Immunoregulation of Inflammatory and Inhibitory Cytokines by Vitamin D3 in Patients with Inflammatory Bowel Diseases

Inflammatory bowel disease (IBD) is a group of idiopathic, chronic and relapsing inflammatory conditions of the gastrointestinal tract, caused by an aberrant and exaggerated immunological response in the gut. Supplementation of vitamin D3 in patients with IBD exerts both direct and indirect regulatory roles on the naïve T cells, thereby maintaining a balance between inflammatory and inhibitory cytokines. The direct actions of vitamin D3 on naïve T cells result in the proliferation of more regulatory T cells and inhibitory cytokines such as IL‐4, IL‐10 and IL‐5. The binding of vitamin D to dendritic cells (DCs) through vitamin D receptors inhibits the action of IL‐12 on DCs, resulting in the downregulation of Th1 and Th17. On the other hand, this interaction favours Th2 and Treg upregulation and facilitates the maintenance of immune homoeostasis between inflammatory and inhibitory cytokines which is essentially significant in the management of patients with IBD. The aim of this review was to explore the current and mounting scientific evidence on the roles of vitamin D3 in immunoregulation of inflammatory and inhibitory cytokines in patients with IBDs. An extensive literature search was conducted using keywords such as Vitamin D3*, IBD*, inflammatory cytokines*, inhibitory cytokines*, naïve‐T‐cells* and antigen presenting cells* through PubMed, SCOPUS and MEDLINE search engines. The results of the accumulated bodies of research that have been conducted demonstrate that vitamin D3 plays a major role not only in the immunoregulation of cytokines involved in the pathogenesis of IBDs but also in many other inflammatory disorders.     

Burden of Neonatal Surgical Conditions in Northern Ghana

World Journal of Surgery - Congenital anomalies have risen to become the fifth leading cause of under-five mortality globally. The majority of deaths and disability occur in low- and middle-income...     

Visual resolution under photopic and mesopic conditions in patients with Sjögren's syndrome

AIM: To focus on different visual resolution tasks under photopic and mesopic conditions in Sjögren’s syndrome patients compared to age-matched healthy controls. METHODS: The visual resolution measurements included high and low visual acuities and contrast sensitivity functions. These tests were conducted under photopic and then mesopic conditions. Twenty-one Sjögren’s syndrome patients and 21 aged-matched healthy volunteers completed all the measurements in this study. RESULTS: Sjögren’s syndrome patients have greater impairment in contrast sensitivity than standardized visual acuity. This reduction was significant under the mesopic condition. Also, Sjögren’s syndrome patients treated with pilocarpine suffer more than patients without pilocarpine treatment under low light conditions. CONCLUSION: Sjögren’s syndrome patients shows greater impairment in different visual resolution tasks due to dry eye symptoms.     

Effects of locomotor skill program on minority preschoolers' physical activity levels

This pilot study examined the effects of a teacher-taught, locomotor skill (LMS)-based physical activity (PA) program on the LMS and PA levels of minority preschooler-aged children. Eight low-socioeconomic status preschool classrooms were randomized into LMS-PA (LMS-oriented lesson plans) or control group (supervised free playtime). Interventions were delivered for 30 min/day, five days/week for six months. Changes in PA (accelerometer) and LMS variables were assessed with MANCOVA. LMS-PA group exhibited a significant reduction in during-preschool (F (1,16) = 6.34, p = .02, d = 0.02) and total daily (F (1,16) = 9.78, p = .01, d = 0.30) percent time spent in sedentary activity. LMS-PA group also exhibited significant improvement in leaping skills, F (1, 51) = 7.18, p = .01, d = 0.80). No other, significant changes were observed. The implementation of a teacher-taught, LMS-based PA program could potentially improve LMS and reduce sedentary time of minority preschoolers.     

Trial of Trachoma Rapid Assessment in a subdistrict of northern Nigeria

PURPOSE. To assess the usefulness of Trachoma Rapid Assessment (RA) in priority ranking of trachoma areas. METHODS. RA was conducted concurrently with a cross-sectional trachoma prevalence survey in some villages selected from the communities at risk for trachoma in the Kaita Local Government Area of northern Nigeria. The RA team consisted of two ophthalmic nurses. Pen torches and loupes were used for the examination. Data were collected on the seven components of the RA ‘information pyramid’ for all the selected villages. The data were analyzed using the RA methodology guidelines to determine the priority villages for trachoma intervention. This was compared with the ranking from the cross-sectional trachoma prevalence survey. RESULTS. The results of RA were found to be in agreement with the cross-sectional survey in 53.3% of the villages in the priority ranking of trichiasis, while in the priority ranking of active trachoma the agreement between the two methods was found to be 60%. The risk factors for trachoma were shown to be of high magnitude in all the villages using both the RA method and the prevalence survey. CONCLUSION. RA may be a more useful tool when applied to a vast area where the risk of trachoma is likely to differ greatly between different parts of the area. In the determination of the trichiasis pattern of a community by RA, it may be more useful to use the actual number of trichiasis cases in the area rather than the prevalence of trichiasis. The operational definition of some risk factor indicators seems very subjective and vague. The RA method needs more validation to sharpen the indicators used.     

Diastolic dysfunction in persons with hypertensive heart failure

Arterial hypertension is the commonest cause of heart failure in the Savannah region of Nigeria. The prevalence of diastolic dysfunction in patients with hypertensive heart failure in this region is unknown. This needs to be determined, since it may influence therapy. Left ventricular function of 95 patients with hypertensive heart failure and 92 age-/sex-matched, healthy normotensive control was determined by echocardiography using ALOKA SSD 1700 two-dimensional echocardiograph/ Doppler and color flow ultrasound machine. Compared to the controls, the hypertensive heart failure patients had increased left ventricular mass index (LVMI), p = 0.0001; cardiothoracic ratio (CTR), p = 0.0001; and electrocardiographic left ventricular hypertrophy (ECG-LVH), p = 0.0001. Isolated diastolic dysfunction, E/A ratio < 1.0, and EF > 50%, was seen in 12 patients (12.6%). Twenty-three patients (24.2%) had combined diastolic and systolic dysfunction (E/A ratio < 1.0 and EF < 50%). Six patients (6.3%) had pseudonormalization (E/A ratio 1.0-2.0 and deceleration time, DT, 150-200 msec), while restrictive pattern of diastolic dysfunction was seen in 25 patients (26.3%). This prevalence of 69.4% of diastolic dysfunction in Nigerians with hypertensive heart failure seen in this study emphasizes the need for Doppler echocardiographic evaluation and diagnosis where these facilities are available. This will aid the physician to prescribe appropriate treatment.