GBA1 rs3115534 Is Associated with REM Sleep Behavior Disorder in Parkinson's Disease in Nigerians

BACKGROUND

Rapid eye movement (REM) sleep behavior disorder (RBD) is an early feature of Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Damaging coding variants in Glucocerebrosidase (GBA1) are a genetic risk factor for RBD. Recently, a population-specific non-coding risk variant (rs3115534) was found to be associated with PD risk and earlier onset in individuals of African ancestry.

OBJECTIVES

We aimed to investigate whether the GBA1 rs3115534 PD risk variant is associated with RBD in persons with PD.

METHODS

We studied 709 persons with PD and 776 neurologically healthy controls from Nigeria. All DNA samples were genotyped and imputed, and the GBA1 rs3115534 risk variant was extracted. The RBD screening questionnaire (RBDSQ) was used to assess symptoms of possible RBD.

RESULTS

RBD was present in 200 PD (28.2%) and 51 (6.6%) controls. We identified that the non-coding GBA1 rs3115534 risk variant is associated with possible RBD in individuals of Nigerian origin (β, 0.3640; standard error [SE], 0.103, P = 4.093e-04), as well as in all samples after adjusting for PD status (β, 0.2542; SE, 0.108; P = 0.019) suggesting that although non-coding, this variant may have the same downstream consequences as GBA1 coding variants.

CONCLUSIONS

Our results indicate that the non-coding GBA1 rs3115534 risk variant is associated with an increasing number of RBD symptoms in persons with PD of Nigerian origin. Further research is needed to assess if this variant is also associated with polysomnography-defined RBD and with RBD symptoms in DLB. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Identification of genetic risk loci and causal insights associated with Parkinson's disease in African and African admixed populations: a genome-wide association study

BACKGROUND

An understanding of the genetic mechanisms underlying diseases in ancestrally diverse populations is an important step towards development of targeted treatments. Research in African and African admixed populations can enable mapping of complex traits, because of their genetic diversity, extensive population substructure, and distinct linkage disequilibrium patterns. We aimed to do a comprehensive genome-wide assessment in African and African admixed individuals to better understand the genetic architecture of Parkinson's disease in these underserved populations.

METHODS

We performed a genome-wide association study (GWAS) in people of African and African admixed ancestry with and without Parkinson's disease. Individuals were included from several cohorts that were available as a part of the Global Parkinson's Genetics Program, the International Parkinson's Disease Genomics Consortium Africa, and 23andMe. A diagnosis of Parkinson's disease was confirmed clinically by a movement disorder specialist for every individual in each cohort, except for 23andMe, in which it was self-reported based on clinical diagnosis. We characterised ancestry-specific risk, differential haplotype structure and admixture, coding and structural genetic variation, and enzymatic activity.

FINDINGS

We included 197 918 individuals (1488 cases and 196 430 controls) in our genome-wide analysis. We identified a novel common risk factor for Parkinson's disease (overall meta-analysis odds ratio for risk of Parkinson's disease 1·58 [95% CI 1·37-1·80], p=2·397 × 10-14) and age at onset at the GBA1 locus, rs3115534-G (age at onset β=-2·00 [SE=0·57], p=0·0005, for African ancestry; and β=-4·15 [0·58], p=0·015, for African admixed ancestry), which was rare in non-African or non-African admixed populations. Downstream short-read and long-read whole-genome sequencing analyses did not reveal any coding or structural variant underlying the GWAS signal. The identified signal seems to be associated with decreased glucocerebrosidase activity.

INTERPRETATION

Our study identified a novel genetic risk factor in GBA1 in people of African ancestry, which has not been seen in European populations, and it could be a major mechanistic basis of Parkinson's disease in African populations. This population-specific variant exerts substantial risk on Parkinson's disease as compared with common variation identified through GWAS and it was found to be present in 39% of the cases assessed in this study. This finding highlights the importance of understanding ancestry-specific genetic risk in complex diseases, a particularly crucial point as the Parkinson's disease field moves towards targeted treatments in clinical trials. The distinctive genetics of African populations highlights the need for equitable inclusion of ancestrally diverse groups in future trials, which will be a valuable step towards gaining insights into novel genetic determinants underlying the causes of Parkinson's disease. This finding opens new avenues towards RNA-based and other therapeutic strategies aimed at reducing lifetime risk of Parkinson's disease.

FUNDING

The Global Parkinson's Genetics Program, which is funded by the Aligning Science Across Parkinson's initiative, and The Michael J Fox Foundation for Parkinson's Research.

Paediatric Cardiac Anaesthesia at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: The Hurdles, Struggles, and Successes

BACKGROUND

Open-heart surgery started at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife, Nigeria, 5 years ago through partnership with foreign partners. This paper reviewed the difficulties facing the development of paediatric cardiac anaesthesia, the pattern, and the outcome of cases managed.

METHODS

A review of the infrastructure, equipment, manpower and operational setup for open-heart surgery at OAUTHC was done. A retrospective study of all patients that were operated on from April 2016 to March 2021 was performed. Extracted data were analysed with Statistical Packages for the Social Scientists using descriptive statistics.

RESULTS

A total of 102 patients had open-heart surgeries during the period under review by the various teams in a shared facility of the hospital's main theatre. Challenges with manpower, infrastructure, and supplies were major limitations to service delivery. Most of the patients (75.5%) were aged < 5 years. The commonest procedures performed were ventricular septal defect closure (31.4%), total correction of tetralogy of Fallot (26.5%), and atrial septal defect closure (9.8%). Fast-tracked anaesthesia was used always except where it was contraindicated. Most (76.7%) of the cases were extubated within 24 hours after surgery; the mean (SD) duration of ventilation in the ICU was 0.99 (1.2) days and the average length of ICU stay was 3 days. The overall mortality rate was 20.6%.

CONCLUSION

Numerous challenges confront the provision of sustainable paediatric cardiac anaesthesia services in resource-constrained settings like ours. Much can be achieved with appropriate investment in material and manpower, and partnership with experienced teams.

Surgical Outcome of Treatment of Tracheobronchial Foreign Bodies in Children: A Retrospective Analysis

BACKGROUND

Foreign body aspiration is an important cause of morbidity and potential mortality in children. The diagnosis of foreign body aspiration may be difficult in children as they are unable to give a history and the condition mimics a host of other childhood illnesses. In this study, we present our experience with foreign body aspiration in children.

OBJECTIVES

To study the presentation of children with airway foreign bodies in our environment and discuss the outcomes of management.

METHODS

This is a single centre retrospective study of all children who were confirmed to have tracheobronchial foreign body aspiration from January 2015 to December 2019. Biodata, clinical features, radiological features and outcome of management are presented in the article. Statistical analysis used: Measures of central tendency, dispersion and other relevant statistical analysis done with IBM SPSS® version 22.

RESULTS

Twenty-one records were complete and analysed. The mean age was 5.95years with a M: F ratio of about 3:1. About 70% of the children presented more than 24 hours after the incident and the vast majority of aspirated objects were inorganic. About half of the children had received a prior wrong diagnosis. Majority of the foreign bodies were left sided (47.6%). Twenty of the 21 foreign bodies were successfully extracted. There were two mortalities recorded in this study.

CONCLUSION

Foreign body aspiration is a life threatening condition. Physicians ought to consider this diagnosis in children presenting with unexplained acute respiratory symptoms.

Aortic Valve Regurgitation following Transthoracic Open Surgical Ligation of Patent Ductus Arteriosus

BACKGROUND

Transthoracic open surgical ligation (TTOSL) of patent ductus arteriosus (PDA) remains the most readily available and affordable treatment option in resource-poor countries such as Nigeria.

OBJECTIVES

To determine the incidence and outcome of aortic valve regurgitation (AR) following TTOSL of PDA.

METHODS

Retrospective audit of consecutive patients who underwent TTOSL of PDA over a 4½-year period (January 2015 to June 2019) at the OAUTHC, Ile-Ife, Nigeria. Hospital records including echocardiograms (pre-operative, immediate post-operative and follow-up performed a day after TTOSL, at 1, 3 and 12 months) were reviewed for presence and severity of AR.

RESULTS

Twenty-six patients (11 males and 15 females) aged 3 months 24 years (Mean = 3.16 years) had TTOS PDA ligation. Only 3 (11.5%) patients had AR pre-operatively; 2 graded moderate AR and 1 graded mild. Twenty (76.9 %) patients had immediate post-operative AR; 4 (20.0%) of which were moderate and the others (80.0%) were mild. Eighteen (69.2%) patients still had AR post-operative day 1; 16 were mild and the rest 2 which were moderate were the same patients that had AR pre-operatively. At 3 months follow-up, 6 of 20 patients (30.0%) had AR; all were mild. Only 2 of 18 (11.1%) followed up for 12 months had AR. They both had had moderate AR pre-operatively which were now graded as mild. There was no mortality.

CONCLUSION

Aortic regurgitation is common after TTOSL of PDA. However, in most instances, it is mild and transient.

Prospective assessment of the risk of obstructive sleep apnea in patients attending a tertiary health facility in Sub-Saharan Africa

Introduction

The impact of Obstructive sleep apnea (OSA) in worsening outcomes is profound, especially in the presence of comorbid conditions. This study aimed to describe the proportion of patients at a high risk of OSA in our practice setting.

Methods

The STOP BANG questionnaire and the Epworth Sleepiness scale were used to assess for OSA risk and excessive daytime sleepiness respectively. Hospitalized patients and out-patients were recruited. Intergroup differences in continuous variables were compared using the analysis of variance. The proportion of patients with high risk of OSA and excessive daytime sleepiness was presented as frequencies and group differences compared with the Pearson χ² test. Independent risk predictors for OSA were assessed in multivariate logistic regression analysis.

Results

A total of 1100 patients (53.4% females) participated in the study. Three hundred and ninety nine (36.3%) had a high risk of OSA, and 268 (24.4%) had excessive daytime sleepiness. Of the participants with high OSA risk, 138 (34.6%) had excessive daytime sleepiness compared to 130 (18.5%) of those with low OSA risk (p).

Conclusion

A significant proportion of patients attending our tertiary care center are at high risk of OSA.

Relationship between admission serum C-reactive protein and short term outcome following acute ischaemic stroke at a tertiary health institution in Nigeria

BACKGROUND

There is evidence of an association between mediators of inflammation, particularly C-reactive protein (CRP), and outcome of acute ischaemic stroke. This provides a potential opportunity for interventions aimed at improving outcome. There is sparse data exploring the role of inflammatory markers such as CRP and stroke outcome in Africans. The study objective was to determine the association between admission serum CRP levels and short-term outcome in the Nigerian patient presenting with acute ischaemic stroke.

MATERIALS AND METHODS

Consecutive patients hospitalized for first-ever acute ischaemic stroke at the Lagos University Teaching Hospital, Lagos, Nigeria, were prospectively enrolled between October 2007 and June 2008. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Serum CRP was determined on samples obtained within 7 days of stroke onset. All stroke patients were followed up till day 30 post-stroke. Outcome measures were 30 day Glasgow outcome scale score and functional impairment on the modified Rankin Scale (mRS). An age- and gender-matched healthy control group had serum CRP determined at inclusion. Elevated CRP was defined as any level above the cutoff (mean +2 x standard deviation of CRP level of controls).

RESULTS

Eighty patients with acute ischaemic stroke (47 men and 33 women) and 40 controls (27 male and 13 female) (P = 0.47) were studied. Mean age in cases was 59.1 ± 15.0 years. Mean CRP was significantly higher in stroke cases than controls (17.7 ± 14.4 mg/L versus 1.1 ± 1.7 mg/L respectively) (P < 0.00001). The frequency of elevated CRP (>4.5 mg/L) was 76.3% in stroke (N = 61) and 5% (N = 2) in controls (P < 0.0001). The case fatality rate in stroke with elevated CRP (32.8%) was significantly higher than stroke with normal admission CRP (0%; P = 0.015). The association of higher admission CRP with fatality () was statistically significant (P < 0.0001). Amongst survivors, mean CRP levels were markedly higher in the patients with unfavorable motor outcome (moderate/severe disability; n = 22; 21.5 ± 11.1) compared to those with favorable outcome (mild disability; n = 38; 6.5 ± 6.2) (P < 0.00001). In multivariate regression analysis, only high NIHSS score (P = 0.004) and admission CRP (P = 0.008) were independently associated with case fatality.

CONCLUSIONS

Elevated admission CRP and high NIHSS score are independent predictors of short-term case fatality and adverse functional outcome following acute ischaemic stroke in Nigerians.

Frog skin peptides (tigerinin-1R, magainin-AM1, -AM2, CPF-AM1, and PGla-AM1) stimulate secretion of glucagon-like peptide 1 (GLP-1) by GLUTag cells

Skin secretions of several frog species contain host-defense peptides with multiple biological activities including in vitro and in vivo insulin-releasing actions. This study investigates the effects of tigerinin-1R from Hoplobatrachus rugulosus (Dicroglossidae) and magainin-AM1, magainin-AM2, caerulein precursor fragment (CPF-AM1) and peptide glycine leucine amide (PGLa-AM1) from Xenopus amieti (Pipidae) on GLP-1 secretion from GLUTag cells. Tigerinin-1R showed the highest potency producing a significant (P<0.05) increase in GLP-1 release at a concentration of 0.1nM for the cyclic peptide and 0.3nM for the reduced form. All peptides from X. amieti significantly (P<0.05) stimulated GLP-1 release at concentrations ⩾300nM with magainin-AM2 exhibiting the greatest potency (minimum concentration producing a significant stimulation=1nM). The maximum stimulatory response (3.2-fold of basal rate, P<0.001) was produced by CPF-AM1 at a concentration of 3μM. No peptide stimulated release of the cytosolic enzyme, lactate dehydrogenase from GLUTag cells at concentrations up to 3μM indicating that the integrity of the plasma membrane had been preserved. The data indicate that frog skin peptides, by stimulating GLP-1 release as well as direct effects on insulin secretion, show therapeutic potential as agents for the treatment of type 2 diabetes.

Regulation of GPCR-mediated smooth muscle contraction: implications for asthma and pulmonary hypertension

Contractile G-protein-coupled receptors (GPCRs) have emerged as key regulators of smooth muscle contraction, both under healthy and diseased conditions. This brief review will discuss some key topics and novel insights regarding GPCR-mediated airway and vascular smooth muscle contraction as discussed at the 7th International Young Investigators' Symposium on Smooth Muscle (2011, Winnipeg, Manitoba, Canada) and will in particular focus on processes driving Ca(2+)-mobilization and -sensitization.

Cardiovascular dysfunction in HIV-infected children in a sub-Saharan African country: comparative cross-sectional observational study

OBJECTIVE

Cardiac dysfunction is rarely diagnosed in HIV-infected children in our setting and standard care does not include baseline and follow-up echocardiography. We aimed to determine the prevalence, pattern and predictors of HIV-related cardiac dysfunction.

METHODS

Pre-diagnosed HIV-infected children aged 18 months to 12 years from a tertiary teaching hospital in Lagos, South-West Nigeria were enrolled in a comparative, observational cross-sectional study; matched with apparently healthy controls of the same age group, were recruited sequentially between May 2004 and 2007. Proportions of pre-defined cardiac abnormalities such as heart failure diagnosed by clinical examination and dilated cardiomyopathy and ventricular dysfunction by echocardiography were determined.

RESULTS

Prevalence of cardiac abnormalities in HIV-infected children was 75.9%. Abnormalities included heart failure, dilated cardiomyopathy (33.7%), decreased LVSF of ≤ 25% in 33.7%, increased left ventricular mass (20.5%) and pericardial effusion (14.5%).

CONCLUSION

Structural and functional abnormalities are prevalent in HIV-infected African children and therefore justify inclusion of routine echocardiography in their standard care.

Tigerinin-1R: a potent, non-toxic insulin-releasing peptide isolated from the skin of the Asian frog, Hoplobatrachus rugulosus

AIM

Characterization of peptides in the skin of the Vietnamese common lowland frog Hoplobatrachus rugulosus with the ability to stimulate insulin release in vitro and improve glucose tolerance in vivo.

METHODS

Peptides in an extract of skin were purified by reversed-phase HPLC, and their abilities to stimulate the release of insulin and the cytosolic enzyme lactate dehydrogenase were determined using BRIN-BD11 clonal β cells. Insulin-releasing potencies of synthetic peptides and their effects on membrane potential and intracellular Ca²⁺ concentration were also measured using BRIN-BD11 cells. Effects on glucose tolerance and insulin release in vivo were determined in mice fed a high-fat diet to induce obesity and insulin resistance.

RESULTS

A cyclic dodecapeptide (RVCSAIPLPICH.NH₂), termed tigerinin-1R, was isolated from the skin extract that lacked short-term cytotoxic and haemolytic activity but significantly (p < 0.01) stimulated the rate of release of insulin from BRIN-BD11 cells at concentrations ≥ 0.1 nM. The maximum response was 405% of the basal rate at 5.6 mM ambient glucose concentration and 290% of basal rate at 16.7 mM glucose. C-terminal α-amidation was necessary for high potency and a possible mechanism of action of the peptide-involved membrane depolarization and an increase in intracellular Ca²⁺ concentration. Administration of tigerinin-1R (75 nmol/kg body weight) to high fat-fed mice significantly (p < 0.05) enhanced insulin release and improved glucose tolerance during the 60-min period following an intraperitoneal glucose load.

CONCLUSION

Tigerinin-1R is a potent, non-toxic insulin-releasing peptide that shows potential for development into an agent for the treatment of type 2 diabetes.

The spectrum of malignant neoplasms in Ekiti State, south-west Nigeria

BACKGROUND

Geographic pathology is an accepted basis for unravelling trends of disease patterns. Proper documentation at the initial stage assists in establishing a foundation data. The authors are not aware of a documented pattern of malignant neoplasm in Ekiti State.

OBJECTIVE

The aim of this study is to update the available literature on malignant neoplasms and compare our findings with previous work done by other investigators.

METHODS

The estimates are based on a systematic retrospective survey of cancer cases identified in the Pathology Laboratories of Federal Medical Centre, Ido-Ekiti and University Teaching Hospital, Ado-Ekiti for the period; January 2002 to December 2009. The data recorded on each case were: source of information (histology or cytology), name, age, and sex, date of diagnosis and site of tumour. Tumour site and histology were coded according to the International Classification of Diseases, ICD-10 for presentation in tabular form.

RESULTS

A total of 498 cancers were recorded. There were 177 (35.5%) males with average age of 54.5 years and 321 (64.5%) females with average age of 48.6 years. The estimated Crude Incidence (CI) rates for all cancer sites are 14.7 for males and 27.4 for females, per 100,000 population. In males, the most frequent cancer is prostate cancer (37.9%) followed by cancer of the liver (10.7%) and NonHodgkin's Lymphoma, NHL (7.9%). In females, the most common cancer is that of the breast (49.3%) followed by the cervix (8.5%) and the ovary (5.32%). A total of 28 childhood cancers were registered (17 males, 11 females). The most frequent tumours were Burkitt's lymphoma (8 cases) and soft tissue sarcomas (3 cases).

CONCLUSION

This study shows that malignant neoplasms are not uncommon in Ekiti State. There is underreporting of cases as the crude incidence rates are low. This study will serve as baseline to more population-based studies in future.

Plasma homocysteine level and its relationship to clinical profile in Parkinson's disease patients at the Lagos University Teaching Hospital

BACKGROUND

Hyperhomocysteinaemia (HHcy) is as a long-term sequelum of levodopa therapy in Parkinson's disease (PD). Information on its frequency and effects in Africans with PD is sparse.

OBJECTIVE

To determine the frequency of HHcy and its relationship to clinical features of PD in African patients.

METHODS

Using a case-control design, 40 consecutively attending PD patients and 40 age- and gender-matched healthy volunteering controls were studied. Parkinson's disease cases were evaluated for disease and treatment characteristics, using the Unified Parkinson Disease Rating Scale (UPDRS) motor and activities of daily living scores and disease stage (Hoehn and Yahr scale). Fasting total plasma homocysteine (Hcy) was determined in all subjects. Hyperhomocysteinaemia was defined as a Hcy level above the 90th percentile for the controls.

RESULTS

Mean Hcy was 13.8 ± 5.4mmol/L in PD and 12.4±3mmol/L in controls (P>0.05). Hyperhomocysteinaemia (Hcy > 16.26umol/L) occurred in nine (22.5%) PD patients (all on levodopa) and 6 (15%) controls (P>0.05). Mean duration of levodopa use was 92 ± 105.3 months in PD with HHcy compared to PD patients with normal Hcy 33.9 ± 33.2 (p < 0.05). Disease severity and disability were similar regardless of Hcy levels. None of current age, disease duration, Hoehn and Yahr stage, UPDRS scores, total levodopa dose and duration was independent predictor of homocysteine level.

CONCLUSION

There is increased occurrence of hyper-homocysteinaemia in Nigerian subjects with Parkinson's disease, receiving Levodopa. This hyperhomocysteinaemia is more common with prolonged use but appears to have no relationship with disease severity or disability.

Incorporating bioinformatics into biological science education in Nigeria: prospects and challenges

The urgency to process and analyze the deluge of data created by proteomics and genomics studies worldwide has caused bioinformatics to gain prominence and importance. However, its multidisciplinary nature has created a unique demand for specialist trained in both biology and computing. Several countries, in response to this challenge, have developed a number of manpower training programmes. This review presents a description of the meaning, scope, history and development of bioinformatics with focus on prospects and challenges facing bioinformatics education worldwide. The paper also provides an overview of attempts at the introduction of bioinformatics in Nigeria; describes the existing bioinformatics scenario in Nigeria and suggests strategies for effective bioinformatics education in Nigeria.

Gender differences among oral health care workers in caring for HIV/AIDS patients in Osun State, Nigeria

The study investigated the relationship between gender and knowledge, attitude and practice of infection control among oral health care workers in the management of patients with HIV/AIDS in Osun State of Nigeria. It was a cross-sectional survey using 85 oral Health care workers (OHCWs) enlisted in the public dental health clinics. A self-administered questionnaire was designed and used for data collection. A total of 85 questionnaires were distributed. The response rate was 93%; 42 (53%) were males and 37 (47%) females. The majority of the respondents were in the 25-40 year old age group and the mean age was 37.3 years. This study found significant differences in gender and ability to identify HIV/AIDS oral manifestations (p<0.001) and recognition of HIV/AIDS risk factors (p<0.001). There was statistically significant gender difference and infection control practices (p=0.02) among the OHCWs. Males were more compliant to the universal cross-infection control principle than the female respondents. A significant association (p< 0.001) was found between OHCW gender and their attitude to the management of HIV/AIDS patients with males showing a better attitude towards the care of HIV/AIDS patients. This study shows that there are significant gender difference in attitudes, behaviour and practices of OHCW with males faring better than the females. National AIDS Control Programme, Health Control bodies, Health educators and other organizations should make efforts to improve the attitude and practice of oral health care workers regarding the management of patients with HIV/AIDS.

Structural heart disease in children in Lagos: profile, problems and prospects

OBJECTIVES

Structural heart disease (SHD) contributes significantly to the health burden of children in Nigeria, unfortunately comprehensive cardiovascular programme including definitive surgery is currently not available locally. This may have contributed to the paucity of research in paediatric cardiology. Available epidemiologic data are limited and mostly outdated. We studied the current distribution SHD in Lagos and compared findings with reports elsewhere. Problems and prospects associated with cardiovascular care at the study site were highlighted.

MATERIALS AND METHODS

Children referred from public and private health facilities for cardiovascular evaluation including echocardiography between January 2004 and December 2005 were studied. PDA in premature babies, PFO and post surgical SHD were excluded. Proportions and relative frequencies of different heart lesions were calculated and analysed using appropriate statistics.

RESULTS

Congenital heart disease (CHD) significantly outnumbered acquired heart disease (AHD) (p=0.0001) in these children aged 4 weeks to 15 years (mean age = 3.8 +/- 2.5 years); the relative frequencies were VSD (41.7%), VSD (41.7%), ASD (20.2%), TOF (11.8%), AVCD/ECD (7.0%), PDA (5.7%), PS (3.1%), single ventricle and TGA (2.2%) each. PS was dominant in males, while septation defects were dominant in females. Pericarditis with effusion (31%), RHD (28.6%), myocarditis (14.3%) and dilated cardiomyopathy (14.3%) were the commonest AHD.

CONCLUSION

Contrary to previous hospital reports CHD rather than RHD and other AHD are dominant in some African settings like Lagos, and their relative frequencies are similar to reports elsewhere. The wide range of children with diverse native CHD is a reflection of non-availability of definitive surgical facilities locally. Regional and International collaboration could be mutually beneficial.

Knowledge and perception of stroke among at risk medical out-patients in a tertiary health institution in Nigeria

BACKGROUND

Patients who recognize their increased risk of stroke are more likely to engage in stroke prevention practices than those who do not.

METHOD

All patients attending medical out-patient clinic of the Federal Medical Center, Ido, Ekiti-State, Nigeria between January 2004-December 2004 were recruited into the screening process following their verbal consent. A set of questionnaire was administered to collect data.

RESULTS

A total of 155 patients were studied having satisfied the inclusion criteria. The mean age of the patients was 58.4 +/- 18.7 years. Majority of the patients indicated paralysis of one side of the body as the most common symptom of stroke. Patients with higher education p = 0.002 and men p = 0.004 were more aware of their increased risk factor for stroke than those with low education and women.

CONCLUSION

Perception about stroke among the at risk medical out patients as found out in this study indicates that more health education both at the community and the hospital is very vital to reducing the prevalence, recurrence, disability and mortality of stroke. Health providers are enjoined to communicate information about stroke risk to their patients.

Studies of the Antioxidative Effects of Green and Black Tea (Camellia sinensis) Extracts in Rats

This paper reports a comparative study of the antioxidative effects of black and green tea extracts in sodium oxalate-challenged rats. A dose of 10 mg/kg of body weight of sodium oxalate was used to induce lipid peroxidation in vivo. Rats treated with sodium oxalate had 42.06 +/- 3.10 nM/hour, 45.39 +/- 9.75 mg/100 mL, 10.95 +/- 1.52%, 15.95 +/- 3.19 mg/dL, 112.25 +/- 5.15 mg/dL, 59.21 +/- 2.95 IU, 39.55 +/- 2.51 IU, and 150.62 +/- 9.62 KA/unit for serum levels of malondialdehyde, reduced ascorbic acid, catalase, cholesterol, phospholipid, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP), respectively. These values are significantly (P < .05) different from values obtained from normal rats. Rats pretreated with 100 mg/kg of body weight of green tea had 27.59 +/- 3.56 nM/hour, 79.11 +/- 5.13 mg/100 mL, 4.23 +/- 0.36%, 50.09 +/- 5.24 mg/dL, 97.58 +/- 4.73 mg/dL, 23.10 +/- 1.59 IU, 31.14 +/- 1.26 IU, and 96.48 +/- 2.36 KA/unit for serum levels of malondialdehyde, reduced ascorbic acid, catalase, cholesterol, phospholipid, AST, ALT, and ALP, respectively, compared with 37.28 +/- 2.07 nM/hour, 72.62 +/- 2.10 mg/100 mL, 6.23 +/- 1.52%, 37.25 +/- 2.84 mg/dL, 78.05 +/- 2.36 mg/dL, 36.08 +/- 1.80 IU, 29.00 +/- 3.02 IU, and 109.23 +/- 6.32 KA/unit recorded for the same parameters in rats treated with black tea. The cholesterol to phospholipid ratio was increased from 0.14 +/- 0.04 in control rats to 0.47 +/- 0.02 and 0.51 +/- 0.01 by black and green tea extracts, respectively. These results suggest that tea extracts have antioxidant properties and that green tea extract is more potent.

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 microg/ml. Their minimum inhibitory concentrations ranged from 12.5approximately 100 microg/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 microg/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.

Identified factors in child-dentist relationship important for the management of dental anxiety in Nigerian children

AIM

To investigate the effects and interrelationship between dental anxiety and dentist's experience, dentist's behaviour, type of treatment received and the behaviour of Nigerian children during treatment.

METHODS

Pre- and post-dental treatment anxiety levels of 69 child patients, who were attending the dental clinic to receive dental treatment for the first time, were assessed using the DFSS-SF. The dentist's and child's behaviour during treatment procedures were unobtrusively observed and recorded. The pre- treatment anxiety levels were classified as high (HAC) and low (LAC), while those of the dentists who managed the children were categorized as experience or inexperienced. The interrelationship between a child's dental anxiety level, dentist's behaviour during child management, dentist's experience and the type of treatment the child received were analysed.

RESULTS

The anxiety level of the children decreased significantly post-treatment when experienced dentists managed the child in comparison to inexperienced dentists (Z=3.22, p<0.02). The dentist's behaviour did not significantly affect the anxiety level of the child. However, physical contact was used more frequently with HAC than LAC (z=2.27;p<0.023). There was no association between a child's behaviour in the dental chair and their anxiety level (chi(2)=0.08, p<0.93). Also, the more invasive the procedure, the less the tendency for a noted decrease in anxiety level of a child post-treatment, though this was statistically insignificant (z=1.34; p<0.44).

CONCLUSION

The dentist's behaviour played no role in changing the anxiety level of a child nor did it have any influence on anxiety-related behaviour of a child. However, the experience of the dentist was a very significant factor for effecting a decrease in the dental anxiety level change for children.

The modulating effect of culture on the expression of dental anxiety in children: a literature review

The experience of anxiety is a universal human phenomenon. Studies have shown a world-wide variation in the prevalence of dental anxiety with estimates ranging between 3% and 43%. The aetiology of dental anxiety is multifactorial, with factors acting in synergy to affect its expression. For children, age and gender play fundamental roles in its expression. However, these two factors are modulated by other variables such as culture which may influence the context in which anxiety is experienced, the interpretation of its meaning and responses to it. The modulating effect of culture in synergy with other variables may be one of the reasons why reports on dental anxiety have varied from region to region. This paper attempts to identify the interrelating roles of culture, age and gender, and how these relationships may affect variability in the expression and measurement of dental anxiety in children.

Dental anxiety in a subpopulation of African children: parents ability to predict and its relation to general anxiety and behaviour in the dental chair

AIM

This was to investigate the ability of Nigerian parents to predict their child's dental anxiety level and the relationship between the child's dental anxiety, general anxiety and behaviour in the dental chair.

METHODS

A group of 53 mothers and 35 fathers and their respective children completed schedules that measured general and dental anxiety. The child's behaviour on the dental chair was also assessed. The child's self report of dental anxiety and general anxiety was compared with that of the parents. Dental anxiety ratings by the children and parents were correlated with the behaviour assessment of the dentist. Statistical significance was determined at <0.05.

RESULTS

There was no statistically significant difference between the parent's assessment of their child's dental anxiety level and the child's self report (t=0.389; p=0.689). However, the mothers were able to rate their child's dental anxiety level better than the fathers (r=0.497 and p<0.001 for mothers, r=-0.049 and p=0.789 for fathers). Also there was a moderate correlation between the child's self reported dental anxiety and general anxiety levels (r=0.58, p<0.05) and a low correlation between the clinical behaviour ratings and the child's self reported dental anxiety level (r=0.10, p>0.05).

CONCLUSION

The Nigerian mothers could be relied upon to make objective assessment of their child's dental anxiety. General anxiety appears to play a significant role in dental anxiety development in Nigerian children who appear to behave well in the dental chair despite their reported dental anxiety levels.

Anti-sickling potential of a Nigerian herbal formula (ajawaron HF) and the major plant component (Cissus populnea L. CPK)

The anti-sickling activities of the extracts of the roots of a plant Cissus populnea L. (CPK) (a major constituent of a herbal formula Ajawaron HF used in the management of sickle cell disease in south-west Nigeria) has been examined. Phytochemical examination of the extract showed the presence of anthraquinone derivatives, steroidal glycosides and cardiac glycosides. Alkaloids and tannins were completely absent in the CPK extracts. Evaluation of the anti-sickling activity involved the use of both positive (p-hydroxybenzoic acid, 5 microg/mL) and negative control (normal saline) for each set of experiments aimed at the inhibition of sodium metabisulphite-induced sickling of the HbSS red blood cells obtained from confirmed non-crisis state sickle-cell patients. The chloroform and water partitioned fractions of the cold methanol extracts of CPK exhibited a 62.2% and 52.9% inhibition of sickling, respectively, at 180 min. The herbal formula (HF) aqueous extract showed the highest anti-sickling activity on a weight by weight basis of all the extracts and fractions tested, giving a 71.4% inhibition of sickling at the end of 180 min incubation when compared with the normal saline control. The maximum percentage inhibition of sickling exhibited by the p-hydroxybenzoic acid control was 46.0% at 90 min incubation.

Potency status and efficacy of measles vaccine administered in Nigeria: a case study of three EPI centres in Lagos, Nigeria

The potency status and efficacy of measles vaccines were studied in three immunization (EPI) centres in the suburban area of Lagos, Nigeria. A total of 14 vials of measles vaccine were collected and subjected to potency testing while, 203 measles-vaccinated children were recruited for this study. Only 85 (41.87%) of the vaccinees reported back for the post-vaccination follow-up screening. The seroconversion pattern showed that 51(60%) had potent antibody titres ranging from 1:40 to 1:1280, while the remaining 34 (40%) had a low antibody titres between < 1:20 and 1:20. The vaccine potency test showed that only 1 (7.14%) of the 14 vaccine vials collected at these centres had virus titre of 3.5 Log while the remaining 13 (92.86%) had virus titres lower than 3.0 Log: the recommended human dose by the World Health Organisation (WHO) for measles vaccine. The administration of these subpotent and/or impotent vaccines vis-à-vis the status of immune response elicited in the vaccinees may be one of the reasons for the occurrence of measles infection in vaccinated children in the recent time in Nigeria. We herein suggested the subjection of all vaccines to a thorough standard laboratory screening before use in Nigeria.

Interpupillary and internipple distances and ear lengths in Nigerian newborns

Two hundred and seventy-eight Nigerian, singleton full term neonates were investigated for interpupillary and internipple distances and ear length. The values were compared with standards derived from an American population. The study showed that the Nigerian neonate is hyperteloric, has a short ear, more closely spaced nipples and a lower ratio of internipple distance to chest circumference relative to the American neonate. It was concluded that local reference standards are needed before these anthropometric parameters can be safely used in the diagnosis of intrauterine growth retardation and dysmorphic states.