In Vivo Comparative Evaluation of Effects of Artemeter-Lumefantrine, Sulphadoxine-Pyrimetamine and Halofantrine on G6PD Activities, Haemoglobin Concentration and Malaria Parasite Clearance Rate in Malaria Infected Adults

Background: The use of antimalaria combination therapy especially regimens containing an artemisin-based compound has been recommended as a good first-line treatment for malaria by WHO. However, limited reports exist on the effects of the ACT and other antimalarial drugs on some vital biological parameters such as G6PD activity and haemoglobin concentration. In this study, we investigated the effects of Artemeter-Lumefantrine, sulphadoxine-pyrimetamine combination therapies and Halofantrine monotherapy on G6PD activity, Haemoglobin level and parasite clearance rate in malaria-infected adults treated with the drugs in Enugu, Nigeria. Methodology: Forty malaria-infected adults aged between 20 and 30 years were used. The subjects were divided into four groups (A, B, C and D). The groups A, B and C were given Artemeter-Lumefantrine, sulphadoxine-pyrimetamine and halofantrine respectively, while group D was a control group (malaria-positive control). Blood samples of the subjects were collected through venepuncture at baseline (Day 0) and after treatment on Day 4, for comparative analysis of G6PD activity, haemoglobin concentration and parasite clearance for each group. Results: The result of this study showed that sulphadoxine-pyrimetamine significantly (p<0.05) lowered haemoglobin concentration as compared with Halofantrine, Artemeter-lumefantrine and control. The haemoglobin concentration of the last three groups did not show any significant difference (p>0.05) between each other. The G6PD activity of the group treated with sulphadoxine-pyrimetamine was significantly (p<0.05) higher as compared with that treated with Artemeter-lumefantrine but non-significant (p>0.05) as compared with halofantrine and control. Parasite clearance rate was significantly (p<0.05) highest with the Halofantrine group (76%, p< 0.05) while Sulphadoxine-pyrimetamine had the lowest (52%) parasite clearance. Conclusion: This study therefore indicated that antimalaria drugs as well as malaria parasite could cause a reduction in haemoglobin concentration with sulphadoxine-pyrimetamine causing significant (p<0.05) increase in G-6-PD activity. Keywords: Antimalarials, Artemether-Lumefantrine, G6PD, sulphadoxine-pyrimetamine, Parasite clearance, Halofantrine, Haemoglobin concentratio

Autoimmune and autoinflammatory mechanisms in uveitis

The eye, as currently viewed, is neither immunologically ignorant nor sequestered from the systemic environment. The eye utilises distinct immunoregulatory mechanisms to preserve tissue and cellular function in the face of immune-mediated insult; clinically, inflammation following such an insult is termed uveitis. The intra-ocular inflammation in uveitis may be clinically obvious as a result of infection (e.g. toxoplasma, herpes), but in the main infection, if any, remains covert. We now recognise that healthy tissues including the retina have regulatory mechanisms imparted by control of myeloid cells through receptors (e.g. CD200R) and soluble inhibitory factors (e.g. alpha-MSH), regulation of the blood retinal barrier, and active immune surveillance. Once homoeostasis has been disrupted and inflammation ensues, the mechanisms to regulate inflammation, including T cell apoptosis, generation of Treg cells, and myeloid cell suppression in situ, are less successful. Why inflammation becomes persistent remains unknown, but extrapolating from animal models, possibilities include differential trafficking of T cells from the retina, residency of CD8(+) T cells, and alterations of myeloid cell phenotype and function. Translating lessons learned from animal models to humans has been helped by system biology approaches and informatics, which suggest that diseased animals and people share similar changes in T cell phenotypes and monocyte function to date. Together the data infer a possible cryptic infectious drive in uveitis that unlocks and drives persistent autoimmune responses, or promotes further innate immune responses. Thus there may be many mechanisms in common with those observed in autoinflammatory disorders

Inhibiting ex-vivo Th17 responses in Ankylosing Spondylitis by targeting Janus kinases

Treatment options for Ankylosing Spondylitis (AS) are still limited. The T helper cell 17 (Th17) pathway has emerged as a major driver of disease pathogenesis and a good treatment target. Janus kinases (JAK) are key transducers of cytokine signals in Th17 cells and therefore promising targets for the treatment of AS. Here we investigate the therapeutic potential of four different JAK inhibitors on cells derived from AS patients and healthy controls, cultured in-vitro under Th17-promoting conditions. Levels of IL-17A, IL-17F, IL-22, GM-CSF and IFN gamma were assessed by ELISA and inhibitory effects were investigated with Phosphoflow. JAK1/2/3 and TYK2 were silenced in CD4+ T cells with siRNA and effects analyzed by ELISA (IL-17A, IL-17F and IL-22), Western Blot, qPCR and Phosphoflow. In-vitro inhibition of CD4+ T lymphocyte production of multiple Th17 cytokines (IL-17A, IL-17F and IL-22) was achieved with JAK inhibitors of differing specificity, as well as by silencing of JAK1-3 and Tyk2, without impacting on cell viability or proliferation. Our preclinical data suggest JAK inhibitors as promising candidates for therapeutic trials in AS, since they can inhibit multiple Th17 cytokines simultaneously. Improved targeting of TYK2 or other JAK isoforms may confer tailored effects on Th17 responses in AS

Protection from ultraviolet damage and photocarcinogenesis by vitamin d compounds

© Springer Nature Switzerland AG 2020. Exposure of skin cells to UV radiation results in DNA damage, which if inadequately repaired, may cause mutations. UV-induced DNA damage and reactive oxygen and nitrogen species also cause local and systemic suppression of the adaptive immune system. Together, these changes underpin the development of skin tumours. The hormone derived from vitamin D, calcitriol (1,25-dihydroxyvitamin D3) and other related compounds, working via the vitamin D receptor and at least in part through endoplasmic reticulum protein 57 (ERp57), reduce cyclobutane pyrimidine dimers and oxidative DNA damage in keratinocytes and other skin cell types after UV. Calcitriol and related compounds enhance DNA repair in keratinocytes, in part through decreased reactive oxygen species, increased p53 expression and/or activation, increased repair proteins and increased energy availability in the cell when calcitriol is present after UV exposure. There is mitochondrial damage in keratinocytes after UV. In the presence of calcitriol, but not vehicle, glycolysis is increased after UV, along with increased energy-conserving autophagy and changes consistent with enhanced mitophagy. Reduced DNA damage and reduced ROS/RNS should help reduce UV-induced immune suppression. Reduced UV immune suppression is observed after topical treatment with calcitriol and related compounds in hairless mice. These protective effects of calcitriol and related compounds presumably contribute to the observed reduction in skin tumour formation in mice after chronic exposure to UV followed by topical post-irradiation treatment with calcitriol and some, though not all, related compounds

First report of Theileria annulata in Nigeria : findings from cattle ticks in Zamfara and Sokoto States

Background: Ticks and tick-borne pathogens (TBPs) represent a significant economic burden to cattle farming in sub-Saharan Africa including Nigeria. However, in the northern part of this country, where the largest livestock population resides, little is known about the contemporary diversity of ticks and TBPs. This area is particularly vulnerable to climate change, undergoing marked transformation of habitat and associated flora and fauna that is also likely to include ticks. This study aimed to document the occurrence of tick species and Apicomplexan TBPs in cattle from north-western Nigeria. Methods: In 2017, ticks were collected from cattle in Zamfara and Sokoto States and identified morphologically. Additionally, a subset of ticks was screened molecularly for the detection of apicomplexan DNA. Results: A total of 494 adult ticks were collected from 80 cattle in Zamfara and 65 cattle in Sokoto State. Nine tick species were encountered, among which the presence of one, Hyalomma turanicum, had not previously been recorded in Nigeria. Hyalomma rufipes was the most prevalent tick infesting cattle in Zamfara State (76%), while Hyalomma dromedarii was the most prevalent in Sokoto State (44%), confirming the widespread transfer of this species from camels onto livestock and its adaptation to cattle in the region. Of 159 ticks screened, 2 out of 54 (3.7%) from Zamfara State and 29 out of 105 (27.6%) from Sokoto State harboured DNA of Theileria annulata, the agent of tropical theileriosis. Conclusions: This study confirms the presence of a broad diversity of tick species in cattle from north-western Nigeria, providing the first locality records for Zamfara State. The occurrence of H. turanicum indicates a distribution of this tick beyond northern Africa. This study provides the first report for T. annulata in Nigerian ticks. Given its enormous burden on livestock farming in north Africa and across Asia, further investigations are needed to better understand its epidemiology, vector transmission and potential clinical significance in cattle from northern Nigeria and neighbouring Sahelian countries

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

A new summability property of the zeros of Bessel functions

No abstract availabl

Large Vulvar Lipoma Following Episiotomy - A Case Report

Vulvar lipomas are rare and few cases have been reported in the world literature. We document a case of large soft vulvar mass following episiotomy in a 23-year-old primipara. The mass was excised and histologic examination confirmed lipoma.KEYWORDS: vulvar, tumour, lipoma

Women’s perception of accuracy of ultrasound dating in late pregnancy: a challenge to prevention of prolonged pregnancy in a resource-poor Nigerian setting

Emmanuel O Ugwu,1 Godwin U Odoh,1 Cyril C Dim,1 Samuel N Obi,1 Euzebus C Ezugwu,1 Innocent I Okafor21Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Parklane, Enugu, NigeriaBackground: Expected date of delivery (EDD) is estimated from the last menstrual period (LMP) or ultrasound scan. Conflicts between these estimates especially on the part of the physician and his/her patient could pose a challenge to prevention of prolonged pregnancy. The objective of this study was to determine the perception and acceptability of menstrual dating (EDD derived from LMP) with regard to timing of labor induction for postdatism by pregnant women who have a late pregnancy (≥23 weeks’ gestation) ultrasound scan.Methods: This cross-sectional study included 443 consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, 2013 to March 31, 2013.Results: The mean age of the women was 27.9±2.41 (range 17–45) years. Most ultrasound scans (90.8%, 357/389) were carried out in late pregnancy, and 41.9% (167/389) were self-referred. The majority of the respondents (51.7%, 229/443) did not accept induction of labor for postdatism at a certain menstrual dating-derived gestational age of 40 weeks plus 10 days if the late pregnancy ultrasound scan dating was less. Predictors of this poor attitude to timing of induction of labor for postdatism included low educational level, low social class, and poor knowledge of the limitations of ultrasound scan dating in late pregnancy (P<0.05).Conclusion: The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy as well as the perinatal effects of prolonged pregnancy.Keywords: ultrasound dating, prolonged pregnancy, Nigeri

Agriculture Lecturers’ Perception of the Benefits of Professional Meetings in Nigeria

The study assessed Agriculture lecturer’s perception of the benefits of professional meetings in Nigeria. The study was conducted in Southeast and southsouth geo political zone of Nigeria. Multistage sampling technique was used to select eighty agriculture lecturers for the study. Data were collected with the aid of structured questionnaire and analysed using frequency counts, percentages and mean. Of the eighty agriculture lecturers used for the study, 59% were male, 81% married and 55% had their doctorate degree. The mean age and working experience were 43yrs and 11yrs respectively. Majority (98.8%) had attended national professional meetings in the past five years while only 32.5% had attended international professional meetings in the past five years. Also, 77% attend at most two professional meetings in a year. Of the five professional meetings (conferences, workshop, trainings, symposiums and seminar) examined in this study, result show that agriculture lecturers attach so much value to conferences (M =3.78). It was also shown that agriculture lecturers strongly perceive the benefits of professional meetings to be: connects one to relevant networking team (M = 3.86), exposes one to new arrears in agriculture (M = 3.82) and gives one the opportunity to contribute his/her quota to knowledge. Based on the results of the study, it was recommended the need to support agriculture lecturer’s attendance to international conferences and other international professional meetings to enable them expand their networking and collaboration activities. This is by offering sponsorships and other incentives to lecturers whose papers are accepted for presentation in such meetings.Key words: professional meetings, benefits