Semi-field evaluation of electrocuting eave tubes for the control of endophagic mosquitoes in south-east Tanzania.

BACKGROUND: Eave spaces are major entry points through which malaria vectors enter houses. Interventions that target mosquitoes at the eaves have recently been developed. However, most of these interventions are based on insecticides for which resistance has been reported. Here we evaluated the efficacy of mosquito electrocuting eave tubes (MEETs) against Anopheles gambiae sensu stricto (An. gambiae s.s.) and Anopheles funestus s.s. under semi-field conditions. METHODS: Experiments were conducted in two semi-field chambers, each containing one experimental hut. Six electrocuting eave tubes were installed in each hut to assess their impact on laboratory-reared An. gambiae s.s. and An. funestus s.s.. Each species was assessed separately over 10 nights by releasing 200 unfed females per night into each chamber. One volunteer slept in each hut from 7 p.m. to 5 a.m. Mosquitoes were collected indoors and outdoors using mouth and Prokopack aspirators. RESULTS: The placement of MEETs significantly reduced the nightly An. gambiae s.s. indoor and outdoor biting, by 21.1% and 37.4%, respectively. Indoor-biting An. funestus s.s. were reduced by 87.5% while outdoor-biting numbers of An. funestus s.s. declined by 10.4%. CONCLUSIONS: MEETs represent a promising tool for controlling mosquitoes at the point of house entry. Further validation of their potential under natural field conditions is necessary. Several advantages over insecticide-based eave tubes are indicated and discussed in this article.

Generation of an induced pluripotent stem cell line (BIORTCi001-A) from a healthy adult indigenous Nigerian participant.

Genetic backgrounds influence cellular phenotypes, drug responses, and health outcomes, yet most human iPSC lines are derived from individuals of European descent, with lines from indigenous Africans particularly scarce. Addressing this gap, we generated iPSCs from dermal fibroblasts of a healthy 60-year-old indigenous Nigerian male of the Babur ethnic group using Sendai virus. The iPSC line displayed a normal karyotype, was characterized for pluripotency markers and differentiated into neural progenitor cells and astrocytes. To enhance African representation in research, this iPSC line will be available to the scientific community, with ongoing efforts focused on creating an open-access African iPSC biobank. Resource Table.

Switched step integral backstepping control for nonlinear motion systems with application to a laboratory helicopter.

In this paper, the energy efficiency of the widespread application of backstepping control to a class of nonlinear motion systems is investigated. A Switched Step Integral Backstepping Control (SSIBC) scheme is introduced to improve immunity to measurement noise and to increase the energy efficiency of conventional backstepping in practice. The SSIBC is realized by switching between two candidate controllers obtained at different steps of the iterative backstepping design process. A bi-state dependent hysteresis rule is developed to supervise stable switching between the different regimes in the presence of noise. The proposed method is experimentally verified on a MIMO twin rotor laboratory helicopter involving coupled nonlinear dynamics, inaccessible states and uncertainties. Experimental results show that in addition to a reduction in power consumption, the SSIBC reduces saturation of the control signal and visible motor jerking in contrast with conventional backstepping. Additional comparisons with a previously proposed optimized decoupling PID controller also show significant improvement in precision achieved with higher energy efficiency. Experimental results obtained with the introduction of an external disturbance into the system also show the robustness of the proposed SSIBC.

Socio-economic and Lifestyle Determinants of Functional Capacity of the Senior Attendees of an Outpatient Clinic in Northern Nigeria: A Cross-Sectional Study.

BACKGROUND: Typical ageing changes and the associated health concerns frequently manifest themselves as reduction in their efficiency and functional capacity. OBJECTIVE: To identify the socioeconomic and lifestyle determinants of the functional capacity of elderly patients. METHODS: A cross-sectional study involving 329 patients aged ≥ 60 years who presented to the General Outpatient Clinic. Data on socioeconomic, lifestyle, and functional capacity were collected. The functional capacity was assessed by the self-reported questionnaires: the Lawton and Katz indexes for the activity of daily living (ADL) and instrumental activity of daily living (IADL) respectively. The chi-square test and logistic regression analysis were used to determine associations between the variables. The level of significance was set at a p-value ≤ 0.05. RESULTS: A total of 312 respondents completed the study, with 59.6% females and a mean age of 67.67 ± 7.69 years. The majority of the respondents (76.3%) belong to the low socioeconomic status (classes V and VI). The prevalence of functional dependence was 21.5% and 44.2% for ADL and IADL respectively. The disability in continence and food preparation had the highest prevalence among the components of ADL and IADL respectively. Advancing age, Hausa/Fulani tribe, polygamy, poor social support, and chronic pain were the determinants of functional dependence in ADL while age, female gender, marital status, and Fulani tribe were the determinants of functional dependence in IADL among the respondents.CONCLUSION: The identified determinants of functional capacity among the older persons should be considered when assessing their functional capacity in the primary care or similar settings.

CONTEXTE: Les changements typiques liés au vieillissement et les problèmes de santé qui y sont associés se manifestent souvent par une réduction de l'efficacité et de la capacité fonctionnelle. OBJECTIFS: Identifier les déterminants socio-économiques et le mode de vie de la capacité fonctionnelle des patients âgés. MÉTHODES: Étude transversale portant sur 329 patients âgés de ≥ 60 ans qui se sont présentés à la consultation externe générale. Des données sur la situation socio-économique, le mode de vie et la capacité fonctionnelle ont été recueillies. La capacité fonctionnelle a été évaluée à l'aide de questionnaires autodéclarés : les indices de Lawton et de Katz pour l'activité de la vie quotidienne (ADL) et l'activité instrumentale de la vie quotidienne (IADL) respectivement. Le test du chi carré et l'analyse de régression logistique ont été utilisés pour déterminer les associations entre les variables. Le niveau de signification a été fixé à une valeur p ≤ 0,05. RÉSULTATS: Au total, 312 personnes ont répondu à l'étude, dont 59,6 % de femmes et un âge moyen de 67,67 ±7,69 ans. La majorité des personnes interrogées (76,3 %) appartiennent à un statut socioéconomique faible (classes V et VI). La prévalence de la dépendance fonctionnelle était de 21,5 % et 44,2 % pour les AVQ et les AIVQ respectivement. Les incapacités liées à la continence et à la préparation des repas ont la prévalence la plus élevée parmi les composantes des AVQ et des AIVQ respectivement. L'âge avancé, la tribu Hausa/Fulani, la polygamie, le manque de soutien social et la douleur chronique étaient les déterminants de la dépendance fonctionnelle dans les AVQ, tandis que l'âge, le sexe féminin, l'état matrimonial et la tribu Fulani étaient les déterminants de la dépendance fonctionnelle dans les AIVQ parmi les personnes interrogées. CONCLUSION: Les déterminants identifiés de la capacité fonctionnelle chez les personnes âgées devraient être pris en compte lors de l'évaluation de leur capacité fonctionnelle dans le cadre des soins primaires ou dans des contextes similaires. Mots clés: Capacité fonctionnelle, Socio-économie, Mode de vie, Personnes âgées et nord du Nigeria.

Biochemical evaluation and molecular docking assessment of glucosamines from Neocarya macrophylla fruits against Naja nigricollis venom.

Two new glucosamines, Microphyllose A and B were isolated from the chloroform fraction of Neocarya macrophylla fruit using flash column chromatography. The structures of these compounds were elucidated based on chemical tests and the analysis of their spectral data (IR, 1D- & 2D-NMR). The compounds have demonstrated significant (p < 0.05) antivenom activity against Naja nigricollis venom with 60 and 80% protection, respectively. When subjected to molecular docking, the compounds have demonstrated different binding affinities against three toxins (phospholipase A2, neurotoxin and cardiotoxin) from Naja nigricollis venom and they were further screened for ADMET analysis based on Lipinski's and Veber's rule and the compounds have failed absorptivity for oral medications. To the best of our knowledge, this is the first report of isolation and molecular docking analysis of these compounds from medicinal plants.

Validation of a laser driven plasma X-ray microfocus source for high resolution radiography imaging.

Hard X-ray radiation with high brightness and high fluxes is nowadays available on the fourth generation of synchrotrons and X-FELs, but the large size and complexity of these sources makes its use difficult for widespread applications. New table top X-ray sources driven by ultrashort high power lasers offer a compelling route to expand the availability of hard X-ray sources. They can be used for advanced imaging techniques, due to its small source size and spatial coherence. We present in this paper the validation of a compact laser-driven X-ray microfocus source for high-resolution radiography imaging. This novel device was built at the Laser Laboratory for Acceleration and Applications (L2A2) at the University of Santiago de Compostela. This paper describes the laser-plasma X-ray source with improved stability and characterize some of its properties. We demonstrate the high-contrast and resolution of the images obtained with this source by using masks with well known geometries, and detailed analysis by using the modulation transfer function. Finally, we discuss the properties of this source in comparison to other compact microfocus X-ray sources.

Providing TB and HIV outreach services to internally displaced populations in Northeast Nigeria: Results of a controlled intervention study.

BACKGROUND: A decade of Boko Haram insurgency brought conflict, mass displacement, and the destruction of basic infrastructure to Northeast Nigeria. Over 2 million internally displaced persons (IDPs) suffering from lack of basic hygienic conditions, malnutrition, and disease live in camps or are hosted by communities in the region, where the conflict has contributed to a massive destruction of health facilities. Infectious diseases like tuberculosis (TB) and HIV are especially difficult to address under such conditions, and IDPs are vulnerable to both. Although international investment supports some health interventions among IDPs, locally sourced solutions are lacking. METHODS AND FINDINGS: We evaluated the impact of an active case finding (ACF) intervention for TB and testing for HIV in IDP communities and provided linkages to treatment in 3 states in Northeast Nigeria: Adamawa, Gombe, and Yobe. The ACF was a component of a multistakeholder collaboration between government, civil society, and IDP community partners, which also included mapping of IDP populations and health services, supporting existing health facilities, developing a sample transport network, and organizing community outreach to support ACF. Between July 1, 2017, and June 30, 2018, ACF was conducted in 26 IDP camps and 963 host communities in 12 local government areas (LGAs) with another 12 LGAs serving as a control population. Outreach efforts resulted in 283,556 screening encounters. We screened 13,316 children and 270,239 adults including 150,303 (55.6%) adult women and 119,936 (44.4%) men. We tested 17,134 people for TB and 58,976 for HIV. We detected 1,423 people with TB and 874 people living with HIV. We linked 1,419 people to anti-TB treatment and 874 people with HIV to antiretroviral treatment sites. We evaluated additional TB cases notified and conducted comparative interrupted time series (ITS) analyses to assess the impact of ACF on TB case notifications. Through our efforts, bacteriologically confirmed TB notifications increased by 847 (45.1%) during the intervention period, with IDPs accounting for 46% of these notifications. The ITS analyses detected significant positive postintervention trend differences in TB notification rates between the intervention and control areas in all forms TB (incidence rate ratio [IRR] = 1.136 [1.072, 1.204]; p ≤ 0.001) and bacteriologically positive TB (IRR = 1.141 [1.058, 1.229]; p = 0.001). The TB prevalence (502 cases per 100,000 screening encounters) was 10 times the national notification rates and 2.3 times the estimated national incidence. Rates of HIV infection (1.8%) were higher than HIV prevalence estimates in the 3 states. Our study was limited by the nonrandom selection of LGAs. Furthermore, we did not use sensitive screening tools like chest X-ray and likely missed people with TB. CONCLUSIONS: In this study, we observed a burden of TB in IDP populations of Northeast Nigeria many times higher than national rates and HIV rates higher than state level estimates. The impact of the intervention showed that ACF can greatly increase TB case notifications. Engaging IDP communities, local governments, and civil society organizations is essential to ensuring the success of interventions targeting TB and HIV, and such approaches can provide sustained solutions to these and other health crises among vulnerable populations.

Photocatalytic activity and doping effects of BiFeO3 nanoparticles in model organic dyes.

The studies of advanced materials in environmental remediation and degradation of pollutants is rapidly advancing because of their wide varieties of applications. BiFeO3 (BFO), a perovskite nanomaterial with a rhombohedral R3c space group, is currently receiving tremendous attention in photodegradation of dyes. The photocatalytic activity of BFO nanoparticle is a promising field of research in photocatalysis. BFO nanomaterial is a photocatalyst enhanced by doping because of its reduce bandgap energy (2.0-2.77 eV), multiferroic property, strong photoabsorption and crystal structure. The material has proven to be very useful for the degradation of dyes under visible light irradiation among other photocatalysts. Its exceptional nontoxicity, suitability, low cost and long term excellent stability makes it an efficient photocatalyst for the degradation of effluents from textile and pharmaceutical industries which ended-up in the environment and now a major concern of the modern world. This mini-review attempts to provide some detailed synthetic routes of BFO and BFO related nanomaterials and the notable achievements so far on the effect of doping the material. It also discusses the effect of crystallite size of the material and other photophysical properties and how they influence the photocatalytic process of model organic dye pollutants, to date.

Improved integral backstepping control of variable speed motion systems with application to a laboratory helicopter.

This paper proposes an improved method of integral backstepping for real time control of a laboratory helicopter with variable speed rotors known as the Two-Rotor Aero-dynamic System (TRAS). The coupled system is decomposed into the horizontal subsystem (HS) and the vertical subsystem (VS) and traditional backstepping, augmented with direct integral action is designed for each subsystem. The transient response to both constant and time varying references is then simultaneously improved by modifying an already proposed method called dual boundary conditional integration. A switching technique is also employed to enhance the tracking response of the undamped HS for its bi-directional motor which exhibits jerking effects. Experimental results show that the proposed approach yields improved transient and tracking performance when compared to previously proposed methods exploiting conditional integration earlier proposed for improving the transient response of controlled nonlinear systems with integral action. The results also show the robustness of the proposed method in the presence of the coupling effects and additional external disturbance applied to the system in the form of a wind gust.

Delineation of aquifer potential zones using hydraulic parameters in Gombe and environs, North-Eastern, Nigeria.

This research is aimed at delineating the groundwater potential zones in Gombe and environs using Dar Zarrouk parameters. The study area is located within longitudes 11°7'0″E to 11°14'0″E, and latitudes 10°15'0″N to 10°21'0″N, it is basically underlain by basement Complex rocks represented by Diorite and Granites, and Cretaceous sedimentary rocks represented by Bima, Yolde, Fika and Gombe Formations. Thirty two (32) vertical electric soundings (VES) using Schlumberger array method with the aid of ABEM Signal Averaging System (SAS) Terrameter was used for the data acquisition. The result of the interpretation shows four to six geo-electric layers. The geo-electric section revealed the major aquifers to be confined and semi confined and consist of Medium grain sandstones, with varying thicknesses. The aquifer hydraulic characteristics indicated that the transverse resistance, ranges from 235.2Ωm2 to 6317.87Ωm2 with an average value of 1789.50Ωm2. The Longitudinal conductance, S, ranges from 0.1415Ωm to 31.933Ωm with an average of 2.002Ωm. The Hydraulic conductivity value range from 2.62m/day to 138.66 m/day with a mean value of 20.662 m/day. The transmissivity values obtained for the various layers range from 78.34 m2/day to 13284.02m2/day, with the average value been 893.57 m2/day. Four groundwater potential zones were delineated including medium grain sandstones, Sandstones, clayey sand and shaly sand.

Prognostic Role of Androgen Receptor in Triple Negative Breast Cancer: A Multi-Institutional Study.

BACKGROUND: The androgen receptor (AR) has emerged as a potential therapeutic target for AR-positive triple-negative breast cancer (TNBC). However, conflicting reports regarding AR's prognostic role in TNBC are putting its usefulness in question. Some studies conclude that AR positivity indicates a good prognosis in TNBC, whereas others suggest the opposite, and some show that AR status has no significant bearing on the patients' prognosis. METHODS: We evaluated the prognostic value of AR in resected primary tumors from TNBC patients from six international cohorts {US (n = 420), UK (n = 239), Norway (n = 104), Ireland (n = 222), Nigeria (n = 180), and India (n = 242); total n = 1407}. All TNBC samples were stained with the same anti-AR antibody using the same immunohistochemistry protocol, and samples with ≥1% of AR-positive nuclei were deemed AR-positive TNBCs. RESULTS: AR status shows population-specific patterns of association with patients' overall survival after controlling for age, grade, population, and chemotherapy. We found AR-positive status to be a marker of good prognosis in US and Nigerian cohorts, a marker of poor prognosis in Norway, Ireland and Indian cohorts, and neutral in UK cohort. CONCLUSION: AR status, on its own, is not a reliable prognostic marker. More research to investigate molecular subtype composition among the different cohorts is warranted.

Use of traditional medicines among pharmacists in Nigeria.

BACKGROUND: Traditional Medicine (TM) use is growing and emerging as an issue of public healthcare importance. Recently, there are increasing interest and trends of TM use among health care professionals (HCP). However, information regarding TM use among pharmacists in Nigeria is limited. This study investigates the use of TM among pharmacists in Nigeria. MATERIALS AND METHODS: This study was a cross sectional study in the form of an online survey (Google Surveys). Eligible participants were pharmacists currently practicing in Nigeria. The closed-ended questionnaire was developed and validated prior to the data collection. The hyperlink to the online survey questionnaire was shared with the eligible pharmacists via social media groups belonging to pharmacists' professional associations. RESULTS: A total of 262 of completed responses were received. Among the respondents, 53.2% had over 5 years of pharmacy practice experience and 48% were practicing in hospitals. 225 respondents (85.9%) have ever used TM at least once in their lifetime, while 21.3% were currently using TM at the time of the data collection. Those that used TM in the last 12 months were 47.0%, while those that used it within the last week, one month and six months were 15.4%, 10.5% and. 12.8% respectively. Herbal medicine was the most frequently used TM among the respondents (94.2%). The most common reason for using TM was for the maintenance of general well-being (38.2%). Among the TM users, 17.3% have reported experiencing an ADE-related to the TM use. Among the respondents, 44.7% felt TM is safe for use while 35.5% indicated that they will recommend TM to their patients. CONCLUSION: TM is commonly used by a pharmacist in Nigeria particularly among those practicing in the community and hospital. This signifies an increasing acceptance of TM among healthcare professionals and a call for more education and training on TM for effective pharmaceutical care delivery.

Antimicrobials usage assessments in commercial poultry and local birds in North-central Nigeria: Associated pathways and factors for resistance emergence and spread.

The World Health Organization's Global Action Plan on antimicrobial resistance (AMR) recommended monitoring of antimicrobial use (AMU) through surveillance and research to help mitigate AMR. This survey was aimed at assessing poultry owners' knowledge/awareness and practices regarding AMU, identified pathways for AMR emergence and spread in small-scale commercial poultry farms and free-range local bird flocks in North-central Nigeria. An interview questionnaire-based cross-sectional study was conducted on commercial poultry farmers and local bird flock keepers in 2017. Also, a Traffic Light system model was used assess risk status of AMU in farms and flocks. All the 384 recruited poultry farmers/keepers participated in the survey. Female respondents were the majority (67.2%). Low proportion of poultry farmers (46.4%, 89/192) and very low proportion of bird keepers (6.8%, 13/192) knew antimicrobials misuse to be when administered under dose. About 48% (93/192) of farmers and 93% (179/192) of keepers arbitrary determined antimicrobial dosage before administration. Respondents used antimicrobials for therapeutic, prophylactic, and growth promotion in birds. Also, participants significantly identified contaminated poultry products, infected poultry or contaminated formites, and discharged contaminated faeces into environment as pathways for transmission of antimicrobial resistant pathogens to humans. Traffic Light system model revealed 88.5% of small-scale commercial poultry farms to frequently used antimicrobials without veterinarians' consultations thereby attaining Class 1 (Red risk) status. The model showed that 92.1% of free-range local bird flocks rarely used antimicrobials thereby attaining Class 3 (Green risk) status. Improper antimicrobial dosage in poultry (OR: 7.23; 95% CI: 2.74, 19.21), non-enforcement of AMU regulating laws in poultry (OR: 4.12; 95% CI: 2.39, 7.10), weak financial status of poultry owners (OR: 3.00; 95% CI: 2.39, 7.10), and management system (OR: 8.94; 95% CI: 5.62, 14.24) were more likely to satisfactorily influenced antimicrobials misuse in poultry farms and local bird flocks. The survey revealed low knowledge level regarding AMU in the poultry. Antimicrobials were rarely used in local bird flocks, making them likely organic and safe from AMR. It is imperative to educate farmers on judicious AMU, enforce existing veterinary legislation on antimicrobials, establish antimicrobials surveillance system, and sensitize farmers on adequate biosecurity measures and routine vaccination of farms, so as to assure food safety, food security, and public health.

Gains in Grain Yield of Extra-Early Maize during Three Breeding Periods under Drought and Rainfed Conditions.

Drought is a key maize (Zea mays L.) production constraint in sub-Saharan Africa. Fourteen, fifteen, and twenty-five extra-early maturing maize cultivars, with varying Striga resistance and drought and low soil N tolerance, were developed from 1995 to 2000 (Period 1), 2001 to 2006 (Period 2), and 2007 to 2012 (Period 3), respectively. The objectives of this study were to examine yield gains in the cultivars and to investigate inter-trait relationships and yield stability under six drought and 17 rainfed conditions in West Africa from 2013 to 2016. Annual rate of yield increase across cultivars was 0.034 (3.28%) and 0.068 Mg ha-1 (2.25%), whereas yield gains per period were 0.17 and 0.38 Mg ha-1 under drought and rainfed environments, respectively. Yield gains under drought and rainfed environments were related to prolonged flowering period, increased plant and ear heights, improved stalk lodging, and ear and plant aspects, whereas delayed leaf senescence and increased number of ears per plant accompanied yield improvement under drought only. Ear aspect and number of ears per plant were primary contributors to yield and could be used as selection criteria for yield enhancement under drought and rainfed conditions. High-yielding and stable cultivars across all environments based on additive main effects and multiplicative interaction (AMMI) biplot included '2004 TZEE-Y Pop STR C4' and 'TZEE-W Pop STR BC2 C0' of Period 2 and '2009 TZEE-W STR', 'TZEE-Y STR 106', 'TZEE-W STR 107', and 'TZEE-W DT C0 STR C5' of Period 3. These cultivars could be commercialized to improve food self-sufficiency in sub-Saharan Africa.

Analysis of risk factors and prevalence of haemoplasma infection in dogs.

Mycoplasma haemocanis (Mhc) and 'Candidatus Mycoplasma haematoparvum' (CMhp) are canine haemoplasma species that can induce anaemia in immunocompromised and/or splenectomised dogs. This study aimed to determine the prevalence and phylogeny of canine haemoplasma species in dogs from Nigeria and describe any risk factors for infection. Canine haemoplasma species-specific and generic haemoplasma qPCR assays were used. The species-specific qPCR assays found Mhc infection in 18 of 245 dogs (7.3%), and CMhp infection in only one dog (0.4%). The generic haemoplasma qPCR assays were positive in 44 of 245 (17.9%) dogs. Twenty-five dogs had discordant qPCR results in that they were generic haemoplasma qPCR positive but species-specific qPCR negative. Further evaluation of these dogs by 16S rDNA sequencing gave limited results but 5 were confirmed to be infected with non-haemoplasma species: 2 Anaplasma phagocytophilum, 1 Anaplasma ovis, 1 Serratia marcescens and 1 Aerococcus spp. The 16S rRNA gene sequences from Mhc species showed>99.8% identity with each other and>99.6% identity with GenBank sequences, and resided in a single clade with other global Mhc and Mycoplasma haemofelis sequences, indicating low 16S rRNA genetic variability amongst this canine haemoplasma species.

Aspergillosis of the bone.

Aspergillosis of the long bones has not been reported. Those of the bones of the paranasal sinuses and ear canal have been reported but rare. A young woman reported to us with history of discharging sinuses around the right knee and recent fracture of the right femur. Despite all efforts, she ended up losing the whole limb from the hip. When a patient with Aspergillosis of the long bones presents late, amputation may be the best option. Early diagnosis will prevent this.

Photoletter to the editor: Scarring alopecia resulting from pyoderma gangrenosum of the scalp.

Pyoderma gangrenosum is an uncommon ulcerative cutaneous condition of uncertain aetiology. It is a disease that causes tissue to become necrotic, leading to deep ulcers. We report a case of pyoderma gangrenosum localized at the scalp, which is an unusual location. After 16 months of treatment with prednisolone 40 mg daily, methotrexate 15 mg weekly, ciprofloxacin 500 mg and honey dressing the indurated elevated ulcer margins flattened and the ulcer healed with scarring of the entire scalp.

Primary cutaneous aspergillosis in an immunocompetent patient.

We present a 32-year-old woman with primary cutaneous aspergillosis and an apparently normal immune status. She is a dietitian who carried out research on Aspergillus contamination of palm oil over a six-month period, during which she apparently shaved her axillae and perineum using a safety razor blade. She presented with nodular lesions, which became extensive ulcers after an attempt at incision and drainage. Diagnosis was based on culture and histology. The patient was treated with itraconazole 200 mg twice a day, with surgical excision and a rhomboid flap cover of the axillae. She has remained disease-free five years after discharge. This highlights the likely benefits of a combination of surgical excision and drug therapy, in achieving a cure in this patient.

Impact of gastro-oesophageal reflux disease symptoms on COPD exacerbation.

BACKGROUND: The association between gastro-oesophageal reflux disease (GORD) and chronic obstructive pulmonary disease (COPD) exacerbation has so far remained unclear. OBJECTIVE: To prospectively establish the clinical significance of GORD symptoms on exacerbation. METHODS: 82 patients with COPD and 40 age matched controls were enrolled in this study. Symptoms were evaluated by a questionnaire using the Frequency Scale for the Symptoms of GORD (FSSG). Patients with COPD were prospectively surveyed for 6 months, and episodes of exacerbation were identified using a diary based on modified Anthonisen's criteria. Exhaled breath condensate (EBC) pH was measured in both groups, and induced sputum was evaluated in patients with COPD. RESULTS: Positive GORD symptoms were reported in 22 (26.8%) patients with COPD and in five (12.5%) controls (p = 0.10). The frequency of exacerbations was significantly associated with the FSSG score (p = 0.03, r = 0.24, 95% CI 0.02 to 0.43). Multiple regression analysis revealed that GORD symptoms were significantly associated with the occurrence of exacerbations (p<0.01; relative risk 6.55, 95% CI 1.86 to 23.11). EBC pH was inversely correlated with FSSG score in both groups (p = 0.01, r = -0.37, 95% CI -0.55 to -0.14 in patients with COPD, and p<0.01, r = -0.45, 95% CI -0.67 to -0.16 in control subjects). CONCLUSIONS: GORD symptoms were identified as an important factor associated with COPD exacerbation.

PRELIMINARY GASTROINTESTINAL STUDIES OF METHANOL EXTRACT OF INDIGOFERA PULCHRA WILLD IN RODENTS.

In this study, the effect of the methanol extract of Indigofera pulchra Willd. (Papillionaceae) was investigated against castor oil induced diarrheoa. Its effects on perfused isolated rabbit jejunum and guinea pig ileum were also evaluated. The extract produced a dose-dependent protection against the castor oil-induced diarrheoa in mice with the highest protection (100%), obtained at 200 mgkg-1 comparable to that of loperamide (5 mgkg-1), a standard antidiarrhoeal drug. The extract (0.4 - 6.4 mgml-1) produced a concentration relaxation of the rabbit jejunum. However, no observable effect was noticed when the guinea pig ileum was treated. The extract blocked the contractile effect of acetylcholine (2 × 10-8 gml-1) and histamine (4 × 10-7 gml-1) on both rabbit jejunum and guinea pig ileum. Phytochemical screening revealed the presence of flavonoids, tannins, saponins and steroids. The intraperitoneal median lethal dose (LD50) value for the extract was found to be 2154.0 mgkg-1. The results obtained revealed that the extract possesses pharmacologically active compounds with gastrointestinal relaxant and antidiarrhoeal activities and may possibly explain the use of the plant in traditional medicine for the treatment of gastrointestinal disorder.