration in the adolescence period. Adolescent rats were assigned into four groups of 10 animals each, administered intraperitoneal (i.p) injections of vehicle or one of three doses of ketamine (7.5, 15 or 30 mg/kg daily) for 8 weeks, and then exposed to behavioural paradigms. Rats were then euthanised after an overnight fast, and blood taken was used for measurement of metabolic indices. The brains were dissected out and either homogenised for estimation of neurochemical parameters, or processed for histological and immunohistochemical studies. Results showed that subchronic administration of ketamine was associated with a lesser weight gain inspite of an increase in food intake across the treatment groups. There was a dose-dependent increase in open-field novelty-induced behaviours, a decline in spatial working-memory, and an anxiolytic effect in the elevated-plus maze. There was associated derangement of serum triglyceride, and increase in brain glutamate levels, acetylcholinesterase activity, plasma/brain oxidative stress parameters, caspase-3 activity and biochemical indices of hepatic and renal function. Ketamine administration was also associated with neurodegenerative changes in the cerebral cortex, hippocampus, cerebellum and the pons. In conclusion, subchronic administration of ketamine to adolescent rats was associated with dose-related memory loss, oxidative stress and possibly caspase-3 mediated neurodegenerative changes.

BOWEL RESECTION IN CHILDREN IN IBADAN, NIGERIA.

BACKGROUND: Acquired, and largely, preventable conditions are the predominant reasons for bowel resection in children in developing countries. This is in contrast to known indications in developed countries, where congenital conditions predominate. It is however, unknown, if the situation has changed with recent public health awareness initiatives. AIM: To examine the current indications, pattern and outcome of bowel resection in children in our center. METHODOLOGY: This was a retrospective review of the records of children 14 years and below who had had bowel resection procedures within a 90-month period at the University College Hospital, Ibadan. Patients who had colonic resections for Hirschsprung's disease were excluded from this study. RESULTS: A total of 91 children (57 boys, 34 girls) aged 6 hours to 14 years with a median of 7 months had bowel resections during the study period. There were 10 (11%) neonates, 51 (56%) infants and 30 (30.9%) children > 1 year. Common indications for bowel resection were intestinal atresia in neonates, intussusception in older infants and typhoid intestinal perforation/adhesive intestinal obstruction in children > 1 year. Overall, intussusception was the commonest indication in 54 (59.3%) followed by typhoid intestinal perforation in 9 (9.9%). The resection types were right hemicolectomy in 56 (61.5%), segmental small bowel resection in 31 (34.1%) and colonic resection in 4 (4.4%) patients. Thirty-seven (40.7%) patients developed post-operative complications, mostly surgical site infection in 25 (27.5%) and 17 (18.7%) developed long-term complications such as incisional hernia in 9 (9.9%). The mortality rate was 5.5% (5 patients). CONCLUSION: Intussusception and typhoid ileal perforation accounted for the majority of bowel resections in children in this study; late presentation was common and associated with high morbidity. Early presentation with prompt and effective management would improve outcome.

Measurement of Testicular Volume in healthy Nigerian newborns AT IBADAN, NIGERIA using THE PRADER Orchidometer.

BACKGROUND: Determining the normal testicular volume in the newborn at birth is essential in the assessment of the degree of virilization of the external genitalia since abnormal development of the genitalia is closely related to the testicular volume in the male newborns. OBJECTIVES: To establish a standard testicular volume (TV) for male newborn Nigerians using the Prader Orchidometer and determine the relationship between the testicular volume in the newborn and the age of the newborns at birth, the birth weight, the maternal age at delivery and the maternal parity. METHODS: Prospective cross-sectional study of all term male neonates within 72 hours of birth from April 2013 to March 2014 in the three largest obstetric centres (University College Hospital, Adeoyo Maternity Hospital and Our Lady of Apostles Catholic Hospital) in Ibadan, Nigeria. They underwent clinical examination of the external genitalia and the testicular volumes were measured using the Prader orchidometer. RESULTS: A total of 867 male neonates were recruited into the study with a mean age of 2.89±6.21 days. The testicular volume ranged from 1 - 3 ml on both sides with a mean right testicular volume of 1.14±0.38 ml. There was a significant correlation between gestational age as well as birth weight and the testicular volume (r = 0.146, p = 0.03). CONCLUSION: This study has determined a normative value for testicular volume measured by Prader Orchidometer in newborns in a typical African population which could be used as a reference when evaluating neonates with patients with testicular abnormalities.

OBSTRUCTED INGUINAL HERNIA IN CHILDREN: CASE-CONTROLLED APPROACH TO EVALUATE THE INFLUENCE OF SOCIO-DEMOGRAPHIC VARIABLES.

BACKGROUND: Obstructed inguinal hernia in children is associated with high morbidity in developing countries due to delay in accessing care. Attempts made to reduce waiting time to herniotomy are not backed by a predictive model of disease occurrence and modeling obstructed inguinal hernia implies knowledge of factors associated with this complication. AIM & OBJECTIVES: To determine the relationship between socio-demographic variables and obstructed inguinal hernia in children. DESIGN: Case controlled. SETTING: Paediatric surgery unit of a tertiary hospital. MATERIALS AND METHODS: The study was prospective - all children presenting with obstructed inguinal hernia at University College Hospital, Ibadan, Nigeria between May 2009 and April 2014 were studied. For each case, two children with non-obstructed inguinal hernia were recruited consecutively as controls. Their demographics, clinical features, management and outcomes were obtained including the socio-demographic attributes of the parents. The data obtained were computed using SPSS; the p-value for significance was set at < 0.05. RESULTS: A total of 81 consecutive patients (27 with obstructed inguinal hernia and 54 with non-obstructed inguinal hernia) were studied; they were aged between 2 weeks and 13 years with a mean of 25.9 ± 3.8 months. There were no differences between cases and controls based on gender, parents' religion, tribe, social status and side affected (p > 0.05). The mean age at presentation was 13.7 ± 5.6 months in the obstructed inguinal hernia vs. 32.0 ± 4.8 months in the non-obstructed inguinal hernia groups (p = 0.016). The duration of groin swelling before presentation was not significantly different (30.0 ± 7.7 vs. 28.3 ± 6.4 months, p = 0.893). Infants were three times more likely than older children to develop obstruction (OR = 3.33, CI: 1.20, 9.09, p = 0.020). CONCLUSION: The age at presentation is the significant socio-demographic variable in this study that could predict obstruction in healthy children with inguinal hernia delivered at term.

Comparison of culture media for detection of Acinetobacter baumannii in surveillance cultures of critically-ill patients.

The objective of this study was to evaluate the performance of CHROMagar Acinetobacter when compared to sheep blood agar, MacConkey agar and MacConkey agar with 6 µg/ml of imipenem for the detection of A. baumannii in surveillance cultures of hospitalized patients. We utilized peri-anal swabs and sputum samples from patients admitted to the University of Maryland Medical Center ICUs from December 7 through December 21, 2009. Samples were plated onto four media in the following order: (1) 5% sheep blood agar (SBA), (2) MacConkey agar, (3) MacConkey agar with 6 µg/ml of imipenem, and (4) CHROMagar Acinetobacter (CHROMagar). SBA was the gold standard to which all media was compared. There were 165 samples collected during the study period. SBA and CHROMagar detected 18 of 18 (100%) Acinetobacter and 11 of 11 (100%) MDR-A. baumannii. MacConkey agar detected 16 of 18 (89%) Acinetobacter and 10 of 11 (91%) MDR- A. baumannii while MacConkey agar with 6 µg/ml imipenem detected 9 of 11 (82%) MDR-A. baumannii. CHROMagar did not differentiate MDR- A. baumannii from non-MDR-A. baumannii. CHROMagar may be useful for rapid detection of patients with MDR-A. baumannii if improved upon to better select for MDR-A. baumannii.

Natural activities of 40K, 238U and 232Th in elephant grass (Pennisetum purpureum) in Ibadan metropolis, Nigeria.

Samples of elephant grass collected at some pasturing farmlands across different locations in Ibadan metropolis were analyzed for their natural radioactivity concentrations due to 40K, 238U and 232Th radionuclides. Radioactivity measurements were carried out using gamma-ray spectroscopy. The average radioactivity concentration of 40K was found to be 25.7+/-5.5 Bq kg(-1) for 238U and 33.4+/-3.9 Bq kg(-1) for 232Th. The radiological health implication to the population that may result from these values is found to be very low and almost insignificant. No artificial radionuclide, however, was detected in any of the samples, hence, measurements have been taken as representing baseline values of these radionuclides in the grass in the metropolis.

"Silent" abdominal tuberculosis: a report of six cases.

Six cases of "silent" or subclinical abdominal tuberculosis seen in patients who belong to the upper socio-economic class, but with a humble childhood are presented. The patients are usually from the Third World countries and the condition is often missed or mis-diagnosed. This condition is often precipitated by some stressful situation, and the presentation is not typical of the well-known clinical features of abdominal tuberculosis. This is most likely due to the fact that the high standard of living later in life tends to distort the classical clinical features of tuberculous abdomen as seen in the rest of the population. There is usually a dramatic response to anti-tuberculosis therapy.

Studies on the prevalence of tinea capitis infection in Ile-Ife, Nigeria.

Investigations were carried out into the prevalence of tinea capitis infection among school children in Ile-Ife, Nigeria. The prevalence rate of clinical infection was found to be 14.02%. The infection was found to be more frequent among pupils between ages 5 and 10 years, and more prevalent among the poor than the rich (p less than 0.005). Families having between 1 and 4 children had lower prevalence than families having minimum of five children (p less than 0.10). Approximately one-third of the clinically infected children were not receiving any treatment while about two-thirds of the remaining two-thirds were using local native remedies, some of which had resulted in deaths of some children. The most common causative agent isolated from the lesions was Microsporum audouinii.

Methylprednisolone sodium succinate (Solu-Medrol) in the treatment of typhoid perforation (a preliminary report).

It is now universally accepted that treatment of typhoid perforation must be surgical. In spite of this and the use of antibiotics, the mortality rate is still high. Previous observations that some patients with typhoid perforation present with features suggestive of septicaemia and septic shock made us conduct a clinical trial with methylprednisolone sodium succinate (Solu-Medrol) in treating this disease. Our data show that use of this drug in addition to antibiotics and early surgical intervention reduces the mortality rate in typhoid perforation.

Tropical pyomyositis.

Tropical pyomyositis, a suppurative condition involving a group or groups of muscles, has only been described in the tropical areas of the world. An etiological factor in the genesis of this disease is closed muscle trauma causing bleeding, hematoma formation, muscle necrosis, and secondary blood borne infection; but this does not explain why the condition occurs or is contracted only in the tropical belt. The commonest organism present in the abscess is Staphylococcus aureus. Neglected or poorly treated tropical pyomyositis can give rise to chronic osteomyelitis or septic arthritis.

"Idiopathic" intra-abdominal abscess.

Primary peritonitis that tends to occur especially in children, and cirrhotic spontaneous bacterial peritonitis are well recognized clinical entities. At the University College Hospital, Ibadan, cases of intra-abdominal abscess that do not fit the recognized criteria for primary peritonitis have been seen. These patients were neither cirrhotic nor nephrotic and all the intra-abdominal organs at operation appeared normal. This "idiopathic" intra-abdominal abscess seems to occur mainly in the tropics and is a strong differential diagnosis of typhoid perforation. Treatment consists of exploratory laparotomy, thorough irrigation of the abdominal cavity with sterile saline solution, and systemic administration of broad spectrum antibiotics.

Breast abscess.

Breast abscess is a relatively important disease in the tropics, and yet this condition has received little attention in the literature. Breast abscess encourages artificial feeding, which in many instances may be responsible for gastroenteritis in infants. This occurs when foods are not properly prepared by mothers of low socioeconomic class with inadequate sanitation.Breast abscess occurs primarily in the lactating breast and is most commonly located in the upper half of the breast.The organism most commonly present in the pus is Staphylococcus aureus. When the abscess is localized, it may present with all the clinical features of a breast carcinoma.