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

Oestrous cyclicity disruption in Wistar rats subjected to partial sleep deprivation

Background: Chronic partial sleep deprivation continues to be a global problem. Studies have shown that oestrous cyclicity is disrupted by total sleep deprivation. The relationship between partial sleep deprivation – the predominant form of sleep deprivation in the current global society – and the oestrous pattern remains elusive. This study examined oestrous cycle patterns of rats subjected to partial sleep deprivation.Methods: Thirty female Wistar rats were divided into control and Sleep-Deprived (SD) groups of fifteen rats each. Oestrous patterns were monitored for two weeks before sleep deprivation and throughout the study. Sleep deprivation was induced using the modified multiple platform method. Five animals were sacrificed under thiopental anaesthesia during proestrus on days 7, 14 and 21. The ovaries, uteri and adrenal glands were examined. Data were compared using t-test at p<0.05.Results: Proestrus and oestrus frequencies reduced in the SD groups; metestrus frequency increased in the 7 days and 14 days SD and diestrus frequency increased in 21 days SD group. Cycle lengths increased in the 14 days and 21days SD groups. The SD groups had inflammation of ovary and uterus, as well as adrenal medulla hyperplasia.Conclusion: Partial sleep deprivation reduces frequencies of phases characterized by sexual activity and ovulation while increasing cycle lengths in Wistar rats. Thus, adequate sleep is important for women who are trying to get pregnant.Keywords: Sleep deprivation, Oestrous cycle, Adrenal medulla, rat

Coconut water prevents renal and hepatic changes in offspring of monosodium glutamate-treated Wistar rat dams

Summary: Monosodium glutamate (MSG) is a widely-consumed taste enhancer which has been implicated in the aetiology of renal and hepatic dysfunction in adults and their offspring. There is increasing evidence on the therapeutic properties of Coconut Water (CW) in kidney and liver disorders. This study investigated the effects of CW on renal and hepatic functions in offspring of MSG-fed dams. Twelve female Wistar rats (120 – 140 g) were grouped into four as follows; Control (10 ml/Kg distilled water), MSG (0.08 mg/Kg), CW (10 ml/Kg) and MSG+CW. Treatments were given orally daily commencing two weeks prior to mating, throughout mating and gestation until parturition. All dams received standard rodent diet and drinking water ad libitum throughout the study. After weaning on Post-Natal Day (PND) 28, serum was obtained from offspring for assay of liver and renal function. Histological analysis of the livers and kidneys were performed on both dams and offspring. There was no significant difference in liver enzymes, urea, creatinine and albumin levels amongst the offspring on PND 28. However, liver and kidney sections from MSG dams and their offspring showed early degenerative changes which were not evident in renal and hepatic tissues from CW and MSG+CW dams and offspring. These observations suggest that coconut water protects against monosodium glutamate-induced renal and hepatic dysfunction in dams and offspring.Keywords: Monosodium glutamate, Cocos nucifera water, Foetal programming, Kidney, Live

Development of an IoT Based Data Acquisition and Automatic Irrigation System for Precision Agriculture

Agriculture has benefited greatly from improvements in Internet of Things based technology. Farm data can be sent to farmers in real-time through the advent of Internet of Things based technology which integrates data collection, transmission, storage and other essential components that provide for great user experience. This work involves the development of a system that enable the transmission of sensor field data to the Internet, via a microcontroller, a transceiver and a Wi-Fi module. In this work, an Internet of Things based data acquisition and automatic irrigation system for precision agriculture was designed and implemented using Arduino Uno, Soil Moisture and Temperature sensors, Proteus design suite, and the Arduino integrated development environment software. The significance of this work is evident as it, enables farmers perform specified functionalities at the comfort of their home, minimize wastage of water during irrigation and most importantly reduce the maintainability cost of the farm through minimal physical supervision. This work also elicits requirements for better improvements on the IoT-based data acquisition and automatic irrigation system

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

Evaluation of knowledge and practice of pharmaceutical waste disposal in hospitals and pharmacies within Lagos State, Nigeria

Background: Treatment and disposal of waste is a major challenge in most developing countries, including Nigeria. Improper disposal of pharmaceutical waste could have negative impact on the environment and human health as they can cause harmful effects.Objectives: This study assessed the knowledge and practise of healthcare personnel in Lagos State, Nigeria towards pharmaceutical waste disposal.Methods: The study was a cross-sectional descriptive survey carried out using structured questionnaires. Target respondents were healthcare workers involved in the use and disposal of pharmaceutical waste in several hospitals and pharmacies located within the State. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20 and presented as tables and charts using descriptive and inferential statistics.Results: There was 83.3 % response to the questionnaires. Majority of the respondents (63.07 %) dispose refuse via authorized garbage collectors. The survey indicated that the drainage systems of most hospitals and pharmacies are connected to general drainages while 6.2 % have sewage systems installed. Most of the respondents (68.9 %) indicated that there was no waste disposal method in place for pharmaceutical waste. Knowledge of most appropriate disposal method for pharmaceutical waste amongst most of the respondents was poor (30.85 %).Conclusion: Limited knowledge on pharmaceutical waste disposal was evident amongst the respondents. Hence, the need to enlighten health care personnel on proper pharmaceutical waste disposal methods, so as to avoid associated environmental hazards, is recommended.Keywords: Healthcare workers, Pharmaceuticals, Waste disposal, Environmental, Hazar