Recent advances in the pathophysiology and management of sepsis: a review

Sepsis is a syndrome consisting of physiological, pathological and biochemical anomalies caused by infectious agents. It causes clinical organ dysfunction, which is identified by an acute increase in the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score of two or more points. SOFA score is a score of three components that can be easily used at the bedside to track the clinical status of a patient while on admission, and these are altered respiratory rate of ≥ 22 breaths/minute, altered mental status, and systolic blood pressure of ≤ 100 mmHg. A patient with SOFA score of ≥ 2 has an attributable 2 - 25-fold increased risk of mortality compared to a patient with SOFA score of ˂ 2. This present review provides information on the new definition of sepsis and septic shock, aetiology, pathophysiology, biochemical, pathological and haematological changes, morbidity and mortality parameters, management, andprognostic factors in patients with sepsis. Key words: Sepsis, septic shock, SOFA score, pathophysiology, management bundle

Use of dexamethasone in the management of respiratory tract infections

Dexamethasone is a potent synthetic member of the glucocorticoid class of corticosteroid drugs that has been useful for the management of some pathological disorders because it affects a protean number of signaling pathways. It is used as adjunct therapy in the management of sepsis, arthritis, cardiac transplant, blood, hormone/immune system disorders, allergic reaction, skin, eye conditions, cancer and other pathologic disorders and as a mainstay of therapy in autoimmune hepatitis. With the advent of COVID-19, there have been investigations of its use as antiinflammatory agent in severely ill patients. This present review elucidates the various studies on the use of dexamethasone in the management of severe respiratory tract infections, with the ultimate aim of reducing mortality amongst severely ill patients, including COVID-19. Keywords: dexamethasone; adjunctive therapy; respiratory infections; COVID-19   English Title: Utilisation de la dexaméthasone dans la prise en charge des infections des voies respiratoires La dexaméthasone est un membre synthétique puissant de la classe des corticostéroïdes glucocorticoïdes qui a été utile pour la gestion de certains troubles pathologiques car elle affecte un nombre protéiforme de voies designalisation. Il est utilisé comme traitement d'appoint dans la prise en charge de la septicémie, de l'arthrite, de la transplantation cardiaque, du sang, des troubles hormonaux/du système immunitaire, des réactions allergiques, des affections cutanées, oculaires, du cancer et d'autres troubles pathologiques et comme pilier du traitement de l'hépatite auto-immune. Avec l'avènement du COVID-19, des études ont été menées sur son utilisation comme agent anti-inflammatoire chez des patients gravement malades. Cette revue présente les différentes études sur l'utilisation de la dexaméthasone dans la prise en charge des infections sévères des voies respiratoires, dans le but ultime de réduire la mortalité chez les patients gravement malades, y compris le COVID-19. Mots clés: dexaméthasone; thérapie d'appoint; infections respiratoires; COVID-1

Determinants of Rice Farmers’ Investment in Value Addition and Its Effect on Poverty Status in Kebbi State, Nigeria

The study examined investment of rice value addition activities among farmers in Kebbi State, Nigeria. Data used for the study were collected with the aid of structured questionnaire administered to 123 randomly selected farmers in three local government areas of the state. Data was analyzed using Foster Greek Thoerboeck (FGT) poverty index and logit regression technique. The results showed that poverty status among the rice farmers was high, as 58.3% were poor and 42.7% were non poor. The result of the analysis showed that the marginal effects of income from parboiling, winnowing, drying, destoning, and bagging value addition were negative and statistically significant related to farmer’s poverty status at 1% level. It was concluded that rice farmers’ investment in value addition should be promoted among the farmers in Kebbi State. High cost of labour (81.0%), poor marketing information (75.6%) and inadequate credit (73.1%) were the three most critical constraints limiting the farmers in engaging in value addition activities. It wasrecommended that farmers cooperatives should form collaboration with extension agent to make farmers aware of the benefits of investment in value addition activities and those farmers already investing in value addition should make use of the modern method of processing instead of the traditional practices which help to increase their income. Keywords: Investment, Value addition, Processing, Poverty status and Rice farmer

Evaluation of some quality parameters of cassava starch and soy protein isolate matrices during deep fat frying in soybean oil

Open Access Journal; Published online: 19 Dec 2018Snack industry is recently focused on the production of snacks with minimal oil content and enhanced quality attributes which prompted the need to study the changes in snack matrices produced from cassava starch processed from three varieties of cassava roots (TMS‐950289, TME‐419, and TMS‐30572) and soy protein isolate blends fried in soybean oil. Effect of frying temperature (170–180°C), frying time (2–4 min), soy protein isolate inclusion level (5%–15%) on proximate composition, color changes, expansion, texture, and sensory attributes of the snacks was investigated. Optimization of process variables was carried out based on a factorial design (2 level by 3 factor) in the Design Expert version 6.0.8, and models were generated showing the relationship between the independent variables and the responses. The desired goal for each constraint (processing conditions) was kept within 170–180°C for 2–4 min, while all responses, except chewiness, expansion, yellowness, and protein, were set at minimum. Evaluation of sensory attributes of the optimized sample was carried out to determine its level of desirability. The optimized frying conditions for matrices produced from starches of TMS‐950289 are 170°C/4 min/5% SPI with desirability value of 0.507; from TME‐419 are 180°C/2 min/5% SPI with desirability value of 0.475 while for those from TMS‐30572 are 170°C/4 min/15% SPI with desirability value of 0.459. At higher SPI level, the protein content was high at 170°C. At 4 min frying time for all the varieties, the moisture content reduces. The most desired optimized fried snack produced from starch of TMS‐30572 (containing 15% SPI) had higher crispness and lower oil content than other optimized fried snacks

Screening African rice (Oryza glaberrima) for tolerance to abiotic stresses: I. Fe toxicity

AbstractIron (Fe) toxicity is recognized as one of the most widely spread soil constraints for rice production especially in West Africa. Oryza glaberrima the cultivated rice species that originated from West Africa is well-adapted to its growing ecologies. The aim of this study was to identify the promising O. glaberrima accessions tolerant to Fe toxicity from the 2106 accessions held at the AfricaRice gene bank. The screenings were conducted over a four-year period and involved evaluating the entries under Fe-toxic field conditions in West Africa, selecting good yielding accessions and repeating the testing with newly selected lines. Three accessions (TOG 7206, TOG 6218-B and TOG 7250-A) were higher yielding than O. sativa checks under stress but with similar yields under control conditions. These accessions yielded over 300g/m2 under both Fe toxicity and control conditions. In conclusion, these materials could be used as donors in breeding programs for developing high yielding rice varieties suited to Fe toxicity affected areas in West Africa

Prevalence of drug-resistant tuberculosis and imputed burden in South Africa : a national and sub-national cross-sectional survey

BACKGROUND : Globally, per-capita, South Africa reports a disproportionately high number of cases of multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis. We sought to estimate the prevalence of resistance to tuberculosis drugs in newly diagnosed and retreated patients with tuberculosis provincially and nationally, and compared these with the 2001–02 estimates. METHODS : A cross-sectional survey was done between June 15, 2012–June 14, 2014, using population proportionate randomised cluster sampling in the nine provinces in South Africa. 343 clusters were included, ranging between 31 and 48 per province. A patient was eligible for inclusion in the survey if he or she presented as a presumptive case during the intake period at a drug resistance survey enrolling facility. Consenting participants (≥18 years old) completed a questionnaire and had a sputum sample tested for resistance to first-line and second-line drugs. Analysis was by logistic regression with robust SEs, inverse probability weighted against routine data, and estimates were derived using a random effects model. FINDINGS : 101 422 participants were tested in 2012–14. Nationally, the prevalence of MDR tuberculosis was 2·1% (95% CI 1·5–2·7) among new tuberculosis cases and 4·6% (3·2–6·0) among retreatment cases. The provincial point prevalence of MDR tuberculosis ranged between 1·6% (95% CI 0·9–2·9) and 5·1% (3·7–7·0). Overall, the prevalence of rifampicin-resistant tuberculosis (4·6%, 95% CI 3·5–5·7) was higher than the prevalence of MDR tuberculosis (2·8%, 2·0–3·6; p=0·01). Comparing the current survey with the previous (2001–02) survey, the overall MDR tuberculosis prevalence was 2·8% versus 2·9% and prevalance of rifampicin-resistant tuberculosis was 3·4% versus 1·8%, respectively. The prevalence of isoniazid mono-resistant tuberculosis was above 5% in all provinces. The prevalence of ethionamide and pyrazinamide resistance among MDR tuberculosis cases was 44·7% (95% CI 25·9–63·6) and 59·1% (49·0–69·1), respectively. The prevalence of XDR tuberculosis was 4·9% (95% CI 1·0–8·8). Nationally, the estimated numbers of cases of rifampicin-resistant tuberculosis, MDR tuberculosis, and isoniazid mono-resistant tuberculosis for 2014 were 13 551, 8249, and 17 970, respectively. INTERPRETATION : The overall prevalence of MDR tuberculosis in South Africa in 2012–14 was similar to that in 2001–02; however, prevalence of rifampicin-resistant tuberculosis almost doubled among new cases. Furthermore, the high prevalence of isoniazid mono-resistant tuberculosis, not routinely screened for, and resistance to second-line drugs has implications for empirical management.President's Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under the terms of 1U19GH000571.http://www.thelancet.com/infection2019-07-01hj2018Medical Microbiolog

Evaluation of improved cassava genotypes for yield and related traits for a better breeding strategy under different agroecologies in Nigeria

Open Access Article; Published online: 29 Mar 2021This study aimed at determining shoot and root characteristics of cassava as affected by root yield and the influence of soil moisture on vegetative growth and yield. Thirty cassava genotypes were evaluated for morphological and physiological characterization in three locations in Nigeria: Ibadan, Mokwa and Zaria. Randomized complete block design was used with four replicates. Studies on the pasting properties of the genotypes were also carried out. Data were collected on plant height, stem girth, stay-green ability, garri and fresh root weight. Genotypes differed significantly (P < 0.05) across and within locations for shoot and root characteristics. Across locations, genotype 011663 had the highest plant height (132.4 cm); 30572 had the largest stem girth (8.6 cm); and 010040 was the best stay-green (2.2). Genotype 011086 had the highest number of roots per plot (95.7), 950289 had the highest fresh root yield (24.3 t/ha), and 990554 had the highest percentage of dry matter (35.2). Trends in root yields across locations were Ibadan (28.9 t/ha), Mokwa (20.3 t/ha), and Zaria (8 t/ha). Five genotypes IITA-TMS-IBA950289, 010034, 990554, 011807, and 980581 had negligible interactions with the environment and so have broad adaptation and are considered stable; and two clones 011807 and 950166 were found to be the best for pasting properties. Breeding strategies that consider root size, total root number, harvest index, dry matter, with applications for household foods and industrial uses, will be an effective and efficient way to select genotypes for high yield

Google Scholar as a source for citation and impact analysis for a non-ISI indexed medical journal

It is difficult to determine the influence and impact of journals which are not covered by the ISI databases and Journal Citation Report. However, with the availability of databases such as MyAIS (Malaysian Abstracting and Indexing System), which offers sufficient information to support bibliometric analysis as well as being indexed by Google Scholar which provides citation information, it has become possible to obtain productivity, citation and impact information for non-ISI indexed journals. The bibliometric tool Harzing's Publish and Perish was used to collate citation information from Google scholar. The study examines article productivity, the citations obtained by articles and calculates the impact factor of Medical Journal of Malaysia (MJM) published between 2004 and 2008. MJM is the oldest medical journal in Malaysia and the unit of analysis is 580 articles. The results indicate that once a journal is covered by MyAIS it becomes visible and accessible on the Web because Google Scholarindexes MyAIS. The results show that contributors to MJM were mainly Malaysian (91) and the number of Malaysian-Foreign collaborated papers were very small (28 articles, 4.8). However, citation information from Google scholar indicates that out of the 580 articles, 76.8 (446) have been cited over the 5-year period. The citations were received from both mainstrean foreign as well as Malaysian journals and the top three citors were from China, Malaysia and the United States. In general more citations were received from East Asian countries, Europe, and Southeast Asia. The 2-yearly impact factor calculated for MJM is 0.378 in 2009, 0.367 in 2008, 0.616 in 2007 and 0.456 in 2006. The 5-year impact factor is calculated as 0.577. The results show that although MJM is a Malaysian journal and not ISI indexed its contents have some international significance based on the citations and impact score it receives, indicating the importance of being visible especially in Google scholar

International Contribution to Nipah Virus Research 1999-2010

This study examines 462 papers on Nipah virus research published from 1999 to 2010, identifying the active authors, institutions and citations received. Data was extracted from SCI-Expanded database, (Web of Science) and analyzed using descriptive figures and tables. The results show the growth of publication is incremental up to 2010 even though the average citations received is decreasing. The ratio of authors to articles is 1330: 426. The active contributing countries are USA (41.0), Australia (19.3), Malaysia (16.0), England (6.5) and France (5.6). The productive authors are mainly affiliated to the Centre for Disease Control and Prevention, USA and Commonwealth Scientific and Industrial Research Organization (CSIRO) in Australia and University of Malaya Medical Centre, Malaysia. A total of 10572 citations were received and the ratio of articles to citation is 1: 24.8. Collaboration with the bigger laboratories in USA and Australia is contributive to the sustained growth of published literature and to access diverse expertise

Auditing scholarly journals published in Malaysia and assessing their visibility

The problem with the identification of Malaysian scholarly journals lies in the lack of a current and complete listing of journals published in Malaysia. As a result, librarians are deprived of a tool that can be used for journal selection and identification of gaps in their serials collection. This study describes the audit carried out on scholarly journals, with the objectives (a) to trace and characterized scholarly journal titles published in Malaysia, and (b) to determine their visibility in international and national indexing databases. A total of 464 titles were traced and their yearly trends, publisher and publishing characteristics, bibliometrics and indexation in national, international and subject-based indexes were described