Unusual Brain Changes in Tetrasomy X Chromosomal Anomaly

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Gum Arabic a superb anti-diarrheal agent

Back ground: Diarrhoea is the second most common cause of death in young children, after pneumonia.Gum Arabic (GA) is a soluble fibre with moderate emulsifying properties that may result in greater accessibility of electrolytes and associated water to the microvillus membrane. Additional work indicated that GA enhanced absorption of the solutes transported by diffusion and does not act via sodium dependent mechanisms.Objective: The objective of this study was to evaluate the effect of Sweetfibre (gum Arabic preparation) as an additive to WHO-ORS in the management of acute diarrhoea in children.Methods: An interventional randomized controlled hospital based clinical trial was performed in OPEH (March to August 2011). One hundred and eighty children presenting with acute none bloody diarrhoea in the absence of severe systemic illnesses were enrolled in the study. These children were divided randomly into two equal groups (study group1 and control group2), their ages ranged between sixand 60 months. The control group received the conventional treatment of diarrhoea according to WHO recommendations and the other group received in addition gum Arabic solution (sweetfibre), 5-10 mg until recovery and continued with 5 mg thereafter. Data were analysed using the SPSS.Results: In the group of children who received gum Arabic; diarrhoea stopped within 24 hours in 90% and 80% were discharged after one day. All of them were improved and discharged within first five days of admission. None of them went into severe dehydration or shock. Only three children developed electrolyte imbalance. The weight at the end of the study increased in 47.8% and decreased in only 5.5%. Sixty one children were followed after 6 weeks only two of them (3.3%) had recurrence of diarrhoea. In the control group diarrhoea stopped within 24 hours in 38.9% and 30% were discharged after one day.10% did not recover during the first five days of admission. Electrolytes imbalance developed in 23.3%, two children developed severe dehydration and one became shocked. The weight decreased in 35.6% and increased in 15.6%. Sixty seven children were followed, 13 (19.4%) of them developed diarrhoea again.Conclusion: Sweetfibre as an additive to WHO-ORS reduces the duration of diarrhoea and hospital stay. It decreases diarrhoea complications and facilitates regaining weight. It has a prebiotic effect in prevention of diarrhoea. All these indicate its potential as a new antidiarrheal therapy for acute diarrhoea in children.Keywords: prebiotic, antidiarrheal, contamination, isonatraemic, isotonic dehydration

EFFECTS OF AESTIVATION DURATION ON REPRODUCTIVE TRACT DIMENSION AND SPERMATOZOA PRODUCTION OF GIANT AFRICAN LAND SNAIL (Archachatinamarginata) DURING DRY SEASON

Aestivation is a process of metabolic suspension which plays a key role in the survival of land snails during a period of drought. Human shave also used this process to transport the animal for commercial purpose. To examine the effect of this physiological process on reproductive apparatus, thirty (30) Giant African Land snail (Archachatinamarginata) with average weight of 130 -150g were used for this study. The snails were allotted to three different treatments with ten (10) replicate each after four weeks of acclimatization period which include: zero (0) week, three (3) weeks and six (6) weeks of aestivation. Parameters measured were: Internal organ weight, ovo-testis weight, reproductive tract length (cm) and weight (g). Also gonado-somatic index and spermatozoa concentration were also determined. Results showed that aestivation duration had significant influence on organ weight, ovo-testis weight, reproductive tract length and weight and spermatozoa concentration. However, gonado-somatic index (GSI) was not significantly influenced. It was observed that organ weight decreased as aestivation duration increased. For ovo-testis, snails with aestivation duration of six weeks had smaller weight compared to the control (0 week) while those at three weeks aestivation duration were not significantly different from the control group and those of six weeks aestivation duration. For reproductive tract weight, there was a significant(P<0.01)decrease in weight of the tract for both snails under three and six weeks aestivation duration compared to the control group (0 week). Spermatozoa count also decreased as aestivation duration increased. It can therefore be concluded that aestivation duration had significant effect on organ weight, ovo-testis weight, reproductive tract weight and spermatozoa concentration. For quick target of reproduction and snail economic value, it is recommended that aestivation duration should not be allowed to reach three weeks and above for whatever reason.     &nbsp

Comparative study of chicken egg yolk and quail egg yolk in two chilled canine semen extenders

The aim of this work was to substitute chicken egg yolk with quail egg yolk in two semen extenders and to evaluate the quality of the extended canine semen following chilled storage. Semen was pooled from male dogs (n= 4) of about 18-months old and body weight of about 28 kg. Four extenders were tested: (1) tris buffered chicken egg yolk extender (2) tris buffered quail egg yolk extender, (3) skimmed milk chicken egg yolk extender and (4) skimmed milk quail egg yolk extender. Semen was diluted with corresponding extender in the ratio 1:4. The diluted semen samples were analyzed for motility, mass activity, viability, abnormalities percentage and pH for three consecutive days. There was no significant difference (P>0.05) between chicken egg yolk and quail egg yolk in either tris diluent or skimmed milk extender with respect to pH, mass activity and sperm motility. Samples stored in both the tris and skimmed milk-based extenders with quail egg yolk displayed greater viability than those in chicken egg yolk but the difference was not significant (P>0.05). Viability, mass activity and sperm motility decreased as treatment days increased in both chicken and quail egg yolk extenders. Results showed that a pH of 6.5 was maintained from day 0 to day 3. There was no difference in semen quality between chicken and quail egg yolk in either the tris diluent or skimmed milk extender (P> 0.05). It was recommended that quail egg yolk could be substituted for chicken egg yolk in the two canine semen extenders. Further modifications of the diluents with quail egg yolk might produce an improved result. Keywords: Canine, Chicken Chilled, Egg yolk, Extenders, Quail, Seme

ANNONA MURICATA LINN. ETHANOLIC LEAF EXTRACT AMELIORATES REPRODUCTIVE COMPLICATIONS IN STREPTOZOTOCIN-INDUCED DIABETIC WISTAR RATS

Diabetes mellitus is an endocrine and metabolic disorder of humans and animals characterized by hyperglycemia and low blood insulin levels or insensitivity of target organs to insulin and it’s a major health problem affecting patient’s quality of life due to its many complications. Infertility is one of the major secondary complications in diabetes. Although numerous drugs have been used for intervention studies on diabetes-induced infertility worldwide, there are currently no treatments for diabetes associated infertility in humans. This study was performed to investigate the effects of Annona muricata ethanolic leaf extract (AMELE) on fertility of male diabetic rats and levels of blood glucose. Twenty male Wistar rats (150-200g) were randomly distributed into 4 groups (n=5) treated thus: CTRL (control), DNT, DT1 and DT2 (diabetic, single intraperitoneal injection, streptozotocin, 60 mg/kg). Group DT1 and DT2 received AMELE orally at 100 mg/kg and 200 mg/kg respectively daily for fourteen days. Data were analysed using ANOVA at α0.05. The animals were sacrificed after 2 weeks via thiopental injection and testicular weights were recorded. Fasting blood glucose was determined using a digital glucometer. Sperm count, motility, viability and morphology were assessed microscopically. Testes were histologically evaluated. The results showed that oral administration of AMELE at 100 mg/kg and 200 mg/kg to diabetic male rats for fourteen days significantly decreased blood glucose level and also ameliorated diabetes-induced decreases in sperm functions in streptozotocin-induced diabetic male rats.   &nbsp

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Evidence of Infection by H5N2 Highly Pathogenic Avian Influenza Viruses in Healthy Wild Waterfowl

The potential existence of a wild bird reservoir for highly pathogenic avian influenza (HPAI) has been recently questioned by the spread and the persisting circulation of H5N1 HPAI viruses, responsible for concurrent outbreaks in migratory and domestic birds over Asia, Europe, and Africa. During a large-scale surveillance programme over Eastern Europe, the Middle East, and Africa, we detected avian influenza viruses of H5N2 subtype with a highly pathogenic (HP) viral genotype in healthy birds of two wild waterfowl species sampled in Nigeria. We monitored the survival and regional movements of one of the infected birds through satellite telemetry, providing a rare evidence of a non-lethal natural infection by an HP viral genotype in wild birds. Phylogenetic analysis of the H5N2 viruses revealed close genetic relationships with H5 viruses of low pathogenicity circulating in Eurasian wild and domestic ducks. In addition, genetic analysis did not reveal known gallinaceous poultry adaptive mutations, suggesting that the emergence of HP strains could have taken place in either wild or domestic ducks or in non-gallinaceous species. The presence of coexisting but genetically distinguishable avian influenza viruses with an HP viral genotype in two cohabiting species of wild waterfowl, with evidence of non-lethal infection at least in one species and without evidence of prior extensive circulation of the virus in domestic poultry, suggest that some strains with a potential high pathogenicity for poultry could be maintained in a community of wild waterfowl

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe