Development and evaluation of a loop-mediated isothermal amplification (LAMP) method for Candida glabrata detection.

PURPOSE: Loop-mediated isothermal amplification (LAMP) is a simple and rapid nucleic acid method for DNA amplification at a constant temperature. The "gold standard" culture method for yeast detection, has low sensitivity with severe consequences, increasing morbidity and mortality rates. Here, we report the development of a LAMP method for the specific detection of C. glabrata. METHODOLOGY: The specific LAMP primers for C. glabrata detection were designed and evaluated. RESULTS: The LAMP assay accurately detected C. glabrata with no cross-reactivity with other Candida species. CONCLUSION: The developed molecular method would be a promising tool in the management of invasive candidiasis.

Perspectives on health, illness, disease and management approaches among Baganda traditional spiritual healers in Central Uganda.

In Uganda, spirituality is closely associated with traditional healthcare; however, though prevalent, it is considered controversial, mystical, less documented and often misunderstood. There is a paucity of literature on the description of health, illness, disease, and management approaches among traditional spiritual healers. This article examines the perspectives on health, illness, disease, and management approaches among Baganda traditional spiritual healers, the Balubaale, in Central Uganda, who engage ancestral spirits during health care and management. We used a qualitative study design in particular grounded theory. We used semi-structured, qualitative interviews and observation on 12 male and female purposively selected Balubaale in Central Uganda. Data was transcribed, coded, and thematically analyzed using ATLAS ti. 22 Computer software based on an inductive approach. Findings show that the words and concepts describing health, illness, disease, and management approaches are descriptive and contextualized to include the problem, the prospected root-causes, and the therapeutic approaches involved. The words for illness "olumbe", disease "obulwadde" and the management approaches such as divination (kulagula), ritual cleansing (kwambulula), amulets (ensiriba and yirizi), and scarification (kusandaga) have spiritual and social dimensions, contextual meanings and attachments. Further research is recommended among other tribes and larger sample size to compare findings and terminologies to facilitate communication and policy considerations.

An exploratory study on becoming a traditional spiritual healer among Baganda in Central Uganda.

Traditional medicinal knowledge and healing practices of indigenous spiritual healers play important roles in health care, and contribute towards achieving Universal Health Care. Traditional spiritual healers (TSHs) are grouped into three categories. One category of Baganda TSHs, Balubaale, engage ancestral spirits during health management. Balubaale are socially significant but not legally accepted. Their initiation and training practices have not been documented in Uganda. The study purpose was to understand and establish the training of traditional spiritual healers. Twelve (10M, 2F); practicing TSHs in Central Uganda were purposively selected and recruited between 15th July 2019 and 29th April 2020, and were prospectively interacted with for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software and presented based on an inductive approach. Findings show key areas of TSHs training include connecting with ancestral spirits and the spiritual powers of non-materials and materials such as living and non-living things through rituals. Spiritual healers train in diagnosis and health management based on ancestral spirits and they finally pass out in a communal ceremony witnessed by family and community members. We conclude that TSHs undergo training and are supervised and supported by experienced spiritualists, family and the community. We recommend similar studies among other ethnic groups to contextualize the process of becoming a TSH, compare and harmonize findings to facilitate inter-medical systems communication and policy considerations.

Current status of infectious diseases among migrants and non-citizens in Malaysia.

The mass movement of migrants to Malaysia for employment is one of the factors contributing to the emergence and re-emergence of infectious diseases in this country. Despite mandatory health screening for migrants seeking employment, prevalence records of infectious diseases amongst migrant populations in Malaysia are still within negligible proportions. Therefore, the present review highlights the incidence, mortality and overall status of infectious diseases amongst migrants' populations in Malaysia, which maybe be useful for impeding exacerbation of inequalities among them and improving our national health system thru robust and effective emergency responses in controlling the prevalent diseases found among these populations and maybe, Malaysian citizens too. Peer-reviewed articles from January 2016 to December 2020 were searched through online platform including SCOPUS, PubMed, Science Direct, and Google Scholar. Non-peer-reviewed reports and publications from ministry and government websites including data from related agencies were also scoured from in order to ensure that there are no cases being overlooked, as most published articles did not have migrants as the research subjects. A total of 29 studies had been selected in the final analysis. Migrants in Malaysia were at higher risk for tuberculosis, malaria, lymphatic filariasis, cholera, leprosy and leptospirosis. Lymphatic filariasis was still endemic among this population while thousand cases of TB and cholera had been reported among them due to cramp living conditions and poor sanitation in their settlements respectively. While malaria had gradually decreased and become sporadic, the influx of migrant workers had led to the rising of imported malaria cases. Low cases of leprosy had been recorded in Malaysia but a significant proportion of it was contributed by migrant workers. As for leptospirosis, studies found that there are prominent cases among migrant workers, which particularly highest within workers with lower educational attainment. Infectious diseases are still prevalent among migrants in Malaysia due to various interplay factors including their working sectors, country of origin, immunization status, type of settlement, impoverished living conditions, and language and cultural barriers that impeding access to health facilities.

Current status of infectious diseases among migrants and non-citizens in Malaysia

@#The mass movement of migrants to Malaysia for employment is one of the factors contributing to the emergence and re-emergence of infectious diseases in this country. Despite mandatory health screening for migrants seeking employment, prevalence records of infectious diseases amongst migrant populations in Malaysia are still within negligible proportions. Therefore, the present review highlights the incidence, mortality and overall status of infectious diseases amongst migrants’ populations in Malaysia, which maybe be useful for impeding exacerbation of inequalities among them and improving our national health system thru robust and effective emergency responses in controlling the prevalent diseases found among these populations and maybe, Malaysian citizens too. Peer-reviewed articles from January 2016 to December 2020 were searched through online platform including SCOPUS, PubMed, Science Direct, and Google Scholar. Non-peer-reviewed reports and publications from ministry and government websites including data from related agencies were also scoured from in order to ensure that there are no cases being overlooked, as most published articles did not have migrants as the research subjects. A total of 29 studies had been selected in the final analysis. Migrants in Malaysia were at higher risk for tuberculosis, malaria, lymphatic filariasis, cholera, leprosy and leptospirosis. Lymphatic filariasis was still endemic among this population while thousand cases of TB and cholera had been reported among them due to cramp living conditions and poor sanitation in their settlements respectively. While malaria had gradually decreased and become sporadic, the influx of migrant workers had led to the rising of imported malaria cases. Low cases of leprosy had been recorded in Malaysia but a significant proportion of it was contributed by migrant workers. As for leptospirosis, studies found that there are prominent cases among migrant workers, which particularly highest within workers with lower educational attainment. Infectious diseases are still prevalent among migrants in Malaysia due to various interplay factors including their working sectors, country of origin, immunization status, type of settlement, impoverished living conditions, and language and cultural barriers that impeding access to health facilities.

Theoretical and experimental studies on the corrosion inhibition potentials of some purines for aluminum in 0.1 M HCl.

Experimental aspect of the corrosion inhibition potential of adenine (AD), guanine (GU) and, hypoxanthine (HYP) was carried out using weight loss, potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) methods while the theoretical aspect of the work was carried out by calculations of semi-empirical parameters (for AM1, MNDO, CNDO, PM3 and RM1 Hamiltonians), Fukui functions and inhibitor-metal interaction energies. Results obtained from the experimental studies were in good agreement and indicated that adenine (AD), guanine (GU) and hypoxanthine (HYP) are good adsorption inhibitors for the corrosion of aluminum in solutions of HCl. Data obtained from electrochemical experiment revealed that the studied purines functioned by adsorption on the aluminum/HCl interface and inhibited the cathodic half reaction to a greater extent and anodic half reaction to a lesser extent. The adsorption of the purines on the metal surface was found to be exothermic and spontaneous. Deviation of the adsorption characteristics of the studied purines from the Langmuir adsorption model was compensated by the fitness of Flory Huggins and El Awardy et al. adsorption models. Quantum chemical studies revealed that the experimental inhibition efficiencies of the studied purines are functions of some quantum chemical parameters including total energy of the molecules (TE), energy gap (E L-H), electronic energy of the molecule (EE), dipole moment and core-core repulsion energy (CCR). Fukui functions analysis through DFT and MP2 theories indicated slight complications and unphysical results. However, results obtained from calculated Huckel charges, molecular orbital and interaction energies, the adsorption of the inhibitors proceeded through the imine nitrogen (N5) in GU, emanine nitrogen (N7) in AD and the pyridine nitrogen (N5) in HPY.

Inhibiting estrogen responses in breast cancer cells using a fusion protein encoding estrogen receptor-alpha and the transcriptional repressor PLZF.

Estrogen receptor alpha (ERalpha) is a ligand-inducible transcription factor that acts to regulate gene expression by binding to palindromic DNA sequence, known as the estrogen response element, in promoters of estrogen-regulated genes. In breast cancer ERalpha plays a central role, where estrogen-regulated gene expression leads to tumor initiation, growth and survival. As an approach to silencing estrogen-regulated genes, we have studied the activities of a fusion protein between ERalpha and the promyelocytic leukemia zinc-finger (PLZF) protein, a transcriptional repressor that acts through chromatin remodeling. To do this, we have developed lines from the estrogen-responsive MCF-7 breast cancer cell line in which the expression of the fusion protein PLZF-ERalpha is conditionally regulated by tetracycline and shows that these feature long-term silencing of the expression of several well-characterized estrogen-regulated genes, namely pS2, cathepsin-D and the progesterone receptor. However, the estrogen-regulated growth of these cells is not inhibited unless PLZF-ERalpha expression is induced, an observation that we have confirmed both in vitro and in vivo. Taken together, these results show that PLZF-ERalpha is a potent repressor of estrogen-regulated gene expression and could be useful in distinguishing estrogen-regulated genes required for the growth of breast cancer cells.

Rupture of the renal pelvis of a ureteropelvic junction hydronephrosis after blunt abdominal trauma.

In the present case report, we present the unusual occurrence of traumatic rupture of a ureteropelvic junction hydronephrosis, and discuss the potential mechanisms producing such a rupture and the management options.

Giant bleeding renal angiomyolipoma: diagnosis and management.

A case of a giant bleeding renal angiomyolipoma is presented. The patient was a 40-year-old Egyptian male with no clinical or radiological evidence of tuberous sclerosis. The radiological features and management, including the role of angiography are briefly discussed and the medical reviews on this subject are briefly considered.

Risk factors for optic nerve disease in communities mesoendemic for savannah onchocerciasis, Kaduna State, Nigeria.

Ophthalmic examinations on 6831 individuals aged 5 years or more, living in 34 guinea savannah communities mesoendemic for onchocerciasis, in Kaduna State, Nigeria, revealed a relatively high prevalence (9%) of optic nerve disease (OND). Further investigations were performed to determine what proportion of this burden of OND might be due to onchocercal infection. Information on history of cerebro-spinal meningitis (CSM), past use of diethylcarbamazine (DEC) and chloroquine, consumption of cassava and locally produced alcohol was collected for all individuals by questioning. In addition, a nested case-control study of 81 cases of OND and 136 age and sex-matched controls was performed to investigate whether syphilis or a variety of other neurological disorders were responsible for a substantial proportion of cases of OND. Our data suggest that in this population, onchocercal infection is the single most important cause of OND and may account for 50% of all cases. Some 13% of cases were associated with signs suggestive of glaucoma. DEC use might be responsible for up to 30% of all OND. We found no evidence to suggest that any of the following are important causes of OND in the communities studied: CSM, syphilis, neurological syndromes such as polyneuropathy or other generalized neurological disease, consumption of raw cassava, consumption of locally prepared alcohol.

Ivermectin dose assessment without weighing scales.

Described are two alternatives to the weighing of patients for assessing the dose of ivermectin for use in mass chemotherapy campaigns against onchocerciasis. The first method uses height to separate patients into four dosing categories (1/2, 1, 11/2 and 2 tablets), while the second involves estimating one of these dosing categories according to an individual's physical appearance, without making any measurements. Data for the height-based method were obtained from 6373 people who were taking part in a placebo-controlled trial of ivermectin in northern Nigeria. Use of an arbitrary trade-off of approximately 100 people "overdosed" for every person "underdosed" would lead to 0.5% of the population being underdosed by 1/2 tablet, 46.5% being dosed correctly, 51.7% being overdosed by 1/2 tablet, and 1.2% being overdosed by 1 tablet. The physical appearance approach involved three observers and 779 subjects. A total of 82% of the observers' estimates were "correct", with all the incorrect dosing deviating by only 1/2 tablet from the dose that the subjects should have received.

PIP: Between December 1988 and October 1989, 6373 inhabitants of 34 rural communities in Kaduna State in northern Nigeria participated in a double-blind, placebo controlled trial of ivermectin for onchocerciasis, in which height was used to determine the dose of ivermectin. In December, 1991, the field team estimated the correct dose of ivermectin solely on the physical appearance of 779 people. Researchers conducted these studies to determine whether these methods could replace weight as a reliable assessment of the dose of ivermectin. (Use of weight poses practical problems, e.g., providing and maintaining many weighing scales in rural areas.) Most participants were assigned a dose of ivermectin that deviated by no more than 1/2 tablet from the correct dose (98.8% for height method and 100% for physical appearance method). The physical appearance method was more successful at determining the correct use than the height method (82 vs. 46.5%). These studies revealed that few underdosings occurred, and they were no more than 1/2 tablet (e.g., 0.5% for height method). This findings was especially important, since underdosing does not effectively destroy the microfiliarae of Onchocerca volvulus, while overdosing causes no harm. The researchers concluded that both the height and physical appearance methods would be appropriate alternative methods to assess the ivermectin dose for people in rural communities. Further research on both methods in different settings and populations would identify which one should become the method of choice.

Early metabolic effects of hypotension on rat kidney.

Saturation-transfer phosphorus nuclear magnetic resonance (STNMR) has been applied to the rat kidney in vivo. The rate of renal metabolism determined by this method compares favorably with the renal oxygen consumption, assuming an ATP:oxygen ratio of 2. Hemorrhagic hypotension resulted in a 20% fall in renal blood flow and a significant fall in oxygen consumption. The rate of renal metabolism fell by 50%. This rate of ATP synthesis was below that required to maintain a normal [ATP], but renal [Pi] was not increased. When renal perfusion was reduced by 60%, intrarenal [Pi] rose. When [P1] was elevated, the method os STNMR no longer gave a reliable measure of the rate ATP synthesis, indicating that this new Pi pool was not in rapid chemical exchange with ATP. STNMR represents a useful noninvasive means of monitoring renal metabolic rate, with limitations due to insensitivity and the existence of multiple pools of intrarenal Pi.

Magnetic resonance spectroscopy for the determination of renal metabolic rate in vivo.

The method of magnetic resonance spectroscopy has been validated and applied to the determination of renal metabolic rate in vivo. Using an indwelling detector coil, 31P NMR spectra from one kidney of anesthetized rats were quantified. The concentration of ATP was the same as that determined enzymatically, but both ADP and Pi were substantially lower. Only 25% of renal Pi and virtually none of the ADP were detected by NMR. The remainder is assumed to be bound to proteins. These concentrations of metabolites contributed to a significantly increased phosphorylation potential, which in turn should increase the free energy of hydrolysis of ATP. Saturation transfer, a non-destructive magnetic technique for the measurement of chemical exchange, was readily able to detect synthesis of ATP from ADP and inorganic phosphate. The rate of ATP synthesis determined was comparable to that determined in parallel studies of renal oxygen consumption. An ATP:O ratio of approximately 2 was found, indicating that fatty acid is the preferred fuel of respiration of the rat kidney in vivo.

Sequential bacteriological findings in the cerebrospinal fluid of Nigerian patients with pneumococcal meningitis.

Sequential bacteriological observations were made on the cerebrospinal fluid (CSF) of 28 patients with pneumococcal meningitis treated with high doses of penicillin for 2 weeks. The organism was isolated from the CSF of four patients 48 h or more after the start of treatment and from a further patient 48 h after treatment was stopped. Positive cultures were obtained in spite of the demonstration in the CSF of penicillin at a concentration well above the minimum inhibitory concentration for the organism isolated. Persistence of bacteria and their products in the CSF of patients with pneumococcal meningitis contrasts with the rapid clearance of bacteria from the CSF of patients with meningococcal meningitis and may contribute to the difference in the prognosis of these forms of meningitis.

Captopril and frusemide in severe drug-resistant hypertension.

10 patients with severe refractory hypertension were treated with captopril and frusemide. All patients had uncontrolled blood pressure (mean arterial pressure > 140 mm Hg), and 7 had developed accelerated hypertension despite maximum conventional treatment. Captopril and frusemide controlled blood pressure in all 10 patients, without side effects in 9. There was a significant rise in plasma-potassium in 9 patients (1 mmol/l), and hyperkalaemia (plasma-potassium > 6 mmol/l) developed in 3 patients despite coincident treatment with frusemide.

Single injection treatment of meningococcal meningitis. 1. Long-acting penicillin.

A single injection of a long-acting preparation of penicillin (Triplopen) was compared with a five-day course of crystalline and procaine penicillin in the treatment of meningococcal meningitis. The clinical response of patients treated with Triplopen was very similar to that of patients treated with crystalline penicillin and much more convenient to administer. However, four patients treated with Triplopen had a positive CSF culture 48 or 72 hours after their injection. One injection of Triplopen cannot, therefore, be recommended as an entirely safe form of treatment for meningococcal meningitis unless patients can be carefully followed.