Fatty Acid Methyl Esters Composition of Trichilia Emetica Shell Oil

The formation of fatty acid methyl esters from Trichilia emetica shell oil by trans-esterification with methanol was monitored by 1H nuclear magnetic resonance spectroscopy. The percentage triacylglycerol conversion to its corresponding methyl esters was calculated to be 98 %. A total of five fatty acid methyl esters (FAMEs) were identified in the oil sample by the retention time and the fragmentation pattern data of GC/MS analysis. The identified FAMEs were hexadecanoic (palmitic), octadecanoic (stearic), eicosanoic (arachidic), 9,12-octadecadienoic (linoleic) and 9,12,15-octadecatrienoic (linolenic) acid  methyl ester. 

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Involvement of Epigenetics in the Pathogenesis, Testing and Management of Coronavirus Disease 2019 (COVID-19) Pandemic: A Narrative Review

Background: There is an intense search for the Coronavirus Disease 19 (COVID-19) cure, to stem the spread and burden of the disease worldwide. Studies revealed that epigenetic modifications impact the pathogenesis of some COVID-19 cases, which can be used as therapeutic targets. &#x0D; Objectives: This review articulated the role of epigenetics in the pathogenesis and management of COVID-19.&#x0D; Methods: Relevant articles published between January 2000 and November 2020 were retrieved from reputable academic databases, including PubMed, SpringerLink, Scopus, and Google Scholar.&#x0D; Results: Epigenetic modifications in the COVID-19’s pathogen, called the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and host’s cells may influence susceptibility or resistance to the disease. Notably, abnormal Deoxyribonucleic Acid (DNA) methylation and histone modification involving immune regulatory genes and molecules, such as cytokines and interferon-regulated genes may compromise immune function and enhance the host’s susceptibility and disease severity. The hypomethylation of SARS-CoV-2’s receptor, called the Angiotensin-Converting Enzyme 2 (ACE2), causing its overexpression, can also enhance SARS-CoV-2’s infectivity. Moreover, SARS-CoV-2 can hijack the host’s MicroRNA (miRNA) using its miRNA and compromise the immune function, increasing its infectivity. Fortunately, epigenetic changes are reversible; thus, a therapy that targets the epigenetic changes in the affected case may reverse COVID-19. &#x0D; Conclusion: Modifications in the SARS-CoV-2 or host epigenome promote the pathogenesis and severity of COVID-19. Epigenetic changes are reversible, so healthcare providers are advised to formulate therapeutic procedures that target the causal mechanisms in the affected individual.</jats:p

Recurring Outbreaks of Lassa Fever in Nigeria: Understanding the Root Causes and Strategies for the Future

Abstract Lassa fever is a severe public health problem in Nigeria with far-reaching political, social, cultural, and religious ramifications. Thus, a further understanding of the disease is critical. Despite attempts to end the viral epidemic, the illness has persisted, leading to several major outbreaks in decades. Additionally, the country's epidemic in 2019–2020 set a new global record for the number of Lassa fever cases. This year, 244 cases and 37 deaths had been reported as of January 2023. To identify gaps and provide recommendations for the complete eradication of Lassa fever in the country. This paper investigates the underlying causes of the continuous outbreaks of the illness in Nigeria and the measures to prevent it. The frequent outbreaks of Lassa fever in Nigeria have been linked to several factors, including inadequate waste management, poor sanitation, restricted access to healthcare, and abject poverty. The reoccurring outbreaks are also attributed to a lack of political will, funding, poor coordination and communication, and low public awareness of the illness and its prevention. To effectively stop outbreaks of Lassa fever in Nigeria, the government and partners must continuously put into practice tried-and-true prevention measures such as improved surveillance to detect outbreaks earlier, increased funding and resources to support effective control measures, better primary healthcare facilities and training for healthcare professionals, heightened community engagement and education to raise awareness, and more effective vector control methods to reduce rodent populations, while looking for innovative approaches and dealing with the underlying social and economic problems contributing to the viral persistence

The Efficacy and Safety of Levamisole in African Children With Idiopathic Nephrotic Syndrome: A Protocol for Systematic Review and Meta-Analysis

Abstract BackgroundNephrotic syndrome (NS) is one of the most common childhood renal disorders globally, with an incidence of 2 to 7 cases per 100,000 children. A characteristic feature is massive proteinuria which may rapidly progress to end stage kidney failure, if uncontrolled. Most of the cases in children are steroid sensitive but associated with frequent relapses. Levamisole, a cheap antihelminthic has been used as steroid sparing agent in steroid sensitive NS (SSNS). This study assesses the efficacy and safety of Levamisole in African children with idiopathic nephrotic syndrome.MethodsWe will conduct a systematic review and meta-analysis of all Randomised controlled trials which reported African children with Idiopathic nephrotic syndrome who were on Levamisole compared to other drugs. Ten databases including PubMed, African Journals Online, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane Library, Web of Science, Scopus, Clinicaltrial.gov and Research Gate will be searched using a search strategy. The search will have no time restrictions, but studies must have been conducted among African children residing in Africa and are retrievable in the English Language. Studies will be selected based on inclusion and exclusion criteria by two independent reviewers without blinding. The study quality will be assessed using the Pedro scale and risk of bias evaluated using the Cochrane Risk of Bias tool. Eligible screened studies will be inlcuded for meta-analysis using the CMA Software. Statistical, clinical and methodological heterogeneity will be tested. Subgroup analyses and meta-regression will be performed on rate of relapses, adverse event and drug dose.DiscussionThe primary outcome will be the proportion of children with remissions and or relapses within 6 -12 months post initiation of levamisole or comparators with effect size being the relative risk. Safety of Levamisole will be measured using reported adverse events. Moderating effects of age, gender, duration of illness, and dosage of Levamisole on the duration of remission, frequency of relapses and adverse events will be examined.Systematic Review RegistrationThis protocol has been registered in PROSPERO, with registration number CRD42020213327.</jats:p