Comparison of three subtypes of depression

The objective of the study is to identify socio-demographic variables and clinical characteristics which distinguish between three subtypes of depression. In a prospective manner, 227 patients meeting ICD-10 criteria for depression were grouped into 3 subtypes--unipolar depression without psychosis, unipolar depression with psychosis and bipolar disorder depression. Using a structured questionnaire, socio-demographic and clinical variables obtained from the patients were compared in the 3 subtypes. Bipolar disorder patients were more likely to have first episode of illness before age 30 years. Psychotic depression patients were most likely to have positive family history of mental disorder and to have attempted suicide previously. Depressed females were less educated and more likely to be married. Early age at onset of depression requires more public awareness on recognition of depression particularly in the economically productive group. Further studies are required especially in community samples to further confirm these findings.     

Knowledge and use of the partograph among healthcare personnel at the peripheral maternity centres in Nigeria.

In an attempt to evaluate the contributory factors to the high frequency of referred cases in obstructed labour at the State's referral hospital, a questionnaire-based survey of 396 maternity care-providers from 66 randomly selected peripheral delivery units in Ogun State, Nigeria was conducted over a 2-month period, to evaluate their knowledge and use of the partograph. The majority of the personnel were nurses/midwives (45.5%) and community health extension workers (CHEW) (42.7%). Of the 216 personnel (54.5%) who were aware of the partograph, 36 (16.7%), 119 (55.5%) and 61 (28.2%) demonstrated poor, fair and good levels of knowledge, respectively. No junior CHEW had a satisfactory knowledge of the partograph. Only 39 (9.8%) of all the personnel routinely employed the partograph for labour management and almost half of these individuals had a poor level of knowledge. Efforts to limit the frequency of referred cases of established obstructed labour to the State's referral hospital should include training of care-providers at the peripheral delivery units, especially junior personnel in the effective use of the partograph, in addition to employing quality assurance measures to check inappropriate use.     

Clinical and demographic risk factors associated with chronic suppurative otitis media

BACKGROUND: The incidence of chronic suppurative otitis media (CSOM) is high worldwide but increasing occurrence of complications appear peculiar to West Africa. However, knowledge of associated risk factors is sparse, we report the sociodemographic risk factors of CSOM with the aim of control of the disease and complications; and possible preventive strategies. METHOD: This is a survey of children with CSOM in five sites spread in two suburban cities in two states in Nigeria. Questionnaire was administered on the informants followed by examination of the children. RESULT: Of the 189 children, 114 (60%) had developed ear suppuration before 6 months of age, the number of attacks within the previous 18 months ranged between 2-12 with average of 7. Sociodemographic risk factors included low socioeconomic class in 153 (81%), 136 (72%) live in congested houses with more than 10 people and 79 (42%) belonged to families with more than 5 children. Indoor-cooking and infant daycare attendance were 117 (62%) while supine bottlefeeding was 115 (61%) and 34 (18%) of subjects had smoking father. The clinical risk factors were upper respiratory tract infection (URI) 85 (45%), allergy 53 (28%), adenoid 54 (28%) and malnutrition 65 (34%). The univariate analysis revealed that low social class (OR=7.33, CI=4.18-12.83, P=0.0001), malnutrition (OR=3.57, CI=1.88-6.76, P=0.00001), bottlefeeding (OR=2.93, CI=1.63-5.28, P=0.0001), indoor-cooking (OR=1.35, CI=0.88-2.10, P=0.161) and high number of people in a household (OR=0.59, CI=0.34-0.98, P=0.04) are significant in development of OM; while multivariate logistic regression analysis showed malnutrition (OR=3.48, CI=1.633-7.425, P=0.001), low social status (OR=7.74, CI=4.15-14.43, P=0.0001) and indoor-cooking (OR=2.34, CI=1.18-4.66, P=0.014), second table. Parental smoking, daycare attendance, allergy, adenoiditis/adenoidal hypertrophy and upper respiratory tract infection were not found significant. CONCLUSION: Low socioeconomic class, malnutrition, congestion from high number of children in the household and bottlefeeding constitute significant risk factor. The early onset of disease (<6 months) may suggest a prenatal predisposition. We need further research for the understanding of the biologic effect of these factors while this remains a database for prevention and control of disease.     

Neutralizing antibodies against poliovirus serotypes among children in southwest Nigeria

In May 1988, the World Health Assembly resolved to eradicate poliomyelitis globally by the year 2000. Despite the reported success in national immunization days, acute flaccid paralysis surveillance and accelerated efforts to meet the deadline including 'mopping-up' were executed in 1999 and subsequent years. Nigeria remains one of the major reservoirs for wild poliovirus transmission. Neutralizing antibody titre to the three poliovirus serotypes was determined among children from different communities in southwest of Nigeria, and analysed by age, gender and location. About 0.5-2 ml of blood sample was collected by venepuncture from each child. Aliquot of serum from each blood sample was inactivated prior to neutralization test by the beta method for poliovirus antibodies. A total of 347 (59.6 per cent) out of 500 and 82 children enrolled for the study had at least antibody titre of 1:8 against each of the three poliovirus serotypes. Immunity level to the three poliovirus serotypes increased with age and peaked in children aged 4-6 years. Seven (53.8 per cent) out of 13 unvaccinated children tested in the study had detectable neutralizing antibody to the three serotypes. Immunity pattern of P2 > P1 and P3 was observed but no correlation between gender and antibody to the poliovirus serotypes. The populations had 59.6 per cent herd immunity for the three poliovirus serotypes. In a country with high incidence of poliomyelitis this situation leaves a high number of non-immunized children at the risk of infection with one or more poliovirus serotypes.     

A physician's guide to the physical examination of the shoulder

Shoulder pain is the third most frequent musculoskeletal complaint presented to physicians. Often considered a benign entity by patients and even their physicians, shoulder disorders can have a devastating effect on a patient's ability to function, as well as serve as an indicator of poor general health. For these reasons, it is important for the physician to be able to identify the etiology of a patient's shoulder problem(s). However, making a correct diagnosis is often difficult because there can be many causes for a patient's shoulder pain, weakness, or loss of function. Moreover, the shoulder girdle is an intricate group of structures that work together to allow for the largest range of motion in the body. This complexity makes it difficult to diagnose a patient's condition(s) based on history alone. A thorough and well-performed physical examination is the key to making a correct diagnosis and helping to distinguish different etiologies of shoulder dysfunction. In this article, we review relevant shoulder anatomy and biomechanics, and general shoulder examinations with special tests for various shoulder pathologies. We provide an effective and methodical approach to the physical examination of the shoulder.     

Structure Formation in Antifriction Composites with a Nickel Matrix and Its Effect on Properties

The paper is devoted to studying the chemical elements distribution in the material’s structure depending on the manufacturing technological parameters and their effect on properties of a new self-lubricating antifriction composite based on powder nickel alloy EP975 with CaF₂ solid lubricant for operation at temperature 800 °C and loads up to 5.0 MPa, in air. The study is focused on the features of alloying elements distribution in the composite matrix, which depends on the manufacturing technology. A uniform distribution of all alloying elements in the studied composite was shown. The chemical elements’ uniform distribution in the material is associated with one of the most important preparatory technological operations in the general manufacturing technology used. This is a technological operation of mixing powders with subsequent analysis of the finished mixture. The uniform distribution of chemical elements determines the uniform arrangement of carbides and intermetallics in the composite. General manufacturing technology, which includes the main operations, such as hot isostatic pressing technology and hardening heat treatment, contributed to the obtainment of a practically isotropic composite with almost the same properties in the longitudinal and transverse directions. Because of the composite’s structural homogeneity, without texturing, characteristics are isotropic. Improving the material’s structural homogeneity helps to keep its mechanical and anti-friction qualities stable at high temperatures and stresses in the air. The performed studies demonstrated the correctness of the developed manufacturing technology that was confirmed by the electron microscopy method, micro-X-ray spectral analysis, mechanical and tribological tests. The developed high-temperature antifriction composite can be recommended for severe operating conditions, such as friction units of turbines, gas pumping stations, and high-temperature units of foundry metallurgical equipment.     

Pharmacokinetics-based identification of pseudoaldosterogenic compounds originating from Glycyrrhiza uralensis roots (Gancao) after dosing LianhuaQingwen capsule

LianhuaQingwen capsule, prepared from an herbal combination, is officially recommended as treatment for COVID-19 in China. Of the serial pharmacokinetic investigations we designed to facilitate identifying LianhuaQingwen compounds that are likely to be therapeutically important, the current investigation focused on the component Glycyrrhiza uralensis roots (Gancao). Besides its function in COVID-19 treatment, Gancao is able to induce pseudoaldosteronism by inhibiting renal 11β-HSD2. Systemic and colon-luminal exposure to Gancao compounds were characterized in volunteers receiving LianhuaQingwen and by in vitro metabolism studies. Access of Gancao compounds to 11β-HSD2 was characterized using human/rat, in vitro transport, and plasma protein binding studies, while 11β-HSD2 inhibition was assessed using human kidney microsomes. LianhuaQingwen contained a total of 41 Gancao constituents (0.01–8.56 μmol/day). Although glycyrrhizin (1), licorice saponin G2 (2), and liquiritin/liquiritin apioside (21/22) were the major Gancao constituents in LianhuaQingwen, their poor intestinal absorption and access to colonic microbiota resulted in significant levels of their respective deglycosylated metabolites glycyrrhetic acid (8), 24-hydroxyglycyrrhetic acid (M2_D; a new Gancao metabolite), and liquiritigenin (27) in human plasma and feces after dosing. These circulating metabolites were glucuronized/sulfated in the liver and then excreted into bile. Hepatic oxidation of 8 also yielded M2_D. Circulating 8 and M2_D, having good membrane permeability, could access (via passive tubular reabsorption) and inhibit renal 11β-HSD2. Collectively, 1 and 2 were metabolically activated to the pseudoaldosterogenic compounds 8 and M2_D. This investigation, together with such investigations of other components, has implications for precisely defining therapeutic benefit of LianhuaQingwen and conditions for its safe use.Keywords: LianhuaQingwen, glycyrrhetic acid, 24-hydroxyglycyrrhetic acid, Gancao-induced pseudoaldosteronism, licorice-induced pseudoaldosteronism, 11β-hydroxysteroid dehydrogenase 2, COVID-19, colonic microbiota     

Catechin,quercetin and taxifolin improve redox and biochemical imbalances in rotenone-induced hepatocellular dysfunction: Relevance for therapy in pesticide-induced liver toxicity?

Hepatotoxicity occurs as a result of adverse effects of some xenobiotics on the liver, which is often the target tissue of toxicity for environmental chemicals. Rotenone, used as a natural pesticide, is an environmental poison reported to cause organ toxicity. This study investigated the protective effect of three flavonoids, catechin, quercetin and taxifolin (2,3-Dihydroquercetin) in rotenone-induced hepatotoxicity. Male Wistar rats were administered rotenone for 10 days followed by post treatment with catechin (5, 10 and 20?mg/kg), quercetin (5, 10 and 20?mg/kg) or taxifolin (0.25, 0.5 and 1?mg/kg), respectively, for 3 days. Bioindices of oxidative stress and hepatocellular injury were measured in serum and tissue homogenate of animals. Rotenone intoxication produced liver damage in rats as reflected in alterations to activities/levels of enzymic and non-enzymic oxidative stress markers and enzymes linked with inflammation, as well as the transaminases, gamma glutamyl transpeptidase, bilirubin, and lactate dehydrogenase. Catechin, quercetin and taxifolin post treatment significantly attenuated these (p?<?0.0001) rotenone-induced imbalances. Comparatively, quercetin displayed the best apparent ameliorative activity. It clearly showed superior activity to catechin. However, taxifolin appeared to show comparable activity to quercetin and better activity than catechin in some of the assays despite being administered at considerably lower doses. The results provide insight on the relative efficacy and structure-activity relationships of the selected flavonoids in ameliorating liver damage and also indicate that additional structural and metabolic factors may be involved in the structure-activity relationships of flavonoids.     

Mechanistic perspective of the oxido‐immunopathologic resolution property of kolaviron in mice influenza pneumonitis

Implicated in influenza‐associated pathology are innate defence overzealousness and unabated secretion of oxidative tissue‐sensitive antimicrobial agents. At different time points, mice were pre‐treated with kolaviron (400 mg/kg), a natural antioxidant and anti‐inflammatory agent, and subsequently challenged with 2 LD₅₀ influenza A/H3N2/Perth/16/09 virus. After euthanasia at day 6, blood, lungs, liver and spleen were collected and processed for biochemical, immunohistochemical and flow cytometric assessment of redo‐inflammatory imbalance, cytokine storm indices and T helper 1 host response. Previously kolaviron was reported to delay mortality onset, improve morbidity and attenuate myeloperoxidase activity and nitric oxide production with minimal impact on viral clearance. This study additionally confirmed nitric oxide, but not hydrogen peroxide, as the major culprit implicated in influenza virus‐induced oxido‐pathology. Systemic effect of the sustained inflammation and nitrosative stress was more prominent in the spleen and lung than in the liver of mice infected with A/H3N2/Perth/16/09. Influential to immunopathology was heightened pulmonary expression of IL‐1β, RANTES, IL‐10, MCP‐1, NF‐κB, iNOS and COX‐2. However, kolaviron combated the influenza‐established nitrative stress, reversed the elicited cytokine storm and restored the oxidized environment to a reductive milieu. Our data also suggest that kolaviron administration early in infection may foster CD4⁺ response. These data indicate that kolaviron may confer disease‐dwindling properties during acute influenza infection via a system‐wide protective approach involving multiple targets especially at the early stage of the infection.