Detection of Legionella antigen in urine by ELISA for diagnosis of Legionaires' disease in parts of South East Nigeria

Diagnosis of Legionnaires’ disease by urinary antigen detection has been shown to be specific and timely. This study is designed to evaluate the presence of Legionella urinary antigen in mid-stream urine of individuals with respiratory tract infections. A total of 90 samples were collected from 38 males and 52 females. The samples were processed by Enzyme- Linked Immunosorbent Assay (ELISA) technique within 24 hours of collection or preserved at 2 – 8 oC for not more than 14 days. The results showed 12.2% prevalence of Legionnaires’ disease in the subjects. A higher prevalence of the disease was observed more in males 63.6% than in females 36.4%. All age groups were at risk for the disease. Hospital admission duration and type of water for bathing were statistically significant (p<0.5) risk factors to Legionnaires’ disease infection. Other risk factors like, level of education, type of artificial air source, smoking habit, alcohol consumption and location of residence did not show statistical significance (p>0.5). It is therefore recommended that Legionella urinary antigen test be included as a primary test for all respiratory tract illnesses since it permits early diagnosis, which will enable prompt treatment of the disease

Glucose Intolerance Among Apparently Healthy Hausa-Fulani Northern Nigerians

Background: Glucose intolerance has been recently reclassified by the World Health Organization (WHO) incorporating a new class known as impaired fasting glycaemia. Previous studies in this environment looked as diabetes mellitus only but not the other forms of glucose intolerance. Objectives: To study the prevalence of glucose intolerance in apparently Nigerian subjects of Hausa-Fulani ethnicity, who had no known family history of diabetes mellitus or hypertension. Method: Standard oral glucose tolerance tests (OGTT) in 39 healthy individuals. Results: Three (7.7%) of the subjects demonstrated impaired glucose tolerance (IGT). There was no case of impaired fasting glycaemia (IFG) noted. All subjects who had IGT were females Conclusions: glucose intolerance appears commoner among females in this study. Factors such as sedentary lifestyles, which are commoner among females in this community, could be the reason for this finding

PREVALENCE OF HEPATITIS B AND C VIRAL INFECTIONS IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC IN NNEWI, NIGERIA

Infections due to Hepatitis B and C viruses are significant health problems around the globe, Nigeria inclusive. This study was conducted among 100 pregnant women attending ante natal clinic at NnamdiAzikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria to determine the seroprevalence of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) and to determine whether liver amino transferases can be affected. The blood samples were tested for hepatitis B surface antigen (HBsAg) and Anti-HCV using HBsAg and Anti-HCV one step rapid test strip and furthermore using ELISA technique. Serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) activities were also estimated in all the subjects using Reitman - Frankel method. The results showed that six percent(6%) and one percent (1%) of the 100 blood samples tested positive for HBV and HCV respectively. The mean AST levels for HBsAg negative and positive subjects were 10.55±2.36 and 12.17±2.23 respectively while the mean ALT levels were 5.54±1.94and 8.00±3.10 respectively. The mean AST for anti-HCV negative and positive subjects were 10.67±2.38 and 9.00±0.00 respectively while the ALT were 5.71±2.09 and 4.00±0.00 respectively There was significant increase in the levels of ALT between the HBsAg positive and negative pregnant subjects (P<0.05). HBV and HCV infection can be present in pregnant women and can alter liver amino transferases. Therefore testing for HBsAg and Anti-HCV is recommended for all pregnant women at first prenatal and postnatal visit so that HBsAg and HCV positive mothers will receive prompt intervention

Cardiovascular risk factors in adult general out-patient clinics in Nigeria: a country analysis of the Africa and Middle East Cardiovascular Epidemiological (ACE) study.

Background: With globalization and rapid urbanization, demographic and epidemiologic transitions have become important determinants for the emergence of cardiovascular disease (CVD).Objective: To estimate the prevalence of CVD risk factors in adult out-patients attending general practice and non-specialist clinics in urban and rural Nigeria.Methods: As part of the Africa and Middle East Cardiovascular Epidemiological (ACE) study, a cross-sectional epidemiologic study was undertaken for the presence of hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and abdominal obesity in Nigeria.Results: In total, 303 subjects from 8 out-patient general practice clinics were studied, 184 (60.7%) were female and 119 (39.3%) were male. Mean age was 42.7±13.1 years; 51.8% were aged <45 years; 4% ≥65 years. Over 90% of subjects had ≥1 of 6 selected modifiable cardiovascular risk factors: 138 (45.6%) had 1-2; 65 (21.5%) had 3; 60 (19.8%) had 4; and 11 (3.6%) had 5 concurrent risk factors. Screening identified 206 subjects (68.0%) with dyslipidemia who did not have a prior diagnosis.Conclusion: Cardiovascular risk factors are highly prevalent in Nigerian subjects attending out-patient clinics. Moreover, many subjects were undiagnosed and therefore unaware of their cardiovascular risk status. Opportunistic screening alongside intensive national, multisectoral education or risk factor education is needed, should be scaled up nationwide and rolled out in both urban and rural communities in Nigeria.Keywords: Nigeria, cardiovascular risk factors, screening programs, risk factor management, The Africa and Middle East Cardiovascular Epidemiological (ACE) study

Atrial Septal Aneurysm in an 80-year-old Woman

Atrial septal aneurysm usually complicates a patent foramen ovale and atrial septal defect. An 80-year-old female presented with two weeks symptoms of chest infection. Examination revealed consolidation in the right lower zone posteriorly in the chest, a third heart sound (S3) and hepatomegaly. Sputum microscopy and culture were unremarkable and the chest radiograph revealed a mild cardiomegaly (CTR 0.53) and consolidation in the right lower zone. Echocardiography revealed an ejection fraction af 36.5% and fractional shortening of 17.6%, displacement of the middle portion of the inter-atrial septum into the left and right atria (the defect was 1.6cm) and the displacement was more than 10 mm. Atrial septal aneurysm is known to be a risk factor for cardiac failure and cerebrovascular events in middle aged and elderly individuals

Molecular Detection of Mycobacterium bovis in Cattle Milk in Enugu State, Nigeria

The study was carried out to detect Mycobacterium bovis in cattle milk in Enugu. Fifty Milk samples were collected from cattle at Fulani settlements which comprised of 13 from Gariki, 16 from 9th Mile and 21 from Monarch in Enugu. DNA was extracted from milk samples using Relia prep DNA spin column method and screened for Tuberculosis using Nested Polymerase Chain Reaction (PCR) with specific Tuberculosis primer; Insertion sequence 6110 (IS6110) while Restriction Fragment Length Polymorphism (IS6110- RFLP) method was used to differentiate between Mycobacterium bovis and Mycobacterium tuberculosis using Nar 1 digestion enzyme. Statistical tools used to analyze the data were: Chi-square, fishers’ exact test and non parametric t test. 9 (18%) samples out of the 50milk samples were positive for tuberculosis with the PCR method. 1 (2%) out of the 9 positive milk samples was found to be Mycobacterium tuberculosis while the remaining 8 (16%) were detected to be Mycobacterium bovis after using the digestion enzyme. 1 (6.3%) of the 16 milk samples collected from the Fulani settlement in 9th Mile was positive for M.bovis while a total of 2 (15.4%) out of the 13 milk samples from Gariki were positive for M.bovis and a total positive of 6 (28.6%) were detected out of the 21 milk samples analyzed from Monarch, 5 (23.8%) of which were found to be M.bovis while M. tuberculosis was detected in 1 (4.8%). The differences however, were not statistically significant (P>0.05). Keywords: Tuberculosis, Mycobacterium bovis, Mycobacterium tuberculosis, DN

High spatial resolution ToF-SIMS imaging and image analysis strategies to monitor and quantify early phase separation in amorphous solid dispersions

Amorphous solid dispersions (ASDs) are formulations with enhanced drug solubility and dissolution rate compared to their crystalline counterparts, however, they can be inherently thermodynamically unstable. This can lead to amorphous phase separation and drug re-crystallisation, phenomena that are typically faster and more dominant at the product’s surfaces. This study investigates the use of high-resolution time of flight-secondary ion mass spectrometry (ToF-SIMS) imaging as a surface analysis technique combined with image-analysis for the early detection, monitoring and quantification of surface amorphous phase separation in ASDs. Its capabilities are demonstrated for two pharmaceutically relevant ASD systems with distinct re-crystallisation behaviours, prepared using hot melt extrusion (HME) followed by pelletisation or grinding: (1) paracetamol-hydroxypropyl methylcellulose (PCM-HPMC) pellets with drug loadings of 10–50% w/w and (2) indomethacin-polyvinylpyrrolidone (IND-PVP) ground material with drug loadings of 20–85% w/w. PCM-HPMC pellets showed intense phase separation, reaching 100% surface coverage within 1-5 months. In direct comparison, IND-PVP HME ground material was more stable with only a moderate formation of isolated IND-rich clusters. Image analysis allowed the reliable detection and quantification of local drug-rich clusters. An Avrami model was applied to determine and compare phase separation kinetics. The combination of chemical sensitivity and high spatial resolution afforded by SIMS was crucial to enable the study of early phase separation and re-crystallisation at the surface. Compared with traditional methods used to detect crystalline material, such as XRPD, we show that ToF-SIMS enabled detection of surface physical instability already at early stages of drug cluster formation in the first days of storage

Extending the SAFT-gamma Mie approach to model benzoic acid, diphenylamine, and mefenamic acid: Solubility prediction and experimental measurement

The prediction of the solubility of active pharmaceutical ingredients (APIs) is a significant challenge which is of importance in pharmaceutical applications and solvent selection. Here, we extend the table of group interactions (3 like interactions, 47 unlike interactions) of the SAFT-γ Mie group-contribution equation of state to model the phase behaviour and solubility of mefenamic acid, a nonsteroidal anti-inflammatory drug, in a range of solvents. In addition to mefenamic acid, we also consider its molecular synthons: benzoic acid and diphenylamine. New experimental solubility data are presented for the three molecules in a range of solvents, and three new SAFT-γ Mie functional groups are defined (aCCOOH, aCNHaC and CH3CO) and characterised, together with their interactions with solvent groups. Literature data for the vapour pressure, single-phase density, saturation density, vapourisation enthalpy, bubble temperature, dew temperature, and bubble pressure are used to characterise the new group interactions. Solubility data are used to characterise the new group-group interactions only if there are no other experimental data available. The transferability and predictive accuracy of the new models are assessed by comparing the theoretical predictions with the experimental solubility data. Our comparison includes alcohols, ketones, and esters as families of solvents and mixed-solvent solubility predictions

The Hookworm Tissue Inhibitor of Metalloproteases (Ac-TMP-1) Modifies Dendritic Cell Function and Induces Generation of CD4 and CD8 Suppressor T Cells

Hookworm infection is a major cause of disease burden for humans. Recent studies have described hookworm-related immunosuppression in endemic populations and animal models. A Tissue Inhibitor of Metalloproteases (Ac-TMP-1) has been identified as one of the most abundant proteins released by the adult parasite. We investigated the effect of recombinant Ac-TMP-1 on dendritic cell (DC) and T cell function. Splenic T cells from C57BL/6 mice injected with Ac-TMP-1 showed reduced proliferation to restimulation with anti CD3 or bystander antigens such as OVA. Incubation of bone marrow-derived DCs with Ac-TMP-1 decreased MHC Class I and, especially, Class II expression but increased CD86 and IL-10 expression. Co-incubation of splenic T cells with DCs pulsed with Ac-TMP-1 induced their differentiation into CD4+ and, particularly, CD8+ CD25+Foxp3+ T cells that expressed IL-10. These cells were able to suppress proliferation of naïve and activated CD4+ T cells by TGF-Β-dependent (CD4+ suppressors) or independent (CD8+ suppressors) mechanisms. Priming of DCs with non-hookworm antigens, such as OVA, did not result in the generation of suppressor T cells. These data indicate that Ac-TMP-1 initiates the development of a regulatory response through modifications in DC function and generation of suppressor T cells. This is the first report to propose a role of suppressor CD8+ T cells in gastrointestinal helminthic infections