Societal awareness on neonatal hyperbilirubinemia: A systematic review and meta-analysis

Early recognition of neonatal hyperbilirubinemia is essential for prevention of bilirubin neurotoxicity and its long-term sequelae. High rates of home delivery in low- and middle-income countries (LMICs) as well as early discharge post-delivery (within 24hours) make community surveillance for neonatal hyperbilirubinemia highly important. Here, we performed a literature review to estimate the level of societal awareness of neonatal hyperbilirubinemia. We searched several databases for studies assessing the knowledge and awareness of neonatal hyperbilirubinemia. We retrieved 211 citations from 206 databases with five being in the grey literature. 52 selected articles were further reviewed. Data from these studies were then analyzed using Stata software (Statacorp® LLC Texas USA). We found that the pooled estimate of societal awareness of neonatal hyperbilirubinemia was 67% (95% confidence interval [CI]: 60, 74). There however was a publication bias (Begg test: P ≤ 0.01; Egger P = 0.06). Studies that scored or graded knowledge reported lower estimates [adjusted odds ratio (aOR) = -0.17; 95% CI: -0.32–0.02; P = 0.03]. Hospital location was an important determinant of awareness of complications [aOR = 0.30; 95% CI: 0.30–0.57; P = 0.03]. We therefore concluded that there is a significant need to improve societal awareness of neonatal hyperbilirubinemia.     

Correction to: Physical,Emotional, and Psychosocial Challenges Associated with Daily Dosing of HIV Medications and Their Impact on Indicators of Quality of Life: Findings from the Positive Perspectives Study

AIDS and Behavior - The article Physical, Emotional, and Psychosocial Challenges Associated with Daily Dosing of HIV Medications and Their Impact...     

Childhood acquired heart disease in Nigeria: an echocardiographic study from three centres

Introduction

Acquired heart diseases (AHD) are not uncommon in children. The current multi-center study aims to provide a more representative data of AHD in Nigeria.

Methods

Over 42 months, children referred for echocardiographic evaluation who had confirmed AHD in three centers in Nigeria were recruited. The data was collected on biodata and types of AHD.

Results

There were 116 children with 132 cases of AHD, with a mean age of 6.7 ± 5.7 years. The males were 63(54.3%). Myocarditis/ dilated cardiomyopathy (DCM) 38(28.8%) was the commonest AHD followed by pericarditis 34 (25.8%), rheumatic heart disease (RHD) 23 (17.4%) and hypertrophic cardiomyopathy 18(13.6%). Endomyocardial fibrosis (EMF) 3(2.3%) was uncommon.

Conclusion

Nigerian children face a quadruped of AHD namely, myocarditis, DCM, pericardial disease and RHD. As other types of AHD other than RHD are becoming prevalent, there is need to improve the scope of intervention facilities in the country to meet with the demands of the growing afflictions.     

Ceftriaxone-Resistant Salmonella enterica Serotype Typhimurium Sequence Type 313 from Kenyan Patients Is Associated with the blaCTX-M-15 Gene on a Novel IncHI2 Plasmid

Multidrug-resistant bacteria pose a major challenge to the clinical management of infections in resource-poor settings. Although nontyphoidal Salmonella (NTS) bacteria cause predominantly enteric self-limiting illness in developed countries, NTS is responsible for a huge burden of life-threatening bloodstream infections in sub-Saharan Africa. Here, we characterized nine S. Typhimurium isolates from an outbreak involving patients who initially failed to respond to ceftriaxone treatment at a referral hospital in Kenya. These Salmonella enterica serotype Typhimurium isolates were resistant to ampicillin, chloramphenicol, cefuroxime, ceftriaxone, aztreonam, cefepime, sulfamethoxazole-trimethoprim, and cefpodoxime. Resistance to β-lactams, including to ceftriaxone, was associated with carriage of a combination of bla_CTX-M-15, bla_OXA-1, and bla_TEM-1 genes. The genes encoding resistance to heavy-metal ions were borne on the novel IncHI2 plasmid pKST313, which also carried a pair of class 1 integrons. All nine isolates formed a single clade within S. Typhimurium ST313, the major clone of an ongoing invasive NTS epidemic in the region. This emerging ceftriaxone-resistant clone may pose a major challenge in the management of invasive NTS in sub-Saharan Africa.     

Differential methylation of genes that regulate cytokine signaling in lymphoid and hematopoietic tumors

The perturbations of the cytokine signaling pathway play an important role in lymphoid/hematopoietic tumors. Aberrant promoter methylation is the major mechanism of gene silencing in tumors. We examined 150 lymphoid/hematopoietic tumors or potential premalignant specimens, 55 control specimens and 12 EBV-transformed B lymphoblastoid cultures and 10 lymphoma/leukemia (L/L) or multiple myeloma (MM) cell lines for the methylation (and, in cell lines, of the expression status) of three genes involved in the cytokine signaling pathway. The genes were: SHP1, a protein tyrosine phosphatase; SYK, a protein kinase; and SOCS1, a suppressor of cytokine signaling. Our major findings were: (1) one or more of the three genes was frequently methylated in L/L and MM cell lines and there was good concordance (90-100%) between methylation and loss of gene expression; (2) treatment of L/L cell lines with a demethylating agent resulted in re-expression of SHP1 protein and downregulation of phosphorylated STAT3 in L/L cell lines; (3) all 55 control specimens and the lymphoblastoid cultures were negative for methylation of the three genes; (4) non-Hodgkin's lymphomas (100%), and leukemias (94%) had almost universal methylation of SHP1 and relatively less frequent (<30%) methylation of SOCS1 and SYK; (5) MM and monoclonal gammopathy of unknown significance (MGUS) had infrequent methylation of SHP1 (<20%), and occasional methylation of SOCS1 and SYK; and (6) comparable methylation frequencies for SOCS1 were observed in MM and MGUS, suggesting that SOCS1 methylation is an early event in MM pathogenesis. At least one gene was methylated in 119 of 130 (93%) of the malignant and 12 of 20 (60%) of the MGUS samples. Our findings demonstrate that the perturbations of cytokine signaling via silencing of these three genes are almost universal in lymphoid/hematopoietic tumors but the patterns of gene methylated for L/L and plasma cell dyscrasias are different.     

Surgery-induced thyroiditis: fact or fiction?

Neck surgery carries a risk that the patient will develop postoperative thyroiditis as a result of the surgical procedure. Surgery-induced thyroiditis can manifest in a mild form as serum hyperthyroxinemia or in a more severe form as clinical hyperthyroidism. We describe a case of surgery-induced thyroiditis and review the very limited literature on this subject.     

Horseradish peroxidase and cobalt chloride as neuromarkers in the hypoglossal nucleus

Summary The hypoglossal nucleus in 129 REJ normal mouse strains was investigated using two neuroanatomical markers, namely the cobalt chloride (CoCl₂) and the horseradish peroxidase (HRP) techniques. CoCl₂ was introduced through the cut end of the hypoglossal nerve. In one set of experiments HRP was injected into the hypoglossal nerve, while in the other it was injected into the tongue musculature. Results show that with these techniques the hypoglossal neurons are conspicuously stained and can be easily located among series of brainstem sections. The mean number±SD of neurons in the hypoglossal nucleus was 1,417±37, 846±28 and 1,272±42 using CoCl₂ and HRP injected into the tongue musculature or the hypoglossal nerve, respectively. The estimated length of the nucleus was 0.92 mm with the CoCl₂ technique.     

Performance of the Cockcroft-Gault and MDRD equations in adult Nigerians with chronic kidney disease

Background  Estimation of the glomerular filtration rate (GFR) is required in the assessment of patients with chronic kidney disease (CKD) in order to provide information regarding the functional status of the kidneys. Current guidelines advocate the use of prediction equations, such as the Cockcroft-Gault (CG) formula and the Modification of Diet in Renal Disease (MDRD) study-derived equations, over clearance of endogenous creatinine (Ccr) in achieving this aim. We were interested in knowing the accuracy of these equations in predicting the GFR in adult Nigerians with CKD. Methods  We conducted a review of records of patients who were evaluated for CKD at the Nephrology Clinic of the Jos University Teaching Hospital between 2001 and 2003. We compared the CG and MDRD equations against the Ccr in predicting the GFR in 130 patients (88 males and 42 females) with CKD. Results  The means ± standard deviation (SD) for the measured and predicted GFR by the CG and MDRD equations were similar (17.6 ± 25.8 ml/min, 19.9 ± 24.0 ml/min and 21.5 ± 28.2 ml/min, respectively; analysis of variance [ANOVA], F = 0.68, P = 0.5). The mean difference between CG and Ccr was −2.2 ± 14.8 ml/min, with discordance at Ccr values >25 ml/min. The mean difference between MDRD and Ccr was −3.9 ± 18.1 ml/min, with discordance at Ccr values >40 ml/min. Conclusion  The CG and MDRD equations provide reliable alternatives to measured Ccr in the estimation of the GFR in Nigerian patients with CKD.