Physicochemical, microbial and sensory properties of milk, butter and garlic butter

A study on the physicochemical, microbial load and sensory properties of milk, butter with or without garlic was carried out using fresh milk from white Fulani cow for eight weeks of the lactation. The milk used was milked manually by the Fulanis early in the  morning. Fat content was highest in milk (4.13±0.16) and least in garlic butter (2.50±0.46). There was no observed significant (P>0.05) difference in the protein, lactose, total solid, ash and pH of the milk, butter and garlic butter. Lactose content of the  products differs with milk having highest (2.82%) while butter had the least (1.26%). Fat content in milk, butter and garlic butter varies in value from 4.13%, 3.25% and 2.50% respectively. Total solid obtained in this study was 9.22% for milk, butter 8.21% and garlic butter 7.69%. Ash content of milk and butter were 0.72% and 0.64% respectively. Garlic had a significant effect on all the microorganisms present in the butter. The taste panel ratings for butter and garlic butter shows that the taste, aroma, flavour and acceptability of ordinary butter were more preferred by the panellist.Keywords: Physicochemical, Microbial, Sensory, Milk, Butter, Garlic butte

Immunovirological treatment outcomes after 2 years of antiretroviral therapy in children living with the human immune deficiency virus in Lagos Nigeria

Background/objective: The World Health Organization (WHO) recommends routine assessment of antiretroviral treatment outcomes to detect  treatment failure early and prevent the development of drug resistance. The aim of this study was to describe treatment outcomes of antiretroviral therapy (ART) over 2 years in children living with the human immune deficiency virus enrolled in the paediatric HIV clinic at the Lagos UniversityTeaching Hospital (LUTH).Materials and methods: This was a retrospective study of antiretroviral treatment outcomes in 278 children receiving antiretroviral therapy at the paediatric HIV clinic of LUTH. Demographic, clinical and laboratory data were retrospectively collected from clinical records of pediatric patientswho received antiretroviral therapy for 2 years ( from November 2015 to December 2017) . Virological failure was defined as viral load > 400  copies/ml and immunological failure was defined as a CD4 count <100 cells/mm3 or CD4 % <15% after receiving antiretroviral agents for 12 months. Data was analysed using graph pad prism version 5.0.Results: After 12 months on antiretroviral therapy (ART), 101 (36%) had virological failure while 14 (5%) and 36 (13%) failed immunologically [CD4 count <100 cells/mn3 and CD4 <15% respectively]. Virological blips were observed at 24 months in 6.1% of patients while immunovirological discordance occurred in 30% of patients (poor virological clearance despite good immunological recovery) . High baseline viral load (>5000  copies/ml), poor adherence (<95%) and low baseline CD4 counts (101-249 cells/mn3) were significantly associated with virological failure, while low baseline CD4 counts (<350 cells/mn3) and poor adherence (<95%) were significantly associated with immunologic failure.Conclusion: The treatment outcomes observed in this study are similar to those reported in earlier studies. At 1 and 2 years of antiretroviral therapy , there was immune restoration however 101 (36%) and 87 (31%) respectively had virological failure despite good adherence to therapy and good Immunological restoration. This calls for early initiation and switch to second and third line drugs . Key words: Human immunodeficiency virus (HIV), zidovudine, lamivudine, nevirapine, virological blips, immunovirological discordance , children, Nigeria

In vivo anti-malarial activity of propranolol against experimental Plasmodium berghei ANKA infection in mice

Background: Malaria is a mosquito-borne infectious disease caused by Plasmodium spp, which is widespread in tropical and subtropical regions of the world. The objective of this study is to evaluate in vivo antimalarial activity of propranolol against experimental Plasmodium berghei ANKA (PbA) infection in a mouse model.Methods: A total of 36 mice weighing between 15 to 18g were randomly divided into six groups of six mice each. Mice in the first group (SAL) were non-infected with P. berghei but received normal saline (control), second group (PbA) were mice infected without treatment (control), third group (PRL) were non-infected mice treated with propranolol at the dose of 7.5 mg/kg/bid, fourth group (PbA+PRL) were mice infected and treated with same dose of propranolol, fifth group (QUN) were non-infected mice treated with quinine at a dose of 20 mg/kg stat, then 10 mg/kg bid, and sixth group (PbA+QUN) were infected mice treated with quinine. Parasitaemia, physiological conditions (cognitive function, temperature) and lethality of infected mice were monitored over 7-day period to assess the antimalarial activity of propranolol and quinine. The Y-maze paradigm was used to assess cognitive impairment induced by PbA infection. The effects of propranolol on malaria indices and cognitive impairment were compared with that of quinine and the control using T-test statistical method.Results: Mortality of mice at day 7 in the infected group without treatment (PbA) was 100% (6/6) while mortality was 50% (3/6) in infected group treated with propranolol (PbA+PRL) and 33.3% (2/6) in infected group treated with quinine (PbA+QUN) (OR=2.000, p=1.000). No mortality was recorded in any of the three groups of uninfected mice. Propranolol reduced parasitaemia to a trough level of 1.40±0.07 three days after treatment, comparable to trough level of 1.39±0.0633 by quinine but did not reverse PbA-induced hypothermia, which quinine did.Conclusion: Propranolol demonstrated in vivo antimalarial activity against experimental PbA infection in mice comparable to that of quinine. Keywords: malaria, propranolol, quinine, Plasmodium, cerebral malaria French Title: Activité antipaludique in vivo du propranolol contre l'infection expérimentale par Plasmodium berghei ANKA chez la souris   Contexte: Le paludisme est une maladie infectieuse transmise par les moustiques causée par Plasmodium spp, qui est répandue dans les régions tropicales et subtropicales du monde. L'objectif de cette étude est d'évaluer l'activité antipaludique in vivo du propranolol contre une infection expérimentale à Plasmodium berghei ANKA (PbA) dans un modèle murin. Méthodes: Un total de 36 souris pesant entre 15 et 18 g ont été réparties au hasard en six groupes de six souris chacun. Les souris du premier groupe (SAL) n'étaient pas infectées par P. berghei mais ont reçu une solution saline normale (contrôle), le deuxième groupe (PbA) était des souris infectées sans traitement (contrôle), le troisième groupe (PRL) était des souris non infectées traitées par propranolol à la dose de 7,5mg/kg/bid, le quatrième groupe (PbA+PRL) étaient des souris infectées et traitées avec la même dose de propranolol, le cinquième groupe (QUN) étaient des souris non infectées traitées avec de la quinine à une dose de 20mg/kg stat, puis 10mg/kg bid et le sixième groupe (PbA+QUN) étaient des souris infectées traitées avec de la quinine. La parasitémie, les conditions physiologiques (fonction cognitive, température) et la létalité des souris infectées ont été surveillées sur une période de 7 jours pour évaluer l'activité antipaludique du propranolol et de la quinine. Le paradigme du labyrinthe en Y a été utilisé pour évaluer les troubles cognitifs induits par l'infection au PbA. Les effets du propranolol sur les indices du paludisme et les troubles cognitifs ont été comparés à ceux de la quinine et du témoin à l'aide de la méthode statistique du test T. Résultats: La mortalité des souris au jour 7 dans le groupe infecté sans traitement (PbA) était de 100% (6/6) tandis que la mortalité était de 50% (3/6) dans le groupe infecté traité avec du propranolol (PbA+PRL) et 33,3% ( 2/6) dans le groupe infecté traité par la quinine (PbA+QUN) (OR=2.000, p=1.000). Aucune mortalité n'a été enregistrée dans aucun des trois groupes de souris non infectées. Le propranolol a réduit la parasitémie à un niveau minimum de 1,40±0,07 trois jours après le traitement, comparable au niveau minimum de 1,39±0,0633 de la quinine, mais n'a pas inversé l'hypothermie induite par le PbA, ce que la quinine a fait. Conclusion: le propranolol a démontré une activité antipaludique in vivo contre l'infection expérimentale au PbA chez la souris comparable à celle de la quinine. Mots-clés: paludisme, propranolol, quinine, Plasmodium, paludisme cérébra

The relationship between zidovudine, lamivudine and nevirapine plasma drug levels and antiretroviral treatment outcomes in Nigeria children living with HIV

Plasma concentrations of antiretrovirals are significant and important determinants of treatment failure and toxicity. The relationship between antiretroviral pharmacokinetic exposures and immunovirological outcomes has not been extensively studied in our setting. The aim of this study was to investigate the relationship between antiretroviral plasma concentrations and virological and immunological treatment outcomes in children living with human immunodeficiency virus (HIV) A retrospective collection of demographic, clinical , laboratory data and a prospective determination of plasma drug concentrations in 120 children aged 2-14 years after two years of receiving fixed dose zidovudine, lamivudine and nevirapine tablets using a simple, rapid, sensitive and validated method of high performance liquid chromatography with UV detection for simultaneous quantification of zidovudine, lamivudine and nevirapine in human plasma. All analyses were performed using graph pad prism version 5.0. A perfect agreement (p<.001) was found between nevirapine drug levels and prescriptionrefill visit adherence records (Kappa 0.093). Plasma zidovudine, lamivudine and nevirapine concentrations were not statistically associated with virological success (Viral load <400copies/μl ) and immunological success (CD4 cells >100 cells/mm3). At 2 years zidovudine, lamivudine and nevirapine therapeutic levels, zidovudine supra therapeutic levels ,and nevirapine subtherapeutic levels were respectively significantly associated with immunologic success (CD4%>15 %). Low nevirapine levels can be used to identify those that require adherence counseling. Despite good virological and immunological outcomes, plasma concentrations of zidovudine, lamivudine and nevirapine were not significantly associated with virological and immunological outcomes (Absolute CD4 counts) but was significantly associated with immunological outcomes (CD4%). Plasma drug levels may be good surrogates of adherence but not of treatment outcomes. Monitoring CD4% remains important to optimize paediatric HIV treatment.Keywords: Antiretroviral treatment, children, therapeutic drug monitoring, treatment outcomes, immune-virological outcomes, plasma concentrations, zidovudine, lamivudine and nevirapin

Does Electroconvulsive therapy aggravate the rise in potassium and creatine kinase following suxamethonium administration?

Background: Potassium and creatine kinase levels increase after the administration of suxamethonium. This rise may be exaggerated by the combination of suxamethonium fasciculation and the modified tonic/clonic convulsion induced by electroconvulsive therapy. This study compared the magnitude of increase in potassium and creatine kinase levels after electroconvulsive therapy and surgery using suxamethonium.Methods: A total of 40 patients were studied; electroconvulsive therapy (ECT), n=20 and surgery (Control), n=20. Intravenous sodium thiopentone (5mg/kg) and suxamethonium (1.5mg/kg) were administered. The changes in potassium and creatine kinase levels were assessed at presuxamethonium, 1 and 3 minutes after fasciculation in Control group and ECTinduced seizure activity in the ECT group. Our hypothesis was that a significant increase occurs in the mean potassium and creatine kinase levels after suxamethonium administration during electroconvulsive therapy.Results: Both groups exhibited a rise in potassium concentration after administration of suxamethonium. The mean increase was significantly higher in the ECT group than in the Control group; at 1 minute; ECT (0.71 ±SEM 0.24) versus control (0.28 ±SEM 0.19) mmol/L, p =0.003, and at 3 minutes; ECT (0.35 ±SEM 0.23) versus control (0.20 ±SEM 0.15), p =0.044. The mean increase in the creatine kinase concentration was significantly higher in the ECT group (34.11 ±SEM 10.76) than in the Control group (19.71 ±SEM 6.32) IU/L, p = 0.023, at 3 minutes.Conclusion: The creatine and potassium concentrations following suxamethonium administration were significantly higher in the electroconvulsive therapy group than in the control group.Keywords: ECT, surgery, creatine kinase, potassiu

The agreement of point-of-care and standard laboratory electrolyte and glucose analysis in critically ill patients in a sub-Saharan tertiary teaching hospital

Background: The critically ill patient undergoes rapid changes in the internal milieu requiring quick intervention. Point of care testing has been shown to be valuable in the early diagnosis and management of such patients.Objective: This study determined the agreement between I-STAT Abbot point of care testing with standard laboratory testing in the analysis of electrolytes and glucose concentrations in critically ill patients.Methods: The study was performed in a Sub-Saharan Tertiary Teaching Hospital in critically ill patients. Electrolyte and glucose analysis were measured with ISTAT Abbot Analyzer unit with parallel blood specimens (n=30) tested in the laboratory on an ion-selective electrode, SFRI analyzer ISE 6000.Results: There was no significant difference in mean sodium, potassium, chloride and glucose between I-STAT POCT and standard laboratory measurements. The agreement between POCT and laboratory glucose was good pc = 0.967, mean difference of 0.79 and 95% limit of agreement from -3.83 to +5.107 mmol/L, p = 0.733. Bicarbonate was moderate (pc) = 0.637, mean difference of 1.95 and 95% limit of agreement from -4.294 to +0.394 mmol/L, p = 0.101. There was moderate agreement for sodium (pc) = 0.32, mean difference of 5.8 and 95% limit of agreement from -0.378 to +11.98 mmol/L, p = 0.064. Agreement for potassium was moderate (pc) = 0.439, mean difference of 0.15 and limit of agreement from -0.401 to +0.701 mmol/L, p = 0.588. There was, however, a significant difference in mean chloride, and BUN values; chloride (pc) = 0.0796, mean difference of 13.8 and 95%  limit of agreement from -7.55 to + 20.015 mmol/L. Blood urea nitrogen (pc) = 0.064, mean difference of 18.55 and 95% limit of agreement from -30.126 to +6.974 mmol/L.Conclusion: The mean sodium, potassium, glucose and bicarbonate were comparable with moderate to good agreement between I-STAT POCT and ISE 6000 Analyzer. Though, the mean BUN and chloride levels between the analytical methods differ significantly.Keywords: Point of care testing, Bland and Altman, concordance, electrolytes, IC

The role of the percentage free PSA in the diagnosis of prostate cancer in Blacks: Findings in indigenous West African men using TRUS guided biopsy

Introduction: In Western and Asian literature, the measurement of percentage free prostate specific antigen (%fPSA) has been known to enhance the predictive role of total prostate specific antigen (tPSA) in early prostate cancer (Ca-P) detection. Relationship between the tPSA and Ca-P are known to be influenced by race. To the best of our knowledge, the relationship between %fPSA and Ca-P has not been studied in sub-Saharan Africa using current established biopsy protocol. Objective: To evaluate the usefulness of %fPSA in indigenous West African men and determine the appropriate cut-off values that may be used as indication for prostate biopsy in men with tPSA of 4–10 ng/ml. Subjects and methods: A total 169 consecutive patients with tPSA of 4–10 ng/ml with non-suspicious findings on digital rectal examination (DRE) had a transrectal ultrasound (TRUS) guided 10-core prostate biopsy. The technique of PSA analysis was the Access hybritech assay technique using the Beckman's Access autoimmuno analyser. The rates of prostate cancer in different %fPSA ranges were evaluated. Receiver operating characteristic curve (ROC) was used to evaluate the efficiency of %fPSA in the diagnosis of prostate cancer. Results: A reduction %fPSA was associated with a higher detection rate of Ca-P. There was a 62% prevalence of Ca-P with %fPSA ≤ 10% while there was a zero prevalence in patients with fPSA above 20%. At a %fPSA cut off of 20% the sensitivity and specificity were 100% and 45%, respectively. Using the ROC curve, the area under the curve (AUC) was 0.76 while the ROC decision plot showed that a %fPSA cut off 15% was associated with the highest ability to discriminate between benign and malignant diseases. Conclusion: The %fPSA is an effective discriminating tool in determining the need for prostate biopsy in indigenous West African men with PSA 4–10 ng/ml. A cut off of 15% was associated with the highest performance