Molecular detection of mobilized colistin resistance (mcr-1) gene in Escherichia coli isolates from Port Harcourt, Nigeria

The emergence of plasmid borne colistin resistance in recent years has been problematic as a result of the potential for rapid dissemination through bacterial populations. This mcr-1 mediated resistance has been reported from around the globe and active surveillance is essential to monitor the developing issue. This study set out to determine the occurrence of such strains in a group of 60 Escherichia coli isolates using DNA extraction and amplification techniques. Following molecular confirmation of the identities of the E. coli isolates based on the detection of E. coli specific 16sRNA gene fragments, phenotypic colistin resistance of isolates was determined and isolates were screened for the mcr-1 gene using standard procedures. Of the 35 confirmed E. coli isolates, 60% were found to be colistin resistant, with a higher level of resistance noted among the non-clinical isolates. Plasmid mediated mcr-1 resistance was however found to be present in only 8.6% of total isolates, making up 14.3% of the colistin resistant strains. This mcr-1 mediated resistance was only noted in clinical isolates however. This detection of mcr-1 mediated colistin resistance in E. coli isolates from Port Harcourt, Nigeria is worrisome as it could point at a looming epidemic of colistin resistance and hence the development of untreatable bacterial isolates. Further studies are essential to properly assess the scope and spread of this situation.Keywords: Colistin resistance, mcr-1, Escherichia coli, Nigeri

Comparison of the Therapeutic Efficacy of Double-Modality Therapy, Phonophoresis and Cryotherapy in the Management of Musculoskeletal Injuries in Adult Nigerian Subjects

Summary: This study was designed to compare the efficacy of double-modality therapy, phonophoresis and cryotherapy in the management of pain among subjects who suffered from musculoskeletal injuries   (MSIs).Sixty (60) subjects were assigned randomly to one of three groups: DMT group (n=20) received cryotherapy and 15% methyl salicylate  phonophoresis, PHONO group (n=20) received 15% methyl salicylate phonophoresis and CRYO group (n=20) received cryotherapy and „sham. phonophoresis. Ultrasound at an intensity of 1.5 W/cm² and frequency of 1MHz was used to apply methyl salicylate while intermittent cryotherapy was the mode of application. Subjects. pre- and post-treatment pain perception scores (PPS) using visual analogue scale (VAS) were assessed and the sessions of treatment in all groups were recorded. Treatment was  administered on alternate days and discharges were made in all groups when subjects were pain free. A total of 275 treatment sessions was recorded – 72 (26.2%) in DMT, 105 (38.2%) in PHONO and 98 (35.6%) in CRYO group respectively which indicated no significant difference (P>0.05). Nineteen (19), thirteen (13) and twelve (12) subjects were pain free in DMT, CRYO or PHONO groups respectively after 1 to 5 treatments. The difference in the severity of pain was significant (P<0.05) in each group post-treatment which suggests that DMT, phonophoresis and cryotherapy were equally effective. The study has demonstrated therapeutic efficacy of DMT, but it was not superior to the single treatment protocol of phonophoresis or cryotherapy. However, it might take fewer sessions in the DMT group to treat and make more than 90% of the subjects pain free and fit to return to active performance.Keywords: Cryotherapy, Double-modality therapy, Musculoskeletal injury, Phonophoresis, Ultrasoun

Thyroid hormone: a “prime suspect” in human immuno deficiency virus (hiv/aids) patients?

Acquired Immunodeficiency Syndrome (AIDS) is the final and most serious stage of the disease caused by human immunodeficiency virus. The Immune system is the target of AIDS. We investigate presentlyany possible involvement of thyroid hormone, the deficiency of which gives rise to oedema and susceptibility to nonspecific infections; with a view to finding the primary factor seeding the disease. It has been reported that circumcision reduced the incidence of HIV/AIDS infection. Beyond circumcision however there might be someconstitutional factor that comprises HIV infection to clinical AIDS. It is against this background that our research team turned to possible dyshormonopoisis and to thyroid hormone as a prime suspect among other possible factors that cause clinical AIDS. Moreover the hormone has been reported to be crucial for optimum immune function. A population of 200 seropositive AIDS patients were investigated against a control of 50 subjects made up of 25 healthy circumcised males and 25 healthy females; all of who were seronegative for the disease. The parameters investigated include thyrotropin (TSH), Thyroxine (T4), Total protein (TP), Albumin (Alb), Globulin (Glob), Immune complex (IC3) and Bence Jones proteins (BJP) levels in serum or urine. All seropositive clinically HIV/AIDS patients were hypothyroid. Seronegatives had significantly higher T4, TP, and Alb levels at

Characterizing the metabolic phenotype of intestinal villus blunting in Zambian children with severe acute malnutrition and persistent diarrhea

Background: Environmental enteric dysfunction (EED) is widespread throughout the tropics and in children is associated with stunting and other adverse health outcomes. One of the hallmarks of EED is villus damage. In children with severe acute malnutrition (SAM) the severity of enteropathy is greater and short term mortality is high, but the metabolic consequences of enteropathy are unknown. Here, we characterize the urinary metabolic alterations associated with villus health, classic enteropathy biomarkers and anthropometric measurements in severely malnourished children in Zambia. Methods/Principal findings: We analysed 20 hospitalised children with acute malnutrition aged 6 to 23 months in Zambia. Small intestinal biopsies were assessed histologically (n = 15), anthropometric and gut function measurements were collected and the metabolic phenotypes were characterized by 1H nuclear magnetic resonance (NMR) spectroscopy. Endoscopy could not be performed on community controls children. Growth parameters were inversely correlated with enteropathy biomarkers (p = 0.011) and parameters of villus health were inversely correlated with translocation and permeability biomarkers (p = 0.000 and p = 0.015). Shorter villus height was associated with reduced abundance of metabolites related to gut microbial metabolism, energy and muscle metabolism (p = 0.034). Villus blunting was also related to increased sucrose excretion (p = 0.013). Conclusions/Significance: Intestinal villus blunting is associated with several metabolic perturbations in hospitalized children with severe undernutrition. Such alterations include altered muscle metabolism, reinforcing the link between EED and growth faltering, and a disruption in the biochemical exchange between the gut microbiota and host. These findings extend our understanding on the downstream consequences of villus blunting and provide novel non-invasive biomarkers of enteropathy dysfunction. The major limitations of this study are the lack of comparative control group and gut microbiota characterization

Effect of aqueous extract of alligator pepper (Zingiberaceae Aframomum melegueta) on gestational weight gain

Increased gestational weight gain is associated with higher rates of complications of pregnancy and delivery. Gestational weight gain of 9-12 Kg has been associated with the best outcome for both mothers and infants. However, weight gain in most pregnant women is not within this range, perhaps due to the difficulty of calculating the exact quantity, timing and duration of dietary restriction in individual patients that would bring their weight gain within the normal range. There is therefore a need to develop a drug or food supplement that would reduce weight gain without causing adverse effects on the fetus. Aframomum melegueta is widely used in Nigeria by most people including pregnant women for various purposes. It is against this background that the present investigation examines the possibility of its beneficial effects on pregnancy, using Sprague Dawley rat as the animal model. Twenty female and ten male Sprague-Dawley rats of proven fertility from a pilot study were randomly mated in groups of two females and one male. Three days later, female rats in the experimental groups were given intra-peritoneal injections of 0.5 mg, 1 mg, 1.5 mg and 2 mg of aqueous extract of alligator pepper respectively while the control had 2 ml of distilled water.. All rats were observed for 18-25 days. There was a significant (

Effects of combined oral contraceptive (Duofem) on some physiological parameters in female Wistar rats

Background: Numerous studies have reported a relationship between oral contraceptives use and cardiovascular disease, altered levels of coagulation factors and thrombosis. The goal of this study was to examine the effect of Combined oral contraceptive (COC, Duofem) on some physiological parameters and elucidate possible mechanism of action in female wistar rats.Methods: Forty (40) female wistar rats aged 10-12 weeks weighing 180-250 g were used for the study. They were divided into four groups (A-D) of 10 rats each comprising 5 treated and 5 control rats. The treated rats received (by intragastric administration), 0.6mg/kg body weight of COC for 36, 48, 60 and 72 days in five-day cycles (four-days treatment with one-day break). The COC was given in 5-day cycles (4-day treatment with 1-day break). An autoanalyzer was used to perform a complete blood count (CBC or FBC). Enzyme-linked immunosorbent assay (ELISA) was used for the quantitative determination of Protein C and S Antigen in citrated rat plasma. Antithrombin (AT) was determined by Chromogenic Assays. Prothrombin time (PT), Activated partial thromboplastin time (APTT) were performed using Sysmex CA-6000 Coagulation Analyzer. Serum electrolytes were determined using Audicom AC99000 and liver function tests by ELISA method. Erythropoietin was determined using rat EPO ELISA kit. Fibrinogen was estimated by Clauss Assay.Results: There were significant decreases in haemoglobin (Hb), packed cell volume (PCV), Red blood cell (RBC) count, white blood cell (WBC) counts, lymphocytes (L), prothrombin time (PT) concentration, fibrinogen (Fib) concentration, antithrombin (AT) concentration , protein C (PC), protein S (PS), interleukin-6 (IL-6) and interleukin-11 (IL-11) in all treated groups compared to controls (P< 0.05, respectively); in contrast, activities of alkaline phosphate (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) as well as sodium and potassium were increased. There were no significant changes in APTT, mean platelet volume (MPV), EPO concentration, MCH, MCV, MCHC, Neutrophil, Eosinophil, Basophil, Bicarbonate and Chloride in all treated groups compared to controls. Most of the changes in the Physiological parameters were observed in long term exposure group C and group D.Conclusion: Long term used of combined oral contraceptives may lead to more complications than short time use. COC users should be monitored for some physiological parameters.Keywords: Combined Oral Contraceptives, Physiological Parameters, Wistar rat

Infrequent small bowel intestinal bacterial overgrowth in malnourished Zambian children.

There is evidence that children with malnutrition have an increased frequency of small intestinal bacterial overgrowth (SIBO) due to impaired gastric acidity, impaired intestinal motility, and dysbiosis. Children with malnutrition respond to antibiotic therapy but it is not clear if this effect is mediated by treatment of SIBO. We set out to determine the frequency of SIBO in children of varying nutritional status in a poor community in Lusaka, Zambia. Hydrogen breath testing, following a dose of 1g/kg oral glucose, was used to determine the presence of SIBO amongst the study participants. Forty nine children, 45 of whom had varying degrees of malnutrition, completed a full series of observations at 15, 30 and 60 minutes. Four children (8%) had a rise of 10ppm from baseline, consistent with SIBO. No correlation with nutritional status was observed. In this small study of Zambian children, SIBO was infrequent and unrelated to nutritional status

The Influence of Thyroid Hormones on Gamma Immunoglobulin Density (Ig-Gp) and Apgar Score

Observations over the years, particularly in the labour rooms of Jos University Teaching Hospital (JUTH), and TANDAM Medical Centre, Jos, Plateau, Nigeria, indicates that several neonates respond differently to these parameters. However, the experience of four mothers who had protracted labour and neonates with weak cry and low muscle tone, prompted this present investigation. Ex-vivo placenta, maternal and cord blood of twenty deliveries (10 primipara and ten multipara; five of which were by elective caesarean section) were assayed for thyroid hormone in maternal serum and IgGp in maternal and cord sera; while the APGAR scores of the neonates were as well, documented. Results showed that the mean immunoglobulin G population (IgGp) or density of neonates compared with that of their euthyriod mothers though higher in neonates was not statistically significant (P> 0.05). It was however significant (p < 0.01) between neonates and their hypothyroid mothers. APGAR score of the neonates of the euthyroid mothers were higher (p < 0.05) than those hypothyroid mothers who also bled for longer periods postpartum. It is our opinion that there could perhaps be an insight into the cause of such agonizing deliveries and to that effect, we recommended possible interventions.Keywords: Euthyroidism, hypothyroidism, APGAR score, Gamma Immunoglobulin (IgG