Fever assessment in children under five: Are we following the guidelines?

BACKGROUND: Fever is a common cause of medical consultation and hospital admission, particularly among children. Recently, the United Kingdom's National Institute for Health and Care Excellence (NICE) updated its guidelines for assessing fever in children under five years of age. The efficient assessment and management of children with fever are crucial for improving patient outcomes. AIM: To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s guideline. METHODS: We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics, Salmaniya Medical Complex, Bahrain, between June and July 2023. Demographic data, vital signs during the first 48 h of admission, route of temperature measurement, and indications for admission were gathered. Fever was defined according to the NICE guideline. The children were divided into five groups according to their age (0-3 months, > 3-6 months, > 6-12 months, > 12-36 months, and > 36-60 months). Patients with and without fever were compared in terms of demography, indication for admission, route of temperature measurement, and other vital signs. Compliance with the NICE Fever in the under 5s guideline was assessed. Full compliance was defined as > 95%, partial compliance as 70%-95%, and minimal compliance as ≤ 69%. Pearson's χ2, Student's t test, the Mann-Whitney U test, and Spearman's correlation coefficient (rs) were used for comparison. RESULTS: Of the 136 patients reviewed, 80 (58.8%) were boys. The median age at admission was 14.2 [interquartile range (IQR): 1.7-44.4] months, with the most common age group being 36-60 months. Thirty-six (26.4%) patients had fever, and 100 (73.6%) were afebrile. The commonest age group for febrile patients (> 12-36 months) was older than the commonest age group for afebrile patients (0-3 months) (P = 0.027). The median weight was 8.3 (IQR: 4.0-13.3) kg. Patients with fever had higher weight than those without fever [10.2 (IQR: 7.3-13.0) vs 7.1 (IQR: 3.8-13.3) kg, respectively] (P = 0.034). Gastrointestinal disease was the leading indication for hospital admission (n = 47, 34.6%). Patients with central nervous system diseases and fever of unknown etiology were more likely to be febrile (P = 0.030 and P = 0.011, respectively). The mean heart rate was higher in the febrile group than the afebrile group (140 ± 24 vs 126 ± 20 beats per minute, respectively) [P = 0.001 (confidence interval: 5.8-21.9)] with a positive correlation between body temperature and heart rate, r = 0.242, n = 136, P = 0.004. A higher proportion of febrile patients received paracetamol (n = 35, 81.3%) compared to the afebrile patients (n = 8, 18.6%) (P < 0.001). The axillary route was the most commonly used for temperature measurements (n = 40/42, 95.2%), followed by the rectal route (n = 2/42, 4.8%). The department demonstrated full compliance with the NICE guideline for five criteria: the type of thermometer used, route and frequency of temperature measurement, frequency of heart rate measurement, and use of antipyretics as needed. Partial compliance was noted for two criteria, the threshold of fever at 38 °C or more, and the respiratory rate assessment in febrile patients. Minimal compliance or no record was observed for the remaining three criteria; routine assessment of capillary refill, temperature reassessment 1-2 h after each antipyretic intake, and refraining from the use of tepid sponging. CONCLUSION: This study showed that fever assessment in hospitalized children under five years of age was appropriate, but certain areas of adherence to the NICE guideline still need to be improved.

One-Pot Synthesis of Amphipathic Esters for Demulsification of Water-in-Crude Oil Emulsions.

The current work aims to synthesize new amphipathic compounds, TGHA and PGHA, and investigate their demulsification performance (DP) in water-in-crude oil emulsions. Their chemical structures, thermal stability, interfacial activity, and micelle formation were investigated by different techniques. The bottle test method was used to investigate the effect of demulsifier concentration, water content, temperature, and demulsification time (DT) on the DP of TGHA and PGHA compared to a commercial demulsifier (CD). The results indicated that these parameters have a noticeable impact on the DP of TGHA and PGHA. The results also showed that TGHA exhibited higher DP than PGHA at all investigated parameters, which could be explained by increasing its hydrophobicity due to lower oxyethylene units in its structure than PGHA. An increase in these units means increased hydrophilicity, which led to obstruction of PGHA molecule diffusion in crude oil as a continuous phase. Moreover, TGHA gave a comparable DP with CD, as it gave a higher DP and shorter DT than CD at a higher water content (50%), while the latter achieved the highest DP and the shortest DT at a low water content (10%).

Synthesis and molecular docking of some new thiazolidinone and thiadiazole derivatives as anticancer agents.

New sets of functionalized thiazolidinone and thiadiazole derivatives were synthesized, and their cytotoxicity was evaluated on HepG2, MCF-7, HTC-116, and WI38 cells. The synthetic approach is based on the preparation of 4-(4-acetamidophenyl)thiosemicarbazide (4) and their thiosemicarbazones 5a-e, which are converted to the corresponding thiazoldin-4-one compounds 6a-e upon cyclization with ethyl bromoacetate. The thiadiazole compounds 9 and 12 were obtained by reacting 4-(4-acetamidophenyl)thiosemicarbazide with isothiocyanates and/or ethyl 2-cyano-3,3-bis(methylthio)acrylate, respectively. The thiazolidinone compounds 6c and 6e exhibited strong cytotoxicity against breast cancer cells, with an IC50 (6.70±0.5 µM) and IC50 (7.51±0.8 µM), respectively, very close to that of doxorubicin (IC50: 4.17±0.2 µM). In addition, the anti-cancer properties of the tested thiazolidinone and thiadiazole scaffolds were further explored by the molecular docking program (MOE)-(PDB Code-1DLS). Compounds 5d, 5e, 6d, 6e, and 7 have the best binding affinity, ranging from -8.5386 kcal.mol-1 to -8.2830 kcal.mol-1.

SYNTHESIS OF SOME NOVEL THIOPHENE ANALOGUES AS POTENTIAL ANTICANCER AGENTS.

The aim of this study involves the synthesis novel thiophene analogues that can be used as anticancer medications through a strategic multicomponent reaction connecting ethyl 4-chloroacetoacetate (1), phenyl isothiocyanate, and a series of active methylene reagents, including ethyl acetoacetate (2), malononitrile, ethyl cyanoacetate, cyanoacetamide 6a-c, N-phenyl cyanoacetamide derivatives 13a-c, and acetoacetanilide derivatives 18. This reaction was facilitated by dry dimethylformamide with a catalytic quantity of K2CO3. The resultant thiophene derivatives were identified as 4, 8a-b, 9, 12a-d, 15a-c, and 20a-b. Further reaction of compound 4 with hydrazine hydrate yielded derivative 5, respectively. When compound 1 was refluxed with ethyl 3-mercapto-3-(phenylamino)-2-(p-substituted phenyldiazenyl)acrylate 10a-e in the presence of sodium ethoxide, it produced thiophene derivatives 12a-d. Comprehensive structural elucidation of these newly synthesized thiophene-analogues was accomplished via elemental and spectral analysis data. Furthermore, the study delves into the cytotoxicity of the newly synthesized thiophenes was evaluated using the HepG2, A2780, and A2780CP cell lines. The amino-thiophene derivative 15b exhibited an increased growth inhibition of A2780, and A2780CP with IC50 values 12±0.17, and 10±0.15 µM, respectively compared to Sorafenib with IC50 values 7.5±0.54 and 9.4±0.14. This research opens new avenues for developing thiophene-based anticancer agents.

Assessment of environmental pollution and human health risks of mine tailings in soil: after dam failure of the Córrego do Feijão Mine (in Brumadinho, Brazil).

The dam failure of the Córrego do Feijão Mine (CFM) located in Minas Gerais State, Brazil, killed at least 278 people. In addition, large extensions of aquatic and terrestrial ecosystems were destroyed, directly compromising the environmental and socioeconomic quality of the region. This study assessed the pollution and human health risks of soils impacted by the tailing spill of the CFM dam, along a sample perimeter of approximately 200 km. Based on potential ecological risk and pollution load indices, the enrichments of Cd, As, Hg, Cu, Pb and Ni in soils indicated that the Brumadinho, Mário Campos, Betim and São Joaquim de Bicas municipalities were the most affected areas by the broken dam. Restorative and reparative actions must be urgently carried out in these areas. For all contaminated areas, the children's group indicated an exacerbated propensity to the development of carcinogenic and non-carcinogenic diseases, mainly through the ingestion pathway. Toxicological risk assessments, including acute, chronic and genotoxic effects, on people living and working in mining areas should be a priority for public management and mining companies to ensure effective environmental measures that do not harm human health and well-being over time.

Diffusion-weighted imaging in hyperacute haemorrhagic stroke patients presenting within thrombolysis window.

INTRODUCTION: Diffusion-weighted imaging (DWI) in magnetic resonance imaging (MRI) has been proposed as the first line of neuroimaging for acute ischaemic stroke. The reliability of DWI in detecting intracranial haemorrhage, however, is still unproven, compared with susceptibility-weighted imaging (SWI) and CT scan which being considered the gold standard. This study seeks to establish the reliability of DWI as a first-line imaging modality to detect the intracranial haemorrhage in the patients present within the thrombolysis window. MATERIALS AND METHODS: A retrospective cross-sectional analysis was performed on patients who presented to our institution from April 2020 until July 2021 for acute stroke and had MRI brain as first-line neuroimaging. A total of 31 subjects were included in this study. Two radiologists assessed the signal patterns in DWI sequence and compared them with SWI and CT Brain, whenever available, as the gold standard for observing the presence of intracranial haemorrhage. RESULTS: The majority of patients with hyperacute bleed proven to be revealed on SWI or CT, thus showed characteristics of central hyperintensity and peripheral hypointense rim, on DWI. Slightly more than half (51.6%) presented with mild to moderate NIHSS scores (1-15). The sensitivity, specificity, positive predictive value and negative predictive value of DWI in detecting intracranial intra-axial haemorrhages were exceptionally high. There is strong interobserver level of agreement in identifying central haemorrhagic signal intensity [kappa = 0.94 (0.06), p < 0.05]. CONCLUSION: This study supported the DWI sequence as a reliable sequence in MRI, to detect intracranial haemorrhage in hyperacute stroke.

Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study.

BACKGROUND: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans. METHOD: This is a single-centered retrospective analytical study. This study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia. Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data. RESULTS: Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively. CONCLUSION: The study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area.

Influence of agricultural activities and seasonality on levels of selected physico-chemical parameters and heavy metals along River Yala in Lake Victoria Basin.

The aim of the work was to establish the effect of anthropogenic activities and seasonality on physico-chemical parameters and heavy metal levels of River Yala (RY) within RY Basin of Lake Victoria (LV), as well as the associated ecological risks. Analyses were done on the collected samples in order to establish the levels of EC, pH, DO, temperature, conductivity, turbidity, acidity, alkalinity, BOD, COD, DOC, TOC and heavy metals (Cu, Fe, Pb, Mn, Zn, Cr and Cd) in RY water and sediments adjacent to Agricultural Farms during dry and wet seasons. The levels in terms of µg/mL, µS/cm (EC), NTU (turbidity) of analyzed parameters in the Agricultural Farms in water ranged from 0.01±0.00 to 121.75±15.23 (Upstream pristine sources of RY - S), 0.02±0.01 to 184.83±23.43 (Nandi Tea Estate and Kaimosi Agricultural Farms - N), 0.02±0.01 to 149.67±22.77 (Subsistence Farms - Sub), 0.02±0.01 to 209.33±18.09 (Lake Agro Limited Agricutural Farms and Yala Swamp - D) and 0.01±0.00 to 164.25±30.33 (Terminal of RY - T). The levels in µg/g of analyzed parameters in sediments ranged from 7.2±1.46 to 3342.8±538.7 (S), 9.12±0.2 to 4063.2±90.4 (N), 3.15±1.14 to 5998.5±588.4 (Sub), 2.03±0.76 to 4519.8±194.9 (D) and 2.13±0.75 to 5514.4±201.4 (T). The significant differences in the levels of analyzed parameters in water between dry and wet seasons were computed as; EC (+20.54 µS/cm), alkalinity (-2.85 µg/mL), DOC (+0.24 µg/mL), Fe (+0.58 µg/mL), Pb (+0.11 µg/mL), Zn (+0.07 µg/mL) and Cd (+0.01 µg/mL) while that for Mn in sediment samples was +163.8937 µg/g. The significantly (p ≤ 0.05) positive values indicated that wet season had more impact on the levels than dry season. There was positive correlation of zinc in water and sediments during dry and wet season. Chromium correlated positively in water and sediments during wet season. Copper and cadmium correlated negatively during dry and wet season while Mn only wet season. Results of geostatistical indices (CF, Cd, mCd, PLI, Er and RI) indicated that sediments located at regions N, D and T were highly contaminated with the heavy metals. However, a wetland at the mouth of Lake Victoria cleaned the water before it drained into the lake. Therefore, despite contamination of RY through anthropogenic activities, wetland mitigation protects LV from pollution by the river, indicating the important ecological and restorative functions played by wetlands.

Efficient Oil Spill Uptake Using Surface-Modified Magnetite Nanoparticles with PET Waste Derivatives.

This work deals with poly(ethylene terephthalate) waste as a precursor to synthesize new cross-linked poly(ionic liquids) (CLPILs). The newly synthesized CLPILs, VPCT-Cl and VPCT-AA, were used for magnetite nanoparticle surface modification, producing VCL/Fe3O4 and VAA/Fe3O4, respectively. The chemical structures of the CLPILs and surface-modified Fe3O4 were elucidated by Fourier transform infrared and X-ray diffraction. Additionally, the particle size, zeta potential (ζ), contact angle, and magnetic properties of VCL/Fe3O4 and VAA/Fe3O4 were investigated using different techniques. Furthermore, the performance of these nanoparticles for oil spill cleanup was evaluated using various influencing factors, e.g., the contact time and the Fe3O4/crude oil ratio. VCL/Fe3O4 and VAA/Fe3O4 showed excellent performance in oil spill cleanup. The data showed that the performance increased with the contact time and the Fe3O4 ratio. Furthermore, the reusability of VCL/Fe3O4 and VAA/Fe3O4 over four cycles was also explored. The reusability data indicated that reused VCL/Fe3O4 and VAA/Fe3O4 showed promising performance in oil spill cleanup.

Surface-modified magnetite nanoparticles using polyethylene terephthalate waste derivatives for oil spill remediation.

This work aims at synthesizing new cross-linked poly ionic liquids, CPILs, VIMDE-Cl and CPIL, VIMDE-TFA, utilizing polyethylene terephthalate waste as a precursor and applying them to magnetite nanoparticles surface modification, producing surface-modified magnetite nanoparticles, SMNPs, VDCL/MNPs, and VDTA/MNPs, respectively. The structures of VIMDE-Cl and VIMDE-TFA, VDCL/MNPs, and VDTA/MNPs, were verified using different techniques. The particle sizes of SMNPs, VDCL/MNPs, and VDTA/MNPs, were evaluated with a transmission electron microscope and dynamic light scattering. The compatibility of VDCL/MNPs and VDTA/MNPs with crude oil components and their response to an external magnet were also measured using contact angle measurements and a vibrating sample magnetometer. The data confirmed the formation of SMNPs, nanosized structure, compatibility with oil components, and response to an external magnet. For that, VDCL/MNPs and VDTA/MNPs were applied for oil spill recovery using different SMNP : crude oil weight ratios. The impact of contact time on SMNPs' performance was also evaluated. The data indicated increased performance with an increase in SMNPs ratio, reaching maximum values of 99% and 96% for VDCL/MNPs and VDTA/MNPs, respectively, at SMNPs : crude oil ratio of 1 : 1. According to the results, the optimal contact time was 6 min, resulting in 89% and 97% performance for VDCL/MNPs and VDTA/MNPs at 1 : 4 SMNPs : crude oil ratio.

The NED foundation experience: A model of global neurosurgery.

Introduction: The Neurosurgery Education and Development (NED) Foundation (NEDF) started the development of local neurosurgical practice in Zanzibar (Tanzania) in 2008. More than a decade later, multiple actions with humanitarian purposes have significantly improved neurosurgical practice and education for physicians and nurses. Research question: To what extent could comprehensive interventions (beyond treating patients) be effective in developing global neurosurgery from the outset in low and middle-income countries? Material and method: A retrospective review of a 14- year period (2008-2022) of NEDF activities highlighting landmarks, projects, and evolving collaborations in Zanzibar was carried out. We propose a particular model, the NEDF model, with interventions in the field of health cooperation that have simultaneously aimed to equip, treat, and educate in a stepwise manner. Results: 138 neurosurgical missions with 248 NED volunteers have been reported. In the NED Institute, between Nov 2014-Nov 2022, 29635 patients were seen in the outpatient clinics and 1985 surgical procedures were performed. During the course of NEDF's projects, we have identified three different levels of complexity (1, 2 and 3) that include the areas of equipment ("equip"), healthcare ("treat") and training ("educate"), facilitating an increase of autonomy throughout the process. Discussion and Conclusion: In the NEDF's model, the interventions required in each action area (ETE) are coherent for each level of development (1, 2 and 3). When applied simultaneously, they have a greater impact. We believe the model can be equally useful for the development of other medical and/or surgical specialties in other low-resource healthcare settings.

Synthesis and Performance of Two New Amphiphilic Ionic Liquids for Demulsification of Water-in-Crude Oil Emulsions.

This work aims to synthesize and apply two novel amphiphilic ionic liquids (AILs) for the demulsification of water-in-crude oil (W/O) emulsions. To do that, 4-tetradecylaniline (TA) and 4-hexylamine (HA) were etherified using tetrethylene glycol (TEG) in the presence of bis(2- chloroethoxyethyl)ether (BE) as a cross-linker, yielding corresponding ethoxylated amines TTB and HTB. The obtained ethoxylated amines TTB and HTB were quaternized with acetic acid (AA), obtaining corresponding AILs TTB-AA and HTB-AA. The chemical structures, surface tension (ST), interfacial tension (IFT), and micelle size were investigated with various techniques. The performance of TTB-AA and HTB-AA to demulsify W/O emulsions was investigated using different influencing factors, including the demulsifier concentration, water content, salinity, and pH. Additionally, the obtained results were compared with a commercial demulsifier. The results indicated that the demulsification performance (DP) increased as the demulsifier concentration increased and the water content decreased; however, increased salinity slightly improved the DP. The data also showed that the highest DPs were achieved at a pH of 7, which suggested a change in the chemical structure of these AILs at a lower and higher pH due to their ionic structure. Furthermore, TTB-AA demonstrated higher DP than HTB-AA, which could be explained by its higher ability to reduce IFT due to a longer alkyl chain than that of HTB-AA. Furthermore, TTB-AA and HTB-AA showed significant DP compared to the commercial demulsifier especially with W/O emulsions at low water content.

Idiopathic Granulomatous Mastitis: Six years of experience and the current evidence in literature.

Objectives: This study aimed to retrospectively describe the clinicopathological pattern and management experience of idiopathic granulomatous mastitis in women receiving care at the Royal Hospital, a tertiary care centre in Oman. The study then compared the researchers' experience with the current literature trends. Methods: The data of patients from January 2012 to December 2017 were reviewed retrospectively, after receiving ethical approval from the Centre of Studies and Research. Results: This retrospective study included 64 patients were confirmed to have idiopathic granulomatous mastitis. All patients were in the premenopausal phase, with only one being nulliparous. Mastitis was the most common clinical diagnosis; furthermore, half of the patients had a palpable mass. Most patients had received antibiotics during the span of their treatment. Drainage procedure was done in 73% of the patients, whereas excisional procedure was done for 38.7%. Only 52.4% of patients were able to achieve complete clinical resolution within six months of follow-up. Conclusion: There is no standardised management algorithm due to the paucity of high-level evidence comparing different modalities. However, steroids, methotrexate and surgery are all considered to be effective and acceptable treatments. Moreover, current literature tends towards multimodality treatments planned tailored case-to-case based on the clinical context and patients' preference.

Spreading, Breakup, and Rebound Behaviors of Compound Droplets Impacting on Microstructured Substrates.

In this study, we numerically investigate the dynamic behaviors of micron-scale compound droplets impacting onto superhydrophobic surfaces patterned by micropillar arrays using a three-dimensional free-energy-based lattice Boltzmann method. We address how the interplay between physical parameters (i.e., Weber number) and geometric parameters (i.e., pillar density and spacing and the droplet core-shell size ratio) affects the spreading, breakup, and rebound behaviors of compound droplets, which remains unknown and unquantified. We identify three flow regimes in which the interfacial morphology between the core and shell evolves and breaks up in distinct ways: namely, hole nucleation at the substrate, rupture of the film at the apex of the shell, and toroidal formation of the core droplet before its detachment from the pillars. We demonstrate that the transition between the three regimes and the maximum spreading factor of compound droplets can be changed by varying the core-shell size ratio, the pillar density, and the Weber number. The non-wetting behavior of the pillar structures eventually forms a new suspended pure droplet or a new suspended compound droplet, which can be characterized by the core-shell size ratio, pillar density, and Weber number.

Portrayal of Punica granatum L peel extract through High Performance Liquid Chromatography and antimicrobial activity evaluation / Retrato do extrato de casca de Punica granatum L por meio de cromatografia líquida de alto desempenho e avaliação da atividade antimicrobiana

ncreasing trend in antimicrobial resistance and failure of chemically synthesized antibiotics lead to discover alternative methods for the treatment of bacterial infections. Various medicinal plants are in use traditionally and their active compounds can be further applied for treatment of bacterial diseases. This study was designed to determine the antibacterial activity of Punica granatum (P. granatum L.) (pomegranate) peel extract against Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) and Shigella Dysenteriae (S. Dysenteriae)] and gram-positive bacterium [Staphylococcus aureus (Staph aureus)]. Methanolic extract of P. granatum L. peel was prepared by Soxhlet apparatus method. Total flavonoid and phenolic contents from the extract were determined by High Performance Liquid Chromatography (HPLC). The antibacterial activity of P. granatum L. peel extract was evaluated through agar well diffusion method. HPLC showed the range of phenolics (gallic acid, caffeic acid, benzoic acid, cinnamic acid) and flavonoid compounds. The chemical structures of flavonoid and phenolics found in the methanolic extract of P. granatum L. peel have been reported for the first time. The methanolic peel extract (50 ul) of yellow P. granatum L. showed 26, 10, 10 and 9mm zones of inhibition (ZOI) against S. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. The methanolic extract of red P. granatum L. (100 ul) showed 27, 8, 12 and 15 mm ZOI against Staph. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. Highest ZOI was observed against Staph. aureus. Many of the bacteria studied in the present work may cause serious gastrointestinal infections, which can lead to hemorrhagic diarrhea in children. These [...].

A tendência crescente na resistência antimicrobiana e na falha dos antibióticos sintetizados quimicamente leva à descoberta de métodos alternativos para o tratamento de infecções bacterianas. Várias plantas medicinais estão em uso tradicionalmente e seus compostos ativos podem ser posteriormente aplicados para o tratamento de doenças bacterianas. Este estudo foi desenhado para determinar a atividade antibacteriana do extrato de casca de Punica granatum (P. granatum L.) (romã) contra Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) e Shigella Dysenteriae (S. Dysenteriae) ] e bactéria gram-positiva [Staphylococcus aureus (Staph aureus)]. O extrato metanólico da casca de P. granatum L. foi preparado pelo método do aparelho de Soxhlet. O conteúdo total de flavonoides e fenólicos do extrato foi determinado por cromatografia líquida de alta eficiência (HPLC). A atividade antibacteriana do extrato da casca de P. granatum L. foi avaliada através do método de difusão em ágar. HPLC mostrou a gama de compostos fenólicos (ácido gálico, ácido cafeico, ácido benzoico, ácido cinâmico) e flavonoides. As estruturas químicas de flavonoides e fenólicos encontradas no extrato metanólico da casca de P. granatum L. foram relatadas pela primeira vez. O extrato metanólico da casca (50 ul) de P. granatum L. amarelo apresentou zonas de inibição (ZOI) de 26, 10, 10 e 9mm contra S. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O extrato metanólico de P. granatum L. vermelho (100 ul) apresentou 27, 8, 12 e 15 mm IOI contra Staph. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O ZOI mais alto foi observado contra Staph. aureus. Muitas das bactérias estudadas no presente trabalho podem causar infecções gastrointestinais graves, que podem levar à diarreia [...].

Portrayal of Punica granatum L. peel extract through High Performance Liquid Chromatography and antimicrobial activity evaluation

Abstract Increasing trend in antimicrobial resistance and failure of chemically synthesized antibiotics lead to discover alternative methods for the treatment of bacterial infections. Various medicinal plants are in use traditionally and their active compounds can be further applied for treatment of bacterial diseases. This study was designed to determine the antibacterial activity of Punica granatum (P. granatum L.) (pomegranate) peel extract against Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) and Shigella Dysenteriae (S. Dysenteriae)] and gram-positive bacterium [Staphylococcus aureus (Staph aureus)]. Methanolic extract of P. granatum L. peel was prepared by Soxhlet apparatus method. Total flavonoid and phenolic contents from the extract were determined by High Performance Liquid Chromatography (HPLC). The antibacterial activity of P. granatum L. peel extract was evaluated through agar well diffusion method. HPLC showed the range of phenolics (gallic acid, caffeic acid, benzoic acid, cinnamic acid) and flavonoid compounds. The chemical structures of flavonoid and phenolics found in the methanolic extract of P. granatum L. peel have been reported for the first time. The methanolic peel extract (50 ul) of yellow P. granatum L. showed 26, 10, 10 and 9mm zones of inhibition (ZOI) against S. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. The methanolic extract of red P. granatum L. (100 ul) showed 27, 8, 12 and 15 mm ZOI against Staph. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. Highest ZOI was observed against Staph. aureus. Many of the bacteria studied in the present work may cause serious gastrointestinal infections, which can lead to hemorrhagic diarrhea in children. These infections can be life-threatening to young children and the elderly. There is an incentive to find alternative control measures, such as plant and herbal extracts, especially in lesser-developed countries where traditional antibiotics may not be readily available.

Resumo A tendência crescente na resistência antimicrobiana e na falha dos antibióticos sintetizados quimicamente leva à descoberta de métodos alternativos para o tratamento de infecções bacterianas. Várias plantas medicinais estão em uso tradicionalmente e seus compostos ativos podem ser posteriormente aplicados para o tratamento de doenças bacterianas. Este estudo foi desenhado para determinar a atividade antibacteriana do extrato de casca de Punica granatum (P. granatum L.) (romã) contra Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) e Shigella Dysenteriae (S. Dysenteriae) ] e bactéria gram-positiva [Staphylococcus aureus (Staph aureus)]. O extrato metanólico da casca de P. granatum L. foi preparado pelo método do aparelho de Soxhlet. O conteúdo total de flavonoides e fenólicos do extrato foi determinado por cromatografia líquida de alta eficiência (HPLC). A atividade antibacteriana do extrato da casca de P. granatum L. foi avaliada através do método de difusão em ágar. HPLC mostrou a gama de compostos fenólicos (ácido gálico, ácido cafeico, ácido benzoico, ácido cinâmico) e flavonoides. As estruturas químicas de flavonoides e fenólicos encontradas no extrato metanólico da casca de P. granatum L. foram relatadas pela primeira vez. O extrato metanólico da casca (50 ul) de P. granatum L. amarelo apresentou zonas de inibição (ZOI) de 26, 10, 10 e 9mm contra S. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O extrato metanólico de P. granatum L. vermelho (100 ul) apresentou 27, 8, 12 e 15 mm IOI contra Staph. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O ZOI mais alto foi observado contra Staph. aureus. Muitas das bactérias estudadas no presente trabalho podem causar infecções gastrointestinais graves, que podem levar à diarreia hemorrágica em crianças. Essas infecções podem ser fatais para crianças pequenas e idosos. Há um incentivo para encontrar medidas de controle alternativas, como extratos de plantas e ervas, especialmente em países menos desenvolvidos, onde os antibióticos tradicionais podem não estar prontamente disponíveis.

Portrayal of Punica granatum L. peel extract through High Performance Liquid Chromatography and antimicrobial activity evaluation / Retrato do extrato de casca de Punica granatum L. por meio de cromatografia líquida de alto desempenho e avaliação da atividade antimicrobiana

Abstract Increasing trend in antimicrobial resistance and failure of chemically synthesized antibiotics lead to discover alternative methods for the treatment of bacterial infections. Various medicinal plants are in use traditionally and their active compounds can be further applied for treatment of bacterial diseases. This study was designed to determine the antibacterial activity of Punica granatum (P. granatum L.) (pomegranate) peel extract against Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) and Shigella Dysenteriae (S. Dysenteriae)] and gram-positive bacterium [Staphylococcus aureus (Staph aureus)]. Methanolic extract of P. granatum L. peel was prepared by Soxhlet apparatus method. Total flavonoid and phenolic contents from the extract were determined by High Performance Liquid Chromatography (HPLC). The antibacterial activity of P. granatum L. peel extract was evaluated through agar well diffusion method. HPLC showed the range of phenolics (gallic acid, caffeic acid, benzoic acid, cinnamic acid) and flavonoid compounds. The chemical structures of flavonoid and phenolics found in the methanolic extract of P. granatum L. peel have been reported for the first time. The methanolic peel extract (50 ul) of yellow P. granatum L. showed 26, 10, 10 and 9mm zones of inhibition (ZOI) against S. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. The methanolic extract of red P. granatum L. (100 ul) showed 27, 8, 12 and 15 mm ZOI against Staph. aureus, S. Typhimurium, S. Dysenteriae and E. coli, respectively. Highest ZOI was observed against Staph. aureus. Many of the bacteria studied in the present work may cause serious gastrointestinal infections, which can lead to hemorrhagic diarrhea in children. These infections can be life-threatening to young children and the elderly. There is an incentive to find alternative control measures, such as plant and herbal extracts, especially in lesser-developed countries where traditional antibiotics may not be readily available.

Resumo A tendência crescente na resistência antimicrobiana e na falha dos antibióticos sintetizados quimicamente leva à descoberta de métodos alternativos para o tratamento de infecções bacterianas. Várias plantas medicinais estão em uso tradicionalmente e seus compostos ativos podem ser posteriormente aplicados para o tratamento de doenças bacterianas. Este estudo foi desenhado para determinar a atividade antibacteriana do extrato de casca de Punica granatum (P. granatum L.) (romã) contra Enterobacteriaceae [Escherichia coli (E. coli), Salmonella Typhimurium (S. Typhimurium) e Shigella Dysenteriae (S. Dysenteriae) ] e bactéria gram-positiva [Staphylococcus aureus (Staph aureus)]. O extrato metanólico da casca de P. granatum L. foi preparado pelo método do aparelho de Soxhlet. O conteúdo total de flavonoides e fenólicos do extrato foi determinado por cromatografia líquida de alta eficiência (HPLC). A atividade antibacteriana do extrato da casca de P. granatum L. foi avaliada através do método de difusão em ágar. HPLC mostrou a gama de compostos fenólicos (ácido gálico, ácido cafeico, ácido benzoico, ácido cinâmico) e flavonoides. As estruturas químicas de flavonoides e fenólicos encontradas no extrato metanólico da casca de P. granatum L. foram relatadas pela primeira vez. O extrato metanólico da casca (50 ul) de P. granatum L. amarelo apresentou zonas de inibição (ZOI) de 26, 10, 10 e 9mm contra S. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O extrato metanólico de P. granatum L. vermelho (100 ul) apresentou 27, 8, 12 e 15 mm IOI contra Staph. aureus, S. Typhimurium, S. Dysenteriae e E. coli, respectivamente. O ZOI mais alto foi observado contra Staph. aureus. Muitas das bactérias estudadas no presente trabalho podem causar infecções gastrointestinais graves, que podem levar à diarreia hemorrágica em crianças. Essas infecções podem ser fatais para crianças pequenas e idosos. Há um incentivo para encontrar medidas de controle alternativas, como extratos de plantas e ervas, especialmente em países menos desenvolvidos, onde os antibióticos tradicionais podem não estar prontamente disponíveis.

Epidemiological trends of Lassa fever in Nigeria, 2018-2021.

BACKGROUND: Lassa fever is a viral haemorrhagic fever endemic in Nigeria. Improved surveillance and testing capacity have revealed in an increased number of reported cases and apparent geographic spread of Lassa fever in Nigeria. We described the recent four-year trend of Lassa fever in Nigeria to improve understanding of its epidemiology and inform the design of appropriate interventions. METHODS: We analysed the national surveillance data on Lassa fever maintained by the Nigeria Centre for Diseases Control (NCDC) and described trends, sociodemographic, geographic distribution, and clinical outcomes. We compared cases, positivity, and clinical outcomes in the period January 2018 to December 2021. RESULTS: We found Lassa fever to be reported throughout the year with more than half the cases reported within the first quarter of the year, a recent increase in numbers and geographic spread of the virus, and male and adult (>18 years) preponderance. Case fatality rates were worse in males, the under-five and elderly, during off-peak periods, and among low reporting states. CONCLUSION: Lassa fever is endemic in Nigeria with a recent increase in numbers and geographical distribution. Sustaining improved surveillance, enhanced laboratory diagnosis and improved case management capacity during off-peak periods should remain a priority. Attention should be paid to the very young and elderly during outbreaks. Further research efforts should identify and address specific factors that determine poor clinical outcomes.