Co-existence of Ventricular Septal Defect and Bronchial Asthma in Two Nigerian Children

Congenital heart diseases (CHD) often present with recurrent or chronic breathing difficulties, as do chronic airway diseases such as asthma. Both are relatively common, and may sometimes co-exist. However, there is a paucity of literature from developing countries to that effect. We present two children diagnosed with ventricular septal defect, later also found to have clinical features consistent with co-existing asthma. We highlight the diagnostic challenges we encountered as well as the crucial role of a careful family respiratory history in children with congenital heart disease

Renal sizes in healthy term newborns in Jos, Nigeria

Introduction Knowledge of the range of normal measurements of body organs including the kidneys in the healthy population is essential. Such reference values provide a quick guide for prompt and accurate evaluation of the abnormal. This study sought to determine renal size by ultrasound measurement in term neonates at the Jos University Teaching Hospital (JUTH).Materials and Methods: Healthy term neonates aged 12 to 72 hours were consecutively enrolled. Ultrasound measurements of their renal sizes were determined. Mean renal dimensions and their 95% confidence intervals (CI) were computed. The renal sizes were correlated with the infants’ anthropometric parameters and gestational ages using Pearson’s correlation coefficient. Sizes of left and right kidneys and of male and female subjects were compared using student’s t-test.Results: Two hundred term newborns consisting of 105 (52.50 %) females and 95 (47.50%) males were enrolled. Their mean renal length was 4.09(95% CI, 3.72, 4.46) cm and 4.08 (95% CI, 3.72, 4.44)cm for right and left kidneys; width2.11 (95% CI, 1.89, 2.33) cm and 2.08 (95% CI, 1.85, 2.31) cm for right and left kidneys, and volume9.66(95% CI, 7.49, 9.87) cm3and 9.41 (95% CI, 7.23, 11.59) cm3 for right and left kidneys respectively. Renal dimensions increased consistently with birth weight. No significant difference in renal dimensions between the right and left kidneys was found.Conclusion: The mean renal dimensions for right and left weresimilar and correlated with birth weight.Key Words: Healthy, Term, Newborn, Ultrasound, Renal Size

Causes of stillbirth in a community survey in Gombe State

Background: Perinatal mortality rate is very high in North Eastern Nigeria mainly due to a large number of still births. The causes and factors related need to be identified so as to proffer solutions with a view to improving obstetric practice and perinatal survival.Objectives: To identify the causes and factors related to stillbirths in Dukku Local Government Area of Gombe state.Methodology: A prospective study that was both hospital and community based, in which parturients were recruited in their last trimester and followed up till delivery. The fetal outcome was recorded and still birth rate calculated.Results: Five hundred and two parturient mothers were recruited. They delivered a total of 520 babies, amongst whom were eighteen sets of twins; five hundred of these were live births. There were 20 still births, giving a stillbirth rate of 38.5/1000. Causes of stillbirth include unbooked and early pregnanacies as well as deliveries unattended to by trained health personnel.Conclusion: Lack of antenatal Care, home delivery and teenage pregnancy were important factors contributing to high still birth rate in Dukku LGA of Gombe State.Key Words: Stillbirth, Perinatal, Mortality

The Radio Light Curve of the Gamma-Ray Nova in V407 Cyg: Thermal Emission from the Ionized Symbiotic Envelope, Devoured from Within by the Nova Blast

We present multi-frequency radio observations of the 2010 nova event in the symbiotic binary V407 Cygni, obtained with the Karl G. Jansky Very Large Array and spanning 1-45 GHz and 17-770 days following discovery. This nova---the first ever detected in gamma rays---shows a radio light curve dominated by the wind of the Mira giant companion, rather than the nova ejecta themselves. The radio luminosity grew as the wind became increasingly ionized by the nova outburst, and faded as the wind was violently heated from within by the nova shock. This study marks the first time that this physical mechanism has been shown to dominate the radio light curve of an astrophysical transient. We do not observe a thermal signature from the nova ejecta or synchrotron emission from the shock, due to the fact that these components were hidden behind the absorbing screen of the Mira wind. We estimate a mass loss rate for the Mira wind of Mdot_w ~ 10^-6 M_sun/yr. We also present the only radio detection of V407 Cyg before the 2010 nova, gleaned from unpublished 1993 archival VLA data, which shows that the radio luminosity of the Mira wind varies by a factor of >~20 even in quiescence. Although V407 Cyg likely hosts a massive accreting white dwarf, making it a candidate progenitor system for a Type Ia supernova, the dense and radially continuous circumbinary material surrounding V407 Cyg is inconsistent with observational constraints on the environments of most Type Ia supernovae.Comment: Resubmitted to ApJ after incorporating referee's comment

Radio studies of novae: a current status report and highlights of new results

Novae, which are the sudden visual brightening triggered by runaway thermonuclear burning on the surface of an accreting white dwarf, are fairly common and bright events. Despite their astronomical significance as nearby laboratories for the study of nuclear burning and accretion phenomena, many aspects of these common stellar explosions are observationally not well-constrained and remain poorly understood. Radio observations, modeling and interpretation can potentially play a crucial role in addressing some of these puzzling issues. In this review on radio studies of novae, we focus on the possibility of testing and improving the nova models with radio observations, and present a current status report on the progress in both the observational front and theoretical developments. We specifically address the issues of accurate estimation of ejecta mass, multi-phase and complex ejection phenomena, and the effect of a dense environment around novae. With highlights of new observational results, we illustrate how radio observations can shed light on some of these long-standing puzzles.Comment: 19 pages, 4 figures. Review article published in the Bulletin of the Astronomical Society of India (BASI) special issue on nova

Impact of Socioeconomic Factors on Neonatal Sepsis in Jos, Nigeria

Background: Neonatal sepsis is very prevalent in sub-saharan Africa and contributes up to 69% to neonatal mortality in Nigeria and other parts of Africa. The objective of this study was to determine the impact of the predominant socio-economic factors that may contribute to neonatal sepsis in this environment.Methodology: The study was a cross-sectional study conducted in Jos University Teaching Hospital (JUTH), Jos, North Central, Nigeria. Clinical and demographic data were collected from mothers, care givers and case notes of 218 neonates enrolled into the study by means of a structured interviewer administered questionnaire. Data collected were analyzed by EPI Info statistical package. Biological samples were also collected from the neonates and processed by standard methods in the microbiology laboratory of JUTH.Results: Bacteria were isolated in 34.4% of the neonates studied. The most common isolates were Klebsiella pneumonia, Staphylococcus aureus and Escherichia coli. Delivery at home had the highest percentage of culture proven sepsis (52.2%). Mothers with no formal education and those with only primary education also had high proportions of culture proven sepsis (41.1% and 58.8% respectively). Place of domicile, level of education of mother and poor feeding were factors that contributed significantly to neonatal sepsis by odds ratio.Conclusion: The findings show that socioeconomic factors have a significant impact on neonatal sepsis. An improved standard of living, education and empowerment of women and increased provision of basic social amenities will go a long way in reducing the morbidity and mortality of neonatal sepsis in our environment

Comparing neonatal outcomes in women with preeclampsia and those with normal pregnancy

Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality. Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates. Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatalanthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight,  prematurity, birth asphyxia and need for admission. SPSS version 25 was used in all analysis. Significance testing was set at p=0.05. Results: The women with preeclampsia were significantly heavier at booking (BMI 29.0±6.9 Kg/ m2 vs 25.0±5.2. p=0.005), have higher mean booking systolic blood pressure (122.±22.6 mmHg vs 111.5±12.7mmHg, p=0.003) and diastolic blood pressure ( 7 9 . 8 ± 1 4 . 3mm Hgvs 68.8±9.0mmHg, p<0.001). Neonates of women with preeclampsia were significantly more premature ( meangestational age = 36 . 8 ± 3 . 2 week svs 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p<0.001). Overall, 22 (49.4%) of the neonates of women with preeclampsiahad significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome.  Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02) Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males Key words: infant outcome, preeclampsia, Nigeri

Microalbuminuria risks and glomerular filtration in children with sickle cell anaemia in Nigeria

Abstract Introduction Evidence of kidney damage is observed in children with sickle cell anaemia (SCA) and this continues through adulthood with progression to severe functional impairment in some. One of the earliest features of kidney damage associated with SCA is microalbuminuria. Our objective was to determine the risk factors of microalbuminuria in these children and its relationship with estimated glomerular filtration rate. Methods This was a cross-sectional and comparative study involving three hundred and twenty three children with SCA in steady state and equal numbers of apparently healthy age and sex matched haemoglobin AA (HbAA) control, aged 6 months to 18 years. They were consecutively recruited over a 6 month period. Result Microalbuminuria was present in 26% of the study subjects compared with 1.85% of control P = 0.001). Anaemia and high estimated glomerular filtration rate (eGFR) showed strong positive correlation with microalbuminuria (OR = 3.19, CI 0.953–1.116, p = 0.003 and OR = 1.7, CI 1.042–1.066, p = 0.001 respectively). Similarly, eGFR was higher in subjects with SCA than in controls and as well as in those with microalbuminuria compared with those who do not (p = < 0.01). Conclusions The two most important risk factors for microalbuminuria were anaemia and high eGFR. Age category was associated more with microalbuminuria than just age as a variable. Glomerular filtration rate was higher in children with microalbuminuria than those who do not and it was also higher in children with SCA than in control

Discovery and Validation of a New Class of Small Molecule Toll-Like Receptor 4 (TLR4) Inhibitors

Many inflammatory diseases may be linked to pathologically elevated signaling via the receptor for lipopolysaccharide (LPS), toll-like receptor 4 (TLR4). There has thus been great interest in the discovery of TLR4 inhibitors as potential anti-inflammatory agents. Recently, the structure of TLR4 bound to the inhibitor E5564 was solved, raising the possibility that novel TLR4 inhibitors that target the E5564-binding domain could be designed. We utilized a similarity search algorithm in conjunction with a limited screening approach of small molecule libraries to identify compounds that bind to the E5564 site and inhibit TLR4. Our lead compound, C34, is a 2-acetamidopyranoside (MW 389) with the formula C17H27NO9, which inhibited TLR4 in enterocytes and macrophages in vitro, and reduced systemic inflammation in mouse models of endotoxemia and necrotizing enterocolitis. Molecular docking of C34 to the hydrophobic internal pocket of the TLR4 co-receptor MD-2 demonstrated a tight fit, embedding the pyran ring deep inside the pocket. Strikingly, C34 inhibited LPS signaling ex-vivo in human ileum that was resected from infants with necrotizing enterocolitis. These findings identify C34 and the β-anomeric cyclohexyl analog C35 as novel leads for small molecule TLR4 inhibitors that have potential therapeutic benefit for TLR4-mediated inflammatory diseases. © 2013 Neal et al