Secondary Plant Metabolites as Potent Drug Candidates against antimicrobial-Resistant Pathogens

Antibiotic resistance is a major public health threat of the twenty-first century and represents an important risk to the global economy. Healthcare-associated infections mainly caused by drug-resistant bacteria are wreaking havoc in patient care worldwide. The spread of such pathogens limits the utility of available drugs and complicates the treatment of bacterial diseases. As a result, there is an urgent need for new drugs with mechanisms of action capable of curbing resistance. Plants synthesize and utilize various metabolic compounds to deter pathogens and predators. Utilizing these plant-based metabolites is a promising option in identifying novel bioactive compounds that could be harnessed to develop new potent antimicrobial drugs to treat multidrug-resistant pathogens. The purpose of this review is to highlight medicinal plants as important sources of novel antimicrobial agents that could be developed to help combat antimicrobial resistance

Stress-related massive gastrointestinal bleeding in a diabetic and obese woman following double leg amputation.

Foot ulceration is a leading cause of hospital admission for patients with diabetes mellitus and the main reason for major amputation. This study presents the rare association of double amputation of both legs within 16 months of each other, a rarer outcome of diabetic foot ulcer disease, and the fatal complication of massive stress-related gastrointestinal bleeding that occurred thereafter leading to haemorrhagic shock and sudden death. On an index patient the clinical management was reviewed, a detailed autopsy performed after demise, and an extensive literature review including MEDLINE searches were carried out. Autopsy study revealed 3 ulcers in the gastric body and 1 in the gastric antrum measuring between 0.5 and 1cm and associated with about 2.5 litres of clotted blood in the gastrointestinal lumen extending from the stomach to the sigmoid colon. The patient combined physical stress factors for gastric ulceration which include uncontrolled diabetes mellitus prior to amputation, massive trauma from lower limb amputation with delayed wound healing, intake of non-steroidal anti-inflammatory drugs in the setting of past medical history of successfully treated peptic ulcer disease and the emotional stress factor of depressive illness related to the loss of her second lower limb. This association has not been reported in literature and with this we wish to warn clinicians to look out for this fatal complication in managing patients with advanced diabetic foot ulcer disease especially those going for a second limb amputation

Toward Sustainable Power Supply and Consumption of an Emerging Economy (Nigeria)

Electricity supply offers significant and immense benefits to human society, and it is instrumental in driving economic growth, increased standard of living and technological developments. Its sustainable supply and consumption is related to many ecological discussions, and thus, present emphasis on renewable sources, such as solar and hydro. In Nigeria, however, challenges associated with electricity generation, transmission, distribution and consumption have not been adequately tackled. Poor electricity supply has adversely impacted the economy resulting to poor production, higher prices of goods and services, closure of industries, and loss of competitive advantage of Nigerian businesses. Conversely, energy-inefficient and non-conservation consumption behaviour of Nigerian electricity consumers contributes to the electricity demand - demand gap. Energy-efficiency and conservation is a sustainable tool for efficient power system. The paper show that the use of mostly post-paid and unmetered billing system is implicated in energy-inefficient consumption. The paper advocates for deployment of pre-paid meters to every electricity consumer; fiscal management, enforcement of energy saving policies such as use of compact fluorescent lamps (CFL); and emphasis on renewable energy (hydro and solar) sources, for electricity generation

Counselling as a Learner Support Service for Enhancing Quality Learning for Students of National Open University of Nigeria, South-East Study Centres of Nigeria

This study investigated the extent counselling as a learner support service have enhanced the quality of learning for students of National Open University of Nigeria (NOUN) Study centres in South-East of Nigeria. Two research questions and one null hypothesis guided the study. The descriptive design was adopted for the study. Survey research study that was carried out at the four Study Centres of NOUN in the South-East states of Nigeria The population of study was 4,765 students while a sample of 480 respondents were selected using a multi-stage sampling technique. The instrument for data collection was researchers` structured questionnaire titled “Counselling as a Learner Support Service for Enhancing Quality Learning” which was face validated by three experts. The Reliability coefficient of 0.77 using Cronbach Alpha was obtained. The research questions were answered mean while hypothesis was tested using Mann-Whitney U-test. The result from the study showed that counselling as a learner support to a high extent has enhanced the quality of learning at the NOUN South-East Study centres. Based on these findings, recommendations were made among which were that: National Open University of Nigeria should make provision for adequate media facilities for counselling so as to ensure that students are guided as expected. Availability of a standard well-equipped computer counselling room that provides for a more supportive counselling delivery will ensure that distance learners’ problems are attended to at all times

Anti-inflammatory activity and accelerated stability studies of crude extract syrup of Cannabis sativa

Purpose: To formulate Cannabis sativa-based syrup and investigate its anti-inflammatory potential and the stability of the formulation under stress conditions.Methods: The syrup was prepared using different combinations of crude C. sativa resin, propylene glycol, aspartame, sucrose, sodium metabisulphite (SMBs) and ethylenediaminetetraacetic acid (EDTA). The stability of the formulations was determined under accelerated temperature conditions. The anti-inflammatory activity of the resin and different formulations were evaluated by the egg albumin induced paw edema model in rats. Biochemical assay was determined by Reitman and Frankel colorimetric assay method while hematological assay was evaluated by standard protocols.Results: EDTA-containing syrup (CE) was the most stable with estimated shelf-life of 2204 days (K25ºC, 4.78 x 10-5/day). Higher propylene glycol levels significantly improved anti-inflammatory activity compared to those containing a lower amount. All the formulations showed anti-inflammatory activity higher than the crude resin with a dose-dependent inhibition of paw edema compared with the control. There was no significant difference (p < 0.05) between the serum glutamate-oxaloacetate transaminase (SGOT, 13.821 ± 0.190 - 16.008 ± 1.012), serum glutamate-pyruvate transaminase (SGPT, 19.241 ± 1.027 - 22.901 ± 1.093) and urea (9.812 ± 0.252 - 10.054 ± 0.252) levels of the treated and 16.856 ± 1.053, 24.960 ± 0.101 and 10.654 ± 0.925 units/L of the control animals respectively. With the exception of eosinophil that disappeared from the blood in the third week, all the hematological parameters showed a gradual increase in lymphocytes, neutrophils, monocytes, packed cell volume (PCV), white and red blood cell counts in the third week compared to control.Conclusion: Formulation of C. sativa as syrup using efficient carriers improves the pharmacological activity of the crude extract. SMBs and EDTA significantly enhance the stability of the syrup with no observable biochemical and hematological changes in treated animalsKeywords: Cannabis sativa, Syrup, Anti-inflammatory, Stability, Hematologica

Familial adenomatous polyposis with synchronous invasive colonic carcinomas and metastatic jejunal adenocarcinoma in a Nigerian male

Familial adenomatous polyposis is rare. Three cases were previously reported in Nigeria. An intriguing feature of this case is an ulcerated jejunal carcinoma which was metastatic rather than synchronous carcinoma. This patient presented with partial large bowel obstruction and the pathological analysis revealed 4 invasive adenocarcinomas, 3 in the colon and 1 in the jejunum (Dukes stage D). Palliative pancolectomy and jejunal tumour resection with chemotherapy was offered to him. He died eight months after surgery from disease progression. The challenges of managing a hereditary cancer syndrome in a resource poor country are highlighted

Gastric Duplication Cyst with Multiple Ectopic Pancreatic Tissues: A Case Report and Review of Literature

A gastric duplication cyst (GDC) is a type of enteric duplication cyst. It can co‑exist with an ectopic tissue. This was a female toddlerwith a GDC at the greater curvature. An abdominal ultrasound and a contrast‑enhanced computed tomogram suggested the cyst. Shehad laparotomy, complete cyst and partial gastric excision with the removal of extragastric pancreatic tissue. The histology reportcame out as a cyst with associated intracystic and an extracystic pancreatic tissue. She made a clinical improvement. GDC can beassociated with both intracystic and extracystic ectopic pancreatic tissues. This should be kept in mind when choosing the modalityof treatment. Keywords: Ectopic pancreas, gastric duplication cyst, intra‑peritoneal cys

High prevalence of radiographic outliers and revisions with unicompartmental knee arthroplasty

BACKGROUND: Alignment outcomes and their impact on implant survival following unicompartmental knee arthroplasty (UKA) are unclear. The purpose of this study was to assess the implant survival and radiographic outcomes after UKA as well as the impact of component alignment and overhang on implant survival. METHODS: We performed a retrospective analysis of 253 primary fixed-bearing and mobile-bearing medial UKAs from a single academic center. All UKAs were performed by 2 high-volume fellowship-trained arthroplasty surgeons. UKAs comprised \u3c10% of their knee arthroplasty practices, with an average of 14.2 medial UKAs per surgeon per year. Implant survival was assessed. Femoral coronal (FCA), femoral sagittal (FSA), tibial coronal (TCA), and tibial sagittal (TSA) angles as well as implant overhang were radiographically measured. Outliers were defined for FCA (\u3e±10° deviation from neutral), FSA (\u3e15° of flexion), TCA (\u3e±5° deviation from neutral), and TSA (\u3e±5° deviation from 7°). Far outliers were an additional \u3e±2° of deviation. Outliers for overhang were identified as \u3e3 mm for anterior overhang, \u3e2 mm for posterior overhang, and \u3e2 mm for medial overhang. RESULTS: Among patients with a failed UKA, revision was performed at an average of 3.7 years (range, 0.03 to 8.7 years). The cumulative revision rate was 14.2%. Kaplan-Meier survival analysis demonstrated 5 and 10-year survival rates of 88.0% (95% confidence interval [CI] = 82.0% to 91.0%) and 70.0% (95% CI = 56.0% to 80.0%), respectively. Only 19.0% (48) of the UKAs met target alignment for all 4 alignment measures, and only 72.7% (184) met all 3 targets for overhang. Only 11.9% (30) fell within all alignment and overhang targets. The risk of implant failure was significantly impacted by outliers for FCA (failure rate = 15.4%, p = 0.036), FSA (16.2%, p = 0.028), TCA (17.9%, p = 0.020), and TSA (15.2%, p = 0.034) compared with implants with no alignment or overhang errors (0%); this was also true for far outliers (p \u3c 0.05). Other risk factors for failure were posterior overhang (failure rate = 25.0%, p = 0.006) and medial overhang (38.2%, p \u3c 0.001); anterior overhang was not a significant risk factor (10.0%, p = 0.090). CONCLUSIONS: The proportions of UKA revisions and alignment outliers were greater than expected, even among high-volume arthroplasty surgeons performing an average of 14.2 UKAs per year (just below the high-volume UKA threshold of 15). Alignment and overhang outliers were significant risk factors for implant failure. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence