Molecular diagnosis of urinary Mycobacterium tuberculosis among patients attending urology clinic in Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Tuberculosis, a communicable disease with significant morbidity and mortality. It is still among the top killers of infectious diseases; Mycobacterium tuberculosis is a successful pathogen that has evolved several mechanisms to manipulate the host immune response. Objective of the study: The objective of this study was to determine the prevalence of urinary tuberculosis among patients attending urology clinic in Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: A prospective cross-sectional laboratory based study that involved the use of questionnaire and consent/assent form prior to sample collection. Xpert MTB/Rif assay was used to analyze the urine samples. Results: The results of this study shows that, out of 71 samples analyzed along with positive control (H37RV) and molecular grade water was used as negative control. The results showed that, 2 (2.8 %) were from urine samples. Data generated were analyzed using descriptive statistics and results were presented in tables and charts. Conclusion: The study confirmed the presence of urinary tuberculosis in the study area, with prevalence of 2.8%. The pattern of tuberculosis was susceptible Mycobacterium tuberculosis. Therefore, there is need to introduce a routine screening of urinary tuberculosis among patients presenting sign and symptoms of urinary tract infection using Gene Xpert. This will be achieved through the engagement and enlightenment of the clinicians, strengthening the laboratory capacity for diagnosis and make the services available and accessible to the patients who need them. Keywords: Mycobacterium tuberculosis; Extra-Pulmonary Tuberculosis; Prevalence and Gene Xpert

Anti inflammatory and antipyretic activities of the methanol leaf extract of Acacia ataxacantha D.C.(Leguminosae) in mice and rats

Acacia ataxacantha (Leguminosae) has been reported to be used in traditional medicine for management of pain and inflammation. The present study was designed to evaluate the anti inflammatory and antipyretic activities of methanol leaf extract of Acacia ataxacantha in rats. The acute toxicity study was carried out using Lorke method (1983). The doses (100, 200 and 400 mg/kg body weight of the extract) selected for the study were based on the calculated LD50. Anti- inflammatory activities were investigated using the carragenaan and albumin induced paw edema, while the antipyretic activity was evaluated using yeast induced pyrexia method. With respect to the negative control (group 1), the carragenaan induced inflammation produced a dose dependent significant (p ≤ 0.05) reduction of inflammation at 200 and 400 mg/kg (3rd h) while a significant (p ≤ 0.05) reduction in oedema was observed at doses of 100, 200 and 400mg/kg (4th h). Similarly there were significant inhibitions (p ≤ 0.05) of inflammation at the 20th, 40th, 60th and 120th minutes post extract administration in albumin induced hind-paw inflammation. The data obtained from the antipyretic study showed no significant effect. These findings suggest that the extract may contain bioactive compounds that possess anti-inflammatory activities, thus supporting the ethno-medical use of the plant in the management of painful inflammation.Keywords: Acacia ataxacantha, Inflammation, Pyrexia, Carragenaan, Albumin, Yeas

Congenital Diaphragmatic Hernia in a 2-Month Old Infant: A case report

Congenital diaphragmatic hernia (CDH) in young infants is easily  misdiagnosed as bronchopneumonia yet survival of such patients lies in prompt diagnosis and surgical treatment. The report aimed to increase awareness among Paediatricians and Paediatric Surgeons of the need for high index of suspicion for this condition to allow for early diagnosis and management. A two-month old infant presented with a five-week history ofcough of sudden onset and a week history of difficulty in breathing. He had been managed in several hospitals for bronchopneumonia. Examination findings showed features of respiratory distress, widespread coarse crepitations and bowel sounds in the lung fields. Chest radiograph showed `loops of bowel in the mediastinum. He had surgical reduction and repair of the hernia, made excellent recovery post-op and was discharged home. CDH is an uncommon anomaly but a high index of suspicion will allow early diagnosis and treatment with favourable outcome when picked early.Key words: Congenital diaphragmatic hernia, Infant, Bronchopneumonia, Respiratory distres

Ujuzi (Practical Pearl/Perle Pratique)

Ujuzi means skills in Swahili and is intended to be a regular feature for colleagues to share practical interventions, innovations and novelties that have proved useful in the management of patients in the prehospital environment or Emergency Centre. You can let Ujuzi know about your practical ideas by emailing [email protected]

Molecular characterization and species differentiation of Fasciola parasite isolated from cattle slaughtered at Sokoto modern abattoir, Nigeria

Fascioliasis is an important zoonotic disease endemic in many African countries, causing significant financial losses due to reduced productivity and visceral condemnation at slaughter. Fasciola hepatica and F. gigantica are the main causative agents of fascioliasis in domestic animals and humans. Traditional species differentiation based on their morphometric characteristics is subjective and can be challenging. This study was undertaken to identify the Fasciola species associated with cattle infection using a molecular approach. Thirty-eight Fasciola parasite samples collected from cattle slaughtered at the Sokoto modern abattoir were characterised by PCR-RFLP analysis of ITS1 and ITS2 genes using RsaI restriction enzyme, sequencing, and phylogenetic analysis. The results revealed that the isolates belonged to the F. gigantica species based on RFLP patterns. Similarly, phylogenetic results showed clustering with F. gigantica when compared with sequences from neighbouring African countries obtained from the GenBank. This study affirmed that F. gigantica is the predominant Fasciola species affecting cattle in Sokoto state, Nigeria. The results also demonstrate the discriminatory potentials of RFLP and its ability to determine genetic variability among Fasciola Parasites

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran