Socio-demographic and clinical factors predicting time to presentation for children with pneumonia in Ilorin, Nigeria

Background: Pneumonia is a major contributor to morbidity and mortality in children, and the time to presentation is a recognized contributor towards disease severity and outcome.Objectives: The current study aimed to explore the influence of some socio-demographic and clinical factors in children with pneumonia on the time to presentation at a health facility in Ilorin, North Central Nigeria.Materials and method: A prospective cross-sectional study of 167 children with pneumonia was done. The duration of the various symptoms and first presentation to a health facility was obtained. Time to presentation was categorized as 0–2 days (early), 3–5 days (intermediate) and greater than five days (late). Multinomial logistic regression analysis was used to identify significant predictors of either early or intermediate presentation compared with late presentation. A p-value of less than 0.05 was considered significant.Results: Fifty-one (30.5%) children with pneumonia had an early presentation, 73 (43.7%) had intermediate presentation and 43 (25.7%) were late in presentation. Predictors of early presentation were younger age (OR 0.96, 95%CI 0.93–0.99), higher respiratory rates (OR 1.03, 95%CI 1.01–1.06) and bronchopneumonia (OR 6.93, 95%CI 1.52–31.63). Predictors of intermediate presentation were families with few number of children (OR 0.73, 95%CI 0.57–0.92) and bronchopneumonia (OR 3.41, 95%C.I. 1.02–11.38).Conclusion: Infancy and families with few children are socio-demographic features that are likely to determine early-to-intermediate presentation of children with pneumonia while high respiratory rates and bronchopneumonia are disease related factors that predict early presentation.Keywords: Socio-demographic, Children, Pneumonia, Time to presentation, Nigeri

Incidence of Fungal flora and Aflatoxin content of millet and maize cereal grains sold in Guinea savanna zones of Kebbi State

Cereal grains get contaminated with fungi and aflatoxin due to poor agricultural, displayed in market and storage practices. A total of three local governments in Guinea savanna zone of Kebbi State were selected for samples collection namely; Zuru, Yauri and Danko/Wasgu. Five heads of millet and five heads of maize were collected in each site, marked total of Thirty (30) head of both millet and maize in all. Fungi were isolated on Potato Dextrose Agar (PDA) using Agar plate method. Eight (8) fugal species were isolated and identified as Aspergillus flavus, Aspergillus fumigates, Fusarium spp., Aspergillus niger, Rhizopus stolonifer, Mucor hiemalis, Eurotium harvarium and Penicillium spp. The highest incidence of fungi were obtained in Aspergillus flavus with (30.9%) and lowest were obtained in Eurotium harvarium (4.4%). Enzyme-linked immunosorbent Assay (ELISA) were used for the determination of Aflatoxin. From the results obtained Zuru had the highest level of aflatoxin 58.00±3.65a μg/kg in millet while Danko/Wsagu with less 12.72±2.99bμg/kg in maize. Implication of this findings showed that both millet and maize had aflatoxin levels above maximum acceptable limit of 10μg/kg set EU and NAFDAC. Therefore, adequate and rapid drying of grains to water content level may be employed as this could reduce the growth of aflatoxingenic fungi to the minimum possible level

SERUM IMMUNOGLOBULIN PROFILE OF Trypanosoma congolense - INFECTED SHEEP IN RELATION TO PARASITAEMIA AND CHANGES IN CIRCULATING LEUCOCYTE AND ERYTHROCYTE MASS

Trypanosomiasis is a major problem in developing countries most especially Africa and the incriminating agents are T. congolense, T.vivax. T.brucei in small ruminants. It has high morbity  and mortality Rates of 70% and 20% respectively . The experimental animals were four Rams which were used as control and infected group, Parameters for this experiment were recorded before infection. Following inoculation with T.congolense, 2 mls of blood was collected from the sheep in vacutainers for serum biochemical assay. Enzyme linked immunosorbent assay was used to assay IGG and IGM concentrations and 1ml of blood was collected in vacutainers with anti coagulant to check leucocytic and erythrocytic index.This was done every day until day 6 and then every other day. Clinical signs observed post infection were , Anemia, Hematuria ,Rhinitis, dyspnea ,emaciation and paralysis of the fore and hind limbs and death .Statistical tables and charts were used for analyses. The  role of   Hypoprotenemia , IGG and IGM  in experimental infection with Trypanosoma congolense   were looked at. The anemia was Normocytic normochromic and later became Microcytic hypochromic, PCV Recorded on the first day prior to infection was 27%  and on the last day of  infection became 6% . Leucocytosis was Degenerative and Leucopenia was also observed Perhaps due to the antigenic nature of the parasite. On first day WBC count was 8.5 x109/L and Prior to death Leucocytosis of 6.1x 109 /L. Hypoproteneimia was also seen with Blood urea Nitrogen and Alanine aminotransferase falling to values below normal 55U/L and 155mg/dl respectively. There were also fluctuations in the values of IGG and IGM  with initial values of 1.4 and 0.71 µg/ML  and terminal values of 0.34 and 0.21 /L. The organs looked at Kidneys,Lungs,Heart and Liver were all in their initial stages of destruction , they were inflamed,edematous , congested and necrotic . Hypoprotenemia, , immune suppression,dyspnea ,Anemia and Leucopenia  may be the cause of death in Trypanosomiasis. Keywords:Leucopenea,Anemia,Trypanosoma,immunogobuins,Hypoprotenemia DOI: 10.7176/JBAH/11-6-06 Publication date:March 31st 202

Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria

Analgesic and Anti-Inflammatory activities of Rothmannia Longiflora Salisb In Mice And Rats

Abstract: In this study, the analgesic and anti-inflammatory activities of the methanolic leaf extract of Rothmannialongiflora were investigated. The methanolic leaf extract of the plant at the doses of 250, 500, and 1000mg/kg orally was evaluated for analgesic activity using acetic acid-induced writhing test, hot plate test and formalin test. The anti-inflammatory potential of the extract was evaluated using carrageenan-induced paw oedema test in rats. The methanolic leaf extract exhibited significant dose dependent analgesic and antiinflammatory effects comparable to piroxicam (20mg/kg body weight orally), which is a standard analgesic and anti-inflammatory drug. The preliminary phytochemical screening of the methanolic leaf extract of Rothmannialongiflora revealed the presence of flavonoids, tannins, saponins, glycosides, steroids/terpanoids, and carbohydrates. The oral median lethal dose (LD 50 ) of the extract in mice and rats were found to be greater than 5000mg/kg, suggesting that the methanolic leaf extract of Rothmannialongiflora is non-toxic. The present findings suggest that the methanolic leaf extract of the plant possesses analgesic and anti-inflammatory activities, and supports the ethno medical claims of the use of the plant in the management of pain and inflammatory conditions

High frequency of tumor cells with nuclear Egr-1 protein expression in human bladder cancer is associated with disease progression

<p>Abstract</p> <p>Background</p> <p>Egr-1 (early growth response-1 transcription factor) has been proposed to be involved in invasion and metastasis processes of human bladder cancer, but Egr-1 protein expression levels in human bladder cancer have not been investigated. In the present study we investigated the expression levels of Egr-1 protein in early stages of human bladder cancer and correlated it to later progression.</p> <p>Methods</p> <p>Expression of Egr-1 protein in human bladder cancer was examined by immunohistochemistry, on a tissue microarray constructed from tumors from 289 patients with non-muscle invasive urothelial bladder cancer.</p> <p>Results</p> <p>The frequency of tumor cells with nuclear Egr-1 immunolabelling correlated to bladder cancer stage, grade and to later progression to muscle-invasive bladder cancer (T2-4). Stage T1 tumors exhibited significantly higher frequencies of tumor cells with nuclear Egr-1 immunolabelling than Ta tumors (P = 0.001). Furthermore, Kaplan-Meier survival analysis showed that a high frequency of tumor cells with nuclear Egr-1 immunolabelling was significantly associated with a higher risk of progression to stage T2-4 (log-rank test, P = 0.035). Tumor cells with nuclear Egr-1 immunolabelling were found to localize at the tumor front in some of the tumor biopsies.</p> <p>Conclusion</p> <p>The results from this study support a potential involvement of Egr-1 in the progression from non-muscle invasive bladder cancers to muscle invasive bladder cancer.</p

Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine.

BACKGROUND: Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). METHODS: From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. RESULTS: A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. CONCLUSIONS: Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the country

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe