Microbiological evaluation of the potencies of brands of four parenteral antibiotic preparations used in the treatment of urinary tract infections

'Urinary tract infection (UTI) is a common disease and sometimes life threatening if not properly treated. In Nigeria, aside adulteration and counterfeiting of antibiotics, potency of antibiotics can also be altered by factors like production errors and storage condition at the Pharmacy stores. This study investigated the potencies of selected brands of four common parenteral antibiotic preparations, in Nigerian drug markets against uropathogens isolated from patients with recurrent UTI. Ten selected clinical bacterial isolates from patients with recurrent UTI were collected from the Microbiology unit of the University College Hospital, Ibadan and authenticated by standard bacteriological methods. The isolates were  subjected to susceptibility test against eight standard antibiotics by disc diffusion method. The selected brands of the four parenteral antibiotic preparations used in this study includes: Ciprofloxacin (Emason® and Uniflox®); Ceftriaxone (Rocephin® and Cefin®); Aminoglycoside (Pe-genta® and Philo-genta®) and Aminopenicillin/inhibitor (Augmentin® and Amoxiclav®). Efficacies of the parenteral antibiotic preparations against the isolates were determined by Minimum Inhibitory Concentrations (MICs) using broth-dilution method. Antibiotic susceptibility test using standard antibiotic discs showed that all (100%) the bacterial isolates were multidrug resistant (MDR), being resistant to two or more classes of antibiotics. Aside E. coli (E1) that was susceptible to the two brands of gentamicin preparations at the Clinical Laboratory Standard Institute (CLSI) susceptibility breakpoint (≤ 4 ag/mL), all the other isolates showed resistance to the four parenteral antibiotic preparations and were only susceptible at higher concentrations (> 2 folds) above the CLSI resistance breakpoints for the different antibiotic preparations. The brands of the parenteral antibiotic preparations used in this study have low potency which varies with different bacterial strains involved. L’EVALUATION MICROBIOLOGIQUE DES PUISSANCES DES MARQUES DE QUATRES PREPARATIONS ANTIBIOTIQUES PARENTERALES UTILISEES DANS LE TRAITEMENT DE L’INFECTION DES VOIES URINAIRES.L’infection des voies urinaires (UTI) est une maladie commune et parfois met la vie en danger si pas correctement traitée. Au Nigeria, a part de la falsification et la contrefaçon des antibiotiques, la puissance des antibiotiques peut également être modifiéepar des facteurs tels que les erreurs de production et les conditions de stockage dans les magasins de la pharmacie. Cette étude a examiné les puissances des marques sélectionnées de quatre préparations antibiotiques parentérales courantes, aux marchés  nigérians de la drogue, contre les uropathogenes isolées des patients avec infection urinaire récidivante. 129Dix isolats bactériens sélectionnés des patients avec infection urinaire(UTI) récidivante ont été recueillies de l’unité microbiologie de l’hôpital Universitaire, Ibadan et authentifie par des méthodes bactériologiques classiques. Les isolats ont été soumis à des tests de sensibilité contre huit antibiotiques Standards par la méthode de diffusion sur disques. Les marques sélectionnées de quatre préparations antibiotiques parentérales utilisées dans cette étude comprennent : Ciprofloxacine (Emason® et Uniflox®) ; Ceftriaxone (Rocephine® et Cefin®) ; Aminoside (Pe - genta® et Philo – genta®) ; et Aminopenicilline/inhibiteur (Augmentin® et Amoxiclav®). L’efficace des préparations antibiotiques parentérales contre les isolats ont été déterminés par concentrations minimales inhibitrices(MICs) en utilisant la méthode du bouillon – dilution. Le test de sensibilité aux antibiotiques en utilisant les disques antibiotiques standard a montré que tous (100%) les isolats bactériens étaient multi résistants (MDR), étant résistant aux deux ou plusieurs classes d’antibiotiques. A part de E.coli (E1) quiétait sensible aux deux marques de préparations gentamicine a l’Institut de Laboratoire Clinique  Standard. Le point d’arrêt de la  sensibilité (≤ 4ag/ml) tous les autres isolats ont montré résistance aux quatre préparations antibiotiques parentérales et étaientseulement sensibles a des concentrations plus élevées (> 2 plis) au- dessus des points d’arrêt de résistance CLSI pour les préparations antibiotiques différentes. Les marques des préparations antibiotiques parentérales utilisées dans cette étude ont une faible puissance qui varie avec les souches bactériennes différentes impliquées.

Exposure to cigarette smoke altered the cytoarchitecture and anti-oxidant activity of the frontal cortex in Wistar rats

This study was designed to determine the effects of cigarette smoke on the body weights of Wistar rats, anti-oxidant activity and the histology of the frontal cortex. Sixteen Wistar rats with mean weight of 131.40 ± 4.43 g were used. They were grouped into four. Group A had a stick of cigarette (Pall Mall brand ®) daily, group B had two sticks and group C had three sticks daily, while Group D served as the control group. They were exposed at 1800 hrs each day for thirty five days, and their weights were monitored. After sacrifice by cervical dislocation, the tissues were processed for histological and biochemical studies. The results showed minimal weight change in the exposed groups compared to the marked increase in the control group. The activity of glutathione peroxidase (GPx) enzyme increased while there was decrease in malondialdehyde (MDA) activity. The histology also showed decreased staining of the nucleic acids as well as increased vacuolations in the exposed groups. The authors suggested these findings could alter brain functions particularly those related to the frontal cortex.Keywords: Cigarette smoke, frontal cortex, GPx, MDA, nucleic acids

Radiotherapy services in cancer management at the lagos university teaching hospital, idi-araba; patients perspective.

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. The incidence of cancer is on the increase, due to growth and ageing of the global population. More than half of all cancers (56.8%) and cancer deaths (64.9%) in 2012 occurred in less developed regions of the world, and these proportions will increase. The treatment of cancer has undergone evolutionary changes as understanding of the underlying biological processes has increased. It is estimated that 52% of cancer patients need the service of Radiotherapy at least once at one time or the other during the course of their disease. Objective: To determining the knowledge of Radiotherapy as a treatment modality in Cancer Management and to assess the perception to Radiotherapy services among patients receiving treatment at the Radiotherapy department of the Lagos University Teaching Hospital Idi-araba. Method: Data collection was by semi structured questionnaires filed by all patients undergoing radiotherapy in the Radiotherapy department of Lagos University Teaching Hospital over a period of two months. A total of 93 questionnaires were reviewed. Data obtained were collated and analyzed using SPSS statistics [Social Sciences Statistical Package] 17.0 version. Results: Majority, Fifty six (60.2%) of the respondents were from the age group of 41-65. Seventy-four(79.6%) respondents had not heard of radiotherapy before they started treatment. Sixty-one (65.6%) of the respondents said they were properly informed about radiotherapy before they started the treatment. Seventy-two (77.4%) respondents think radiotherapy is effective and 90(96.8%) respondents said radiotherapy is too expensive. Majority, Forty eight (51.6%) said the waiting time before they receive treatment is too long

Cytotoxic potentials of thiocyanate administration on the liver of male wistar rats (RattusNorvegicus)

The use of thiocyanate as an anti-sickling drug is currently on the increase among sickle cell disease (SCD) patients. The continuous use of this substance without sufficient toxicity data does not guaranty continuously functional and healthy  internal organs among the SCD patients that are susceptible to multi-organ failure such as hepatic failure. Hence this study was performed to elucidate the  consequence(s)of thiocyanate administration on the liver of adult male wistar rats.Twenty adult male wistar rats with an average weight of 234.5g were used. The rats were grouped into four (A, B, C & D) with five animals in each group. Group A represented the control and was given only 1ml of distilled water daily while B,C,&D received 1ml of thiocyanate solution at doses of 10mg/Kg/day, 20mg/Kg/day, & 30mg/Kg/day for twenty-eight (28) days. The administration was carefully done with the use of an oral cannula. Thereafter, the rats were sacrificed via cervical dislocation. The rats were dissected and blood samples were immediately collected from the apex of the heart for the analysis of serum total bilirubin. A fraction of the liver was cut to prepare homogenates for biochemical enzymes (alanine   aminotransferase-ALT, aspartate aminotransferase- AST) analysis. Thereafter the animals were wholly perfused with normal saline and then fixed with 4%   paraformaldehyde. The fixed liver tissues were then taken for histological   assessments. The slide sections (H&E and PAS stains) in the treated groups  showed varying degrees (mild to severe disruption of hepatocellular morphology plus prominence and widening of sinusoids) of thiocyanateinduced liver damage. But hepatocellular appearance was normal in the control group. Biochemical assays of serum total bilirubin and tissue AST increased fairly with increasing dose although this was not significant. The increase in tissue level of ALT in group B was also not significant with respect to the control. But increase in ALT level was found to be significant in groups C&D when compared with the control. Therefore, this study can be used to infer that SCN use in sickle cell disease management regimen can cause hepatocellular damage in wistar rats.Key Words: Thiocyanate,Biochemical enzymes,Hepatocellular morphology,  Anti-sicklin

Characterization of cucumber mosaic virus isolated from yam (Dioscorea spp.) in West Africa

Millions of people in the West African sub-region depend on yam for food and income. In 2008, cucumber mosaic virus (CMV), one of the most economically important plant viruses was detected in yam fields in Ghana, Benin and Togo, three of the five topmost yam producing countries in the world. Some strains of CMV are reportedly more virulent than others thus the need to characterise the strain isolated from yam. Sap inoculation of the yam strain induced systemic mosaic on Cucumis sativus and systemic chlorosis, necrotic lesions and leaf distortion on Nicotiana glutinosa. Sequence analysis of the 3' end of the coat protein gene and C-terminal noncoding region revealed 98 to 99, 93 to 98 and 78 to 79% nucleotide homology with members of the subgroups IA, IB and II, respectively. This analysis further revealed the absence of the EcoR1 restriction site characteristic of subgroup II strains and the presence of 15 nucleotide deletions dispersed along the C-terminal noncoding region of subgroup IA strains. At the amino acid level, the virus had 99 to 100% homology with subgroup I strains and 89% homology with subgroup II strains. Phylogenetic analysis of the amino acid confirms that the yam strain of CMV belongs to subgroup I while nucleotide sequence phylogeny confirms its placement in subgroup IA.Keywords: Yam viruses, cucumber mosaic virus, sequence analysisAfrican Journal of Biotechnology Vol. 12(22), pp. 3472-348

Malignant Otitis Externa in Developing Country

Objective: Malignant otitis externa is a potentially life threatening infection of external auditory canal and skull base in an immunocompromised person. The outcome tends to be fatal due to the skull base osteomyelitis, especially if diagnois is delayed or is poorly treated. This epidemiological study in developing country is aimed at sensitizing for high level of suspicious early diagnosis and treatment. Method: This is a prospective study of patients with diagnosis of malignant otitis externa managed in a tertiary hospital between year 2012 - 2016. All consented patients with the disorder were enrolled into the study. Data obtained were collated and analysed. Result: Nine patients with malignant otitis externa were seen during the study period. Male to female ratio was 1:1. The peak was between 61 and 70 years. The most frequent symptoms were otalgia 9 (100%) and hearing loss 9 (100%) while cranial neuropathy was encountered in 6 (66.7%). The most implicated microganisms was Pseudomonas aeruginosa 7(28%). All patients had combination of both medical and surgical intervention. There was 1death (11.1%). Conclusion: Malignant otitis external is a complication of diabetes with high morbidity, however prompt diagnosis and treatment could mitigate the mortalit

Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study

Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one control were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria

The impact of a communal multidisciplinary tumour board on medical education

Introduction: Numerous challenges hinder the development of multidisciplinary medical education in a resource-constrained environment. Communal tumour boards built through networking could be a suitable model for the effective management of diseases and enhancement of medical education. This study evaluated the impact of an integrated care pathway for patients with musculoskeletal tumours via multi-institutional networking in a metropolis. Methodology: Musculoskeletal tumours managed in different institutions in a large metropolis were included for discussion at monthly meetings, under the aegis of the Lagos Musculoskeletal Oncology Network (LAMON). The cases discussed were collated and presented by designated senior residents. The meetings ensured adherence to agreed national and international guidelines in the management of musculoskeletal tumours. Decisions about the treatment modalities were planned at the meetings. The impact on medical residency training was evaluated using the achievement of significant milestones by the residents supported by the network. Results: The tumour board network included health professionals from various specialist hospitals in the metropolis. Within the decade (2013–2022), 1,272 patients were reviewed of which 968 patients had definitive histological diagnoses. There was an improvement in limb salvage rate and disease outcome. The tumour board supported significant milestones in graduate medical training, including the completion of 4 residents’ fellowship dissertations, 22 conference presentations by residents, the publication of 12 articles by residents and the completion of an orthopaedic oncology subspecialty fellowship by 9 orthopaedic surgeons. Conclusion: The tumour board/network improved the outcome of musculoskeletal tumours over the study period. The network improved the education of medical doctors and increased the capacity for training newer instructors in a resource-limited environment. Perhaps with appropriate social and corporate support, communal tumour boards like LAMON may translate into a good model for multidisciplinary care of diseases and capacity building in resource-limited settings