Pattern and antimicrobial sensitivity of pathogens in acute bacterial meningitis beyond neonatal period at Ahmadu Bello University Teaching Hospital (ABUTH) Shika, Zaria

The causative agents of acute bacterial meningitis vary from time to time and from place to place. In addition, changes in pathogen’s sensitivity to antibiotics in use occur. The study was undertaken to identify the pattern and susceptibility of pathogens to antibiotics among children beyond neonatal period for prompt empirical treatment of this important cause of morbidity and mortality especially in developing countries.Objective. To identify the pattern and susceptibility of pathogens in acutebacterial meningitis among children aged one month to 12 years atABUTH Shika, Zaria.Method: This was a prospective study carried out in children presentingto Emergency Pediatric Unit of ABUTH Shika, Zaria, from October1st 2005 to September 30th, 2006. Children who met the inclusion criteriafor lumbar puncture were consecutively recruited. Cerebrospinalfluid (CSF) samples were collected for microscopy, culture, sensitivity,and Latex Particle Agglutination (LPA) test. Sixty-six (66) patientssatisfied the criteria for acute bacterial meningitis and were studied.Results: The prevalence of acute bacterial meningitis in this study was6.9%. Sixty-six patients with acute bacterial meningitis were identifiedusing 3 diagnostic methods (Gram stain, culture and LPA). The 3 commonest organisms were Streptococcus pneumoniae 34 (51.5%), Haemophilus influenzae 18 (27.3%), and Neisseria meningitidis 12(11.2%). The sensitivity of the isolates to three commonly used noncephalosporin antibiotics was chloramphenicol 74.4%, penicillin38.5%, and ampicillin 2.6%. The sensitivity to the cephalosporin wascefotaxime 97.4%, and ceftriaxone 89.7% while that to Ofloxacin, aquinolone, was 100%.Conclusion: The three commonest bacterial agents causing post neonatalmeningitis were Streptococcus pneumoniae, Haemophilus influenzae,and Neisseria meningitidis. There is an increasing resistance to the three commonly used non c e p h a l o s p o r i n a n t i b i o t i c s(chloramphenicol, ampicillin and penicillin) and hence, cefotaxime orceftriaxone should be used in the empirical treatment of children withsuspected acute bacterial meningitis beyond neonatal period

Epidemic cerebrospinal meningitis in children at Federal Medical Centre, Gusau, Zamfara state, Nigeria

Epidemic meningococcal meningitis is a major public health problem still affecting tropical countries, particularly in Sub-Saharan Africa, which lieswithin African meningitis belt. Repeated large scale epidemics of CSM have been reported in northern Nigeria for the past four decades. It is one of the important causes of morbidity and mortality in these regions. Mortality from the CSM remains high despite advances in treatment modalities. Neisseria meningitidis serogroup A have been the major cause of large scale epidemics in tropical countries, while serogroups B, C, Y and W-135 are responsible for most of invasive disease in America and other developed countries.Objective: To determine the pattern of epidemic CSM in children atFederal Medical Centre, Gusau.Method: The study was a retrospective one carried out in children agedsix months to 12 years admitted into Emergency Paediatrics Unit (EPU) with a diagnosis of CSM within the period January to May, 2009.Results: Seventy- seven children with epidemic CSM were admittedand managed in EPU from January-May 2009.Conclusion: Neisseria meningitidis serogroup A CSM is becoming thedisease of young infants, and stresses the need for inclusion ofCSM vaccine in early infancy in routine immunization policy, in areas within the meningitis belt in Sub-Saharan Africa

Providing distributed certificate authority service in mobile ad hoc networks

In this paper, we propose an architecture for providing distributed Certificate Authority (CA) service in Mobile Ad Hoc Networks (MANET), based on threshold cryptography. We have two major contributions: 1) we make use of the cluster structure to provide CA service, and design a scheme for locating CA server nodes in MANET; 2) we provide a proactive secret share update protocol, which periodically updates CA secret shares with low system overhead. Compared with existing approaches, our CA architecture provides faster CA services to user nodes at reduced system overhead. © 2005 IEEE.published_or_final_versio

P20-08. Glycosylation: an important factor in Env diversity

Supported by a CAVD Grant from the Bill and Melinda Gates Foundation

AVALIAÇÃO DE BRUXISMO NA INFÂNCIA – RELATO DE CASO CLINICO

Introdução: O bruxismo é um hábito parafuncional caracterizado pelo rangido e/ou apertamento dos dentes, sendo inconsciente. Sua etiologia é multifuncional e existem fatores psicológicos, como estresse e ansiedade, e fatores neurofisiológicos, ligados a alterações do sono

The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: Outcomes of a SIOP Europe survey.

BACKGROUND AND PURPOSE: Children receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations for contouring and dose constraints to dentofacial structures are lacking in clinical practice. We report on a survey aiming to understand current practice in contouring and dose assessment to dentofacial structures. METHODS: A digital survey was distributed to European Society for Paediatric Oncology members of the Radiation Oncology Working Group, and member-affiliated centres in Europe, Australia, and New Zealand. The questions focused on clinical practice and aimed to establish areas for future development. RESULTS: Results from 52 paediatric radiotherapy centres across 27 countries are reported. Only 29/52 centres routinely delineated some dentofacial structures, with the most common being the mandible (25 centres), temporo-mandibular joint (22), dentition (13), orbit (10) and maxillary bone (eight). For most bones contoured, an 'As Low As Reasonably Achievable' dose objective was implemented. Only four centres reported age-adapted dose constraints.The largest barrier to clinical implementation of dose constraints was firstly, the lack of contouring guidance (49/52, 94%) and secondly, that delineation is time-consuming (33/52, 63%). Most respondents who routinely contour dentofacial structures (25/27, 90%) agreed a contouring atlas would aid delineation. CONCLUSION: Routine delineation of dentofacial structures is infrequent in paediatric radiotherapy. Based on survey findings, we aim to 1) define a consensus-contouring atlas for dentofacial structures, 2) develop auto-contouring solutions for dentofacial structures to aid clinical implementation, and 3) carry out treatment planning studies to investigate the importance of delineation of these structures for planning optimisation

Estimation of Dietary Iron Bioavailability from Food Iron Intake and Iron Status

Currently there are no satisfactory methods for estimating dietary iron absorption (bioavailability) at a population level, but this is essential for deriving dietary reference values using the factorial approach. The aim of this work was to develop a novel approach for estimating dietary iron absorption using a population sample from a sub-section of the UK National Diet and Nutrition Survey (NDNS). Data were analyzed in 873 subjects from the 2000–2001 adult cohort of the NDNS, for whom both dietary intake data and hematological measures (hemoglobin and serum ferritin (SF) concentrations) were available. There were 495 men aged 19–64 y (mean age 42.7±12.1 y) and 378 pre-menopausal women (mean age 35.7±8.2 y). Individual dietary iron requirements were estimated using the Institute of Medicine calculations. A full probability approach was then applied to estimate the prevalence of dietary intakes that were insufficient to meet the needs of the men and women separately, based on their estimated daily iron intake and a series of absorption values ranging from 1–40%. The prevalence of SF concentrations below selected cut-off values (indicating that absorption was not high enough to maintain iron stores) was derived from individual SF concentrations. An estimate of dietary iron absorption required to maintain specified SF values was then calculated by matching the observed prevalence of insufficiency with the prevalence predicted for the series of absorption estimates. Mean daily dietary iron intakes were 13.5 mg for men and 9.8 mg for women. Mean calculated dietary absorption was 8% in men (50th percentile for SF 85 µg/L) and 17% in women (50th percentile for SF 38 µg/L). At a ferritin level of 45 µg/L estimated absorption was similar in men (14%) and women (13%). This new method can be used to calculate dietary iron absorption at a population level using data describing total iron intake and SF concentration

Expression of Distal-less, dachshund, and optomotor blind in Neanthes arenaceodentata (Annelida, Nereididae) does not support homology of appendage-forming mechanisms across the Bilateria

The similarity in the genetic regulation of arthropod and vertebrate appendage formation has been interpreted as the product of a plesiomorphic gene network that was primitively involved in bilaterian appendage development and co-opted to build appendages (in modern phyla) that are not historically related as structures. Data from lophotrochozoans are needed to clarify the pervasiveness of plesiomorphic appendage forming mechanisms. We assayed the expression of three arthropod and vertebrate limb gene orthologs, Distal-less (Dll), dachshund (dac), and optomotor blind (omb), in direct-developing juveniles of the polychaete Neanthes arenaceodentata. Parapodial Dll expression marks premorphogenetic notopodia and neuropodia, becoming restricted to the bases of notopodial cirri and to ventral portions of neuropodia. In outgrowing cephalic appendages, Dll activity is primarily restricted to proximal domains. Dll expression is also prominent in the brain. dac expression occurs in the brain, nerve cord ganglia, a pair of pharyngeal ganglia, presumed interneurons linking a pair of segmental nerves, and in newly differentiating mesoderm. Domains of omb expression include the brain, nerve cord ganglia, one pair of anterior cirri, presumed precursors of dorsal musculature, and the same pharyngeal ganglia and presumed interneurons that express dac. Contrary to their roles in outgrowing arthropod and vertebrate appendages, Dll, dac, and omb lack comparable expression in Neanthes appendages, implying independent evolution of annelid appendage development. We infer that parapodia and arthropodia are not structurally or mechanistically homologous (but their primordia might be), that Dll’s ancestral bilaterian function was in sensory and central nervous system differentiation, and that locomotory appendages possibly evolved from sensory outgrowths