Antioxidative action of manganese treatment in delayed healing of acetic acid-induced ulceration in rat stomach

Background: The role of manganese in disease treatment such as diabetes, arthritis and osteoporosis has been well documented. Unhealed or delayed gastric ulcer is an experimental model mimicking recurrent peptic ulcer of which information is lacking. This study sought to examine the role of manganese during delayed gastric ulcer healing and its probable mechanism. Methods: 75 male wistar rats (150-170g) were divided into 5 groups of 15 rats each; Groups 1 was delayed untreated ulcerated animals while II, III, IV and V received 100mg/kg Manganese, 50mg/kg Manganese, 40 mg/kg Cimetidine and 100mg/kg Vitamin E respectively. Ulcer was induced by serosa application of 30% acetic acid and by day 5 post-induction, ulcer was delayed by continuous subcutaneous administration of 2mg/kg indomethacin (once daily) for 14 days simultaneously. Body weights of experimental animals were monitored daily, haematological studies; stomach ulcer score, biochemical and histological analysis were assessed by days 3, 7 and 14 indomethacin and drug treatment after quick decapitation. Data were expressed as Mean + SEM, analysed using one-way ANOVA while p=0.05 was considered statistically significant. Results: The percentage healing rates in Manganese (50mg/kg and 100mg/kg respectively) significantly increased on days 3 (76.5% and 42.9%), 7 (97.3% and 75.5%) and 14 (100% and 97.5%). Haematological data revealed increased circulating blood cells in the Manganese and Vitamin E treated groups compared with ulcerated untreated groups. Manganese treatment reduced gastric inflammation and lipid peroxidation (malodiadehyde, MDA) with a concomitant increase in superoxide dismutase and nitric oxide levels of gastric tissue homogenate compared with other treatment groups. Histological evaluations of gastric tissue from the manganese treated groups revealed healing compared with other treatment groups which further buttressed biochemical analysis. Conclusion: Manganese probably exerts its gastro-protective property on delayed ulcer by promoting increased antioxidant levels in experimental animals which probably mitigated the effect of continuous indomethacin injection.Keywords: Manganese, delayed ulcers, anti-inflammatory and antioxidative activitie

Safety and Efficacy of Axicabtagene Ciloleucel versus Standard of Care in Patients 65 Years of Age or Older with Relapsed/Refractory Large B-Cell Lymphoma

Purpose: Older patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) may be considered ineligible for curative-intent therapy including high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). Here, we report outcomes of a preplanned subgroup analysis of patients >= 65 years in ZUMA-7. Patients and Methods: Patients with LBCL refractory to or relapsed = 65 years were random-ized to axi-cel and SOC, respectively. Median EFS was greater with axi-cel versus SOC (21.5 vs. 2.5 months; median follow-up: 24.3 months; HR, 0.276; descriptive P = 3 adverse events occurred in 94% of axi-cel and 82% of SOC patients. No grade 5 cytokine release syndrome or neurologic events occurred. In the quality-of-life analysis, the mean change in PRO scores from baseline at days 100 and 150 favored axi-cel for EORTC QLQ-C30 Global Health, Physical Functioning, and EQ-5D-5L visual analog scale (descriptive P = 65 and = 65 years with R/R LBCL

Improved antiretroviral treatment outcome in a rural African setting is associated with cART initiation at higher CD4 cell counts and better general health condition

Background Data on combination antiretroviral therapy (cART) in remote rural African regions is increasing. Methods We assessed prospectively initial cART in HIV-infected adults treated from 2005 to 2008 at St. Francis Designated District Hospital, Ifakara, Tanzania. Adherence was assisted by personal adherence supporters. We estimated risk factors of death or loss to follow-up by Cox regression during the first 12 months of cART. Results Overall, 1,463 individuals initiated cART, which was nevirapine-based in 84.6%. The median age was 40 years (IQR 34-47), 35.4% were males, 7.6% had proven tuberculosis. Median CD4 cell count was 131 cells/μl and 24.8% had WHO stage 4. Median CD4 cell count increased by 61 and 130 cells/μl after 6 and 12 months, respectively. 215 (14.7%) patients modified their treatment, mostly due to toxicity (56%), in particular polyneuropathy and anemia. Overall, 129 patients died (8.8%) and 189 (12.9%) were lost to follow-up. In a multivariate analysis, low CD4 cells at starting cART were associated with poorer survival and loss to follow-up (HR 1.77, 95% CI 1.15-2.75, p = 0.009; for CD4 100 cells/μl). Higher weight was strongly associated with better survival (HR 0.63, 95% CI 0.51-0.76, p < 0.001 per 10 kg increase). Conclusions cART initiation at higher CD4 cell counts and better general health condition reduces HIV related mortality in a rural African setting. Efforts must be made to promote earlier HIV diagnosis to start cART timely. More research is needed to evaluate effective strategies to follow cART at a peripheral level with limited technical possibilities

Asymptomatic genital infection among pregnant women in Sagamu, Nigeria.

Background: Untreated genital tract infections in pregnancy may be associated with adverse effects on foetal and maternal health leading to poor pregnancy outcome.Aim: The aim of this study is to determine the prevalence and microbial isolates associated with asymptomatic genital infectionsin pregnancy.Methodology: This was a cross-sectional study on 252 pregnant women attending their first antenatal clinic. Data on socio-demographic characteristics of study participants was recorded. Microbial culture was carried out on High Vaginal and Endocervical swab samples. Statistical analysis was done using IBM-SPSS Windows version 20.Results: The prevalence of asymptomatic genital infection was 44.8%. Multiparity had statistically significant association with increased prevalence of the condition. Candida albicans and Staphylococcus aureus were the most predominant microbial isolates. Erythromycin and Levofloxacin were the most sensitive antibiotics against the bacterial isolates.Conclusion: This prevalence of asymptomatic genital infectionsis high in pregnant women in Sagamu. It is recommended that routine screening and treatment of these infections should be included in the antenatal clinic services offered to pregnant women so as to prevent the adverse foetal and maternal effects associated with asymptomatic genital infections in pregnancy.Keywords: Genital infection, Pregnancy, Asymptomatic, Sagamu

Asymptomatic Urinary Tract Infection among Pregnant Women in Sagamu, Nigeria

A cross-sectional study involving 201 pregnant women with no symptoms and/or clinical signs of urinary tract infection who attended antenatal booking clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu Nigeria. The two hundred and one pregnant women were examined for asymptomatic bacteriuria, 34 (16.9%) had positive urine culture for significant bacteriuria and 12 (5.9%) had candiduria. There were statistically significant associations between bacteriuria and age (p=0.018), educational level (p=0.019) and occupation (p=0.008). The most prevalent bacterial isolate was Staphylococcus aureus (47.1%) and least cultured isolate was Escherichia coli (5.9%). Cotrimoxazole and ofloxacin were the most sensitive antimicrobial agents while Nitrofurantoin was the least sensitive. The prevalence of asymptomatic bacteriuria among women attending antenatal care in Sagamu is still high (16.9%) and this underscores the need for routine antenatal screen for all pregnant women at least on the first antenatal visit.Keywords: Urinary tract infection, Asymptomatic bacteriuria, Pregnant women, Age, Educational level, Occupation, Sagamu

Safety and Efficacy of Axicabtagene Ciloleucel versus Standard of Care in Patients 65 Years of Age or Older with Relapsed/Refractory Large B-Cell Lymphoma.

PURPOSE: Older patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) may be considered ineligible for curative-intent therapy including high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). Here, we report outcomes of a preplanned subgroup analysis of patients ≥65 years in ZUMA-7. PATIENTS AND METHODS: Patients with LBCL refractory to or relapsed ≤12 months after first-line chemoimmunotherapy were randomized 1:1 to axicabtagene ciloleucel [axi-cel; autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy] or standard of care (SOC; 2-3 cycles of chemoimmunotherapy followed by HDT-ASCT). The primary endpoint was event-free survival (EFS). Secondary endpoints included safety and patient-reported outcomes (PROs). RESULTS: Fifty-one and 58 patients aged ≥65 years were randomized to axi-cel and SOC, respectively. Median EFS was greater with axi-cel versus SOC (21.5 vs. 2.5 months; median follow-up: 24.3 months; HR, 0.276; descriptive P \u3c 0.0001). Objective response rate was higher with axi-cel versus SOC (88% vs. 52%; OR, 8.81; descriptive P \u3c 0.0001; complete response rate: 75% vs. 33%). Grade ≥3 adverse events occurred in 94% of axi-cel and 82% of SOC patients. No grade 5 cytokine release syndrome or neurologic events occurred. In the quality-of-life analysis, the mean change in PRO scores from baseline at days 100 and 150 favored axi-cel for EORTC QLQ-C30 Global Health, Physical Functioning, and EQ-5D-5L visual analog scale (descriptive P \u3c 0.05). CAR T-cell expansion and baseline serum inflammatory profile were comparable in patients ≥65 and CONCLUSIONS: Axi-cel is an effective second-line curative-intent therapy with a manageable safety profile and improved PROs for patients ≥65 years with R/R LBCL