Factors infleuncing neonatal septicaemia in Maiduguri, north-eastern Nigeria

BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents and their antibiotic sensitivity pattern have continued to change (in the same centre over time), hence the need to have undertaken this study.AIMS AND OBJECTIVES: The primary objective of the study was to determine the risk factors influencing the aetiology of neonatal septicaemia at the University of Maiduguri Teaching Hospital.PATIENTS AND METHODS: The study was prospective and all the newborn that had clinical diagnosis of septicaemia were consecutively enrolled and admitted to the Special Care Baby Unit of the Department of Paediatrics of University of Maiduguri Teaching Hospital (UMTH). The patients were appropriately investigated including blood cultures, cerebrospinal fluid cultures and urine culture among others.RESULTS: One hundred and ten neonates were studied, of these 46(42.0%) had positive blood culture, while 64 (58.0%) were blood culture negative. Eighteen (39.1%) of the septicaemic neonates were inborn, while 28 (60.9%) were out born. The incidence of neonatal septicaemia among babies delivered at UMTH was 5.9/1000 live births and the male to female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane (PROM), prematurity and low socioeconomic status of parents among others. Fever was the commonest clinical feature at presentation (87%), others include: poor feeding (64 %), excessive crying (33%), tachypnoea, hepatomegaly were some of the common examination findings. Staphylococcus aureus 16(69.6%) and Streptococcus pyogenes 5(21.8%) were the predominant Gram positive organisms isolated while Escherichia coli 9(39.1%) and Klebsiella Pneumoniae 7(30.4%) were the predominant Gram negative organisms isolated.CONCLUSION: Mortality was high in infection associated with Gram negative organisms and in the presence of conditions/complications like urinary tract infections, tetanus and meningit

SYNTHESIS, CHARACTERIZATION AND EVALUATION OF 4-HYDROXY-1-PHENYL/METHYL-3-(3-SUBSTITUTED-1-(SUBSTITUTEDIMINO) PROPYL) QUINOLINE-2(1H)-ONE DERIVATIVES AND 4-HYDROXY-1-PHENYL/METHYL-3-(1-(SUBSTITUEDIMINO) ETHYL) QUINOLINE-2(1H)-ONE DERIVATIVES AS POSSIBLE ANTICANCER AGENTS

Objective: Synthesis, characterization and evaluation of quinolin-2-one derivatives as possible anticancer agents.Methods: A series of novel 4-hydroxy-1-phenyl/methyl-3-(3-substituted-1-(substitutedimino)propyl)quinolin-2(1H)-one derivatives IIa(1-5)/IIb(1-5) and 4-hydroxy-1-phenyl/methyl-3-(1-(substituedimino)ethyl)quinolin-2(1H)-one derivatives IIIa(1-3)/IIIb(1-3) were synthesised by nucleophilic addition of substituted anilines on 3-acetyl-4-hydroxy-1-phenyl/methylquinolin-2(1H)-one (a/b) and 4-hydroxy-3-(3-substitutedpropanoyl)-1-phenyl/methyl quinolin-2(1H)-one (Ia/Ib); respectively. The synthesised derivatives were characterised by spectral analysis and were tested for their in vitro anticancer activity against K562 and Hep 3b cell lines by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method.Results: The compounds were tested for their in vitro anticancer activity against K562 and Hep 3b cell lines at 10, 20, 25, 30 and 50 µg/ml concentration using MTT assay method. The compound 4-hydroxy-3-(3-morpholino-1-(phenylimino)propyl)-1-phenylquinolin-2(1H)-one (IIa-1) showed anticancer activity with IC50 value 20 µg as compared to the control against K562 cell lines. The compound 4-hydroxy-1-phenyl-3-(1-(phenylimino) ethyl) quinolin-2(1H)-one (IIIa-1) showed anticancer activity with IC50 value less than 10 µg.Conclusion: The proposed method for the synthesis of novel derivatives is convenient and gives a good yield. Some of the synthesised compounds showed promising anticancer activity against K562 and Hep 3b cell lines. Compound IIa-1 (R=-C6H5; R1= morpholine; R2= C6H5-NH-) exhibited most potent activity against K562 cell lines. Compound IIIa-1 (R=-C6H5; R3= C6H5-NH-) has been proved to be the most cytotoxic compound among the other derivatives against Hep 3b cell lines

Designing the social Internet of Things

Copyright © 2017 by the Association for Computing Machinery, Inc. (ACM). What role do people have in the Internet of Things? Compared to the impressive body of research that is currently tackling the technical issues of the Internet of Things, social aspects of agency, engagement, participation, and ethics, are receiving less attention. The goal of this 'Designing the Social Internet of Things' workshop is to contribute by shedding light on these aspects. We invite prospective participants to take a humanistic standpoint, explore people's relations with 'things' first, and then build on such relations so as to support socially relevant goals of engagement, relatedness, participation, and creativity

Alarming rates of virological failure and HIV-1 drug resistance amongst adolescents living with perinatal HIV in both urban and rural settings: evidence from the EDCTP READY-study in Cameroon

Objectives: Adolescents living with perinatal HIV infection (ALPHI) experience persistently high mortality rates, particularly in resource-limited settings. It is therefore clinically important for us to understand the therapeutic response, acquired HIV drug resistance (HIVDR) and associated factors among ALPHI, according to geographical location. Methods: A study was conducted among consenting ALPHI in two urban and two rural health facilities in the Centre Region of Cameroon. World Health Organization (WHO) clinical staging, self-reported adherence, HIVDR early warning indicators (EWIs), immunological status (CD4 count) and plasma viral load (VL) were assessed. For those experiencing virological failure (VF, VL ≥ 1000 copies/mL), HIVDR testing was performed and interpreted using the Stanford HIV Drug Resistance Database v.8.9-1. Results: Of the 270 participants, most were on nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (61.7% urban vs. 82.2% rural), and about one-third were poorly adherent (30.1% vs. 35.1%). Clinical failure rates (WHO-stage III/IV) in both settings were < 15%. In urban settings, the immunological failure (IF) rate (CD4  < 250 cells/μL) was 15.8%, statistically associated with late adolescence, female gender and poor adherence. The VF rate was 34.2%, statistically associated with poor adherence and NNRTI-based antiretroviral therapy. In the rural context, the IF rate was 26.9% and the VF rate was 52.7%, both statistically associated with advanced clinical stages. HIVDR rate was over 90% in both settings. EWIs were delayed drug pick-up, drug stock-outs and suboptimal viral suppression. Conclusions: Poor adherence, late adolescent age, female gender and advanced clinical staging worsen IF. The VF rate is high and consistent with the presence of HIVDR in both settings, driven by poor adherence, NNRTI-based regimen and advanced clinical staging

Seroprevalence of parvovirus B19 and its clinical effect among anaemic SCA patients in Northeastern Nigeria

ABSTRACT Sickle cell anaemia (SCA) is a globally widespread genetic disorder affecting 5% of the world's over 6 billion people. Parvovirus infection and the resulting aplastic crisis is a recognised complication in individuals with SCA. Aplastic crisis increases the need for blood transfusion and its attendant risk of Transfusion Transmissible Infection (TTI). Hence there is a vicious cycle in which Parvovirus B19 causes aplastic crisis which in turn causes increased transfusion need; and transfusion increases risk of transfusion transmissible infection in which parvovirus B19 is included in certain parts of the world. Sickle cell anaemia is associated with foetal death and infection with parvovirus B19 increases the risk to early mortality. The objective of this study was to determine the seroprevalence of parvovirus B19 among SCA and compare with that of controls in the study area. Furthermore clinical and laboratory profile of subjects were analysed to identify possible correlation with parvovirus B19 seropositivity and explore the possibility of involvement of white cell and platelets. A total of 90 subjects comprising 45 consecutive SCA case subjects and 45 age-and sex-matched non SCA controls were studied in a cross sectional comparative study. Ten millilitres of blood was drawn from the antecubital fossa of each subject after obtaining informed consent. The 10mls of blood was divided into two aliquots, 4.5 mls was added into EDTA anticoagulated bottle and was used for basic complete blood count (CBC), while the remaining 5mls was added into a plain specimen container allowed to clot and serum obtained to test for anti-parvovirus B19 IgG and IgM using an immunochromatography based technique specifically BIOCARD TM Parvo B19 diagnostic test kit. There was male preponderance in the study. The SCA subjects comprised 26 males and 19 females (male to female ratio = 1.4:1), while the non-SCA controls comprised 25 males and 20 females (male to female ratio 1.3:1).. The analysis of anti-parvovirus B19 IgG antibody revealed a prevalence of 23.3% among SCA cases with 18.9% among controls. The haematological profile is not affected by IgG seropositivity. However pregnancy outcome revealed that the total number of stillbirths is 12 among IgG seropositive SCA cases which is higher than the 6 encountered in IgG seronegative SCA subjects; the difference is statistically significant (p=0.04)

Dendritic cell density and activation status in human breast cancer – CD1a, CMRF-44, CMRF-56 and CD-83 expression

Low CD1a-positive putative dendritic cell numbers in human breast cancer has recently been described and may explain the apparent ‘poor immunogenicity’ previously reported in breast cancer. Little attention has been given to dendritic cell activation within the tumour microenvironment, which is another reason why the in-situ immune response may be severely deficient. We have therefore examined CD1a expression as a marker for dendritic cells, together with CMRF-44 and -56 as markers of dendritic cell activation status, in 40 human breast cancers. The results demonstrate few or no CD1a-positive putative dendritic cells and minimal or no expression of the dendritic cell activation markers. Both dendritic cell number and dendritic cell activation appear substantially deficient in human breast cancers, regardless of tumour histological grade

What 'outliers' tell us about missed opportunities for tuberculosis control: a cross-sectional study of patients in Mumbai, India

BACKGROUND: India's Revised National Tuberculosis Control Programme (RNTCP) is deemed highly successful in terms of detection and cure rates. However, some patients experience delays in accessing diagnosis and treatment. Patients falling between the 96th and 100th percentiles for these access indicators are often ignored as atypical 'outliers' when assessing programme performance. They may, however, provide clues to understanding why some patients never reach the programme. This paper examines the underlying vulnerabilities of patients with extreme values for delays in accessing the RNTCP in Mumbai city, India. METHODS: We conducted a cross-sectional study with 266 new sputum positive patients registered with the RNTCP in Mumbai. Patients were classified as 'outliers' if patient, provider and system delays were beyond the 95th percentile for the respective variable. Case profiles of 'outliers' for patient, provider and system delays were examined and compared with the rest of the sample to identify key factors responsible for delays. RESULTS: Forty-two patients were 'outliers' on one or more of the delay variables. All 'outliers' had a significantly lower per capita income than the remaining sample. The lack of economic resources was compounded by social, structural and environmental vulnerabilities. Longer patient delays were related to patients' perception of symptoms as non-serious. Provider delays were incurred as a result of private providers' failure to respond to tuberculosis in a timely manner. Diagnostic and treatment delays were minimal, however, analysis of the 'outliers' revealed the importance of social support in enabling access to the programme. CONCLUSION: A proxy for those who fail to reach the programme, these case profiles highlight unique vulnerabilities that need innovative approaches by the RNTCP. The focus on 'outliers' provides a less resource- and time-intensive alternative to community-based studies for understanding the barriers to reaching public health programmes