Antimicrobial susceptibility pattern of Aeromonas and Plesiomonas strains isolated from patients with diarrhoea in Nigeria

The susceptibilities of 53 isolates of Aeromonas species and 16 Plesiomonas shigelloides, from patients with diarrhoea, to 15 commonly used antimicrobial agents were determined by the disk-agar diffusion technique. All the strains were susceptible to ofloxacin, a recent quinolone. Also, over 70 pc of our strains were susceptible to gentamicin, carbenicillin, ceftriaxone, erythromycin, Chloramphenicol, tetracycline and co-trimoxazole. However, less than 30 pc of our strains were susceptible to ampicillin. Results of this in vitro study indicate that for cases of serious Aeromonas or Plesiomonas infections requiring antimicrobial therapy, ofloxacin, gentamicin, carbenicillin or chloramphenicol could be useful.     

The role of informed consent in risks recall in otorhinolaryngology surgeries: verbal (nonintervention) vs written (intervention) summaries of risks

Background

Informed consent is a phrase often used in the law to indicate that the consent a person gives meets certain minimum standards. It relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. Informed consent is the method by which fully informed, rational persons may be involved in choices about their health care.

Aim

The aims of this study were to study how much patients remember of the risks discussed with them about their otolaryngologic surgery and to evaluate whether a simple intervention, the addition of an information handout, improves their recall.

Methods

This was a prospective study carried out between January and December 2009 in the Department of Otorhinolaryngology, University of Ilorin teaching hospital. Fifty patients undergoing a variety of otorhinolaryngologic procedures, including mastoidectomy, tympanoplasty, nasal polypectomy, rhinotomy, maxillectomy, and laryngoscopy, were verbally consented by the operating surgeon with a standard checklist of potential surgical complications and adverse effects. Three surgeons participated in the study. Patients were stratified into 2 groups: a higher education group and a lower education group. Within each group, patients were randomized to either a control group, consisting of a verbal explanation only, or an intervention group, which added a written handout to the verbal explanation. A follow-up telephone interview was conducted at an average of 20.6 days (range, 14-53 days) to survey for recall of the complications discussed. The main outcome measure is risk recall. This was analyzed by education level and written sheet intervention. Other parameters examined were patient demographics and time elapsed from when the consent was obtained.

Results

Of the 50 patients involved in the study, 30 were men and 20 were women, with male/female ratio of 1.5:1.0. The average age was 43 years (range, 16-76 years). With respect to educational status, 26 patients had the equivalent of high school or less (group 1), and 24 had some degree of postsecondary training (group 2). Overall recall of potential complications was 56%. Those who received the handout recalled 67% of the complications overall, whereas those who did not receive the handout remembered 51% of the complications. The difference was significant Recall of the specific risks varied considerably. For those with potential risk of facial nerve paralysis, 88% of them recalled, which was the highest in the study. This was followed by hearing loss (85%) and nasal adhesion (23%). The least were anesthetic reactions (4%) and hoarseness (2%). Those who received the handout recalled 62% of the complications overall, whereas those who did not receive the handout remembered 51% the complications.

Conclusion

The addition of a handout significantly alters recall of potential complications of otorhinolaryngologic surgery with the recall of specific risk highest for facial nerve paralysis.     

Growth pattern of schoolchildren in Sagamu,Nigeria using the CDC standards and 2007 WHO standards

Objective  

To compare the median weight, height and body mass index of school children with the 2000 CDC and 2007 WHO reference values.     

Defective NOTCH signaling drives increased vascular smooth muscle cell apoptosis and contractile differentiation in bicuspid aortic valve aortopathy: A review of the evidence and future directions

Bicuspid aortic valve (BAV) disease remains the most common congenital cardiac disease and is associated with an increased risk of potentially fatal aortopathy including aortic aneurysm and dissection. Mutations in the NOTCH1 gene are one of only a few genetic anomalies identified in BAV disease; however evidence for defective NOTCH signaling, and its involvement in the characteristic histological changes of VSMC apoptosis and differentiation in ascending aortae of BAV patients is lacking. This review scrutinizes the evidence for the interactions of NOTCH signaling, cellular differentiation and apoptosis in the context of aortic VSMCs and provides focus for future research efforts in the diagnosis of BAV aortopathy and prevention of catastrophic complications through NOTCH signaling manipulation.     

Effect of molecular weight of amine end-modified poly(β-amino ester)s on gene delivery efficiency and toxicity

Amine end-modified poly(β-amino ester)s (PBAEs) have generated interest as efficient, biodegradable polymeric carriers for plasmid DNA (pDNA). For cationic, non-degradable polymers, such as polyethylenimine (PEI), the polymer molecular weight (MW) and molecular weight distribution (MWD) significantly affect transfection activity and cytotoxicity. The effect of MW on DNA transfection activity for PBAEs has been less well studied. We applied two strategies to obtain amine end-modified PBAEs varying in MW. In one approach, we synthesized four amine end-modified PBAEs with each at 15 different monomer molar ratios, and observed that polymers of intermediate length mediated optimal DNA transfection in HeLa cells. Biophysical characterization of these feed ratio variants suggested that optimal performance was related to higher DNA complexation efficiency and smaller nanoparticle size, but not to nanoparticle charge. In a second approach, we used preparative size exclusion chromatography (SEC) to obtain well-defined, monodisperse polymer fractions. We observed that the transfection activities of size-fractionated PBAEs generally increased with MW, a trend that was weakly associated with an increase in DNA binding efficiency. Furthermore, this approach allowed for the isolation of polymer fractions with greater transfection potency than the starting material. For researchers working with gene delivery polymers synthesized by step-growth polymerization, our data highlight the potentially broad utility of preparative SEC to isolate monodisperse polymers with improved properties. Overall, these results help to elucidate the influence of polymer MWD on nucleic acid delivery and provide insight toward the rational design of next-generation materials for gene therapy.     

Maternal mortality ratio in selected rural communities in Kebbi State,Northwest Nigeria

Background

Maternal mortality remains a topical issue in Nigeria. Dearth of data on vital events posed a huge challenge to policy formulation and design of interventions to address the scourge. This study estimated the lifetime risk (LTR) of maternal death and maternal mortality ratio (MMR) in rural areas of Kebbi State, northwest Nigeria, using the sisterhood method.

Methods

Using the sisterhood method, data was collected from 2917 women aged 15–49?years from randomly selected rural communities in 6 randomly selected local government area of Kebbi State. Retrospective cohort of their female siblings who had reached the childbearing age of 15?years was constructed. Using the most recent total fertility rate for Kebbi State, the lifetime risk and associated MMR were estimated.

Result

A total of 2917 women reported 8233 female siblings of whom 409 had died and of whom 204 (49.8%) were maternal deaths. This corresponds to an LTR of 6% (referring to 11?years before the study) and an estimated MMR of 890 deaths/100,000 live births (95% CI, 504–1281).

Conclusion

The findings provide baseline information on the MMR in rural areas of the State. It underscores the need to urgently address the bane of high maternity mortality, if Kebbi State and Nigeria in general, will achieve the health for all by year 2030 as stated in the Sustainable Development Goals (SDGs).

     

Prevalence of acute otitis media among children with pyrexia in a Nigerian hospital

Objective

This was to determine the prevalence of acute otitis media in children with pyrexia in an area with malaria endemicity and also the relevance of socio-economic factors on AOM.

Methods

This prospective study was conducted between January 2004 and June 2005 at the emergency paediatric unit of the hospital among children aged 0–15 years presenting with pyrexia. All the children had full ENT examinations in addition to the evaluation by the emergency paediatricians. Diagnosis of AOM was based on history, examinations and otoscopic findings.

Results

Two-hundred children with pyrexia were seen and the age range was 3 months to 15 years (mean 4.73). The male/female ratio was 1.7:1.03 years; 32 had features of AOM. Two third of the children were from the low socio-economic class.

Conclusion

AOM with late presentation in the suppurative stage of the disease is a common cause of pyrexia in children with a male preponderance and two third of the children were from the low socio-economic status. There is the need for otoscopic examinations of all pyretic children as the resultant hearing loss is related to difficulties in language acquisition in children below 2 years of age with effects on literacy and school achievement.     

Ophthalmic manifestations and risk factors for mortality of HIV patients in the post‐highly active anti‐retroviral therapy era

Background: To evaluate the ophthalmic manifestations and risk factors for mortality in HIV patients in the post‐highly active anti‐retrovirus therapy (HAART) era. Design: Retrospective study. Samples: 151 patients with HIV infection. Methods: Review of all HIV patients who have attended the Hong Kong Eye Hospital between 2000 and 2007. Main Outcome Measures: Ocular findings especially opportunistic infections and medical information including mortality during follow up. Results: At presentation, 139 (92.1%) patients were already diagnosed with HIV and 58 (41.7%) had an AIDS indicator condition. Fifty‐one (33.8%) patients had HIV‐related eye disease on presentation and the leading manifestations were cytomegalovirus (CMV) retinitis and HIV microangiopathy. Low baseline CD4 cell count <100 cells/L was significantly related with HIV‐related ophthalmic manifestations and CMV retinitis at presentation (P < 0.013). 105 patients were followed for 6 months or more and the mean follow‐up was 4.8 years. There was no significant change in visual acuity compared with baseline (P = 0.13). 20 (19.0%) patients had one eye with final visual acuity of 20/200 or worse and the leading cause for poor vision was CMV retinitis. 11 (10.5%) patients died during the follow‐up due to complications of HIV/AIDS. The presence of HIV retinal microangiopathy was significantly associated with mortality (P = 0.005). Conclusions: CMV retinitis remains the main HIV‐related ocular disease in the post‐HAART era. HIV retinal microangiopathy might be an important prognostic factor for mortality. Appropriate ophthalmic monitoring is justified to detect for ophthalmic complications in HIV patients regardless of HAART use in order for prompt initiation of treatment.     

Alternate hosts of African cassava mosaic virus and East African cassava mosaic Cameroon virus in Nigeria

Cassava mosaic disease (CMD) caused by African cassava mosaic virus (ACMV) and East African cassava mosaic Cameroon virus (EACMCV) is the major constraint to cassava production in Nigeria. Sequences of the DNA-A component of ACMV and EACMCV isolates from leguminous plant species (Senna occidentalis, Leucana leucocephala and Glycine max), castor oil plant (Ricinus communis), a weed host (Combretum confertum) and a wild species of cassava (Manihot glaziovii) were determined. All ACMV isolates from these hosts showed 96-98% nucleotide sequence identity with cassava isolates from West Africa. EACMCV was found only in four hosts (S. occidentalis, L. leucocephala, C. confertum, M. glaziovii), and sequences of these isolates showed 96-99% identity with cassava isolates from West Africa. These results provide definitive evidence for the natural occurrence of ACMV and EACMCV in plant species besides cassava.