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Epilepsy is one of the oldest recorded medical ailments. Ethnomedicinal survey was carried out to identify and take a detailed list of the medicinal plant species used to treat epilepsy and assess how they are used in Etche Local Government Area (LGA) of Rivers State, Nigeria. Semi-structured questionnaires were used during the survey to conduct interviews with traditional healers and other knowledgeable individuals on the use of medicinal plants in the treatment of epilepsy. Twelve communities were randomly selected while a total of 54 respondents were purposively selected. The respondents consist of 82.5% males and 12.3% females, 43.9% were above 60 years while 28.1% were between 51-60 years. Traditional medicine practitioners (TMP) formed 75.4% of the respondents, primary occupation of other knowledgeable respondents on plants used for epilepsy were civil servants (8.8%), farming and trading (3.5%). A total of 25 medicinal plant species were recorded during the survey. Phytochemical screening was carried out on five medicinal plants based on frequency of mention, the screening showed presence of alkaloids, triterpenoids, steroids, saponins, tannins, flavonoids, anthraquinones, cardenolides and carbohydrates. Plant resources employed in the local treatment of epilepsy in Etche were documented. Further research on isolation of active compounds on frequently used plants for epilepsy is encouraged to harness their potentials.

Benzene-sulfonohydrazide (ECMMBSH) Schiff base has been made available in an excellent yield via reflux dehydrate of 4-methylbenzene-sulfonohydrazide with 9-ethyl-9H-carbazole-3-carbaldehyde in EtOH. The synthesis of the ECMMBSH was monitored via two main spectroscopic techniques FT-IR and UV–vis tools; ECMMBSH was characterized via MS, 1H NMR, FT-IR, CHN-EA, TG/DTG, EDX, and UV–vis., analysis. Moreover, DFT-optimized, Molecular Electrostatic Potential (MEP) and MAC/NPA-charge models were performed for ECMMBSH. The HOMO/LUMO and Density of State (DOS) calculated energy levels were compared to Tuac experimental optical energy gap values in methanol. Additionally, the TD-DFT and UV–vis. experimental absorption behavior was matched under the same condition. Moreover, the chemo-sensation effect of the ECMMBSH towered Cu2+ ions via complexation was evaluated by naked eye in addition to the UV–vis spectrophotometric measurements.

Inert-particles spouted bed reactor (IPSBR) is characterized by intense mixing generated by the circular motion of the inert particles. The operating parameters play an important role in the performance of the IPSBR system, and therefore, parameter optimization is critical for the design and scale-up of this gas–liquid contact system. Computational fluid dynamics (CFD) provides detailed modeling of the system hydrodynamics, enabling the determination of the operating conditions that optimize the performance of this contact system. The present work optimizes the main IPSBR operating parameters, which include a feed-gas velocity in the range 0.5–1.5 m/s, orifice diameter in the range 0.001–0.005 m, gas head in the range 0.15–0.35 m, mixing-particle diameter in the range 0.009–0.0225 m, and mixing-particle to reactor volume fraction in the range 2.0–10.0 vol % (which represents 0.01–0.1 kg of mixing particles loading). The effects of these parameters on the average air velocity and average air volume fraction in the upper, middle, and conical regions of the reactor were studied. The specific distance for each region has been measured from the orifice point to be 50 mm for the conical region, 350 mm for the middle region and 550 mm for the upper rejoin. The selected factors were optimized to obtain the minimum air velocity distribution (maximum gas residence time) and the maximum air volume fraction (maximum interfacial area concentration) because these conditions will increase the gas holdup, the gas–liquid contact area, and the mass transfer coefficient among phases. Response surface methodology (RSM) was used to determine the optimum operating conditions. The regression analysis showed an excellent fit of the experimental data to a second-order polynomial model. The interaction between the process variables was evaluated using the obtained three-dimensional surface plots. The analysis revealed that under the optimized parameters of a feed-gas velocity of 1.5 m/s, orifice diameter of 0.001 m, gas head of 0.164 m, mixing-particle diameter of 0.0225 m, and mixing-particle loading of 0.02 kg, the minimum average air velocity and highest air volume fraction were observed throughout the reactor.

Autophagy is the major mechanism involved in degradation and recycling of intracellular components, and its alterations have been proposed to cause beta cell dysfunction. In this study, we explored the effects of autophagy modulation in human islets under conditions associated to endoplasmic reticulum (ER) stress. Human pancreatic islets were isolated by enzymatic digestion and density gradient purification from pancreatic samples of non-diabetic (ND; n = 17; age 65 ± 21 years; gender: 5 M/12 F; BMI 23.4 ± 3.3 kg/m2) and T2D (n = 9; age 76 ± 6 years; 4 M/5 F; gender: BMI 25.4 ± 3.7 kg/m2) organ donors. Nine ND organ donors were treated for hypertension and 1 for both hypertension and hypercholesterolemia. T2D organ donors were treated with metformin (1), oral hypoglycemic agents (2), diet + oral hypoglycemic agents (3), insulin (3) or insulin plus metformin (3) as for antidiabetic therapy and, of these, 3 were treated also for hypertension and 6 for both hypertension and hypercholesterolemia. Two days after isolation, they were cultured for 1–5 days with 10 ng/ml rapamycin (autophagy inducer), 5 mM 3-methyladenine or 1.0 nM concanamycin-A (autophagy blockers), either in the presence or not of metabolic (0.5 mM palmitate) or chemical (0.1 ng/ml brefeldin A) ER stressors. In ND islets palmitate exposure induced a 4 to 5-fold increase of beta cell apoptosis, which was significantly prevented by rapamycin and exacerbated by 3-MA. Similar results were observed with brefeldin treatment. Glucose-stimulated insulin secretion from ND islets was reduced by palmitate (−40 to 50%) and brefeldin (−60 to 70%), and rapamycin counteracted palmitate, but not brefeldin, cytotoxic actions. Both palmitate and brefeldin induced PERK, CHOP and BiP gene expression, which was partially, but significantly prevented by rapamycin. With T2D islets, rapamycin alone reduced the amount of p62, an autophagy receptor that accumulates in cells when macroautophagy is inhibited. Compared to untreated T2D cells, rapamycin-exposed diabetic islets showed improved insulin secretion, reduced proportion of beta cells showing signs of apoptosis and better preserved insulin granules, mitochondria and ER ultrastructure; this was associated with significant reduction of PERK, CHOP and BiP gene expression. This study emphasizes the importance of autophagy modulation in human beta cell function and survival, particularly in situations of ER stress. Tuning autophagy could be a tool for beta cell protection.

Objectives: The acquisition of carbapenemases by Acinetobacter baumannii is reported increasingly worldwide, but data from Lebanon are limited. The aims of this study were to evaluate the prevalence of imipenem-resistant A. baumannii in Lebanon, identify resistance determinants, and detect clonal relatedness. Methods: Imipenem-resistant A. baumannii were collected from nine Lebanese hospitals during 2012. Antimicrobial susceptibility, the cloxacillin effect, and ethylenediaminetetraacetic acid (EDTA) synergy were determined. Genes encoding carbapenemases and insertion sequence ISAba1 were screened via PCR sequencing. ISAba1 position relative to genes encoding Acinetobacter-derived cephalosporinases (ADCs) and OXA-23 was studied by PCR mapping. Clonal linkage was examined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Results: Out of 724 A. baumannii isolated in 2012, 638 (88%) were imipenem-resistant. Of these, 142 were analyzed. Clavulanic acid–imipenem synergy suggested carbapenem-hydrolyzing extended-spectrum β-lactamase. A positive cloxacillin test indicated ADCs, while EDTA detection strips were negative. Genotyping indicated that 90% of isolates co-harbored blaOXA-23 and blaGES-11. The remaining strains had blaOXA-23, blaOXA-24, blaGES-11, or blaOXA-24 with blaGES-11. ISAba1 was located upstream of blaADC and blaOXA-23 in 97% and 100% of isolates, respectively. ERIC-PCR fingerprinting revealed 18 pulsotypes spread via horizontal gene transfer and clonal dissemination. Conclusion: This survey established baseline evidence of OXA-23 and GES-11-producing A. baumannii in Lebanon, indicating the need for further surveillance.

Objectives: To detect, characterize, and assess the genetic clonality of carbapenem-non-susceptible Enterobacteriaceae in 10 Lebanese hospitals in 2012. Methods: Selected Enterobacteriaceae isolates with reduced susceptibility to carbapenems were subject to phenotypic study including antibiotic susceptibility, cloxacillin effect, modified Hodge test, and activity of efflux pump inhibitor. Carbapenemase genes were detected using PCR; clonal relatedness was studied by pulsed field gel electrophoresis. Results: Out of 8717 Enterobacteriaceae isolated in 2012, 102 (1.2%) showed reduced susceptibility to carbapenems. Thirty-one (70%) of the 44 studied clinical isolates harbored blaOXA-48, including 15 Klebsiella pneumoniae, eight Escherichia coli, four Serratia marcescens, three Enterobacter cloacae, and one Morganella morganii. The majority of OXA-48 producers co-secreted an extended-spectrum beta-lactamase, while one had an acquired AmpC of the ACC type. In the non-OXA-48 producers, carbapenem resistance was attributed to the production of acquired AmpC cephalosporinases of MOX or CIT type, outer membrane impermeability, and/or efflux pump overproduction. DNA fingerprints revealed that OXA-48 producers were different, except for clonal relatedness among four K. pneumoniae, two E. coli, two E. cloacae, and three S. marcescens. Conclusions: Nosocomial carbapenem-non-susceptible Enterobacteriaceae are moderately spread in Lebanon and the predominant mechanism is OXA-48 production.

Two-step optimized hybrid methods of order five and order six are developed for the integration of second order oscillatory initial value problems. The optimized hybrid method (OHMs) are based on the existing nonzero dissipative hybrid methods. Phase-lag, dissipation or amplification error, and the differentiation of the phase-lag relations are required to obtain the methods. Phase-fitted methods based on the same nonzero dissipative hybrid methods are also constructed. Numerical results show that OHMs are more accurate compared to the phase-fitted methods and some well-known methods appeared in the scientific literature in solving oscillating second order initial value problems. It is also found that the nonzero dissipative hybrid methods are more suitable to be optimized than phase-fitted methods.

Two new Runge-Kutta-Nyström (RKN) methods are constructed for solving second-order differential equations with oscillatory solutions. These two new methods are constructed based on two existing RKN methods. Firstly, a three-stage fourth-order Garcia’s RKN method. Another method is Hairer’s RKN method of four-stage fifth-order. Both new derived methods have two variable coefficients with phase-lag of order infinity and zero amplification error (zero dissipative). Numerical tests are performed and the results show that the new methods are more accurate than the other methods in the literature.

We constructed three two-step semi-implicit hybrid methods (SIHMs) for solving oscillatory second order ordinary differential equations (ODEs). The first two methods are three-stage fourth-order and three-stage fifth-order with dispersion order six and zero dissipation. The third is a four-stage fifth-order method with dispersion order eight and dissipation order five. Numerical results show that SIHMs are more accurate as compared to the existing hybrid methods, Runge-Kutta Nyström (RKN) and Runge-Kutta (RK) methods of the same order and Diagonally Implicit Runge-Kutta Nyström (DIRKN) method of the same stage. The intervals of absolute stability or periodicity of SIHM for ODE are also presented.

Abstract Background In terms of survival rate, recurrent oral squamous cell carcinoma (OSCC) after primary surgery is considered as a poor prognostic indicator. Objective This study aims to determine the incidence of OSCC recurrence among patients treated at Khartoum Teaching Dental Hospital (KTDH) and possible risk factors associated with it. Methods Records of 303 patients with a history of radical surgery were retrieved from the hospital’s archives, and the histopathological records were retrieved from the archival specimens of Professor Ahmed Suleiman Oral Pathology Laboratory, Faculty of Dentistry, and University of Khartoum. Results Advanced stages of OSCC (III, IV) were associated with higher recurrence rates, and the poorly differentiated OSCC was the commonest recurrent type. Conclusion The condition of the surgical margin is a significant predictor of OSCC recurrence and tumor stage. The tumor site, the type of surgical resection, and the tumor differentiation were also identified as significant factors influencing the recurrence of OSCC.

Quantifying the global bromine monoxide (BrO) budget is essential to understand ozone chemistry better. In particular, the tropospheric BrO budget has not been well characterized. Here, we retrieve nearly a decade (February 2012–July 2021) of stratospheric and tropospheric BrO vertical columns from the Ozone Mapping and Profiling Suite Nadir Mapper (OMPS-NM) on board the Suomi National Polar-orbiting Partnership (Suomi-NPP) satellite. In quantifying tropospheric BrO enhancements from total slant columns, the key aspects involve segregating them from stratospheric enhancements and applying appropriate air mass factors. To address this concern and improve upon the existing methods, our study proposes an approach that applies distinct BrO vertical profiles based on the presence or absence of tropospheric BrO enhancement at each pixel, identifying it dynamically using a satellite-derived stratospheric-ozone–BrO relationship. We demonstrate good agreement for both stratosphere (r = 0.81–0.83) and troposphere (r = 0.50–0.70) by comparing monthly mean BrO vertical columns from OMPS-NM with ground-based observations from three stations (Lauder, Utqiaġvik, and Harestua). Although algorithm performance is primarily assessed at high latitudes, the OMPS-NM BrO retrievals successfully capture tropospheric enhancements not only in polar regions but also in extrapolar areas, such as the Rann of Kutch and the Great Salt Lake. We also estimate random uncertainties in the retrievals pixel by pixel, which can assist in quantitative applications of the OMPS-NM BrO dataset. Our BrO retrieval algorithm is designed for cross-sensor applications and can be adapted to other space-borne ultraviolet spectrometers, contributing to the creation of continuous long-term satellite BrO observation records.

Background: Malaria is a major cause of mortality among children. Objective: This study determines the clinical profile, outcome (discharge and death), and factors associated with poor outcome in children with severe malaria in a tertiary health facility in Northern Nigeria. Methods: We conducted a descriptive retrospective study of all children (≤14 years) admitted with severe malaria based on positive malaria parasite on thick film and or rapid diagnostic test and the World Health Organization guideline for severe malaria. We extracted relevant data from patients’ case files and departmental records and analyzed with the Statistical Package for the Social Sciences (SPSS) for Windows, version 20.0. (IBM Corp, Armonk, NY). Results: A total of 483 children with severe malaria were admitted with median age interquartile range of 4.0 (2.5–8.0) years. Males were 261 (54.0%). Underfives were 258 (53.4%). Common forms of presentation were cerebral malaria 169 (35.0%), prostration (102; 21.1%), and multiple convulsion (86; 17.8%). Cerebral malaria and prostration were significantly higher among children aged 5 years and older. The mortality rate was 4.3% (21). Multivariate logistic regression analyses showed that impaired consciousness (adjusted odds ratio [aOR] 8.5, 95% confidence interval [CI]: 2.345, 30.484), hypoglycemia (aOR: 21.4, 95% CI: 2.766, 165.410), presence of two or more components (aOR: 4.5, 95% CI: 1.630, 12.522), and duration of hospitalization of 24 h or less (aOR: 4.6, 95% CI: 1.621, 12.782) were independent predictors of poor outcome. Conclusion: Our study showed that cerebral malaria was the most common form of severe malaria with a significant burden in children above 5 years. The presence of impaired consciousness, hypoglycemia, multiple components, and duration of

Growing evidence suggests that dipeptidyl peptidase 4 (DPP4) inhibitors, in addition to their role in improving glycemic control, help to reduce endothelial dysfunction and have hypolipidemic, anti-atherosclerotic, antitumor, antiviral, and neurotropic properties. This multi-target property may be one of the reasons for repurposing therapeutic treatment strategies with existing agents and the basis for finding new agents to inhibit this target. Based on the structural prerequisites and the evolutionary path of creating DPP4 inhibitors, an inhibitory (R)-β-aminoamide base was used as the basis for constructing potential candidates. It contained a substituted piperazine-2-one derivative and (S)-pyrrolidine-2-carbonitrile fragment, as well as phenyl and diphenyl rings, which were additionally saturated with substituents of various electronic structures, in position 4 of the β-aminoamide chain. The construction of the molecules was carried out taking into account the correspondence of chiral centers to combinations of chiral chains at the DPP4 binding site to possibly prevent a decrease in the inhibitory activity. In silico assessment of the “drug-likeness” and pharmacokinetic profile of the group of compounds studied showed that it had favorable characteristics and could be recommended for further molecular docking in order to predict the likely inhibition of the catalytic activity of DPP4. According to the results of docking, molecules with a moderate and high affinity were found. A detailed analysis of the resulting complexes showed that only nine compounds had a binding mode similar to classical inhibitors. According to the calculated array of values and analysis of the results of docking among the derivatives tested, a hit compound was found as a promising DPP4 inhibitor.

Summary: T cells are the most common immune cells in atherosclerotic plaques, and the function of T cells can be altered by fatty acids. Here, we show that pre-exposure of CD4+ T cells to oleic acid, an abundant fatty acid linked to cardiovascular events, upregulates core metabolic pathways and promotes differentiation into interleukin-9 (IL-9)-producing cells upon activation. RNA sequencing of non-activated T cells reveals that oleic acid upregulates genes encoding key enzymes responsible for cholesterol and fatty acid biosynthesis. Transcription footprint analysis links these expression changes to the differentiation toward TH9 cells, a pro-atherogenic subset. Spectral flow cytometry shows that pre-exposure to oleic acid results in a skew toward IL-9+-producing T cells upon activation. Importantly, pharmacological inhibition of either cholesterol or fatty acid biosynthesis abolishes this effect, suggesting a beneficial role for statins beyond cholesterol lowering. Taken together, oleic acid may affect inflammatory diseases like atherosclerosis by rewiring T cell metabolism.

Aim. Using in silico technologies to search for potential SARS-CoV-2 inhibitors among novel tetracyclic ring systems, which are the common core of Crinipellin. Materials and methods. The study object was new compounds previously synthesized via oxidative dearomatization of Crinipellin A. The method of the flexible molecular docking was applied in the study. Results and discussion. Using the molecular docking, the affinity of five compounds for the receptor-ACE2 SARS-CoV-2 (PDB ID: 7DF4), a spike protein SARS-CoV-2 (PDB ID: 1WNC), a PL protein SARS-CoV-2 (PDB ID: 7CJD) and a reverse transcriptase enzyme SARSCoV-2 (PDB ID: 6YYT) was studied. The results of the molecular docking obtained suggest that 8,8-dimethyl-5-(phenylsulfonyl)-3,3a,4,5,8,9-hexahydroindeno[3a,4-b]furan-2(7H)-one may be a potential SARS-CoV-2 inhibitor; it is the basis for its further experimental pharmacological study. Conclusions. The study constitutes one of the stages of searching for SARS-CoV-2 inhibitors. According to the results obtained, a way to search for potential SARS-COV-2 inhibitors based on Crinipellin A derivatives was proposed. Using the most promising compound with hexahydroindeno[3a,4-b]furan core further studies open up another direction for searching for compounds of SARS-COV-2 inhibitors and will save time and laboratory animals while conducting targeted experimental research.

Abstract Background We recently described the tumor immune microenvironment (TIME) in oral squamous cell carcinomas (OSCC) from Sudan by assessing the core of the lesions. However, the invasive tumor front (ITF) is the most active part of OSCC lesions; thus, TIME should also be characterized at the ITF in this patient cohort. Objectives We aimed to evaluate patterns of immune cell infiltration at the ITF in a cohort of OSCC patients from Sudan previously investigated at the tumor center and their association with clinicopathological parameters. Methods This study was performed on a prospective cohort of 22 OSCC patients attending Khartoum Dental Teaching Hospital with a median follow‐up of 48 months. Inflammatory infiltrate densities of CD4‐, CD8‐, FoxP3‐, CD20‐, CD66b‐, M1 (CD80/CD68)‐, M2 (CD163/CD68)‐, and PD‐L1‐positive cells were assessed at the ITF by immunohistochemistry, followed by digital quantitative analysis at the stromal and epithelial compartments separately. Histopathological parameters such as the worst pattern of invasion, differentiation, and tumor budding (TB) were also assessed. Correlations between clinicopathological parameters and survival analysis were investigated using SPSS. Results All inflammatory cell subsets investigated were found to be higher in the stromal compartment as compared to the epithelial one, except for the PD‐L1+ subset. Stromal infiltration with the CD8+ cell subset was associated with low TB. Kaplan–Meier analyses identified higher epithelial and stromal CD4+ cell subsets. The presence of PD‐L1 was found to be associated with unfavorable overall survival. Further, Cox's regression analysis using an age‐ and tumor‐stage‐adjusted model identified epithelial PD‐L1 expression at the ITF as the only independent prognosticator. Conclusions Epithelial PD‐L1 expression at the ITF was found to be an independent prognostic biomarker for OSCC in a cohort of Sudanese patients.

BackgroundSkeletal muscle is the main site for insulin-dependent glucose disposal. The hyperinsulinemic euglycemic clamp (HIEC) is the gold standard for the assessment of insulin sensitivity (IS). We have previously shown that insulin sensitivity, measured by HIEC, varied widely among a group of 60 young healthy men with normoglycemia. The aim of this study was to correlate the proteomic profile of skeletal muscles to insulin sensitivity.MethodsMuscle biopsies from 16 subjects having the highest (M ≥ 13; n = 8, HIS) and lowest (M ¾ 6, n = 8, LIS) IS were obtained at baseline and during insulin infusion after stabilization of the blood glucose level and glucose infusion rate at the end of the HIEC. The samples were processed using a quantitative proteomic analysis approach.ResultsAt baseline, 924 proteins were identified in the HIS and LIS groups. Among the 924 proteins detected in both groups, three were suppressed and three were increased significantly in the LIS subjects compared with the HIS subjects. Following insulin infusion, 835 proteins were detected in both groups. Among the 835 proteins, two showed differential responsiveness to insulin; ATP5F1 protein was decreased, and MYLK2 was higher in the LIS group compared with that in the HIS group. Our data suggest that alteration in mitochondrial proteins and an increased number of proteins involved in fast-twitch fiber correlate to insulin sensitivity in healthy young Arab men.ConclusionsThese results suggest a change in a small number of differentially expressed proteins. A possible reason for this small change could be our study cohorts representing a homogeneous and healthy population. Additionally, we show differences in protein levels from skeletal muscle in low and high insulin sensitivity groups. Therefore, these differences may represent early events for the development of insulin resistance, pre-diabetes, and type 2 diabetes.

Background: Hepatitis B virus (HBV) infection is one of the public health diseases causing global health problems. It is a leading cause of cirrhosis and hepatocellular carcinoma. Blood transfusion is a major route of its transmission and screening of blood is suboptimal in our environment. Occult HBV infection describes the presence of HBV DNA in blood or liver tissue in patients who are hepatitis B surface antigen (HBsAg) seronegative. This study documented the common genotypes of HBV a blood-borne infection in the population of blood donors in Lagos. Methods: This was a cross-sectional study carried out at the blood donor clinics of ten Lagos State Government-owned hospitals in Lagos State. A total of 1400 participants were recruited consecutively from November 2020 to June 2021. All participants' samples were screened using Diaspot Rapid Test Kit (RTK) and Dialabenzyme enzyme-linked immunosorbent assay (ELISA) kit. Furthermore, some of the plasma samples were used for HBV DNA extraction and genotyping using the real time-polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS) software version 26 and P value was considered significant at ≤0.05. Results: The sero-prevalence of HBsAg using RTK and ELISA was 19.9% and 22.4%, respectively. The prevalence of occult HBV infection was 5.2%. A total of 278 and 313 HBsAg RTK and ELISA positive samples were obtained, respectively. HBV genotype result had A (46.6%) as the most prevalent followed closely by B (44.7%), E (23.8%), D (20.9%) and C (11.2%). Conclusion: HBV infection has a high prevalence among blood donors. ELISA is a more sensitive screening tool and its use should be advocated nationally. HBV genotype A is the most prevalent genotype from our study.

The clinical efficacy of remote dielectric sensing (ReDS) monitoring is not well known. Digital databases were searched to identify relevant articles. Pooled unadjusted odds ratio (OR) for dichotomous outcomes were calculated using a random-effects model. Findings were reported as a point estimate with its 95% confidence interval (CI). A total of 985 patients across seven studies were included in the meta-analysis. Patients with heart failure monitored with ReDS had significantly lower odds of hospital readmission compared with non-ReDS patients (OR = 0.40; 95% CI 0.29–0.56; z = 5.43 p = 0.000, I2 = 0%). Subgroup analysis based on the duration of follow-up showed a lower odd of readmission within 30 days (OR = 0.36; 95% CI 0.18–0.71; z = 2.93; p = 0.003; I2 5.7%), as well as between 1 and 3 months (OR = 0.42; 95% CI 0.29–0.61; z = 4.54; p = 0.000; I2 = 0.0%). ReDS effect of lower readmissions of HF was observed irrespective of the duration of follow-up (

Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF. Methods: The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS). Results: A total of 74,995 octogenarian patients with HF (TAVR-HF n = 64,890 (86.5%); SAVR n = 10,105 (13.5%)) were included. The median age of patients in TAVR-HF and SAVR-HF was 86 (83–89) and 82 (81–84) respectively. TAVR-HF had lower percentage in-hospital mortality (1.8% vs. 6.9%;p

Increase in demand for an alternative to conventional pesticides, resulted in testing various plants materials against different storage pests. In this study, white thyme (Thymus vulgaris L) essential oil (TEO) obtained by steam distillation using Clevenger apparatus was evaluated against two developmental stages of Dermestes maculatus by residual contact method under laboratory conditions (260C ±20C and 75% ±3% RH). Four concentrations (2.5%, 5%, 7.5% and 10%) of TEO were separately applied on fifteen grams of C. gariepinus. Newly emerged adults and 3rd instar larvae of the pest were exposed to the treated samples for a period of five days. Results showed that the TEO had significant (P< 0.05) effect on both adult and larval mortalities which was concentrations and time of exposure dependent. It was recorded that 7.5% and 10% concentrations resulted in 40% and 50% larval mortality of Dermestes maculatus48 HAE. Meanwhile 70% and 90% mortalities were observed in the same concentrations at 72 and 96HAE, respectively. On the other hand, adults were more susceptible than the larvae whereby higher (80% and 90%) mortalities were recorded within 24HAEin 7.5% and 10% concentrations, and complete(100%) adult mortality was observed at 48 HAE, respectively at the same concentrations. The LC50 of TEO against adults D. maculatus at 24 hours is 5.71% and against larvae is 13.93% with LT50 of 9.63h at 10% concentration against adult and 43.87h against larvae at the same concentration. Therefore, TEO can be used as an alternative to synthetic pesticides in the control of Dermestes maculatus infestations.

Background: African trypanosomiasis is a protozoan disease with huge socio-economic burden to sub-Saharan African exceeding US$4.6 annual loss. To mitigate the incidence of trypanosomal drug resistance, efforts are geared towards discovery of molecules, especially from natural products, with potential to inhibit important molecular target (trypanosome alternative oxidase, TAO) in trypanosomes that are critical to their survival. Method: Crude methanol extract of Anogeissus leiocarpa was subjected to in vitro bioassay-guided antitrypanosomal assay to identify the most active extract with trypanocidal activity. The most active extract was run on a column chromatography yielding five fractions, F1-F5. The fractions were assayed for inhibitory effect on TAO. The most promising TAO inhibitor was subjected to antitrypanosomal evaluation by trypanosome count, drug incubation infectivity test (DIIT) and in vivo studies. Gas chromatography-mass spectrometry (GC-MS) was used to identify and quantify phytochemical constituents of the potential TAO-inhibiting fraction. Results: Ethyl acetate extract (EtOAc) significantly (p

Abstract Background Azadirachta indica, Khaya senegalensis, Anogeissus leiocarpus and Tamarindus indica are important ethnomedicinal plants used for health mitigation since the history of mankind. They are used discretionarily in folkloric medicine on the premise that they are natural products devoid of synthetic preservatives. However, nature endows plants with metabolites for warding off potential attacks from animals and the environment. Some of these metabolites are responsible for toxicity of some plants. Furthermore, drug-induced liver injuries and nephrotoxicity are the leading causes of pharmaceutical attrition of promising drug candidates in clinical trials. Thus, we aimed to evaluate the safety of four ethnomedicinal plants in short-, medium- and long-term usage. Methods Rats dosed once with 5000 mg/kg extracts of each of these plants served as acute study (AS) while rats dosed daily with 2000 mg/kg for 2, 12 and 14 weeks served as sub-acute (SAS), sub-chronic (SCS) and chronic (CS) studies, respectively. Rats administered distilled water served as the negative control (NC). Results A. leiocarpus and T. indica significantly reduced percentage weight gain in the SCS compared to the NC. A. leiocarpus significantly (P

Cattle production is greatly challenged by the activities of parasites, which are a major constraint to production and welfare of livestock. This study was conducted to determine the occurrence of haemo and gastrointestinal (GI) parasites in cattle slaughtered at Gwadabawa abattoir of Sokoto State, Nigeria. A total of 108 blood and feacal samples were collected from the sampled cattle. Blood samples were processed using giemsa techniques while feacal samples were analyzed using formol-ether concentration. PCV for each sample were determined via microhematocrit methods. The study revealed that haemoparasites were less prevalent (7.4%) compared to gastrointestinal parasites (35.2%). Out of the total prevalence of gastrointestinal parasites, (13.9%) were for Eimeria, (8.3%) for Strongyle egg, 7.4% for Fasciola egg, and (2.8%) for Taenia egg and mixed infection of Eimeria and Strongyle egg(2.8%). Cattle with haemoparasites had a lower Pack cell volume (26%) lower than(31%) for noninfected ones. The mean PCV of cattle with Gastrointestinal was (29.7%) while (31.2%) was for noninfected ones. There was a higher prevalence of haemoparasites in Males (10.0%) than in Females (5.2%), in young’s (9.8%) than in older ones (4.3%) and in emaciated(25%) than in cattle good BCS (4.3%). However, a contrary trend was observed for GI parasites in terms of BCS and age of the cattle. This study confirmed occurrence of certain parasites in cattle, there is need to take measures to circumvent the situation.

Abstract The promotion of enhanced gas recovery (EGR) and CO2 storage is still shrouded in contention and is not well accepted, due to the excessive in situ CO2 mixing with the nascent natural gas. This adulterates the recovered CH4 and thus results in a high sweetening process cost thereby making the technique impractical. This has not only limited the field application of EGR in actual projects to a few trails but renders it uneconomical. This study aims to present, experimentally, alternating N2 injection as a potential technique for EGR and CO2 storage in sandstone rock cores. A laboratory core flooding experiment was carried out to simulate a detailed process of unsteady-state methane (CH4) displacement using Bandera grey core plug. This was carried out at 40 °C, 1500 psig, and 0.4 ml/min injection rate by alternative injection of N2 and CO2 in succession designed to suit the application based on optimum operating conditions. The results show that both CO2 storage capacity and CH4 recovery improved significantly when gas alternating gas (GAG) injection was considered. The best results were observed at lower N2 cushion volumes (1 and 2 PV). Therefore, the GAG injection method with N2 as cushion gas can potentially increase both CO2 storage and CH4 recovery of the gas reservoir. This technique if employed will assert the current position and provide vital information for further researches aimed at promoting environmental sustainability and economic viability of the EGR and CO2 sequestration processes.

The alkylation of 6-methyl-2-thioxo-2,3-dihydro-1H-pyrimidine-4-one phenacyl bromides under different conditions was investigated. It was found that during the reaction in the medium of DMF/K2CO3 a mixture of 2-(2-aryl-2-oxoethyl)thio-6-methyl-pyrimidine-4(3H)-one and 3-hydroxy-3-aryl-7-methyl-2,3-dihydro-5H-thiazolo[3,2-a]pyrimidine-5-one was formed. The holding of the resulting mixture in the concentrated sulphuric acid leads to the formation of cyclization products - derivatives of 3-aryl-7-methyl-5H-thiazolo[3,2-a]pyrimidin-5-one with high yields. Individual S-alkylated derivatives – 2-(2-aryl-2-oxoethyl)thio-6-methyl-pyrimidine-4(3H)-one - were obtained by reacting in methanol in the presence of sodium methoxide. Pharmacological screening of synthesized compounds for anticonvulsant activity on the model of pentylenetetrazole seizures in rats was carried out and some regularity “structure-activity” was established.

Intussusception is a common pediatric emergency, although a prolapsed intussusception is a rare entity, often misdiagnosed as a rectal prolapse.We report a 10-month-old female baby who presented with a three week history of a mass protruding per anus and vomiting, and a 2 week history of bloody diarrhoea. A clinical diagnosis of a prolapsed intussusception was made and no imaging studies were ordered to avoid a delay in management. The patient underwent an emergency laparotomy, where a dual reduction was done and the bowels were found to be ischemic hence a right hemicolectomy was performed with end-to-end ileo-transverse anastomosis. Unfortunately, 2 weeks post laparotomy, the patient presented with a high output enterocutaneous fistula. Another emergency laparotomy was performed, with findings of intestinal adhesions and an anastomotic leak. Adhesiolysis was done along with re-freshening of the ileo-transverse anastomosis.Intussusceptions presenting in the form of a prolapse through the anus is a rare condition indicating a serious sign and is often mistaken for a rectal prolapse. A digital rectal examination can help differentiate the two from each other. Surgery is the mainstay treatment for a prolapse intussusception, and should not be delayed.

Healthcare professionals are standing against the widespread use of e-cigarettes among the population, especially young adults. E-cigarettes are generally introduced, especially via social media platforms, as a safer alternative to conventional cigarette smoking. The aim of this study was to measure the prevalence of e-cigarette use among healthcare professions students at the University of Jordan, as well as to explore their knowledge and attitudes toward the use of e-cigarettes. An anonymous Google-Form®-based cross-sectional questionnaire was presented to potential participants at the University of Jordan. Students’ responses were analyzed using SPSS® 23.0 software. A total of 679 online surveys were completed. About 37.4% of students reported using e-cigarettes at least once in their lifetime and about 20% of students were current e-cigarette users. The multivariate analysis showed that the factors associated with E-cigarette smoking are being male, having mothers, siblings, or friends using e-cigarettes, having easy access to e-cigarettes, and having social media as the main source of knowledge regarding e-cigarettes. The relatively high acceptance level and use of e-cigarettes among health professions students should be an alarming sign to decision-makers to give more attention to legislation that controls tobacco products including e-cigarette selling and advertising.

This paper presents the retrieval algorithm for the operational Ozone Monitoring Instrument (OMI) total bromine monoxide (BrO) data product (OMBRO) developed at the Smithsonian Astrophysical Observatory (SAO) and shows comparisons with correlative measurements and retrieval results. The algorithm is based on direct nonlinear least squares fitting of radiances from the spectral range 319.0–347.5 nm. Radiances are modeled from the solar irradiance, attenuated by contributions from BrO and interfering gases, and including rotational Raman scattering, additive and multiplicative closure polynomials, correction for Nyquist undersampling and the average fitting residual spectrum. The retrieval uses albedo- and wavelength-dependent air mass factors (AMFs), which have been pre-computed using a single mostly stratospheric BrO profile. The BrO cross sections are multiplied by the wavelength-dependent AMFs before fitting so that the vertical column densities (VCDs) are retrieved directly. The fitting uncertainties of BrO VCDs typically vary between 4 and 7×1012 molecules cm−2 (∼10 %–20 % of the measured BrO VCDs). Additional fitting uncertainties can be caused by the interferences from O2-O2 and H2CO and their correlation with BrO. AMF uncertainties are estimated to be around 10 % when the single stratospheric-only BrO profile is used. However, under conditions of high tropospheric concentrations, AMF errors due to this assumption of profile can be as high as 50 %. The retrievals agree well with GOME-2 observations at simultaneous nadir overpasses and with ground-based zenith-sky measurements at Harestua, Norway, with mean biases less than -0.22±1.13×1013 and 0.12±0.76×1013 molecules cm−2, respectively. Global distribution and seasonal variation of OMI BrO are generally consistent with previous satellite observations. Finally, we confirm the capacity of OMBRO retrievals to observe enhancements of BrO over the US Great Salt Lake despite the current retrieval setup considering a stratospheric profile in the AMF calculations. OMBRO retrievals also show significant BrO enhancements from the eruption of the Eyjafjallajökull volcano, although the BrO retrievals are affected under high SO2 loading conditions by the sub-optimum choice of SO2 cross sections.

Objectives To introduce surgical safety checklists and time outs to future physicians through early incorporation of time outs in the first year gross anatomy course.Setting The Wayne State University School of Medicine Anatomy Lab.Participants Approximately 300 first year medical students per year participated in the intervention.Interventions An educational presentation on medical errors focusing on surgical errors was developed. Students in 2017–2018 viewed the presentation and completed two time outs, one with the first anatomy dissection and a second with the last dissection. Preintervention and postintervention surveys were completed and results compared. Students completed a second postintervention survey after the second time out. Students in 2018–2019 were asked to complete the time outs before every dissection. Time out procedure sheets were collected to determine completion rates. The intervention was further modified for academic year 2019–2020 and time out sheets were again collected.Outcome measures Four domains of learning were surveyed: (1) major components and goals/limitations of universal protocol, (2) medical error lexicon, (3) components of a time out, and (4) confidence in completing time out checklists.Results Postintervention surveys demonstrated significant improvement in each domain. Students found time outs easy to complete and developed confidence in performing time outs. Following a successful pilot, time outs were incorporated into every dissection. Students continued to perform this procedure despite absence of adverse consequences for not doing so.Conclusion Students found the time outs easy to complete and developed the confidence and ability to perform a surgical time out early in their medical education. The new skills, knowledge and attitudes that these medical students have developed will hopefully improve the care they provide to patients, thereby advancing the practice of quality improvement and patient safety in the clinical setting.

ObjectivesAutoimmune bullous diseases vary in their clinico-epidemiological features and burden across populations. Data about these diseases was lacking in Sudan. We aimed to describe the epidemiological profile and to estimate the burden of autoimmune bullous diseases in Sudan.MethodsThis was a retrospective cross-sectional study conducted at Khartoum Dermatological and Venereal Diseases Teaching Hospital. We used routinely collected health care data, and included all patients with an autoimmune bullous disease who presented to the hospital between 2001 and 2016.ResultsOut of the 4736 patients who were admitted to the hospital during the study period, 923 (19.5%) had an autoimmune bullous disease. The average rate of patients at the hospital was 57.7 per year representing 1.3 per 100,000 population per year. After exclusion of patients where the final diagnosis was missing, 585 were included in the further analysis. Pemphigus vulgaris was the most common disease (50.9%), followed by bullous pemphigoid (28.2%), linear IgA disease/chronic bullous disease of childhood (8.4%), and pemphigus foliaceous (8.2%). Pemphigoid gestationis and IgA pemphigus constituted 1.4% and 1.2% of the cohort, respectively. Paraneoplastic pemphigus, mucous membrane pemphigoid, lichen planus pemphigoidis, bullous systemic lupus erythematosus, and dermatitis herpetiformis were rare. None of the patients had epidermolysis bullosa acquisita.ConclusionsThe clinico-epidemiological characteristics vary among the types of autoimmune bullous diseases. Females were more predominant in most of them. Sudanese patients tended in general to present at a younger age than other populations. The pool of Sudanese patients with autoimmune bullous diseases is large which requires investigation for the local risk factors and presents a field for future trials.

يتناول هذا البحث أثر اللغة العربية في الشعر الكردي عامة و شعر أحمدي خاني في ديوانه ( مم وزين ) خاصة ، لقد كانت اللغة العربية و لا تزال وسوف تبقى مصدراً خصباً ومعيناً ثراً لا ينضب بنصوصها المتنوعة المتميزة للشعراء عامة وشعراء الكرد الكلاسيكيين خاصة اللذين نهلوا منها سطور المجد والخلود . ويعد الشاعر أحمدي خاني أنموذجاً لهذا التأثير إذ يحتوي ديوانه ( مم وزين ) الكثير من الكلمات و الألفاظ والمعاني وأسماء الشخصيات العربية والإسلامية وهذا دليل على مدى أثر اللغة العربية في ثقافته وفكره ووجدانه وحبه للغة العربية . وينقسم البحث إلى مقدمة وتمهيد وثلاثة مباحث وخاتمة ذكرنا فيها أهم الاستنتاجات التي توصلنا إليها . أما المقدمة فتحدثنا فيها عن أهمية اللغة العربية وأثرها في الشعر الكردي ، وأما التمهيد فبينا فيه الكرد وأدبهم ثم تحدثنا عن الشاعر أحمدي خاني وسيرته وكتبه وديوانه ( مم وزين ) ، أما المباحث الثلاثة ففي المبحث الأول بينا فيه المفردات والأسماء العربية التي في ديوانه (مم وزين) ، وفي المبحث الثاني أثر القرآن والمضامين القرآنية الموجودة في ( مم وزين ) ، أما المبحث الثالث فخصصناه لمكانة الرسول (صلى الله عليه وسلم ) والأحاديث النبوية الشريفة المتوفرة في ( مم وزين ) .

Due to the shortcomings associated with modern synthetic antidiarrhoeal drugs, it is important to find newer, safer and cheaper antidiarrhoeal agents from natural sources. The study was conducted to evaluate the anti-diarrhoeal activity of the fractions of the stem-bark of Terminalia avicennioides in laboratory animal models. The effect of different concentrations (1.0 × 10−3, 2.0 × 10−3, 4.0 × 10−3 and 8.0 × 10−3 mg/mL) of the aqueous methanol (AMF), ethyl acetate (EAF) and hexane (HXF) fractions of T. avicennioides were tested against spontaneous and acetylcholine-induced contractions of rabbit jejunum as well as on histamine-induced contraction of guinea pig ileum. Similarly, the effects of the AMF on gastro-intestinal transit time, castor oil-induced diarrhoea and castor oil-induced enteropooling were evaluated. The AMF, EAF and HXF at concentrations of 1.0 × 10−3, 2.0 × 10−3, 4.0 × 10−3 and 8.0 × 10−3 mg/mL attenuated the contractile effects of both the spontaneous and acetylcholine-induced contractions of rabbit jejunum and that of histamine-induced contraction of guinea pig ileum in a concentration-dependent manner. The AMF at doses of 200, 300 and 500 mg/kg produced significant (p

Background and Objectives: Elderly patients constitute a large segment of healthcare receivers. Considering the functional deterioration of multiple organ systems with aging, achieving a safe perioperative approach is challenging. Our aim is to study the safety and effectiveness of a genuinely regimented co-induction technique in order to minimize anesthesia-related complications. Materials and Methods: One hundred and five patients were assigned to three groups according to the induction technique: propofol, sevoflurane and co-induction group. Inclusion criteria: patients with age ≥65 and American Society of Anesthesiologists physical status classification (ASA) II-III who underwent endoscopic urological procedures. The propofol group received a dose of 1.5 mg kg−1 of propofol over two minutes for induction. The sevoflurane group received 8% of sevoflurane and 100% oxygen through a plastic facemask with the fresh gas flow set at 8 L min−1. The co-induction group received 4% sevoflurane through plastic facemask for two minutes, followed by a 0.75 mg kg−1 dose of propofol. After ensuring full range jaw relaxation, the laryngeal mask airway (LMA) was inserted. Results: Overall, the co-induction technique had a favorable profile in terms of respiratory adverse events, while the sevoflurane group had a favorable profile in terms of hemodynamic stability. Furthermore, 24 (68.6%) patients receiving inhalational sevoflurane had episodes of transient apnea, which constitutes 77.4% of the 31 episodes of transient apnea in the studied sample (p < 0.001). Moreover, six (17.1%) patients in the sevoflurane group had an episode of partial laryngospasm (p = 0.034). Compared with the co-induction group, we found that the propofol group had significantly less systolic and diastolic blood pressures in the second minute, with p values of (0.018) and (0.015), respectively. Conclusions: The co-induction technique utilizing 4% sevoflurane at 8 L min−1 flow of oxygen inhaled over two minutes followed by 0.75 mg kg−1 of propofol achieved less respiratory adverse events compared with the sevoflurane group, and less hemodynamic instability compared with the propofol group.

Background: Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Methods: Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. Results: In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Conclusion: Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step.

Aim: The study was carried out to determine the in vivo antitrypanosomal effect of methanolic extract of Zingiber officinale (ginger) in Trypanosoma brucei brucei-infected mice. Materials and Methods: Twenty-five mice were randomly allocated into five groups of five animals each. Group I and II were given Tween 80 (1 ml/kg) and diminazene aceturate (3.5 mg/kg) to serve as untreated and treated controls, respectively. Groups III-V received the extract at 200, 400 and 800 mg/kg body weight, respectively. All treatments were given for 6 consecutive days and through the oral route. The mean body weight, mean survival period and daily level of parasitaemia were evaluated. Results: Acute toxicity showed the extract to be relatively safe. There was an insignificant increase in body weight and survival rate of mice treated with the extract. The level of parasitaemia in the extract treated groups was decreased. Conclusion: This study shows the in vivo potential of methanolic extract of Z. officinale in the treatment of trypanosomiasis.

Objectives: Cleaning products are considered less hazardous than those used in other sectors. Suppliers and distributors are less conscientious when it comes to informing users on health risks. The aim of the study was to elaborate on the usefulness and clarity of information in the safety data sheets (SDS) for cleaning products, and considering if the use of these SDSs can be seen as a risk factor towards occupational exposure to hazardous chemicals in the sector. Material and Methods: Safety data sheets were selected based on the risk level of the product assigned in an industrial sector scheme. 320 SDSs for cleaning products were reviewed. Constituent components found in the products over a given threshold were listed and available information thereof used to assess the perceived non-hazard consideration of the chemicals. Results: The contents of the SDSs was generic and mostly incomplete. Safety measures and health information lacked sufficient specificity despite varying compositions and concentrations of components. There is generally incompatibility between mentioned sections on the suggested non-hazardous nature of the products and health effects. Not all substances used in these products have harmonized classifications, which makes them open to various classification of the products and the suggested safety measures. This results in different companies classifying similar products differently. Risk management measures and suggested personal protective equipment (PPEs) are given haphazardly. Physical properties relevant to risk assessment are not included. Conclusions: The safety data sheets are ambiguous, and they lack relevant and important information. Inadequate information and risk assessment concerning the products can lead to workers being exposed to hazardous chemicals. Underestimation of the hazard contribution of the components of the products and the insufficient, non-objective mention of appropriate control and protective measures are the major contributing elements. There is a need to test the products in order to establish health effects and product specific safety measures.

Objectives: The aim of this study was to compare the efficacy and safety of topical prednisolone acetate 1% and topical ketorolac tromethamine 0.5% in the maintenance of pupillary mydriasis during cataract surgery. Methods: Fifty patients were enrolled in this prospective, partially masked and randomised study. They were assigned to receive topical treatment with either prednisolone acetate (n = 25) or ketorolac tromethamine (n = 25), starting 24 hours before cataract extraction (either routine extracapsular cataract extraction or phacoemulsification). One drop of the study medication was instilled every 6 hours for a total of 4 drops. No epinephrine was used in the intraoperative irrigation solution. Pupil diameter was measured three different times during surgery. To ensure participant safety, biomicroscopy, ophthalmoscopy, intraocular pressure, adverse events and visual acuity were also monitored. Results: The mean pupil diameter change from the time of the pre-incision until after cortical irrigation and aspiration and lens implantation was significantly less with ketorolac than with prednisolone (P = 0.003). Consequently, mean pupil diameter after cortical irrigation and aspiration and lens implantation was significantly greater with ketorolac than with prednisolone (P

Every year, about 3 million stillbirths occur globally, almost a third occurring during the intra-partum period. Almost all stillbirths (98%) occur in low and middle income countries, with Nigeria having the third largest burden. The aim of this study was to determine the stillbirth rate and its determinants in the Federal Medical Centre Katsina, located in north western Nigeria. This study was a retrospective review of all deliveries conducted between 1st March 2010 and 31st December 2012 in Federal Medical Centre Katsina. Data were extracted from labor room and theatre records, and patient folders. Cases were matched with controls by booking status. The privacy and confidentiality of information retrieved from cases and controls was also ensured by anonymizing the data retrieved. No conflict of interest was identified. The data was analyzed with SPSS 20. During the period under review, there were 6628 deliveries, out of which 331 of the products were stillborn. The stillbirth rate was 46.9±3.6 per 1000 deliveries. Determinants of stillbirths were antepartum hemorrhage, hypertensive disorders of pregnancy, uterine rupture, low birth weight and congenital fetal malformations. The study highlighted the poor perinatal health in the study population.

We report a rare case of common atrium and acute decompensated heart failure most likely precipitated by acute bacterial pericarditis leading to premature death, in a 25-year-old male footballer. The silent course of the disease for decades as well as the diagnostic and management pitfalls of this case illustrates the importance of early detection by echocardiography and urgent appropriate treatment in intensive care settings to limit the poor prognosis of the condition.

Treatment with indinavir has been shown to result in marked decreases in viral load and increases in CD4 cell counts in HIV-infected individuals. A randomized double-blind study to evaluate the efficacy of indinavir alone (800 mg q8h), zidovidine alone (200 mg q8h) or the combination was performed to evaluate progression to AIDS. 996 antiretroviral therapy-naive patients with CD4 cell counts of 50-250/mm3 were allocated to treatment. During the trial the protocol was amended to add lamivudine to the zidovudine-containing arms. The primary endpoint was time to development of an AIDS-defining illness or death. The study was terminated after a protocol-defined interim analysis demonstrated highly significant reductions in progression to a clinical event in the indinavir-containing arms, compared to the zidovudine arm (p

In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30), antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78), premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67), maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57), pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99), type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38) and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56). The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.