The efficacy of intramuscular loading dose of MgSO4 in severe pre-eclampsia/ eclampsia at a tertiary referral centre in Northwest Nigeria

Aims and Objectives: The efficacy of 10g intramuscular loading dose of magnesium sulphate in women with severe preeclampsia/eclampsia was assessed at a tertiary health centre for potential use at primary health level. Subjects and Methods: Intramuscular 10g loading dose and 14g loading dose of Pritchard were compared in women with severe preeclampsia/eclampsia. Primary outcome measures were the occurrence of fits in women with severe preeclampsia, further fits in those with eclampsia and maternal death. Other outcome measures were mode of delivery and severe birth asphyxia at 5 minutes of life. Results: One hundred and three women were enrolled; 54 and 49 women had 10g and 14g loading dose respectively. No significant convulsions (p= 0.1424) occurred in women with severe preeclampsia who had 10g intramuscular loading dose and repeat convulsion was averted in 93% of women with eclampsia. 10g loading dose did not increase the likelihood of caesarean section in women with preeclampsia (p=0.2832) or eclampsia (p=0.9112). The mean Apgar score at 5 minutes of life of neonates whose mothers had 10g and 14g loading dose for preeclampsia was 8 and 8.46 respectively, and 8.9 and 8.8 respectively for eclampsia. There was no statistically significant difference in maternal death between the two groups for severe preeclampsia (p= 0.2020) and eclampsia (p=0.3496). Conclusion: This study suggests a potential use of intramuscular 10 gram loading dose of MgSO4 at the primary health care level in Nigeria.     

Angiotensin-converting enzyme inhibition and angiotensin AT1-receptor antagonism equally improve doxorubicin-induced cardiotoxicity and nephrotoxicity

Doxorubicin (Dox) is a potent anticancer agent; its clinical use is limited for its marked cardiotoxicity and nephrotoxicity. The present study investigated the possible protective effect of telmisartan, an angiotensin AT₁-receptor blocker versus captopril, an angiotensin-converting enzyme inhibitor, on Dox-induced cardiotoxicity and nephrotoxicity in rats. Rats were allocated into four groups. Control group, Dox group, Dox + telmisartan group, and Dox + captopril group. Cardiotoxicity and nephrotoxicity were assessed biochemically and histopathologically. Frozen heart and kidney specimens were used for estimation of lipid peroxides product (MDA), reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD) and nitric oxide (NO). Expression of induced nitric oxide synthase (iNOS) was detected by immunohistochemistry. Coadministration of either telmisartan or captopril with Dox equally decreased the biochemical markers of both cardiotoxicity (LDH and CK–MP) and nephrotoxicity (urea and creatinine). Both telmisartan and captopril attenuated the effects of Dox on oxidative stress parameters and NO. Histopathologically, coadministration of either drug with Dox was able to attenuate Dox-induced myocardial fibrosis and renal tubular damage. Immunohistochemistry, expression of iNOS was increased in both cardiac and renal tissues. Both telmisartan and captopril significantly and equally attenuated the effect of Dox on all measured parameters. These results suggested that telmisartan has protective effects equal to that of captopril against Dox-induced cardiotoxicity and nephrotoxicity; implying that angiotensin II pathway plays a role in Dox-induced cardiac and renal damage. The protective effect of either drug relies, at least in part, on their antioxidant effects and decreased the expression of iNOS.     

Oral administration of live Bifidobacterium substrains isolated from healthy centenarians enhanced immune function in BALB/c mice

Generally, there is an age-related decline in the human gut titer of Bifidobacterium species, but the titer in healthy centenarians was previously reported to be comparable to that found in much younger people. We addressed whether elevated Bifidobacterium titers relate positively to immune function. This study evaluated the immunoactivities of 2 Bifidobacterium strains (B adolescentis BBMN23 and B longum BBMN68) isolated from healthy centenarians in China. Different dosages (2 × 10¹¹, 2 × 10⁹, or 2 × 10⁷ colony-forming units [CFU]/kg body weight) of live bifidobacteria were orally administered once per day to healthy BALB/c mice, and the control group was given sterile skim milk every day. After 4 weeks, the immune parameters including cellular immunity (delayed-type hypersensitivity [DTH], and splenic lymphocyte proliferation), humoral immunity (serum hemolytic activity in immunized animals), and nonspecific immunity (peritoneal macrophages phagocytsis natural killer [NK] cell activity) were measured. We report that both Bifidobacterium strains independently increased the DTH response. Macrophage phagocytosis was also enhanced, while activities of the NK cells and levels of the serum hemolysin also were significantly higher than in the control group. There was a significant increase in splenic lymphocyte proliferation in bifidobacteria treatment animals compared to controls. In conclusion, ingestion of B. adolescentis BBMN23 and B. longum BBMN68 can enhance both innate and acquired immunity in healthy specific pathogen-free (SPF) mice and strains of bifidobacteria from healthy centenarians in Bama longevity villages in China may possess potentially valuable immunomodulatory properties.     

Shear Strength of Externally U-Bonded Carbon Fiber-Reinforced Polymer High-Strength Reinforced Concrete

In this paper, we investigate the contribution of Fiber-Reinforced Polymer (FRP) to the load-carrying capacity of shear-strengthened Reinforced Concrete (RC) beams. Specifically, the investigation is focused on the FRP’s contribution in the presence and absence of shear stirrups. To this end, two sets of full-scale RC beam specimens were tested to failure in a simply supported setup. Set 1 consisted of specimens without shear stirrups whereas Set 2 included steel stirrups spaced at 170 mm. One and two layers of FRP discrete strips were bonded to the beams in a U-jacketing configuration. To investigate the contribution of FRP and its interaction with the stirrups, two different locations were considered when bonding the FRP strips: between the stirrups (referred to as Off-beams) and at the same level of the stirrups (referred to as On). Results of the experimental program showed that strengthening the beams with two layers of FRP does not necessarily translate to improved capacity. Furthermore, the location of FRP strips with respect to the location of shear stirrups has an influence on the beam’s overall behavior, especially its displacement ductility. This is an important parameter to consider to avoid premature failure of RC members. Test results were then used to assess the performance and accuracy of the predictions of ACI PRC-440.2-17 and fib-TG9.3. Both design codes were found to be conservative with an average prediction-to-test ratio of 0.7.     

Serum vitamin D levels in children with recurrent otitis media

The aims of this study were to evaluate serum vitamin D levels in cases of recurrent otitis media and investigate the effect of vitamin D therapy on the risk of re-occurrence of the disease. This prospective study was performed by comparing serum vitamin D levels in children with recurrent otitis media and healthy children. Eighty-four children between 1 and 5 years of age and diagnosed with recurrent otitis media were enrolled as the study group. One hundred-and-eight healthy children with similar demographic characteristics were enrolled as the control group. Patients were divided into groups according to their serum 25(OH) vitamin D levels. In patients with low initial serum vitamin D levels, vitamin D therapy was administered in addition to conventional treatment for otitis media. Mean serum 25(OH) vitamin D level in the study group was 11.4 ± 9.8 ng/mL Serum 25(OH) vitamin D levels were below 20 ng/mL in 69 % (n = 58) of cases in this group. In the control group, mean serum 25(OH) vitamin D level was 29.2 ± 13.9 ng/mL and was below 20 ng/mL in 30 % (n = 32) of cases. Comparison of serum 25(OH) vitamin D levels and PTH in the study and control groups revealed a statistically significant difference (p < 0.05). Treatment was initiated in cases diagnosed with vitamin D deficiency, and patients were followed up in due course. The only episodes detected over the course of 1-year follow-up were one attack in five patients and two attacks in two. We believe that co-administration of supplementary vitamin D together with conventional treatments is appropriate in the management of upper respiratory infections such as otitis media.     

MR spectroscopy and diffusion MR imaging in characterization of common sellar and supra-sellar neoplastic lesions

Background

MR spectroscopy and diffusion-weighted imaging are useful non invasive imaging modalities used for characterization of different sellar and suprasellar lesions.

Patient and methods

We studied 30 cases of suprasellar SOLs (as proved by conventional MRI), MRS and DWI. Our findings were correlated with histopathological analysis after surgical resection.

Results

Three false positive cases in which cMRI give diagnosis mismatched with that obtained after adding the MRS findings and ADC values. MR spectrum type IIC is found in macroadenoma, craniopharyngioma, meningioma and germinoma with characteristic broad lipid peak in the second and forth types and elevated alanine peak in meningioma. Glioma had MRS appearance of type IIB. Simple differentiation between tumor types were achieved by the mean ADC values which were statistically significant (p < 0.001) when correlated to the histological diagnosis. When the ADC value of 0.6 × 10⁻³ mm²/s this strongly points to macroadenoma, ADC value of 1.05 × 10⁻³ mm²/s in meningiomas, ADC value 1.88 8 × 10⁻³ mm²/s strongly points to craniopharyngioma, while gliomas and germinoma had ADC values 1.6 × 10⁻³ mm²/s and 1.0 × 10⁻³ mm²/s respectively.

Conclusion

MR spectroscopy and DWMRI are considered important diagnostic tools complementary to cMRI in pre-surgical evaluation and discrimination between different sellar and suprasellar lesions.