Review of childhood measles admissions at the National Hospital, Abuja

The global disease burden from measles as a vaccine preventable disease remains high despite decades of interventions by various organs and agencies. To determine the prevalence and outcome of childhood cases of measles admitted into the children's emergency ward of the National hospital and highlight the possible contributing factors.Retrospective.Atotal number of 43 children with measles presenting at the National HospitalAbuja, seen over a 40 months period; January 2002 andApril 2005. Cases-folders of patients seen at the Emergency Paediatric Unit (EPU) of the National Hospital Abuja during the period under review with the clinical diagnosis of measles were reviewed. The children were aged between seven to 12months, with 25 (58.1%) age 24months and below.Twenty three (53.5%) of the subjects had received prior measles vaccination. History of contact with cases of acute measles was present in 26 (60.5%). Associated protein energy malnutrition (PEM) was found in 30(69.8%) with 28 (65.1%) parents of these children being of lower social economic classes (III, IV &V). Recorded complications included gastroenteritis, bronchopneumonia, laryngo-tracheo-bronchitis as part ofcroup syndrome, tuberculosis, and otitis media. Three fatalities (7.0%) were record in this review, all in association with bronchopneumonia.Measles with its complications still present as a fatal illness even among vaccinated children

Are the WNT5A isoforms functionally distinct? - promoter and signaling pathway analyses

WNT5A is a secreted glycoprotein that binds to both canonical and non-canonical Wnt receptors and has important roles in morphogenesis (e.g., anterior-posterior axis elongation and limb formation) and differentiation (e.g., bone and cartilage). On a cellular level WNT5A functions in proliferation, adhesion, migration, and cell polarity. Altered WNT5A expression is associated with various human diseases, particularly cancer, but has also been linked with the inflammatory response. WNT5A has two isoforms that are derived from distinct promoters; the proteins isoforms referred to as L(A) and S(B) differ by 18 amino acids. In this project I examined the functional differences between the proteins isoforms L(A) and S(B) and the regulation of their promoters. The isoforms may have differential affinity for non-canonical receptors, selectively activating particular signaling pathways. They may also display distinct patterns of expression in particular cells, during differentiation and in development, as a consequence of their unique promoters. Conditioned medium (CM) was prepared from CHO cells expressing either isoform L(A) or S(B). Using a TOPFlash system the CML(A) and CM-S(B) were shown to be active. The CM was used to analyze the effects of the isoforms on the non-canonical Wnt signaling pathways Ca2+ and PCP/CE in HCT 116 (colon cancer) and hFOB1.19 (normal human osteoblast) cell lines by measuring levels of phospho (p)PKC and phospho (p)JNK, downstream targets of each pathway. Results showed that the CM-S(B) activated both pPKC and pJNK in HCT 116 cells whereas CML(A) had less of an effect. There was little or no effect of both CM’s in hFOB1.19 cells. AP-1 and NFAT luciferase reporter assays in HCT 116 cells confirmed the effect of CMS(B) on pJNK. Next the effect of the CM’s on apoptosis, proliferation, and migration were analyzed. Neither CMs affected the level of apoptosis in HCT 116 cells. Both isoforms were found to decrease proliferation in HCT 116 cells but CM-S(B) had a more consistent effect. CM-S(B) was found to increase migration and CM-L(A) decrease migration in HCT 116 cells. In a mouse embryonic fibroblast (MEF)-with a PORCN gene knock-out, both CMs caused a decrease in migration. Next, isoform L(A) and S(B) luciferase promoter constructs were transfected into HCT 116 and hFOB1.19 cells. The pattern of expression in the two cell types was similar for promoter L(A) and promoter S(B) but promoter S(B) showed a higher level of expression. 1707bp of upstream sequence showed a maximal expression for promoter L(A) and 1257 bp showed a maximal expression for promoter S(B) in both proliferating cell types. Analysis of the promoter L(A) and promoter S(B) reporter constructs during hFOB1.19 differentiation indicated that promoter L(A) is more highly activated than promoter S(B). Sequences within 420bp and 187bp for promoter L(A) and promoter S(B), respectively, were sufficient for activation. Putative transcription factor binding sites were identified in promoter L(A) and promoter S(B) upstream sequences. Some of these factors are known to be involved in osteogenesis. In summary, my results suggest that the WNT5A isoform proteins have distinct and cell type dependent. The isoform promoters have distinct sequences and include similar and unique putative transcription factor binding sites but both promoters are activated during osteogenesis

Upregulation of ROS detoxification genes by triterpenoid CDDO-Im in macrophages: protection against lipopolysaccharide-induced inflammatory injury

Dysregulated response by the body towards an infection leads to tissue and organ damage is known as sepsis. Currently, approximately 18 million people worldwide are affected by this deadly disease annually. Septic shock, a severe form of sepsis, continues to have a very high mortality rate. When the immune system fails to regulate an infection, this results in the buildup of reactive oxygen species (ROS) and cytokine storm due to an increase in pro-inflammatory cytokines. This ultimately results in organ failure and death. Currently, no viable treatment method is available to combat sepsis. Lipopolysaccharide (LPS), also known as endotoxin, is commonly used in controlled experiments to trigger the symptoms of sepsis. Macrophages, a type of immune cells, initiate a key response responsible for the cascade of events leading to the surge in inflammatory cytokines and immunopathology of septic shock. This study was undertaken to determine whether the LPS-induced inflammation could be ameliorated via the endogenous upregulation of antioxidant defense in macrophage cells. CDDO-IM (2-cyano-3,12 dioxooleana-1,9 dien-28-oyl imidazoline), a novel triterpenoid compound, was used to upregulate endogenous antioxidant defenses. Phorbol-12-myristate-13- acetate (PMA) was used to differentiate ML-1 monocytes into macrophages. This differentiation was analyzed through the increase in the expression of CD206, differentiation marker present on macrophage cells. Data from this study show that gene expression levels of inflammatory cytokine genes such as interleukin-1 beta (IL-1beta), interleukin-8 (IL-8), tumor necrosis factor-a (TNF-a) and monocyte chemoattractant protein-1 (MCP-1) were considerably increased by treatment with LPS in macrophages differentiated from ML-1 monocytes. Interestingly, LPS-induced increase in expression of pro-inflammatory cytokine levels is reduced by CDDO-IM. Additionally, CDDO-IM has been shown to protect against LPS-induced cytotoxicity in macrophages, and NF-kB transcriptional activity was also noted to decrease upon treatment with CDDO-IM in macrophages. In vivo mice trials indicated that levels of serum TNF-alpha had been significantly reduced by the administration of CDDO-IM. Also, pro-inflammatory cytokine levels of TNF-alpha, IL-6, and IL-1ß in hepatic tissue were significantly decreased as a result of CDDO-IM treatment in LPS-induced mice. This data demonstrated that the endogenous upregulation of a multitude of antioxidants by CDDO-IM attenuated LPS-induced inflammation and injury. This study may contribute to the advancement of our understanding of treating life-threatening inflammatory diseases such as sepsis. [This abstract has been edited to remove characters that will not display in this system. Please see the PDF for the full abstract.]]]> 2019 Septicemia Endotoxins Macrophages Active oxygen English http://libres.uncg.edu/ir/uncg/f/Ahmed_uncg_0154M_12792.pdf oai:libres.uncg.edu/26490 2021-06-30T10:15:17Z UNCG Hotspotting in home health: the impact of interprofessional student-team home visits on health outcomes of super-utilizers of the health care system Alderman, Jennifer Taylor NC DOCKS at The University of North Carolina at Greensboro <![CDATA[The purpose of this study was to examine the impact of interprofessional student-team home visits on the health outcomes of super-utilizers of the health care system. The cost of health care continues to increase at an unsustainable pace. Innovative educational approaches integrated with existing models of care are an example of a potential strategy aimed at reducing costs and improving outcomes. The model implemented in this study is referred to as hotspotting, an emerging term that describes an intervention during which super-utilizers are the focus of the intervention. Teams of interprofessional health professions students performed home visits on these patients in conjunction with the patients being in the care of one home health agency. This study analyzed 30-day hospital readmission rates and emergency department visits of the super-utilizers. There were twenty patients in the intervention group and twenty patients in the control group. Data analysis revealed a statistically significant difference in 30-day readmission rates between the two groups, with the group receiving interprofessional student-team home visits having fewer 30-day hospital readmissions. The number of emergency department visits were too small to warrant analysis. Home health agencies may find hotspotting an effective intervention to decrease costs and improve patient outcomes

Fusing uncertain data with probabilities

Discovering the correct data among the uncertain and possibly conflicting mined data is the main goal of data fusion. The recent research in fusing uncertain data shows that taking source confidence into account helps to achieve this goal because the sources have different degree of accuracy. Thus, understanding different modern fusing techniques and using different data sets can be useful to research community. Previous work has fused uncertain data with and without considering correlation between the sources by using training data sets [5]. In our proposed research, we extended this work by calculating the initial probability which is given by the sources that provide the information and then calculating the final probability for the given data. In our work there is no need to training set in which the algorithm can work with different type of uncertain data sets. Also, we present a method to calculate the threshold of the given data set; and we did our experiments by using two types of data sets; one type contains intentional false and other random false

Adolescent malnutrition: Prevalence and pattern in Abuja Municipal Area Council, Nigeria

Objective: To determine the prevalence and pattern of malnutrition among adolescents in senior secondary schools in The Abuja Municipal area councilMethods: Study design: this is a cross-sectional study conducted among adolescents (10-19 years) in secondary schools. A multistage sampling technique was employed to select a total of 1700 students from classes in selected schools. All schools in the Abuja Municipal Area council (AMAC) were stratified into urban and rural schools. Eight schools were selected by balloting from a list of schools obtained from the Education centre. A school was selected from each of the four major districts of AMAC and four schools were selected from the rural making a total of 8 schools. Although the consent of the school authorities was obtained, individual subject also consented to the study before being enrolled. The study excluded those adolescents who were physically challenged thus limiting physical activity. Information was obtained via the use of questionnaires that were administered by trained personnel. Subject’s height and weight was taken using the floor-type height (H) and weight (W) measuring scale model ZT-120 using Massachusetts department of public health protocol. The nutritional status was determined using the formula: BMI= W/H2 , where W =weight (in kilograms) and H= height (in meters). The age and sex specific height and BMI percentile for each subject was determined using the 2007 WHO Height and BMI growth charts for age 5-19years. The students were then classified into one of the following categories using previously used standards: normal, stunted, wasted, overweight or obese. Data was analyzed using SPSS version 17 statistical package.Results: The mean age was 14.43±1.94 years; male 688, female 862, M:F ratio 1.1.3. Mean BMI, weight and height were 20.31±3.07kg/m2, 51.07± 10.80 kg, and 157.88±9.33 cm. The prevalence of wasting, stunting, overweight and obesity was documented as 1.7% (27/1550), 11.3% (175/1550), 13.2% (205/1550), and 2.6% (41/1550) respectively. Those in urban schools had higher mean BMI (20.91±3.22 kg/m2 versus 19.71±2.78 kg/m2) and height (160.41±9.14 cm versus 155.32±8.81 cm) and p values &lt;0.05.Conclusion: There is a double burden of over-nutrition (overweight and obesity) and under-nutrition (stunting and wasting) among adolescents in Nigeria.Key words: Adolescent, malnutrition, school populatio

Three studies on the assessment and diagnosis of auditory processing disorders

Three studies on the assessment and diagnosis of Auditory Processing Disorder (APD) were conducted. The first study measured the failure rate of AP tests (speech and non-speech) and the APD diagnosis rate using four different diagnostic criteria. A retrospective analysis was conducted on test scores of 117 individuals with suspected APD. Failure rate was 3 to 4 times higher on the speech tests than the non-speech tests and consequently, there was a decrease in the diagnosis rate of APD when non-speech tests were included. Based on these findings, it was recommended that test batteries used to diagnose APD should include at least one non-speech test. The second study questioned whether an adding 2 seconds to the response time in three AP tests would benefit both typically developing students and those with learning disabilities. Learning disabled (LD) and 12 typically developing (TD) children (24 and 12 children, respectively) were administered three AP tests, Dichotic Digits (DD), Duration Pattern Sequence (DPS), and Random Gap Detection (RGD), under standard and extended time conditions. Students with LD improved significantly on the DD and DPS tests in the extended time condition. These findings indicate that adding 2 seconds to response time will significantly reduce the rate of APD diagnosis in students with LD. The third study investigated whether children with suspected APD are normally distributed between 1 and 2 standard deviations (SDs) below the mean. Retrospective analysis of AP assessments of 98 children did in fact show a normal distribution. Analysis revealed that the measured difference in the sample was not significantly different from the expected difference of 13.59% between 1 and 2SD. Consistent with AAA and ASHA guidelines, performance below 2 SD on at least two tests should be used to diagnose APD

Relationship between dietary habits and nutritional status among adolescents in Abuja municipal area council of Nigeria

Background: Dietary intake assessment is essential to understanding the nutritional status. Healthy eating pattern promotes optimal health, growth and intellectual development and prevents diseases, while poor dietary eating choices may cause malnutrition.Aims: To determine the dietary eating patterns and nutritional status among adolescents in secondary schools within Abuja Municipal area council (AMAC).Subjects and Methods: crosssectional among adolescents, 10 – 19years in secondary schools within AMAC, Nigeria. Using a multistage stratified sampling technique, four urban and four rural schools, 1550 students, were enrolled. Subject’s bio data, dietary habits and knowledge of nutrition and general physical examination were obtained. Dietary assessment included intake of main meals (breakfast, lunch and dinner), skipping meals; methods used to control weight in the previous 30days; knowledge and preference of a balanced diet and food choices. Subject’s height and weight and Body Mass Index (BMI) were determined using the 2007 WHO charts. Data was analyzed using SPSS version 17 statistical package and p value less than 0.05 was significant.Results: 1550 students were recruited, males 688 (44.4%) and females 862 (55.6%); mean age 14.43±1.94 years. Of the 780 urban adolescents, 502 (64.4%) were of upper class and 68 (8.7%) lower class; and of the 770 (49.7%) rural, 206 (26.8%) and 232 (30.1%) belong to upper and lower class respectively, p=.000. Stunting 174(11.2%) and overweight 195(12.6%) were the major forms of malnutrition recorded. Food preferences was based mainly on good taste in 546 (35.2%), balanced diet 530 (34.2%); and 539 (34.8%) had good nutritional knowledge of a balanced diet. Five hundred and forty six (35.2%) admitted to taking carbonated drinks within the previous 7days and 147 (9.5%) missed breakfast, lunch and supper as single meal. Breakfast only was skipped by 71(4.6%) while 160 (10.3%) took lunch outside the home. The methods used to control weight were eating less food or fats, fasting, use of diet pills, inducing vomiting/use of laxatives. Skipping meals and taking meals outside the home was significant for the sex, (p value &lt;0.05), school setting (p value .000) and the infrequent intake of fruits/ vegetables (p value .025). Those that skipped meals showed significant stunting (p value .009), while those who took fruits and vegetables infrequently had significant wasting (p value .049).Conclusion: poor dietary habits were identified among the adolescent. Malnutrition especially stunting and wasting was identified among those that skipped meals and took little fruits and vegetables.Key words: dietary habits, adolescent, urban, rural, prevalence, nutritional status, carbonated drinks

Traditional Underground Grain Storage in Clay Soils in Sudan Improved by Recent Innovations

In the central clay plain of the Sudan, traditional subsistence farmers and small farmers that also produce for local markets want to keep the region near food self-sufficiency. They combine annual production of sorghum with underground pit storage of part of the harvest. With increasing climate variability this food security is coming more and more under pressure. Farmers recently experimented with pit innovations that would allow storage for more than one season. These innovations were quantified and further improvements were suggested. It was found that in the most abundantly occurring cracking clay soils, wide shallow pits, using thick chaff linings, with wider above ground soil caps, are most suitable for longer term storage

Thermal conductivity and dynamic viscosity of mono and hybrid organic- and synthetic-based nanofluids: A critical review

Thermal conductivity and dynamic viscosity are two critical properties of nanofluids that indicate their heat transfer performance and flow. Nanofluids are prepared by dispersing mono or several organic or synthetic nanoparticles in selected base fluids to form mono or hybrid nanofluids. The qualitative and quantitative stability measurement of nanofluids will then be addressed, followed by a detailed discussion on how the dispersion of nanoparticles in water (W), ethylene glycol (EG), and themixture of W:EG 60:40%by volume affects the thermal conductivity and dynamic viscosity ratio. The data comparison demonstrated that the thermal conductivity ratio increases with increasing normalized concentrations, the bulk temperature of nanofluids, and the smaller nanoparticle size. The dynamic viscosity ratio is multiplied by the normalized concentration increase. Nevertheless, as the bulk temperature climbed from 0 to 80°C, the dynamic viscosity ratio was scattered, and the dynamic viscosity ratio trend dropped with increasing particle size. While the majority of nanofluids enhanced thermal conductivity ratio by 20%, adding carbon-based nanoparticles to synthetic nanofluid increased it by less than 10%. The disadvantage of nanofluids is that they multiply the dynamic viscosity ratio of all nanofluids, which increase power consumption and reduces the efficiency of any mechanical system

Late gadolinium enhancement in Brugada syndrome: A marker for subtle underlying cardiomyopathy?

BACKGROUND: There is increasing evidence that the Brugada ECG pattern is a marker of subtle structural heart disease. OBJECTIVE: We characterised Brugada syndrome (BrS) patients using cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). METHODS: BrS was diagnosed according to international guidelines. 26% BrS patients carried SCN5A mutations. CMR data from 78 BrS patients were compared with 78 healthy controls (44±15 vs 42±14 years; p=0.434 and 64% vs 64% male; p=1.000). RESULTS: Right ventricular (RV) ejection fraction was slightly lower (61±8% vs 64±5%; p=0.004) and RV end-systolic volume slightly greater (31±10mL/m(2) vs 28±6mL/m(2); p=0.038) in BrS compared with controls. These values remained within the normal range. LGE was demonstrated in 8% BrS patients (left ventricular (LV) midwall LGE in 5%) but not in controls (p=0.028). In BrS patients with midwall LGE there were no other features of cardiomyopathy at the time of CMR but genetic testing and follow-up has revealed a desmoplakin mutation in one patient and evolution of T-wave inversion throughout all precordial ECG leads in another. Neither patient fulfils diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy. CONCLUSION: Some BrS patients have LV midwall LGE consistent with an underlying cardiomyopathic process. Even cases without LGE show greater RV volumes and reduced RV function. These findings lend further support to the presence of subtle structural abnormalities in BrS. The BrS pattern with LGE may serve as early markers for evolution of a cardiomyopathic phenotype over time. CMR is a potentially useful adjunct investigation in the clinical evaluation of BrS