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

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

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

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

Interventions Targeting Child Undernutrition in Developing Countries May Be Undermined by Dietary Exposure to Aflatoxin

Child undernutrition, a form of malnutrition, is a major public health burden in developing countries. Supplementation interventions targeting the major micronutrient deficiencies have only reduced the burden of child undernutrition to a certain extent, indicating that there are other underlying determinants that need to be addressed. Aflatoxin exposure, which is also highly prevalent in developing countries, may be considered an aggravating factor for child undernutrition. Increasing evidence suggests that aflatoxin exposure can occur in any stage of life, including in utero through a trans-placental pathway and in early childhood (through contaminated weaning food and family food). Early life exposure to aflatoxin is associated with adverse effects on low birth weight, stunting, immune suppression, and the liver function damage. The mechanisms underlying impaired growth and aflatoxin exposure are still unclear but intestinal function damage, reduced immune function, and alteration in the insulin-like growth factor axis caused by the liver damage are the suggested hypotheses. Given the fact that both aflatoxin and child undernutrition are common in sub-Saharan Africa, effective interventions aimed at reducing undernutrition cannot be satisfactorily achieved until the interactive relationship between aflatoxin and child undernutrition is clearly understood, and an aflatoxin mitigation strategy takes effect in those vulnerable mothers and children

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

Seroprevalence and determinants of human herpes virus 8 infection in adult Nigerians with and without HIV-1 infection

Background: There is a dearth of studies on HHV8-HIV co-infections from Nigeria, even as both infections have been shown to be endemic in Africa. This study examined the seroprevalence and determinants of HHV8 infections in adult Nigerians with and without HIV-infection. Methods: In 2007, a cross sectional study undertaken in a tertiary hospital in Zaria, northern Nigeria enrolled 71 HIV-1 positive adults without Kaposi&apos;s sarcoma and 85 apparently healthy HIV-negative adult volunteers of the general population. Anti-lytic antibodies to HHV8 infection was determined by ELISA. A univariate analysis including age, sex, marital status, past sexually transmitted disease (STD), past blood transfusion, HIV/AIDS staging and CD4 count was used to determine variables associated with HHV8 seropositivity. Significant variables were adjusted in a logistic regression model expressed in odds ratio (OR) with 95% confidence interval (CI). P<0.05 was considered significant Results: The seroprevalence of HHV8 infection was 62% in HIV-1 positive patients and 25.9% in HIV negative adults (p<0.001). A past history of STD [OR= 2.88, 95% CI= 1.0 - 8.2] and advanced HIV/AIDS (WHO stage 3 and 4) [OR=3.5, 95% CI= 1.21-10.1] were the only variables independently associated with HHV8 seropositivity in HIV-infected patients. In HIV-negative adults, none of the variables was significantly associated with HHV8 seropositivity. Conclusion: The study findings suggest an adverse interaction between HHV8 and HIV-1. The higher prevalence of HHV8 infection in HIV-infected patients and its association with STD support a predominant sexual route of HHV8 transmission among adult Nigerians

ATRIAL SEPTAL ANEURYSM IN AN 80-YEAR-OLD WOMAN: A CASE REPORT AND REVIEW OF LITERATURE

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

Genital tuberculosis presenting as pyrexia of undetermined origin

A case of Genital tuberculosis in a female patient is presented. The key presenting features in this lady were chronic weight loss, colicky lower abdominal pains, fever, and amenorrhea

Smoking prevention and cessation in the Africa and Middle East Region: A consensus draft guideline for healthcare providers - executive summary

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