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author:("ajani, A. O.")
1.  Cobalamin status in sickle cell disease 
Background
Some studies comparing serum cobalamin in individuals with and without sickle cell disease (SCD) have suggested a higher prevalence of cobalamin deficiency in SCD but others have not. Our aim was to prospectively compare cobalamin status in African-Americans with and without SCD.
Methods
We analyzed blood samples from 86 subjects in 2 groups; SCD (n = 29) and non-SCD (n = 57). Serum cobalamin, folate, homocysteine, methylmalonic acid (MMA), anti-intrinsic factor antibody, helicobacter pylori antibody and gastrin were measured and compared.
Results
The median cobalamin was 235 pmol/L in the SCD group versus 292 pmol/L in the non-SCD group (p-value = 0.014). No significant differences in MMA or homocysteine were seen. Using the criteria of a low cobalamin and an elevated MMA or an elevated MMA alone, cobalamin deficiency was suggested in 4 (13.8%) in the SCD group and 6 (10.5%) in the non-SCD group. Two of these SCD patients and 4 of these control subjects had chronic renal disease, which may lead to elevated MMA in the absence of cobalamin deficiency. The remaining 4 met criteria for cobalamin deficiency, 2 (6.9%) in the SCD group and 2 (3.5%) in the non-SCD group (p = 0.6).
Conclusion
A lower cobalamin was observed in SCD patients without a higher prevalence of cobalamin deficiency. The inclusion of haptocorrin and holotranscobalamin measurement in future studies may provide a better assessment of cobalamin status in this patient group.
doi:10.1111/j.1751-553X.2012.01457.x
PMCID: PMC3484229  PMID: 22830455
sickle cell disease; cobalamin deficiency; vitamin B12; homocysteine; methylmalonic acid
2.  Comparative Study on the Effects of Chloroquine and Artesunate on Histopathological Damages Caused by Plasmodium berghei in Four Vital Organs of Infected Albino Mice 
Malaria Research and Treatment  2012;2012:960758.
The aim of the present study was to investigate the positive influence of chloroquine and artesunate on the pathological damages caused by Plasmodium berghei on vital organs of mice in an established infection. Healthy adult albino mice with average weight of 25 g were used for the study. Treated group was administered orally with 100 mg/kg of chloroquine and artesunate, respectively. Control animals were given water for the same period. Histological examination of the liver, spleen, lungs, and kidney revealed absence of accumulation of iron (haemosiderosis) in the liver, thickened alveolar wall, and interstitial mononuclear cells infiltration in the lungs of the artesunate group, while absence of emphysema in the lungs and megakaryoblast hyperplasia in the spleen was observed in the chloroquine group. Lymphoid hypoplasia in the chloroquine group and megakayoblast hyperplasia in the artesunate group were observed but not in the control group. Thus, the use of these drugs especially under the practice of self-medication should be prohibited in lands where they are still in use as antimalaria medicine.
doi:10.1155/2012/960758
PMCID: PMC3388589  PMID: 22792509
3.  Drug prescription pattern for asthma among nigerian doctors in general practice: A cross-sectional survey 
Annals of Thoracic Medicine  2012;7(2):78-83.
BACKGROUND:
A wide range of medications are now available for the treatment of asthma and selection of the optimal treatment combination of agents is essential.
OBJECTIVES:
This study was designed to evaluate a self-reported drug prescribing pattern for asthma among Nigerian doctors in general practice.
METHODS:
It was a cross-sectional survey conducted among general practitioners in six states of Nigeria.
RESULTS:
For acute severe asthma, 75.9% of the doctors prescribed intravenous methylxanthines, which was combined with oral or inhaled short-acting β2 agonists (SABA) by 56.3% of them. Systemic steroids were prescribed mainly via the intravenous route by 58.8% of them. Aberrant drugs such as antibiotics, antihistamines, and mucolytics were prescribed by 25.6% of them. For long-term, follow-up treatment of asthma, oral steroids, and oral SABA were commonly prescribed, while inhaled corticosteroids (ICS) and ICS/LABA (long acting beta agonists) were infrequently prescribed. Aberrant drugs such as analgesics, antimalaria, and antihistamines were prescribed by 22.8% of them. About 48% of the doctors had never attended any form of update training on asthma management, whereas, only 16.3% attended update training on asthma within the last year preceding this study. Awareness of international guidelines on asthma treatment was poor among them with only 16.4% being able to mention any correct guideline on asthma management.
CONCLUSION:
The poor anti-asthma prescribing behavior among these doctors is associated with a low level of participation at update training on asthma management and poor awareness of asthma guidelines. The Nigerian Medical Association and the Nigerian Thoracic Society should urgently address these problems.
doi:10.4103/1817-1737.94524
PMCID: PMC3339208  PMID: 22558012
Asthma; drug prescription; general practitioners; Nigeria
4.  Ambulatory blood pressure profile and left ventricular geometry in Nigerian hypertensives 
Background:
Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertensives and the structural classification of left ventricular (LV) geometry provides additional prognostic information. Ambulatory blood pressure (ABP) monitoring has been shown to be superior to office blood pressure (BP) in relation to hypertension LVH. We investigated ambulatory BP variables in relation to LV geometric patterns in Nigerian hypertensives.
Materials and Methods:
A total of 130 patients (males = 96, females = 34) with hypertension had their 24-hours ambulatory BP and trans-thoracic 2D/M- mode echocardiography. Data were analyzed with SPSS 13.0. P < 0.05 was considered statistically significant.
Results:
The mean age of the patients was 54.08±11.88 years. The prevalence rate of abnormal LV geometry was 48.4%. Mean ambulatory Systolic BP (day time, night time and 24-hour-average) was significantly higher in patients with LVH compared with those without LVH. Day-night systolic and diastolic BP decay (i.e. percentage nocturnal decline in BP) was also significantly lower in LVH group than in the group without LVH. Patients with eccentric LVH had abnormal day time mean ambulatory systolic BP, night time mean ambulatory systolic BP, elevated day time and night time systolic BP loads, as well as non-dipping diastolic BP pattern. Significant correlates of LV mass index in this study population were mean ambulatory systolic BP (day time: r = 0.355, P = 0.004; night time: r = 0.343, P = 0.005; 24- hour average: r = 0.358, P = 0.004) and day-night decay (systolic: r = -0.388, P = 0.007; diastolic: r = -0.290, P = 0.022) as well as 24-hour systolic BP variability.
Conclusion:
The presence of LVH in hypertension was associated with higher mean ambulatory systolic BP and lower percentage nocturnal decline in systolic and diastolic BP than its absence which appeared to be worse in patients with eccentric LV geometry when compared with other geometric patterns.
doi:10.4103/0975-3583.85263
PMCID: PMC3195195  PMID: 22022144
Ambulatory blood pressure; left ventricular geometry; hypertensives; Nigerians
5.  Small Bowel Obstruction Caused by Intraluminal Migration of Retained Percutaneous Endoscopic Gastrostomy Internal Bumper 
INTRODUCTION
Early complications associated with percutaneous endoscopic gastrostomy are well documented. Late complications associated with retained gastrostomy flange are rare. It is unclear why some patients with retained gastrostomy flange (internal bumper) develop mechanical obstruction and others do not. We report a case of mechanical obstruction with perforation occurring 6 months after the tube was cut.
PATIENT AND METHODS
A 76-year-old hemiplegic patient with no swallowing reflex and who previously was on long-term percutaneous gastrostomy feeding tube underwent removal of the feeding tube but the internal bumper was left in situ due to encrustation.
RESULTS
Due to migration of the retained flange, the patient developed small bowel obstruction.
CONCLUSIONS
Retained internal bumper is potentially dangerous and we recommend endoscopic retrieval of such flange.
doi:10.1308/147870807X227728
PMCID: PMC2121259  PMID: 18201462
Small intestinal obstruction; Percutaneous endoscopic gastrostomy (PEG); Internal bumper; Gastric flange
6.  Pesticides use by smallholder farmers in vegetable production in Northern Tanzania. 
Crop protection (Guildford, Surrey)  2007;26(11):1617-1624.
Small-scale farmers in Northern Tanzania grow vegetables that include tomatoes, cabbages and onions and use many types of pesticides to control pests and diseases that attack these crops. Based on the use of questionnaires and interviews that were conducted in Arumeru, Monduli, Karatu, and Moshi rural districts, this study investigates farmers’ practices on vegetable pest management using pesticides and related cost and health effects. The types of pesticides used by the farmers in the study areas were insecticides (59%), fungicides (29%) and herbicides (10%) with the remaining 2% being rodenticides. About a third of the farmers applied pesticides in mixtures. Up to 90% had a maximum of 3 pesticides in a mixture. In all cases there were no specific instructions either from the labels or extension workers regarding these tank mixtures. Fifty three percent of the farmers reported that the trend of pesticide use was increasing, while 33% was constant and 14% was decreasing. More than 50 percent of the respondents applied pesticides up to 5 times or more per cropping season depending on the crop. Insecticides and fungicides were routinely applied by 77% and 7%, respectively by these farmers. Sixty eight percent of farmers reported having felt sick after routine application of pesticides. Pesticide-related health symptoms that were associated with pesticides use included skin problems and neurological system disturbances (dizziness, headache). Sixty one percent of farmers reported spending no money on health due to pesticides. These results can be used to develop a tool to quantify the cost of pesticide use in pest management by small-scale vegetable farmers in Northern Tanzania and contribute to the reformation of pesticide policy for safe and effective use of pesticides.
doi:10.1016/j.cropro.2007.01.008
PMCID: PMC2410092  PMID: 18528532
Northern Tanzania; Small-scale farmers; Vegetables; Pesticides; health; cost
7.  Antibacterial potency of methanol extracts of lower plants 
Antibacterial potency of methanol extracts of three green lower plants, Pneumatopteris afra, Platycerium bifurcatum and Nephrolepsis bisserata was determined using agar dilution method on clinical strains of Escherichia coli, Staphylococcus aureus, Klebsiella spp. and Salmomelia typhi. Antibacterial activities were observed at concentrations of 12.5, 25.0, 50.0 and 100.0 µg/ml. Their minimum inhibitory concentrations ranged from 12.5~100 μg/ml. Extracts of P. afra and P. bifurcatum were most active. Antibacterial activities observed with N. bisserata were less pronounced with no detectable activity at extract concentrations of 12.5 and 25.0 µg/ml. E. coli, together with S. aureus appeared to be the most susceptible of the test bacteria while Klebsiella spp. was least sensitive. The significance of our findings is discussed.
doi:10.1631/jzus.2007.B0189
PMCID: PMC1810385  PMID: 17323431
Lower plants; Extracts; Antibacterial activity; MIC (minimum inhibitory concentration)
8.  Ophthalmological morbidity in very-low-birthweight infants with bronchopulmonary dysplasia. 
This study was undertaken to determine the relationship between retinopathy of prematurity, ocular sequelae of retinopathy, and bronchopulmonary dysplasia in infants weighing < 1250 g at birth prior to the introduction of steroid therapy for chronic lung disease. Ophthalmological data from 67 infants (22 with severe bronchopulmonary dysplasia and 45 controls) who were enrolled prospectively in an early intervention program were analyzed. The infants had two or more eye examinations prior to discharge and a follow-up examination at 12 to 18 months postconceptual age. The incidence of any retinopathy of prematurity was 33%, and severe retinopathy was 25%. Infants with severe bronchopulmonary dysplasia were 1.7 times more likely to develop any retinopathy and 1.8 times more likely to develop severe retinopathy than controls. The incidence of ocular sequelae, was 45%. Infants with any retinopathy had a 2.3 odds of developing sequelae, and infants with severe retinopathy had a 2.64 odds ratio. When adjusted for bronchopulmonary dysplasia, the odds ratio for developing sequelae was 1.36 in infants with any retinopathy and 1.27 in those with severe retinopathy. The predictors of retinopathy were lower birthweight and gestational age, acidosis, and hypoxemia. Bronchopulmonary dysplasia per se has an adverse effect on ophthalmologic morbidity. Evaluation of the adverse effect of any therapy for chronic lung disease on retinopathy of prematurity should make adjustments for the underlying lung disease.
PMCID: PMC2608256  PMID: 9347682
9.  Evaluation of the relationship between cocaine and intraventricular hemorrhage. 
To evaluate the relationship of cocaine to intraventricular hemorrhage in preterm (< or = 37 weeks gestation) infants, the charts of infants admitted to an intensive care nursery over a 2-year period were reviewed. Data were extracted regarding intrauterine exposure to cocaine, head ultrasonography, and specific independent variables: gestational age, 5-minute Apgar score, and the presence of pneumothorax. These variables were classified into high-, moderate-, and low-risk groups for the development of intraventricular hemorrhage. Analysis was done using chi-square, Mantel-Haentzel tests, crude odds ratio with 95% tests, crude odds ratio with 95% confidence intervals, and stepwise multiple logistic regression analysis. Intraventricular hemorrhage developed in 24 (22%) cocaine-exposed infants versus 49 (20%) nonexposed infants. Thirteen (12%) infants exposed to cocaine developed grades I to II and 11 (10%) developed grades III to IV intraventricular hemorrhage. The figures in the nonexposed infants were 29 (12%) and 20 (8%), respectively. Intraventricular hemorrhage was more likely to occur in infants who belonged to the high-risk groups: gestational age < or = 30 weeks, 5-minute Apgar score < or = 5, and the presence of pneumothorax. Pneumothorax was the single most significant factor associated with intraventricular hemorrhage grades III to IV. Intrauterine exposure to cocaine does not seem to influence the prevalence or severity of intraventricular hemorrhage in the preterm infant.
PMCID: PMC2607640  PMID: 8040903
10.  Evaluation of Serum Ferritin Levels and Other Hematological Parameters in a Nigerian Population 
Hematological parameters, including serum ferritin, were estimated in a healthy Nigerian population and in patients with other clinical conditions. The hematological values fell within the reported range for healthy populations in other parts of the world. The mean serum ferritin value in the male population was 72.4 ng/mL compared with the female value of 34.3 ng/mL. There was a strong correlation between the percentage of transferrin saturation and the serum ferritin level in males only (r = .40, P < .002).
In patients with sickle cell disease, SC-group patients had a significantly higher hemoglobin concentration (P < .001) than the SS group. However, the SS group had higher values for mean corpuscular hemoglobin, mean corpuscular volume, and transferrin saturation than the SC group. Also, the mean ferritin level in the SS group (296.3 ± 61.9 ng/mL) was significantly higher (P < .01) than in the SC group (mean 180.8 ± 97.2 ng/mL).
When sickle cell anemia was complicated by chronic osteomyelitis, the ferritin level was much higher (mean, 1,470 ng/mL) than at the steady state. Finally, in patients with leukemia, serum ferritin levels were much higher than in the healthy population.
PMCID: PMC2561499  PMID: 6631995
11.  Taboos and clinical research in West Africa. 
Journal of Medical Ethics  1980;6(2):61-63.
Moral principles or the rules of conduct are based in the society. If the purpose of ethics in research is to take into consideration the needs and the rights of the experimental subject, his social milieu must then largely determine the ethical considerations of a projected study. The inability to comprehend such rights may often be due to ignorance, disease and his societal values. Blood letting, biopsy and post-mortem examinations may so conflict with local beliefs that so called 'consent' to these is much more than a surrender of the rights of the individual. It is difficult to conform with the highest principles of ethics in research in any uniform society. It is more so when the many variables are further complicated by cultural demands and social taboos. The best custodians of ethical standards must relate intimately with the norms of the local population.
PMCID: PMC1154800  PMID: 7420370

Results 1-12 (12)