Effects of topical application of virgin coconut oil on infection, mortality and dermal maturation in preterm newborns: Systematic review and meta-analysis

Background@#Preterm birth is an important health concern in countries with limited resources and healthcare access. Topical therapy may be effective for improving outcomes in preterm neonates whose skin barriers are compromised due to immaturity.@*Objectives@#To systematically review the topical VCO's effects in preterm infants on infection, mortality, and dermal maturity.@*Methodology@#Systematic review and meta-analysis of RCTs of topical VCO in preterm infants were conducted. Databases included PubMed, Google Scholar, Clinical trials.gov, Trip, Cochrane Library, and HERDIN. The risk of bias was assessed by two authors independently. RR with 95% CI was used for the pooled estimate of dichotomous outcomes including infection prevention, mortality reduction, and skin irritation. Mean differences with 95% CI were used for the pooled estimate of weight loss and NSCS.@*Results@#Of 110 records identified, 3 RCTs with 2440 patients were included. Prevention of infection had a trend toward VCO (RR = 0.90, [95% CI: 0.64, 1.27] while the results for mortality reduction were inconclusive (RR = 0.45, [95% CI: 0.06, 3.38]. NSC scores showed a beneficial trend toward VCO (RR = -0.03, [95% CI: -0.16, 0.09]. Both secondary outcomes of skin irritation and weight loss had inconclusive results.@*Conclusions@#This review showed the lack of evidence of the effectiveness of topical VCO in improving various outcomes in premature infants. The effects on infection prevention and dermal maturation were favorable. However, its effects on preventing mortality, skin irritation, and weight loss were inconclusive.

Protective effects of spirulina against hemato-biochemical alterations, nephrotoxicity, and DNA damage upon lead exposition.

The current study was aimed at exploring the protective efficacy of spirulina against the hemato-biochemical alterations and nephrotoxicity induced by lead (Pb). Female rats aged 12 weeks were treated for 4 weeks with Pb (0.344 g kg-1 bw) associated or not with spirulina (5.3 g kg-1 bw). Renal damage induced by Pb was related to a severe anemia, increases of oxidative stress-related parameters (thiobarbituric acid reactive substances (TBARS) (+29%), protein carbonyl (PCO) (+66.3%), and advanced oxidation protein product (AOPP) (+110%)), plasma lactate dehydrogenase (LDH) (+80%), creatinine and urea levels in plasma, and uric acid concentration in urine, as well as genotoxic changes (+89.3% and +60% for DNA and mRNA levels, respectively). Conversely, LDH and antioxidant enzyme activities in kidney were decreased, as well as the levels of plasma uric acid, and urinary creatinine and urea levels. Spirulina-supplemented rats exhibited normal peripheral blood and renal parameters and renal histology. It can be suggested that Arthrospira platensis alleviates damages induced by Pb, thanks to its high phenolic content and antioxidant capacity.

Anti-aging activities of extracts from Tunisian medicinal halophytes and their aromatic constituents.

Six medicinal halophytes widely represented in North Africa and commonly used in traditional medicine were screened for pharmacological properties to set out new promising sources of natural ingredients for cosmetic or nutraceutical applications. Thus, Citrullus colocynthis, Cleome arabica, Daemia cordata, Haloxylon articulatum, Pituranthos scoparius and Scorzonera undulata were examined for their in vitro antioxidant (DPPH scavenging and superoxide anion-scavenging, ß-carotene bleaching inhibition and iron-reducing tests), antibacterial (microdilution method, against four human pathogenic bacteria) and anti-tyrosinase activities. Besides, their aromatic composition was determined by RP-HPLC. H. articulatum shoot extracts exhibited the strongest antioxidant activity and inhibited efficiently the growth of Salmonella enterica and Escherichia coli. P. scoparius and C. arabica inhibited slightly monophenolase, whereas H. articulatum was the most efficient inhibitor of diphenolase activity. Furthermore, H. articulatum exhibited the highest aromatic content (3.4 % DW), with dopamine as the major compound. These observations suggest that shoot extract of H. articulatum, and to a lesser extent of C. arabica, could be used as antioxidant, antibiotic as well as new natural skin lightening agents. Also, possible implication of aromatic compounds in anti-tyrosinase activity is discussed.

Methyl thiophanate-induced toxicity in liver and kidney of adult rats: a biochemical, molecular and histopathological approach.

The aim of this study was to elucidate the redox effects of Thiophanate methyl (MT) in the rat liver and kidney. Our results showed, after 3 days of MT injection (700 mg/kg), an increase in malondialdehyde (MDA), hydrogen peroxide and advanced oxidation protein products levels. Glutathione peroxidase and superoxide dismutase activities were also remarkably increased in the liver but decrease in the kidney. Glutathione and vitamin C values were significantly reduced. The changes in biochemical parameters were substantiated by histological and molecular data. A smear without ladder formation on agarose gel was shown, indicating random DNA degradation in the liver and the kidney of MT treated rats. The increase in cyclooxygenase-2 gene expression, marker of inflammation, and an increase in genes expression of glutathione peroxidase and superoxide dismutase in liver and their decrease in the kidney were also occurred after MT exposure. These data confirmed the pro-oxidant and genotoxic effects of this fungicide.

Dandelion-enriched diet of mothers alleviates lead-induced damages in liver of newborn rats.

Lead (Pb) is a highly toxic metal present in the environment. It causes disturbances of several functions, including hematologic, renal, reproductive and nervous ones. Preventive or curative use of medicinal plants against these disorders may be a promising and safe therapeutic strategy. This study evaluated the hepatic toxic effects of prenatal exposure to lead in rats and the possible protective effect of dandelion (Taraxacum officinale) added to the diet. Female rats were given a normal diet (control) or a diet enriched with dandelion (treated). In addition, lead acetate was administered to half of the rats through drinking water from the 5th day of gestation until the 14th day postpartum. Lead toxicity was evaluated in their offspring by measuring body and liver weights, plasma biochemical parameters, liver damage, as well as protein content and activities of antioxidant enzymes in the liver tissues. Lead poisoning of mothers caused lead deposition in blood and stomach of their pups as well as hepatic tissue damages. Moreover, significant decreases in liver weight and protein content were found. Lead treatment caused oxidative stress and marked changes in the activity of antioxidant enzymes. However, no damages or biochemical changes were observed in puppies from the rats co-treated with lead and dandelion. These results indicate that supplementation of pregnant and lactating rats with dandelion protects their offspring against lead poisoning, likely through reduction of oxidative stress and liver damages.

Spirulina exhibits hepatoprotective effects against lead induced oxidative injury in newborn rats.

Lead is a toxic metal that induces a wide range of biochemical and physiological effects. The present investigation was designed at evaluating the toxic effects of a prenatal exposure to lead of mothers on hepatic tissue of newborn rats, and potent protective effects of spirulina. Female rats were randomly divided into 4 groups which were given a normal diet (control),a diet enriched with spirulina (S), lead acetate administered through drinking water (Pb), or a diet enriched with spirulina and lead contaminated water (S Pb), respectively. The duration of treatments was from the 5th day of gestation to 14 days postpartum. Lead toxicity was assessed by measuring body and liver weights, blood and stomach lead levels, hepatic DNA, RNA and protein amounts, blood enzyme activities (AST and ALT), as well as lipid peroxidation level and activities of antioxidant enzymes in hepatic tissues of neonates. Lead intoxication of mothers caused reduction of liver weight as well as of hepatic DNA, mRNA and protein levels in newborns. Moreover, oxidative stress and changes in antioxidant enzyme activities were recorded. Conversely, supplementation of mothers with spirulina mitigated these effects induced by lead. These results substantiated the potential hepatoprotective and antioxidant activity of spirulina.

Assessment of Imatinib in the treatment of chronic myeloid leukemia in Gabon: a cohort of 17 cases.

The prognosis for chronic myeloid leukemia, the first hematologic malignancy for which successful targeted therapy has been developed, has changed markedly in the West. In developing countries, however, prognosis remains poor, mainly because of lack of access to treatment. The effort made by some nongovernmental organizations to distribute first-generation tyrosine kinase inhibitors free of charge has changed this situation in some regions, notably in sub-Saharan Africa and Gabon in particular. We report the results in a cohort of 17 patients.

[Tuberculosis of the breast: four cases report at the Armies Instruction's Hospital Omar Bongo Ondimba (HIAOBO) in Libreville (Gabon)]. / Tuberculose mammaire : à propos de quatre cas à l'hôpital d'instruction des armées Omar Bongo Ondimba (HIAOBO) de Libreville (Gabon).

Mammary tuberculosis is a rare localization of extra pulmonary tuberculosis. Its frequency increases proportionally with the HIV pandemic. We report four cases of breast tuberculosis diagnosed in the general medicine department of HIAOBO including two with positive HIV serology. It is necessary to know this extra pulmonary form/feature as the differential diagnosis with breast tumors is sometimes difficult.

Caractéristiques cliniques de la bronchopneumopathie chronique obstructive à l'Hopital d'Instruction des Armées Omar Bongo Ondimba

Il s'agit d'une étude rétrospective menée sur cinq ans à l'hôpital d'instruction des armées Omar Bongo Ondimba au cours de laquelle nous avons obtenu les résultats suivants : une prévalence de 0,78.Une prédominance masculine (68,9%), avec un âge moyen de 66 ans chez des patients présentant des co-morbidités à type de diabète (6,6%) et d'HTA (36,34%). La majorité des patients était des sans-emploi (31,45%). Les antécédents tabagiques (principale étiologie) étaient retrouvés dans 85% des cas avec 70% de fumeurs actifs et une consommation moyenne de 24±18 paquets/année.Le motif de consultation le plus fréquent était la dyspnée (50,8%) alors que le facteur favorisant prédominant était le tabac (83,6%). Mais les infections (surtout tuberculeuse) vienaient en seconde position (9,84%). L'anomalie radiologique la plus fréquente était l'emphysème centro lobulaire (30,51%). Les patients étaient pour la plupart au stade II (57,4%). Ils avaient quasiment tous bénéficié de beta 2 mimétiques (95,08%) et de corticothérapie inhalées (91,80%).La BPCO est une maladie chronique évolutive dont la principale cause reste le tabac (surtout en Occident). Mais la pollution et les infections post tuberculeuses ne doivent pas être négligées dans les pays en voie de développement. Ceci nécessite de la part des pouvoirs publics une mobilisation des ressources humaines et financières avec intégration de la BPCO dans le programme de santé publique. Le dépistage (peak Flow dans les salles de consultation) et la prise en charge des patients doivent être assurés. Il faut élaborer un cadre législatif anti-tabac et renforcer les moyens préventifs et thérapeutiques de la lutte contre la tuberculose

[Epidemiology of upper gastrointestinal bleeding in Gabon]. / Profil épidémiologique des hémorragies digestives hautes au Gabon.

The department of internal medicine of the military hospital of Gabon managed 92 cases of upper gastrointestinal bleeding from April 2009 to November 2011. The frequency of these hemorrhages in the department was 8.2%; they occurred most often in adults aged 30-40 years and 50-60 years, and mainly men (74%). Erosive-ulcerative lesions (65.2%) were the leading causes of hemorrhage, followed by esophageal varices (15.2%). These results underline the importance of preventive measures for the control of this bleeding.

[Profile of adenopathies in a tropical setting: 78 observations in Gabon]. / Profil étiologique des adénopathies en milieu tropical : soixante-dix-huit observations au Gabon.

OBJECTIVE: To determine the main causes of lymphadenopathies and their clinical characteristics in Gabon. MATERIAL AND METHOD: This retrospective study analyzed the records of patients hospitalized in the medical department at the Military Hospital of Libreville (Gabon) from January 2010 through December 2011 who presented one or more lymphadenopathies. RESULTS: The study included 78 patients (45 men, 33 women), with a mean age of 42.2 ± 15.9 years. Lymphadenopathies were superficial in 67.9% of cases, abdominal in 42% of cases and mediastinal in 24% of cases. Both deep and superficial locations were noted in 26% (20 cases). Weight loss (63%), fever (56%), asthenia (54%), hepatomegaly (26%), and splenomegaly (20%) were the clinical signs most frequently associated with lymphadenopathy. The main diagnoses were tuberculosis (52%, 41 cases) and non-Hodgkin's lymphoma (11%, 9 cases). Infection with human immunodeficiency virus (HIV) was found in 47% of cases. CONCLUSION: Tuberculosis remains the most frequent cause of lymphadenopathy in our setting. HIV testing should be routinely performed in all patients with lymphadenopathy.

[Morbidity and mortality in HIV-infected patients in the Military Hospital in Libreville (Gabon)]. / Morbimortalité chez les patients infectés par le VIH à l'hôpital militaire de Libreville, Gabon.

OBJECTIVE: To study the morbidity and mortality of HIV-infected patients at the military hospital in Libreville (Gabon). MATERIALS & METHODS: A retrospective study of the clinical records of 289 HIV-positive patients hospitalized in the department of internal medicine between January 2008 and December 2010. RESULTS: The patient's median age was 40 years (range: 18-70). The principal presenting complaints were fever (82%), weight loss (76.47%) and coughing (26.64%). Median time from symptom onset to consultation was 150 days (1-365). The predominant opportunistic diseases were oropharyngeal candidiasis (71.62%), all forms of tuberculosis (26.29%) and cerebral toxoplasmosis (23.87%). The median CD4 lymphocyte count was 177/mm(3 )(1-590). In-hospital mortality was 27.68%. The factors associated with death were long time to consultation and severe immunosuppression (CD4 count <100/mm(3)). CONCLUSION: Despite increased awareness, lateness of diagnosis and thus of treatment persist, and AIDS remains one of the principal causes of morbidity and mortality in Gabon.

[Histoplasmosis: case report from Gabon]. / Histoplasmose : première observation au Gabon.

The purpose of this report is to describe the first case of infection with Histoplasma capsulatum variety duboisii in Gabon, in a patient with HIV infection.

[Multifocal pyomyositis after being hit by a truncheon in Gabon]. / Pyomyosite multifocale après coups de matraque au Gabon.

Pyomyositis is an acute primary bacterial infection of striated muscle. It affects mainly but not only immunocompromised patients, especially in tropical areas. The responsible microbe is often found to be Staphylococcus aureus. We report here the case of an immunocompetent 17-year-old with multifocal pyomyositis from which S. aureus was isolated two weeks after he was hit with a truncheon.

[Multi-resistant tuberculosis at the hôpital d'instruction des armées de Libreville (Gabon) about 16 cases]. / Tuberculose multirésistante à l'hôpital d'instruction des armées de Libreville (Gabon) à propos de 16 cas.

According to WHO estimates, between 1 and 20% of tuberculosis cases in the world are multiresistant. In Gabon, this prevalence is estimated at 1.9%. In this forward-looking study from March 2006 to August 2010, we report 16 cases of multi-resistant tuberculosis out of 24 suspected resistant samples (persistence of the clinical and radiological signs after three months of well conducted treatment with first-line anti-tuberculous drugs). This study is realized in association with the laboratory of mycobacterium of the Percy military teaching hospital, Clamart, France.

[Clinical and radiological features of tuberculosis during HIV infection in Libreville, Gabon]. / Aspects cliniques et radiologiques de la tuberculose au cours de l'infection par le VIH à Libreville, Gabon.

OBJECTIVE: The purpose of this report is to describe the clinical and radiological features of tuberculosis during HIV infection. MATERIALS AND METHODS: This retrospective comparative study was based on review of patients treated between 2006 and 2010 in the Department of Medicine of the Military Hospital in Libreville, Gabon. A total of 156 patients with all types of tuberculosis were included, i.e., a study group of 78 tuberculosis patients co-infected with HIV and a control group of 78 seronegative tuberculosis patients. Analysis was carried out on demographic, clinical and radiological data. RESULTS. Most patients in both groups were male. Mean patient age was 37.1 +/- 10.3 in the seropositive group and 29.5 +/- 11.5 in the seronegative group. Deterioration in general health was quantitatively higher in the seropositive group. Tuberculosis was confined to the lungs in 41% of patients co-infected with HIV and 55% of seronegative patients. Chest x-rays showed more extensive cavitation in seronegative patients. Mixed pulmonary and extrapulmonary disease was observed in 20.5% of seropositive patients and 10.3% of seronegative patients. The CD4 lymphocyte rate was not statistically different between patients with pulmonary versus extrapulmonary tuberculosis. CONCLUSION. Tuberculosis during HIV infection often has an atypical or banal clinical presentation. Radiological findings may be non-distinctive or even normal. For this reason, diagnosis of tuberculosis may be difficult.

[Pneumocystis jiroveci pneumonia: first documented case in Libreville, Gabon]. / Pneumonie à pneumocystis jiroveci: premier cas documenté à Libreville (Gabon).

The purpose of this report is to describle the first documented case of pneumocystosis in Gabon. Diagnosis was confirmed based on microbiological methods in a 59-year-old immunodepressed HIV-positive man. Diagnosis was further documented by observation of Pneumocystis jiroveci cysts in the broncho-alveolar lavage (BAL) after Gomori-Grocott color reaction. The patient responded well to treatment with Cotrimoxazole, corticoids and oxygen.

Electrodeposited nanoporous versus nanoparticulate ZnO films of similar roughness for dye-sensitized solar cell applications.

We present a comparative study of two different ZnO porous film morphologies for dye-sensitized solar cell (DSSC) fabrications. Nanoparticulate ZnO was prepared by the doctor-blade technique starting from a paste containing ZnO nanoparticles. Nanoporous ZnO films were grown by a soft template-assisted electrochemical growth technique. The film thicknesses were adjusted at similar roughness of about 300 in order to permit a worthy comparison. The effects on the cell performances of sensitization by dyes belonging to three different families, namely, xanthene (eosin Y) and indoline (D102, D131, D149 and D205) organic dyes as well as a ruthenium polypyridine complex (N719), have been investigated. The mesoporous electrodeposited matrix exhibits significant morphological changes upon the photoanode preparation, especially upon the dye sensitization, that yield to a dramatic change of the inner layer morphology and increase in the layer internal specific surface area. In the case of indoline dyes, better efficiencies were found with the electrodeposited ZnO porous matrixes compared to the nanoparticulate ones, in spite of significantly shorter electron lifetimes measured by impedance spectroscopy. The observation is interpreted in terms of much shorter transfer time in the oxide in the case of the electrodeposited ZnO films. Among the tested dyes, the D149 and D205 indoline organic dyes with a strong acceptor group were found the most efficient with the best cell over 4.6% of overall conversion efficiency.

Epileptiform seizures revealing neurocysticercosis: report of two clinical cases in Libreville, Gabon.

Neurocysticercosis (NCC) is the most common helminth infection of the central nervous system. It is caused by the larval form of the tapeworm Taenia solium and is increasingly recognized as a major cause of neurologic disease worldwide. Epilepsy is the usual mode of revelation. Neuroimaging, including computed tomography and magnetic resonance imaging, combined with serodiagnostic techniques have led to this increased recognition. We report on two cases (one co-infected with the HIV) of NCC diagnosed in 2006 and 2008 at the Omar Bongo Ondimba Army Teaching Hospital. New-onset epilepsy revealed the two cases. Medical treatment with albendazole, anti-epileptic drugs and corticosteroids led to full recovery. NCC should be considered in tropical countries as a leading cause of epilepsy. Moreover, NCC should be included in the differential diagnosis of neurologic infections in HIV patients in endemic populations.

[Neuromeningeal cryptococcosis and AIDS: an 11-case series from Libreville, Gabon]. / Cryptococcose neuroméningée et sida: 11 observations a Libreville, Gabon.

UNLABELLED: Neuromeningeal cryptococcosis occurs mainly in immunodepressed patients and especially AIDS patients. The purpose of this study was to determine the clinical and prognostic features of this severe brain infection. PATIENTS AND METHODS: This retrospective study was carried out on HIV-infected patients hospitalized for cryptococcal meningitis in the internal medicine unit of a military hospital in Libreville, Gabon from January 1, 2006 to November 31, 2009. RESULTS: Eleven cases of cryptococcosis were identified among a total of 290 cases of AIDS. Mean patient age was 39 years. The main clinical manifestation was headache that was either isolated or associated with other cerebral signs. In all cases, cerebrospinal fluid analysis demonstrated a clear aseptic aspect with direct examination after addition of India ink showing the presence of encapsulated yeast cells identified as cryptococcus. The patient was treated with amphotericin B and fluconazole. The mortality rate was 81.8% (9/11 cases). CONCLUSION: Since the manifestations of cryptococcosis during clinical AIDS are non-specific, systematic screening is recommended in AIDS patients. Early treatment could reduce mortality.