Coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site in a HIV-AIDS patient: A very rare occurrence

Introduction: There have been numerous reported opportunistic infections among HIV/AIDS patients. However, coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site is a rare finding. Case presentation: A 37-year-old man poorly adherent to antiretroviral therapy presented with Molluscum contagiosum and Kaposi sarcoma occurring simultaneously on numerous skin lesions around mid-2017 at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria. Management and outcome: The patient was counselled and re-initiated on a second-line highly active antiretroviral therapy regimen. The patient’s lesions resolved three months later. Discussion: The case is presented to improve the index of suspicion among clinicians and pathologists on such rare occurrences

Challenges of Immunization Coverage among a Semi-Nomadic Population in Kano State, North West Nigeria

Nigeria has been reported to be off track in achieving the 4th Millennium Development Goal (Reducing Child Mortality) due to poor health indicators such a

Large Outbreak of Neisseria meningitidis Serogroup C - Nigeria, December 2016-June 2017.

On February 16, 2017, the Ministry of Health in Zamfara State, in northwestern Nigeria, notified the Nigeria Centre for Disease Control (NCDC) of an increased number of suspected cerebrospinal meningitis (meningitis) cases reported from four local government areas (LGAs). Meningitis cases were subsequently also reported from Katsina, Kebbi, Niger, and Sokoto states, all of which share borders with Zamfara State, and from Yobe State in northeastern Nigeria. On April 3, 2017, NCDC activated an Emergency Operations Center (EOC) to coordinate rapid development and implementation of a national meningitis emergency outbreak response plan. After the outbreak was reported, surveillance activities for meningitis cases were enhanced, including retrospective searches for previously unreported cases, implementation of intensified new case finding, and strengthened laboratory confirmation. A total of 14,518 suspected meningitis cases were reported for the period December 13, 2016-June 15, 2017. Among 1,339 cases with laboratory testing, 433 (32%) were positive for bacterial pathogens, including 358 (82.7%) confirmed cases of Neisseria meningitidis serogroup C. In response, approximately 2.1 million persons aged 2-29 years were vaccinated with meningococcal serogroup C-containing vaccines in Katsina, Sokoto, Yobe, and Zamfara states during April-May 2017. The outbreak was declared over on June 15, 2017, after high-quality surveillance yielded no evidence of outbreak-linked cases for 2 consecutive weeks. Routine high-quality surveillance, including a strong laboratory system to test specimens from persons with suspected meningitis, is critical to rapidly detect and confirm future outbreaks and inform decisions regarding response vaccination

Nutritional Composition and Phytochemical Analysis of Aqueous Extract of Allium cepa (Onion) and Allium sativum (Garlic)

Allium cepa (onion) and Allium sativum (Garlic) are commonly used as spice in food preparation and source of nutrient around the globe. Additionally, they are used in the treatment of several diseases associated with metabolism. In this study phytochemical constituent, proximate analysis, mineral and vitamin compositions of both Allium cepa and Allium sativum were analysed using standard analytical procedures and atomic absorption spectroscopy (AAS). Proximate analysis revealed a significant difference (P<0.05) in the moisture content, Ash content, crude fibre, protein, carbohydrate, and lipid contents in both extracts. However, these extracts showed no significant difference (P>0.05) in the minerals compositions i.e. manganese, copper, Iron and magnesium except calcium where the significant difference (P<0.05) was observed. A significant difference (P<0.05) was seen in antioxidant vitamins (A, C and E) in both extracts. In conclusion, the rich nutritional contents present in Allium cepa and Allium sativum might be the reason why these spices are used in the management and prevention of several nutritionally related diseases and disorders

Availability, accessibility and use of antivenom for snakebite envenomation in Africa with proposed strategies to overcome the limitations

Africa remains one of the regions with the highest incident and burden of snakebite. The goal of the World Health Organization to halve the global burden of snakebite by 2030 can only be achieved if sub-optimal access to antivenoms in the most affected regions is addressed. We identified upstream, midstream, and downstream factors along the antivenom value chain that prevent access to antivenoms in the African region. We identified windows of opportunities that could be utilized to ensure availability, accessibility, and affordability for snakebite endemic populations in Africa. These include implementation of multicomponent strategies such as intensified advocacy, community engagement, healthcare worker trainings, and leveraging the institutional and governance structure provided by African governments to address the challenges identified

Cost-effectiveness of Antivenoms for Snakebite Envenoming in Nigeria

<div><p>Background</p><p>Snakebite envenoming is a major public health problem throughout the rural tropics. Antivenom is effective in reducing mortality and remains the mainstay of therapy. This study aimed to determine the cost-effectiveness of using effective antivenoms for Snakebite envenoming in Nigeria.</p><p>Methodology</p><p>Economic analysis was conducted from a public healthcare system perspective. Estimates of model inputs were obtained from the literature. Incremental Cost Effectiveness Ratios (ICERs) were quantified as deaths and Disability-Adjusted-Life-Years (DALY) averted from antivenom therapy. A decision analytic model was developed and analyzed with the following model base-case parameter estimates: type of snakes causing bites, antivenom effectiveness to prevent death, untreated mortality, risk of Early Adverse Reactions (EAR), mortality risk from EAR, mean age at bite and remaining life expectancy, and disability risk (amputation). End-user costs applied included: costs of diagnosing and monitoring envenoming, antivenom drug cost, supportive care, shipping/freezing antivenom, transportation to-and-from hospital and feeding costs while on admission, management of antivenom EAR and free alternative snakebite care for ineffective antivenom.</p><p>Principal Findings</p><p>We calculated a cost/death averted of ($2330.16) and cost/DALY averted of$99.61 discounted and $56.88 undiscounted. Varying antivenom effectiveness through the 95$137.02 to $86.61 respectively. Similarly, varying the prevalence of envenoming caused by carpet viper from 0$254.18 to $78.25 respectively. More effective antivenoms and carpet viper envenoming rather than non-carpet viper envenoming were associated with lower cost/DALY averted.</p><p>Conclusions/Significance</p><p>Treatment of snakebite envenoming in Nigeria is cost-effective with a cost/death averted of$2330.16 and cost/DALY averted of $99.61 discounted, lower than the country's gross domestic product per capita of$1555 (2013). Expanding access to effective antivenoms to larger segments of the Nigerian population should be a considered a priority.</p></div

Thermosensitive Hydrogels Loaded with Resveratrol Nanoemulsion: Formulation Optimization by Central Composite Design and Evaluation in MCF-7 Human Breast Cancer Cell Lines

The second most common cause of mortality among women is breast cancer. A variety of natural compounds have been demonstrated to be beneficial in the management of various malignancies. Resveratrol is a promising anticancer polyphenolic compound found in grapes, berries, etc. Nevertheless, its low solubility, and hence its low bioavailability, restrict its therapeutic potential. Therefore, in our study, we developed a thermosensitive hydrogel formulation loaded with resveratrol nanoemulsion to enhance its bioavailability. Initially, resveratrol nanoemulsions were formulated and optimized utilizing a central composite-face-centered design. The independent variables for optimization were surfactant level, homogenization speed, and time, while the size and zeta potential were the dependent variables. The optimized nanoemulsion formulation was converted into a sensitive hydrogel using poloxamer 407. Rheological studies proved the formation of gel consistency at physiological temperature. Drug loading efficiency and in vitro drug release from gels were also analyzed. The drug release mechanisms from the gels were assessed using various mathematical models. The effect of the optimized thermosensitive resveratrol nanoemulsion hydrogel on the viability of human breast cancer cells was tested using MCF-7 cancer cell lines. The globule size of the selected formulation was 111.54 ± 4.16 nm, with a zeta potential of 40.96 ± 3.1 mV. Within 6 h, the in vitro release profile demonstrated a release rate of 80%. According to cell line studies, the produced hydrogel of resveratrol nanoemulsion was cytotoxic to breast cancer cells. Overall, the results proved the developed nanoemulsion-loaded thermosensitive hydrogel is a promising platform for the effective delivery of resveratrol for the management of breast cancer

Targeting Post-Translational Modifications of the p73 Protein: A Promising Therapeutic Strategy for Tumors

The tumor suppressor p73 is a member of the p53 family and is expressed as different isoforms with opposing properties. The TAp73 isoforms act as tumor suppressors and have pro-apoptotic effects, whereas the ΔNp73 isoforms lack the N-terminus transactivation domain and behave as oncogenes. The TAp73 protein has a high degree of similarity with both p53 function and structure, and it induces the regulation of various genes involved in the cell cycle and apoptosis. Unlike those of the p53 gene, the mutations in the p73 gene are very rare in tumors. Cancer cells have developed several mechanisms to inhibit the activity and/or expression of p73, from the hypermethylation of its promoter to the modulation of the ratio between its pro- and anti-apoptotic isoforms. The p73 protein is also decorated by a panel of post-translational modifications, including phosphorylation, acetylation, ubiquitin proteasomal pathway modifications, and small ubiquitin-related modifier (SUMO)ylation, that regulate its transcriptional activity, subcellular localization, and stability. These modifications orchestrate the multiple anti-proliferative and pro-apoptotic functions of TAp73, thereby offering multiple promising candidates for targeted anti-cancer therapies. In this review, we summarize the current knowledge of the different pathways implicated in the regulation of TAp73 at the post-translational level. This review also highlights the growing importance of targeting the post-translational modifications of TAp73 as a promising antitumor strategy, regardless of p53 status

Tornado diagram assessing the impact of changes in envenoming/antivenom and cost parameters on the incremental cost-effectiveness ratio (ICER) per DALY for antivenom use in Nigeria.

<p><b>Diagram Parameter Definitions</b>: c20WBCTest  =  cost of 20 minutes Whole Blood Clotting Test on 10 occassions over 7 days at diagnoses and monitoring; cAntivenom  =  Cost of Antivenom; cFeed_Transp  =  Cost of transporation and stay in Hospital for 7 days; cRefrg_Transp  =  Cost of shipping and refrigeration; cNoAntivenom  =  Cost of management without effective antivenoms either traditional/herbal care or other alternatives; cSupp_care  =  Cost of supportive care. All costs are in Nigerian Naira. antivenomeff  =  Effectiveness of antivenom to prevent death; pEARmono  =  probability of early adverse reactions with monospecific antivenom; pEARpoly  =  probability of early adverse reactionswith polyspecific antivenom; pEARmort  =  probability of dying following effective antivenom and early adverse reactions; pCVmort  =  probability of dying following carpet viper envenoming; pNCVmort  =  probability of dying following non-carpet viper envenoming; pCV  =  proportion of envenoming due to carpet viper; pDisabl =  probability of disability;</p

Targeting Post-Translational Modifications of the p73 Protein: A Promising Therapeutic Strategy for Tumors

The tumor suppressor p73 is a member of the p53 family and is expressed as different isoforms with opposing properties. The TAp73 isoforms act as tumor suppressors and have pro-apoptotic effects, whereas the ΔNp73 isoforms lack the N-terminus transactivation domain and behave as oncogenes. The TAp73 protein has a high degree of similarity with both p53 function and structure, and it induces the regulation of various genes involved in the cell cycle and apoptosis. Unlike those of the p53 gene, the mutations in the p73 gene are very rare in tumors. Cancer cells have developed several mechanisms to inhibit the activity and/or expression of p73, from the hypermethylation of its promoter to the modulation of the ratio between its pro- and anti-apoptotic isoforms. The p73 protein is also decorated by a panel of post-translational modifications, including phosphorylation, acetylation, ubiquitin proteasomal pathway modifications, and small ubiquitin-related modifier (SUMO)ylation, that regulate its transcriptional activity, subcellular localization, and stability. These modifications orchestrate the multiple anti-proliferative and pro-apoptotic functions of TAp73, thereby offering multiple promising candidates for targeted anti-cancer therapies. In this review, we summarize the current knowledge of the different pathways implicated in the regulation of TAp73 at the post-translational level. This review also highlights the growing importance of targeting the post-translational modifications of TAp73 as a promising antitumor strategy, regardless of p53 status