Complicated Community-Acquired Staphylococcus Endocarditis and Multiple Lung Abscesses: Case Report and Review of Literature

Background. Isolated tricuspid valve endocarditis in the absence of risk factors in the community setting is very rare and can be easily missed in patients with hitherto normal valves. Case Presentation. We present a case of a 49 year old gentleman who presented with generalized body aches, fever, and jaundice and was initial diagnosed as hepatitis. He subsequently developed recurrent episodes of panic attacks and shortness of breath and later multiple skin abscesses. Further investigations excluded pulmonary embolism but revealed multiple abscesses in the body including the lungs. Blood cultures and culture from abscesses grew S. aureus. An initial transthoracic echocardiogram was normal. A transesophageal echocardiogram subsequently confirmed endocarditis on a normal natural tricuspid valve and multiple lung abscesses. He was successfully treated with appropriate antibiotics. Conclusion. We discuss the pathogenesis of this patient's presentation highlight the need for assessment and proper evaluation of patients with unexplained bacteremia

Aflatoxin Total and Microbial Contamination of Grains, Oil Seeds, Yam Chips and Fish Sold in Maiduguri Market

Aflatoxins are secondary metabolites of fungus Aspergillus flavus and closely related species that infects severalagricultural commodities. The consumption of contaminated commodities adversely affects the health of humansand animals and also a cause of significant economic losses to producers. This study surveyed the aflatoxincontamination level of cowpea, maize, melon, groundnut, yam chips and fish sold in Maiduguri metropolis.Samples from each product (250 g) were bulked and thoroughly mixed using coning and quartering method to geta representative sample for analysis. Laboratory observations were carried out regarding microbial analysis,proximate composition and aflatoxin content. Samples for aflatoxin detection were classified into three; unsortedsamples, sorted samples and sorted/washed dried samples. Fish had the highest bacterial load 2.48 x 106 cfu/ml andAspergillus species were found to be the predominant fungi identified. Maize and groundnut with moisture contentof 5.63 and 5.62 had the highest total aflatoxin contamination (320.51 μg/kg and 236.3 μg/kg respectively) both inthe unsorted group. Total aflatoxin reduction of (58.82 - 99.99%) was observed in all the sorted samples andsorted/washed dried samples. It can be concluded that commonly sold food in Maiduguri had fungal and Aflatoxincontamination. Food should undergo several rounds of sorting to remove discoloured grains and grains that showsevidence(s) of deterioration to reduce the ingestion of food contaminated with aflatoxin

RCMV ALL-03 model and study of CMV pathogenesis in congenital infection

Cytomegalovirus (CMV) is one of the most commonly studied members of the Herpesviridae family. So far several strains have been identified but human CMV (HCMV) remains the most important due to its ability to infect humans and also cross the placenta causing neonatal infection and mortality. However, there are several limitations in the study of this strain which includes availability and use of model animals. Although strains such as Rhesus CMV (RhCMV), Guinea pig CMV (GPCMV) and Rat CMV (RCMV ALL-03) have been shown to cross the placenta and exhibit similar pathogenesis to HCMV, only RCMV ALL-03 can be conveniently used without much limitations as guinea pigs are resistant to antiviral drugs, while rhesus monkeys are seropositive, considered costly and have ethical use restrictions. We therefore propose the use of RCMV ALL-03 as a model for the study of CMV infection

Clinical management of dietary induced urolithiasis associated with balanoposthitis in a Boer goat

A Boer-Kajang cross male goat was presented to the Veterinary Hospital, University Malaysia Kelantan with a history of dysuria, hematuria and restlessness. The goat was intensively managed (confined to the pen) and fed with only palm kernel cake for the last three months. Physical examination revealed that the goat was dull, depressed, having an inflamed penis and prepuce with blood stained urine dripping from the penis. The differential diagnoses were obstructive urolithiasis, urinary tract infection and balanoposthitis. Based on the history, clinical signs, physical examination, urinalysis, ultrasonagraphy and feed analysis, the goat was diagnosed with obstructive urolithiasis and balanoposthitis. Treatment was instituted by amputation of the urethral process and retrograde urohydropulsion to relieve the blockade. Sulfadiazine-trimethoprim (Norodine®24) 15mg/kg, I.M; flunixin meglumine 2.2mg/kg, I.M; vitamin B complex 1ml/10kg, I.M and ammonium chloride 300mg/kg orally were administered. The goat responded well to treatment and was recovering well during a follow up visit

Effect of Clausena excavata Burm. f. (Rutaceae) leaf extract on wound healing and antioxidant activity in rats

Shaymaa Fadhel Abbas Albaayit,1,2 Yusuf Abba,3 Rasedee Abdullah,3 Noorlidah Abdullah1 1Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq; 3Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Abstract: Clausena excavata is a well-known plant used in folkloric medicine for the treatment of different ailments. This study aimed to determine the in vitro cytoxicity of its leaf solvent extracts as well as the in vivo wound healing and antioxidant activities of the methanolic extracts of C. excavata (MECE). HaCaT (keratocyte) and Vero cell lines were used for evaluation of the in vitro cytotoxic effects, while the in vivo wound healing and antioxidant activities were determined in skin wounds inflicted on rats. Twenty adult male Sprague-Dawley rats were divided into five groups of four animals each. Approximately 3.14 cm2 excisional wound was inflicted on the nape of each rat following anesthesia. The treatment groups received topical application of MECE at 50 mg/mL (MECE-LD [low dose]), 100 mg/mL (MECE-MD [medium dose]), and 200 mg/mL (MECE-HD [high dose]), while the negative control group was treated with gum acacia in normal saline and the positive control group with intrasite gel. Wound contraction was evaluated on days 5, 10, and 15 after wound infliction, and tissue from wound area was collected at day 15 post-wound infliction for antioxidant enzyme evaluation and histopathological analyses. Generally, Vero cells were more resistant to the cytotoxic effects of the solvent extracts as compared with HaCaT cells. Chloroform (CH) and ethyl acetate (EA) extracts of C. excavata were toxic to HaCaT cells at 200 and 400 µg/mL, but the same concentrations showed higher (P<0.05) viability in Vero cells. There was significantly (P<0.01) greater wound contraction at days 10 and 15 post-wound infliction in all the treatment groups than in the control groups. Histopathologically, the MECE-HD-treated wound showed significantly (P<0.05) lesser inflammatory cell proliferation, degeneration, and distribution of granulation tissue than other groups. Similarly, the degree of collagen maturation, angiogenesis, and collagen distribution were significantly (P<0.05) lower in MECE-HD than in other groups. The MECE-HD, MECE-MD, and intrasite treatment groups showed a significantly (P<0.05) higher number of VEGF-positive and TGF-β1-positive cells in the skin wound than the control groups. The activities of superoxide dismutase and catalase were significantly (P<0.01) higher in the MECE-HD and intrasite treatment groups than in the other groups. Lipid peroxidase activity of the treated groups was significantly (P<0.01) lower than that in the control group. The study showed that MECE is a potent wound healing agent through anti-inflammatory and antioxidant effects that enhanced the rate of wound contraction, re-epithelialization, and collagen deposition. The effect of MECE is suggested to be due to its high polyphenolic compound content. Keywords: Clausena excavata, cytotoxicity, wound healing, antioxidant, histopathology, VEGF, TGF-β

Abrupt withdrawal of inhaled corticosteroids does not result in spirometric deterioration in chronic obstructive pulmonary disease: Effect of phenotyping?

Background and Objective: Some studies show a decline of FEV 1 only one month after withdrawal of inhaled corticosteroids (ICS), while others show no decline. We speculate that the presence of an asthma phenotype in the Chronic Obstructive Pulmonary Disease (COPD) population, and that its exclusion may result in no spirometric deterioration. Methods: We performed a prospective clinical observation study on 32 patients who fulfilled the Global Initiative for Chronic Obstructive lung disease definition of COPD (Grade II-IV). They were divided into two phenotypic groups. 1. Irreversible asthma (A and B) (n = 13): A. Asthma: Bronchial biopsy shows diffuse thickening of basement membrane (≥ 6.6 ΅m). B. Airflow limitation (AFL) likely to be asthma: KCO > 80% predicted if the patient refused biopsy. 2. COPD (A and B) (n = 19): A. COPD: hypercapneic respiratory failure with raised bicarbonate, panlobular emphysema with multiple bullas, or bronchial biopsy showing squamous metaplasia and epithelial/subepithelial inflammation without thickening of the basement membrane. B. AFL likely to be COPD: KCO < 80% predicted. Results: The asthma phenotype was significantly younger, had a strong association with hypertrophy of nasal turbinates, and registered a significant improvement of FEV 1 (350 ml) vs a decline of - 26.5 ml in the COPD phenotype following therapy with budesonide/formoterol for one year. Withdrawal of budesonide for 4 weeks in the COPD phenotype resulted in FEV 1 + 1.33% (SD ΁ 5.71) and FVC + 1.24% (SD ΁ 5.32); a change of <12% in all patients. Conclusions: We recorded no spirometric deterioration after exclusion of the asthma phenotype from a COPD group