Acute Toxicity Study and Hepatocurative Effect of Aqueous Stem Bark Extract of Parkia Biglobosa in Wister albino Rats

Parkia biglobosa plant is widely is used in folk medicinal practices to treat and/or manage various diseases including diabetes, malaria, diarrhea and pains. The current research seek to establish the toxicity profile and hepatocurative ability of aqueous stem bark extract of the plant. Twelve (12) rats were used for Oral LD50 determination, and were grouped into four (4) groups of three rats (3) each. The first three groups were administered with 10 mg/kg, 100 mg/kg and 1000 mg/kg body weight of the extract respectively, while the last group was subdivided into three groups of one rat each and were administered with 2500mg/kg, 3500mg/kg and 5000mg/kg body weight of the extract respectively. For the hepatocurative studies, twenty five (25) experimental rats were divided into five groups of five (5) rats each. Group I served as normal rats, Group II served as test Control while Groups III to V were induced with liver damage and administered with 50mg/kg, 100mg/kg and 150mg/kg of the extract respectively. The LD50 was found to be greater than 5000mg/kg, while phytochemical screening revealed the presence of Flavanoids, Glycosides, Tanins, Saponins, Steroids and Phenols, with the absence of Anthraquinones. For the hepatocurative study, a significant (p<0.0.5) increase in serum albumin and liver enzymes (AST, ALT and ALP) was observed in test control compared to normal control. Upon administration of the extract, a significant (p<0.0.5) fall in Albumin, AST, ALT and ALP was recorded in a dose dependent pattern. No significant difference (p>0.05) was observed between groups in total protein, direct and total bilirubin. The research concludes that the extract is practically non-toxic and possess strong hepatocurative ability which might be due to the phytochemicals present. Keywords: Acute toxiicity; CCl4; Liver; P. biglobosa; Phytochemical and wistar rats. DOI: 10.7176/JNSR/13-16-04 Publication date:September 30th 202

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.

OBJECTIVES: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. DESIGN: Descriptive case study. SETTING: Neonatal intensive care units in Nigeria. PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Comparative Study of the Inhibitive properties of Ethanolic Extract of Gmelina arboreaon Corrosion of Aluminium in Different Media

Inhibition of aluminium corrosion in NaOH and HCl solutions in the absence and presence of Gmelina arborea extract was studied using thermometric method of analysis. Gmelina arborea extract acts as a better inhibitor in the acidic environment than in alkaline environment. The inhibition efficiency increased with increase in inhibitor concentration but decreased with increase in HClor NaOH corrodent concentration. The inhibiting effect of the Gmelina arborea extract could be attributed to the presence of some phytochemical constituents in the extract which may be adsorbed on the surface of the aluminium. Quantitative structure activity relationship (QSAR) of the four isolates obtained from the bulk Gmelina arborea extract proves the inhibition efficacy of the compounds through the process of back donation. Adsorption and/or binding energy data calculated from molecular dynamic simulations shows all the compounds to obey the mechanism of physical mechanism. Fukui indices showed oxygen atoms present in the phytochemical substituents as the active sites for nucleophilic and electrophilic attacks. Quantum chemical parameters and molecular dynamic simulations confirmed the spontaneity and adsorption stability of the molecules on aluminium surface respectively

Hepatocurative Effect of Oral Administration of Aqueous Leaf Extract 0f Senna Occidentalis in CCL4 Induced Hepatotoxic Rats

Awareness on the utilization of medicinal plants to curtail diseases is on the increase. This study is to evaluate the phytochemical contents and effect of aqueous leaf extract of Senna occidentalis on liver function indices in CCl4 induced hepatotoxic rats. A total of 32 male albino rats were used for this study. They were divided into six groups of 5 rats each. Group II-VI were induced with CCl4 at the dose of 150mg/kg for hepatotoxicity. Aqueous extract of Senna occidentalis orally administered to animals in groups III, IV and V at doses of 500mg/kg, 250mg/kg and 166mg/kg for four weeks respectively. Animals in group I were used as normal control, while those in group II were CCl4 induced hepatotoxic control. Group VI were orally administered with livolin at a dose of 100mg/kg for four weeks. At the end of fourth week, the animals were sacrificed and their serum activities of aspartate amino transferase (AST), alkaline phosphatase (ALP) and alanine amino transferase (ALT) as well as serum levels of total bilirubin, direct bilirubin, total protein (TP) and Albumin (Alb) were determined. Results of phytochemical screening revealed the presence of tannins, saponins, cardiac glycosides, resins and flavonoids. The results showed significant (p&lt;0.05) increase in mean serum activities of AST, ALP, and ALT, serum total bilirubin and direct bilirubin levels, and decrease in mean serum TP and albumin levels in the group II when compared with group I. Results of the effect of oral administration of aqueous leaf extract of Senna occidentalis at the doses of 500mg/kg, 250mg/kg and 166mg/kg for four weeks showed a significant (p&lt;0.05) decrease in the serum AST, ALP, ALT, total bilirubin, direct bilirubin, and significant increase (p&lt;0.05) in TP and albumin when compared with group II. Thus, it could be suggested that, equeous leaf extract of Senna occidentalis could have a hepatocurative effect against CCl4 toxicity

Characteristics, predictors and prospects of lung function among male cigarette smokers in Sokoto Metropolis, North-West Nigeria

Background: Cigarette smoking is a major risk factor for airflow limitation in addition to its other multi-systemic deleterious effects. Peak expiratory flow (PEF) measurement offers an opportunity to assess ventilatory function abnormalities in cigarette smokers.Objective: The objective of this study is to determine ventilatory function using peak expiratory flow rate among adult male cigarette smokers in comparison with matched predicted value.Methodology: This is a cross-sectional study among 150 current cigarette smokers aged 18-60years that were consecutively sampled in Sokoto metropolis. Peak expiratory flow was measured using Mini Wright’s Peak Flow Meter and adapted questionnaire was used to record all measurements and relevant data. Comparison was made between the measured and predicted peak expiratory flow rate.Result: A total of 150 male subjects who were predominantly below the age of 40years (76%) with mean age of 34.27±8.91years participated in this study. The mean pack-years and cigarette smoking index were 8.71±8.92 and 163.98±192.62, respectively. While the mean age of cigarette smoking commencement was 16.90±4.17years (9-36years).The mean measured PEF was 405.63±76.5 with the age group mean consistently decreasing with advancing age. Similarly, the difference between measured PEF and predicted PEF was significant and the magnitude of difference increased with advancing age. There was a negative correlation between PEF and pack-years smoked.Conclusion: Cigarette smoking is associated with decline in ventilatory function. The intensity of cigarette smoking and advancing age were the main predictors that determine the airflow status among cigarette smokers.Keywords: Determinants, pack-years, tobacco use, ventilatory functio

Vertical transmission of SARS-CoV-2: a systematic review of systematic reviews

The COVID-19 pandemic has hugely impacted global public health and economy. The COVID-19 has also shown potential impacts on maternal perinatal and neonatal outcomes. This systematic review aimed to summarize the evidence from existing systematic reviews about the effects of SARS-CoV-2 infections on maternal perinatal and neonatal outcomes. We searched PubMed, MEDLINE, Embase, and Web of Science in accordance with PRISMA guidelines, from 1 December 2019 to 7 July 2021, for published review studies that included case reports, primary studies, clinical practice guidelines, overviews, case-control studies, and observational studies. Systematic reviews that reported the plausibility of mother-to-child transmission of COVID-19 (also known as vertical transmission), maternal perinatal and neonatal outcomes, and review studies that addressed the effect of SARS-CoV-2 infection during pregnancy were also included. We identified 947 citations, of which 69 studies were included for further analysis. Most (>70%) of the mother-to-child infection was likely due to environmental exposure, although a significant proportion (about 20%) was attributable to potential vertical transmission of SARS-CoV-2. Further results of the review indicated that the mode of delivery of pregnant women infected with SARS-CoV-2 could not increase or decrease the risk of infection for the newborns (outcomes), thereby emphasizing the significance of breastfeeding. The issue of maternal perinatal and neonatal outcomes with SARS-CoV-2 infection continues to worsen during the ongoing COVID-19 pandemic, increasing maternal and neonatal mortality, stillbirth, ruptured ectopic pregnancies, and maternal depression. Based on this study, we observed increasing rates of cesarean delivery from mothers with SARS-CoV-2 infection. We also found that SARS-CoV-2 could be potentially transmitted vertically during the gestation period. However, more data are needed to further investigate and follow-up, especially with reports of newborns infected with SARS-CoV-2, in order to examine a possible long-term adverse effect