Studies on the prevalence of renal disease and hypertension in relation to schistosomiasis: I Some aspects of epidemiological methods in the rural illiterate setting.
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Biomedical subjects
Publications and source records attributed to O Ayeni.
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The blood pressures of young Black and White American schoolchildren were measured and compared with those of Nigerian children of similar ages. Both diastolic and systolic pressures were consistently higher in the Nigerian children than in the Americans, both Black and White. The White children had the lowest pressures at each age. The mean weights and heights at each age were not significantly different in the three groups. Although the blood pressure of African children was higher than that of Black Americans, mean adult pressures are known to be similar in both groups. This suggests that the difference in childhood pressures must be due more to environmental factors than to genetic ones.
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The treatment of iron-deficiency anaemia in pregnancy with a new intramuscular iron preparation, iron-poly (sorbitol-gluconic acid) complex (Ferastral), has been assessed and compared with oral iron therapy. Sixty-one of the eighty-four patients studied, many of whom had mild to moderate degree of anaemia were treated with Ferastral. The results were satisfactory, the mean increase of haematocrit at the sixth post treatment week was 28.7% for the whole series. Complete correction of anaemia was achieved in most patients between the 4th and 6th week of treatment. The mean haematocrit of the group treated with oral iron was initially significantly higher than for the group treated with Ferastral. At the first follow-up, two weeks after beginning treatment, the mean values for both groups were similar; at four weeks, those receiving Ferastral had a significantly higher mean PCV than those on oral iron, and remained so through the period of observation. No side-effects were detected using 10 ml of Ferastral intramuscularly on alternate days. The mean hospitalization time of patients with severe to moderate anaemia was reduced when given parenteral therapy, and the frequency of blood transfusion in these patients was also decreased.
Measurements of the mid-upper arm circumference and the triceps skin-fold thickness were made at six montly intervals in 15 malnourished children. From these measurements, values were obtained for 'muscle bulk' and 'fat bulk' using local standards. Over a 12 month period, both measurements increased among the overtly malnourished children. The fat increased most in the children who were initially underweight (marasmic children). All these indicated an improvement in the nutritional status of these children. The Oje group of children deteriorated in all the parameters without any evidence of acute illness. A possible reason for this situation was a false sense of confidence on the part of the children's mothers and consequently, inadequate provision of food. The use of subcutaneous fat as an index of inadequate intake, and skeletal muscle for evidence of protein depletion, was also highlighted.
The results of a prospective survey of post-operative wound sepsis following obstetrical and gynaecological laparotomies at the University College Hospital, Ibadan, Nigeria are presented. The overall wound sepsis rate was 20.2 per cent, but the corresponding rates in the gynaecological, primary obstetrical and repeat obstetrical cases were 14.9 per cent, 7.0 per cent and 29.9 per cent respectively. Statistical tests indicate that these rates differ significantly. The rate among the gynaecological cases did not differ significantly from the primary obstetrical cases, but that of the repeat obstetrical cases was significantly higher than those of the other two groups. The poorer wound healing in the repeat obstetrical laparotomies is thought to be due to poor blood supply. The variables that correlated significantly with wound sepsis rate were: pre-operative anaemia, number of medical students in theatre, antibiotic chemoprophylaxis and excision of previous scar in repeat laparotomies. The commonest organism involved in the wound sepsis was staph pyogenes. The wound sepsis rate obtained in this survey was high and various preventive measures are discussed.
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Fifty-five patients have been investigated for anaemia in pregnancy. Using the serum iron/T.I.B.C. ratio as a diagnostic index it has been found that iron deficiency exists in 60% of our expectant mothers with mild anaemia. This type of anaemia was more common in multiparous women and more frequent in the first and second trimesters of pregnancy, There is, therefore, a strong indication for the routine administration of iron supplements to our women during pregnancy and the puerperium.
The median ages at menarche were obtained from a sample of 2029 urban and 328 rural Nigerian girls by the status quo method, and calculated by probits. The median age at menarche for the urban girls was 13-70 +/- 0-03 years whilst it was 14-50 +/- 0-09 years for the rural girls. There were significant differences in the median menarcheal ages of the girls according to the level of education and the occupation of the parents, and their geographical residence. The number of siblings and the birth rank of the girls did not influence the age of onset of menstruation. A secular trend towards earlier menarcheal age at a rate of 5 to 6 months per decade was observed amongst children of the professionally privileged group. The earliest menarche occurred amongst girls with university-educated fathers or mothers; in this group the median was 13-26 +/- 0-06 years, a value comparable with current European medians.
Data on low birth weight among 1111 singleton and normal livebirths were collected in two Nigerian, urban and rural communities, belonging to the lower socio-economic group. The mothers attended MCH centres. The incidence rates of low birth weights were 9.4% and 9.8% of total live birth deliveries in the urban and rural locations, respectively. Low birth weight was found to correlate significantly with maternal age, height and parity; no significant urban/rural differentiation was detected.
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The effects of a mixture of red pepper suspension and alpha-alanine (an amino-acid) on gastric acid secretion in 33 duodenal ulcer and 18 non-duodenal ulcer patients were studied. This mixture caused an increase of gastric acid in the two groups of patients, more so in the duodenal ulcer group (0.025 > P > 0.010). Compared with the results of previous studies the administration of alpha-alanine in red pepper suspension produced less gastric acid than the fresh red pepper suspension alone.
A retrospective study of birthweights, the incidence, and possible aetiology of low birthweight in 31,490 Nigerian children, delivered in two hospitals at Ibadan, is reported. The important findings were: (a) mean birthweights for males (3,000 gm), and for females (2,880 gm) in a non-teaching hospital were significantly higher than 2,980 gm and 2,860 gm for males and females respectively in the teaching hospital; (b) the mean birthweights for boys were significantly higher than those for girls in both hospitals; (c) these mean birthweights, though generally higher than previous reports from Nigeria, were significantly lower than those for North American Caucasian and Negro babies, and of babies of three different racial groups in Malaysia. Other interesting, though expected findings were: (a) a high incidence of low birthweight (15.5 per cent) and (b) a high incidence of small for dates babies (60 per cent). It is suggested that since birthweights, the incidence of low birthweight and its aetiology are vital in the planning of health care in any country, a prospective study involving many urban and rural areas of the country and including factors known to influence birthweight should be undertaken.
Amniotic fluid bilirubin and creatinine levels were determined in 143 pregnant patients of known maturity. The bilirubin values did not bear any significant relationship with the gestational age. The creatinine levels however, showed a rise as pregnancy progressed. Amiotic fluid mean creatinine values were below 1 mg/100 ml before 30 weeks and around 2 mg/100 ml close to term. Eighty per cent of all creatinine values at 37 weeks gestation and over were 1.6 mg/100 ml or more. The mean level of creatinine in amniotic fluid correlated with gestational age. This test can therefore be applied antenatally along with other clinical data to distinguish between the premature and mature infants.
Serial estimations of plasma immunoglobulins IgG, IgM and IgA were undertaken in the first year of life of healthy Nigerian infants by the single radial immunodiffusion method. High levels of IgG present at birth dropped below half their values in the first month of life and remained low for about four months after which a sustained rise was observed although birth levels were not attained at 1 year of age. IgM was low at birth and IgA was absent but was detached at one month. Both IgM and IgA rose rapidly in the first four months of life which is in keeping with immunological competence and primary antibody response to various subclinical infections in infancy.