Profile of septic work up among patients admitted into the intensive care unit in University of Abuja teaching hospital Gwagwalada, Abuja

Background: Several infectious agents are responsible for sepsis in all age groups presenting with fever which can have devastating consequences if not adequately treated. Sepsis may arise from bacteria, fungi and viral origin but are localized in particular organ or system with systemic affectation. Febrile illness is a leading reason for admission to the intensive care unit of hospitals in the tropics and these patients comes mostly from inpatients rather than from outpatients. Diagnostic apparatus needed for sepsis work up are usually not available in most cases and the data regarding septic work up are very scanty. Therefore, this research set out to determine the pattern of isolates from septic work-up among patients admitted to the intensive care unit in Abuja.Methodology: This was a descriptive cross-sectional study. Sixty-four consecutive patients admitted to the intensive care unit with symptoms such as fever were involved in the study in a view to determine the septic state of the patients. Samples were collected. Blood culturing was performed using the BACTEC 9050® system and biochemical analytical profile index were used for identification and confirmation of bacterial isolates.Results: The mean age of the patients admitted to ICU was 40.9±3.2 with the highest proportion within the age range of 31-40 years accounting for 31.7% of the patients enrolled and the lowest proportion being 10-20 years group accounting for 5.0%.Out of the 64 patients investigated in the ICU 60 patients had clinical and positive cultures with an overall positive and negative infection rate of 93.8% and 6.3% respectively. From the positive cultures yields 86.7% were bacteremia and 13.3% were fungaemia. Multiple infections were observed among the male patients, Multi-drug resistance bacteria were observed among Klebsiella pneumonia, E. coli and P. aeroginosa isolates.Conclusion: Bacterial and fungal isolates were found in this study but increased rate of polymicrobial isolation and nosocomial infections calls for concern.Key words: Profile of infectious agents, sepsis, fever, septic work up, Abuj

Prevalence and risk factors of hepatitis b infection in HIV infected children seen at national hospital Abuja

Background: Human immunodeficiency virus infection remains a global pandemic. Co infection with hepatitis B virus leads to rapid progression to AIDS if not diagnosed and promptly treated or better still prevented. The study aims at determining the prevalence and risk factors of hepatitis B infection in HIV infected children being followed up at the Paediatric HIV clinic. Patients and methods: A cross-sectional study of 261 HIV infected children aged eight months to fourteen years to determine the prevalence of Hepatitis B infection and pattern of hepatitis B vaccination was carried out between July and October 2012 at the Paediatric HIV clinic of National Hospital Abuja. Ethical approval was obtained from Ethical Committee of the hospital. Vaccination and transfusion history were obtained from the parents and guardians of the subjects using a proforma after signed informed consent. Blood samples were collected for Hepatitis B surface antigen screening and Hepatitis B screening in those with HBsAg positive blood samples. Results: Only 3 (1.15%) of the 261 HIV infected children had Hepatitis B infection. All the children less than 5 years old in this cohort received hepatitis B vaccination and none of them had Hepatitis B infection. The HIV/HBV co infected children were older than ten years (p = 0.047) and history of blood transfusion (p = 0.003) was also significant. However, scarification (p = 0.996), local circumcision (p = 0.928); uvulectomy (p = 0.898) were not significant risk factors in this cohort. Conclusion: There is need to intensify routine hepatitis B vaccination and routine screening of blood before necessary transfusion. This would further lead to a low prevalence of Hepatitis B in HIV infected children and the general populace at large

Isolation and Characterization of an Anticonvulsant Principle from Leaf Extract of Pyrenacantha Staudtii

Pyrenacantha staudtii was investigated as a potential source of novel anticonvulsant drug nucleus. Systematic isolation of compounds in the non – polar extracts (i.e n-hexane and dichloromethane) of the leaves of Pyrenacantha staudtii was carried out using column and thin layer chromatography. The isolated compounds were characterized using infra red (IR) and nuclear magnetic resonance (NMR) spectroscopic techniques to be bis(8-hydroxyl-2-methylnonyl) phthalate and bis(8-methylnonyl) phthalate. The two compounds were screened for anticonvulsant activity using mice. Bis(8-hydroxyl-2-methylnonyl) phthalate  showed appreciable anticonvulsant activity but bis(8-methylnonyl) phthalate did not. Key words: Pyrenacantha staudtii, Icacinacae, anticonvulsan

Hepatoprotective role of Moringa oleifera ethanolic leaf extract on Liver functions (Biomarker) in cadmium chloride induced hepatotoxicity in Albino wistar rats

This study investigated the hepatoprotective role of ethanolic extract of Moringa oliefera (M.O) on liver function (Biomarkers) in cadmium chloride (CdCl2)-induced hepatotoxicity on the liver of albino Wistar rats. Sixty-six adult male albino wistar rats weighing between 130g – 180g were used. LD50 was determined for both CdCl2and MO using twenty-six (26) rats, while 40 rats were used for the experiment proper. The experimental rats were distributed into eight groups –A (control) and B, C, D, E, F, G and H, served as the treatment groups that received graded doses of CdCl2or MOor both simultaneously or at separate periods. The animals were then euthanized for sample collection and analysis using standard methods. The results showed significant increase (P<0.05) in the serum levels of Alanine aminotransferase (ALT) (430.50 ± 149.20), Aspartate aminotransferase (AST) (421.10 ± 8.34) and Alkaline Phosphatase (ALP) (515.60 ± 21.78) of animals in group B, but some protective effect of MO in the treatment groups with significant decreases in ALT, AST and ALP levels. The study therefore concludes that ethanolic extract of Moringa oleifera showed appreciable hepatoprotective values on liver functions (biomarkers) in CdCl2hepatotoxicity.Key words: Liver Functions, Cadmium, Moringa oleifera, Hepatoprotective, Hepatotoxici

Sero-prevalence of human T-lymphotrophic virus 1/2 among HIV-1 infected individuals in Ilorin, Nigeria

Background: HTLV–1 or 2 co–infection in individuals infected with HIV–1 can lead to increased morbidity. The shared routes of transmission of HTLV with HIV–1 may increase the prevalence of HTLV among HIV–1 infected population and subsequently affect patient’s management.Methods: Sera were collected from 144 HIV–1 infected individuals attending the highly active anti–retroviral therapy (HAART) clinic of the University of Ilorin Teaching Hospital between the months of May and August 2016. Sera were tested for anti–HTLV IgM and IgG antibodies to HTLV– 1&2 using the sandwich enzyme–linked immunosorbent assay.Results: Out of the 144 participants tested, 47 (32.6%) and 37 (25.7%) were positive for HTLV IgG and IgM respectively. Twenty–one participants (14.6%) had both IgG and IgM antibodies to HTLV–1&2. Ten individuals were anti–retroviral drug naïve out of which, four and six were positive to anti–HTLV IgG and IgM respectively.Conclusion: Findings from this study revealed that there is high sero–prevalence of HTLV IgG and IgM antibodies among HIV–1 sero–positive individuals in Ilorin. The high rate of co–infection supports routine screening for HTLV–1/2 co-infection among HIV–1 infected individuals in Ilorin, Nigeria so that the purpose of HAART treatment and monitoring of patients to prevent progression to AIDS will not be aborted.Keywords: Human T-cell lymphotrophic Virus, Human immunodeficiency virus–1, IgG, IgM, CD4+ count

Effects of Forest Fire on the Regeneration Potentials of Tree Species in Olokemeji Forest Reserve, Ogun State, Nigeria

Effects of forest fire on the regeneration potential of trees at Olokemeji Forest Reserve was established in this study. The Olokemeji fire experimental plot was selected at the reserve. The site was divided into three plots; late fire treatment was applied to Plot A, Early fire treatment was also applied to Plot B and no fire treatment at plot C (Control plot). The diameter at breast height (dbh) and tree height (m) of the tree species in the plots were assessed prior and post fire treatment. The regeneration potential of the selected plots after burning were assessed through the occurrence of saplings and seedlings obtained. The highest basal area (m2) were found in plot C followed by plot B and Plot C with mean value of 0.64, 0.55 and 0.30 m2 respectively. The number of stems per plot ranged from 25 to 67. The regeneration potentials of the three plots were found to be noteworthy. Early and late year fire regime adopted had both positive and negative effect on the regeneration potentials of tree species. This study has established the effect and relevance of fire on forest and wildlife management. It’s therefore recommended in this study that Prescribed or controlled burning should be encouraged as appropriate sivilcultural management tool for stimulating basal area growth, natural regeneration, production of tree species seedlings and saplings

Effects of ethanolic extract of Irvingia gabonensis on the liver of progesterone induced obesity in female Swiss mice

Objective: The study was designed to investigate the effects of Irvingia gabonensis ethanolic extract (IGE) on the liver and lipid profile of progesterone induced obesity in female swiss mice.Methods: Fifteen female mice weighing between 20-25g were randomly divided into three groups with each group comprising of five mice. Obesity was induced by giving the test animals progesterone (10ml/kgbw) subcutaneously at the dorsal neck region. The groups were divided as Group A- obesity controlled + diluent (10 ml/kgbw), B- obese induced +Low dose IGE (5ml/kg bw) and C- obesity induced + high dose IGE (10 ml/kg bw). After 14 days of treatments, blood samples were collected centrifuged and lipid profile levels Cholesterol, HDL, LDL and Triglyceride concentrations were estimated in the serum. The liver, peri-ovarian fat, ovary and uterus were removed from each of the mice and weighed with a sensitive balance and liver prepared for histological examinations and evaluation.Results: Preliminary phytochemical analysis of the extract revealed the presence of glycosides. Obesity induction caused some fatty changes in the liver hepatocytes and the IGE treatment caused reduction of the fat globules around the hepatocyte with focal necrosis. The cholesterol and triglyceride level was higher in the low dose IGE treated but does not differ significantly from the high dose IGE treated and control (P<0.05).Conclusion: The ethanolic extract of Irvingia gabonensis at doses studied caused a reduction in the body weight in mice which is very obvious at the low dose, while the lipid profile and the blood parameters were not affected. Hence, it may be a safe herb at doses considered. The extracts caused a significant change in the liver histology which was evident by reduction of fat globules and focal necrosis, swelling of cells.Keywords: Progesterone, Induced Obesity, Irvingia gabonensis, Blood parameters, Lipid Profile

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global burden of 87 risk factors in 204 countries and territories, 1990�2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk�outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk�outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk�outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95 uncertainty interval UI 9·51�12·1) deaths (19·2% 16·9�21·3 of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12�9·31) deaths (15·4% 14·6�16·2 of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253�350) DALYs (11·6% 10·3�13·1 of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0�9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10�24 years, alcohol use for those aged 25�49 years, and high systolic blood pressure for those aged 50�74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens