Anecdotal reports have attributed persistent splenomegaly in African sickle cell anemia (SS) patients to the effects of malaria. However, no comparative studies of patients in malarial and nonmalarial regions have been conducted, and few studies of malaria antibody titers have been reported. In the present study, age- and sex-matched Nigerian patients (n = 310), while it was found only in 8% of U.S. patients (n = 100) from Georgia. There was significant linear correlation between spleen size and Hb levels and with serum immunoglobulins in the Nigerian group. However, serum complement levels (C3 and C4) were not affected by spleen size. In both groups, patients with splenomegaly had fewer circulating pitted red cells than their counterparts without splenomegaly. The mean +/- SE of IgG-specific malaria antibody titer among the Nigerian patients without palpable spleens was 9,386 +/- 2,036; 9,334 +/- 2,980 in those with spleens between 1 and 5 cm, 16,201 +/- 4,502 in those with spleens between 6 and 10 cm, and 22,445 +/- 8,456 in those with spleens above 10 cm. Coexistent alpha-thalassemia did not influence the prevalence of splenomegaly among the Nigerian SS patients. This study provides additional evidence that malaria plays a significant role in the persistence of splenomegaly in African patients.
Nigeria is the most populated black African nation, with a population of 140 million from the 2006 population census. Medical education began with the establishment of the University College Hospital, Ibadan as a College branch of the University of London in 1948. Since then four generations of medical schools have evolved. The newer medical schools adopted the curriculum of the older schools with little modification. The subsequent introduction of changes and modification in the curriculum of medical education worldwide did not seem to affect Nigerian medical schools. Teacher training in educational methods for medical educators has not been introduced, nor has there been any curriculum planning or review. Efforts made regionally and nationally to change the medical curriculum and improve quality of medical training has not yielded the desired results. The regulatory bodies, the National Universities Commission and the Medical and Dental Council of Nigeria introduced separate curricula for medical schools, as a guide to minimum standards, but there has been so far a varying degree of compliance by the Universities. There is an urgent need to bring Medical Education and teacher training issues to the fore. Needs assessment of medical school faculty to determine their training would be seen to be a good starting point, as well as curriculum transformation and the introduction of newer assessment methods. It is suggested that the Medical and Dental Council of Nigeria (MDCN) should take a leading role by collaborating with outside bodies concerned with medical education.
Equilibrium adsorption studies for detoxification of Congo Red (CR) dye from single component model wastewater by powdered watermelon rinds and neem leaves adsorbents were carried out with the view to test the applicability of the adsorption process to Langmuir, Freundlich, Temkin, Dubinin-Radushkevich and Harkins-Jura isotherm models. The values of correlation coefficient, R 2 (0.9359-0.9998), showed that all the experimental data fitted the linear plots of the tested isotherm models. Dubinin-Radushkevich's monolayer maximum adsorption capacity qD (20.72-26.06 mg/g) is better than Langmuir's qm (18.62-24.75 mg/g) for both adsorbents with the capacities higher for adsorption on watermelon rind than on neem leaves. Values of Langmuir separation factor (RL) suggest unfavourable adsorption processes (i.e. chemisorption) of the dye on both the adsorbents, while Freundlich constant (nF) indicates unfavourable process only for CR adsorption onto neem leaves. The Dubinin-Radushkevich's mean free energy of adsorption, (0.29-0.32 kJ/mol), suggests physical adsorption processes. Values for Temkin's heat of adsorption, bT (-0.95 to 0.74 kJ/mol), also show physical adsorption process.
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