Evaluation of traditional and machine learning approaches for modeling volatile fatty acid concentrations in anaerobic digestion of sludge: potential and challenges.

This study evaluates models for predicting volatile fatty acid (VFA) concentrations in sludge processing, ranging from classical statistical methods (Gaussian and Surge) to diverse machine learning algorithms (MLAs) such as Decision Tree, XGBoost, CatBoost, LightGBM, Multiple linear regression (MLR), Support vector regression (SVR), AdaBoost, and GradientBoosting. Anaerobic bio-methane potential tests were carried out using domestic wastewater treatment primary and secondary sludge. The tests were monitored over 40 days for variations in pH and VFA concentrations under different experimental conditions. The data observed was compared to predictions from the Gaussian and Surge models, and the MLAs. Based on correlation analysis using basic statistics and regression, the Gaussian model appears to be a consistent performer, with high R2 values and low RMSE, favoring precision in forecasting VFA concentrations. The Surge model, on the other hand, albeit having a high R2, has high prediction errors, especially in dynamic VFA concentration settings. Among the MLAs, Decision Tree and XGBoost excel at predicting complicated patterns, albeit with overfitting issues. This study provides insights underlining the need for context-specific considerations when selecting models for accurate VFA forecasts. Real-time data monitoring and collaborative data sharing are required to improve the reliability of VFA prediction models in AD processes, opening the way for breakthroughs in environmental sustainability and bioprocessing applications.

Response surface methodology optimization of the effect of pH, contact time, and microbial concentration on chemical oxygen removal potential of vegetable oil industrial effluents.

The vegetable oil refinery industry generates highly polluted effluents during oil production, necessitating proper treatment before discharge to prevent environmental hazards. Treating such wastewater has become a major environmental concern in developing countries. Chemical oxygen demand (COD) is a key parameter in assessing the wastewater's organic pollutant load. High COD levels can lead to reduced dissolved oxygen in water bodies, negatively affecting aquatic life. Various technologies have been employed to treat oily wastewater, but microbial degradation has gained attention due to its potential to remove organic pollutants efficiently. This study aims to optimize the biodegradation treatment process for vegetable oil industrial effluent using response surface methodology (RSM). The wastewater's physicochemical properties were characterized to achieve this, and COD removal was analyzed. Furthermore, RSM was used to investigate the combined effects of pH, contact duration, and microbial concentration on COD removal efficiency. The result showed that the microbial strain used recorded a maximum COD removal of 92%. Furthermore, a quadratic model was developed to predict COD removal based on the experimental variables. From the analysis of variance (ANOVA) analysis, the model was found to be significant at p < 0.0004 and accurately predicted COD removal rates within the experimental region, with an R2 value of 90.99% and adjusted R2 value of 82.89%. Contour plots and statistical analysis revealed the importance of contact duration and microbial concentration on COD removal. PRACTITIONER POINTS: Response surface methodology (RSM) optimization achieved a significant chemical oxygen demand (COD) removal efficiency of 92% in vegetable oil industrial effluents. The study's success in optimizing COD removal using RSM highlights the potential for efficient and environmentally friendly wastewater treatment. Practitioners can benefit from the identified factors (pH, contact time, and microbial concentration) to enhance the operation of treatment systems. The developed predictive model offers a practical tool for plant operators and engineers to tailor wastewater treatment processes. This research underscores the importance of sustainable practices in wastewater treatment, emphasizing the role of microbial degradation in addressing organic pollutant loads.

The influence of various chemical oxygen demands on microbial fuel cells performance using leachate as a substrate.

Microbial fuel cells (MFCs), hailed as a promising technology, hold the potential to combat various wastewater pollutants while simultaneously converting their chemical energy into electricity through biocatalysts. This study explores the applicability of a dual compartment MFC (DC-MFC) under varying conditions, targeting the removal of chemical oxygen demand (COD) from landfill leachate and electricity generation. In this setup, anaerobic sludge from a wastewater treatment plant serves as the inoculum in the anode compartment of the MFC, with a Nafion117 membrane acting as the separator between MFC units. The cathode compartments are filled with distilled water and continually aerated for 24 h to enhance air supply. The study assesses the MFC's performance across different COD concentrations, focusing on COD removal, power generation, and Coulombic efficiency. The findings reveal that COD removal efficiency is notably enhanced at higher concentrations of organic matter. Specifically, at a COD concentration of 3325.0 mg L-1, the MFC exhibited the highest COD removal efficiency (89%) and maximum power density (339.41 mWm-2), accompanied by a Coulombic efficiency of 25.5%. However, as the initial substrate concentration increased to 3825 mg L-1, the efficiency decreased to 72%, with a Coulombic efficiency of 13.56% and a power density of 262.34 mWm-2. Optical density levels increased due to bacterial growth at ambient temperature and neutral pH, reflecting the dynamic microbial response within the system.

Assessment of Legibility of Handwritten Prescriptions and Adherence to W.H.O. Prescription Writing Guidelines in Ahmadu Bello University Teaching Hospital Zaria - Kaduna State, Nigeria.

Introduction: The issues of incorrectness and incompleteness for written prescriptions may result to dispensing errors and unintended outcomes of care. The objective of the study was to assess the legibility of handwritten prescriptions and adherence to W.H.O. prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria. Method: A cross-sectional prospective study design was used, and existing prescriptions were sampled from selected in-patient and outpatient pharmacy units of Ahmadu Bello University Teaching Hospital Zaria. This was approved by the ethics and research committee of the institution. The prescriptions were then evaluated for quality based on the layout, legibility, and clarity of the details in the prescriptions and screened for medication errors. Result: The extent of prescribing drugs by generic name was (68.37%), the legibility percentage was moderate and the percentage of prescriptions in which details of the drug, route of administration, and duration of treatment were complete was 85.23%, 80.80%, and 82.40%, respectively. The doctor's signature (84.87%) was present in the prescriptions. Many of the prescribers did not use to indicate patients' weight, age, and clinic on prescriptions, these are deviations from good prescribing practices while total medication error was 38.01%. Conclusion: Prescribers have a duty of care to their patient and a professional duty to their colleagues (pharmacists) to ensure drug prescriptions are readily identifiable. Interventional techniques such as the use of printed or electronic prescriptions can improve the ease of interpreting information and reduce medication errors.

Imperatives of Mathematical Model of Arterial Blood Dynamics for Interpretation of Doppler Velocimetry: A Narrative Review.

Clinicians frequently study arterial Doppler velocimetric waveforms depicted by Doppler sonography of the kidneys, the heart, the brain, and the feto-maternal circulation to assess the well-being of the aforementioned vital organs. The waveform interpretation of the Doppler indices can be studied using a mathematical model. The developed models serve as teaching tools and for easy comprehension of the regulatory mechanism of the organs. It will also obtain accurate wall shear stress (WSS) and likely atherosclerotic sites can be predicted early. The aim of this review is to reveal the imperatives of mathematical models in the study of the physical interpretation of Doppler velocimetry. The models will explore sonographic Doppler velocimetry and computational fluid dynamics (CFD) in determining the segments of the arteries that are prone to the development of atheromatous plaque. It will be achieved by comparing and computing the measurement differences of the WSS. A thorough literature review was carried out between 1971 and 2021 on the mathematical modeling of blood dynamics and Doppler velocimetry of different blood vessels, across various electronic databases including NC AHEC Digital Library, PUBMED, ERIC, MEDLINE, Free Medical Journals, and EMBASE. The results of the literature search were presented using the PRISMA flow chat. The narrative review of the mathematical models of arterial blood dynamics is based on incompressible Navier-Stokes equations, the Windkessel model, and CFD. It was deduced that the blood flow velocity decreased with time across the varying frequency from 0.2Hz to 0.50Hz in the interlobar arterial channels. The review also revealed that adult humans' Doppler indices of the renal-interlobar artery agree with developed models of renal interlobar arterial blood dynamics. The mathematical model measurements of the great vessels matched the sonographic Doppler velocimetry with <15% variation. In our fast-paced world of epidemiological transition, the imperatives of mathematical modeling of arterial flow dynamics based on the Navier-Stokes equations to represent various physiologic and pathologic situations cannot be overstated. The practical consequences include the possibility of mathematical models to acquire precise WSS distribution and early detection of potential atherosclerotic sites during cardiovascular Doppler sonography.

Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria.

Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births.

Characterization of WOX genes revealed drought tolerance, callus induction, and tissue regeneration in Gossypium hirsutum.

Cotton is an important natural fiber crop; its seeds are the main oil source. Abiotic stresses cause a significant decline in its production. The WUSCHEL-related Homeobox (WOX) genes have been involved in plant growth, development, and stress responses. However, the functions of WOX genes are less known in cotton. This study identified 39, 40, 21, and 20 WOX genes in Gossypium hirsutum, Gossypium barbadense, Gossypium arboreum, and Gossypium raimondii, respectively. All the WOX genes in four cotton species could be classified into three clades, which is consistent with previous research. The gene structure and conserved domain of all WOX genes were analyzed. The expressions of WOX genes in germinating hypocotyls and callus were characterized, and it was found that most genes were up-regulated. One candidate gene Gh_ A01G127500 was selected to perform the virus-induced gene silencing (VIGS) experiment, and it was found that the growth of the silenced plant (pCLCrVA: GhWOX4_A01) was significantly inhibited compared with the wild type. In the silenced plant, there is an increase in antioxidant activities and a decrease in oxidant activities compared with the control plant. In physiological analysis, the relative electrolyte leakage level and the excised leaf water loss of the infected plant were increased. Still, both the relative leaf water content and the chlorophyll content were decreased. This study proved that WOX genes play important roles in drought stress and callus induction, but more work must be performed to address the molecular functions of WOX genes.

Interleukin-6 cytokine: An overview of the immune regulation, immune dysregulation, and therapeutic approach.

Several studies have shown that interleukin 6 (IL-6) is a multifunctional cytokine with both pro-inflammatory and anti-inflammatory activity, depending on the immune response context. Macrophages are among several cells that secrete IL-6, which they express upon activation by antigens, subsequently inducing fever and production of acute-phase proteins from the liver. Moreover, IL-6 induces the final maturation of B cells into memory B cells and plasma cells as well as an adaptive role for short-term energy allocation. Activation of IL-6 receptors results in the intracellular activation of the JAK/STAT pathway with resultant production of inflammatory cytokines. Several mechanisms-controlled IL-6 expression, but aberrant production was shown to be crucial in the pathogenesis of many diseases, which include autoimmune and chronic inflammatory diseases. IL-6 in combination with transforming growth factor ß (TGF-ß) induced differentiation of naïve T cells to Th17 cells, which is the cornerstone in autoimmune diseases. Recently, IL-6 secretion was shown to form the backbone of hypercytokinemia seen in the Coronavirus disease 2019 (COVID-19)-associated hyperinflammation and multiorgan failure. There are two classes of approved IL-6 inhibitors: anti-IL-6 receptor monoclonal antibodies (e.g., tocilizumab) and anti-IL-6 monoclonal antibodies (i.e., siltuximab). These drugs have been evaluated in patients with rheumatoid arthritis, juvenile idiopathic arthritis, cytokine release syndrome, and COVID-19 who have systemic inflammation. JAK/STAT pathway blockers were also successfully used in dampening IL-6 signal transduction. A better understanding of different mechanisms that modulate IL-6 expression will provide the much-needed solution with excellent safety and efficacy profiles for the treatment of autoimmune and inflammatory diseases in which IL-6 derives their pathogenesis.

Integrated transmission assessment surveys (iTAS) of lymphatic filariasis and onchocerciasis in Cross River, Taraba and Yobe States, Nigeria.

BACKGROUND: Integrated transmission assessment surveys (iTAS) have been recommended for evaluation of the transmission of both lymphatic filariasis (LF) and onchocerciasis as the prevalence of both diseases moves toward their respective elimination targets in Nigeria. Therefore, we conducted an iTAS between May and December 2017 in five local government areas (LGAs), also known as implementation units (IUs), in states of Cross River, Taraba and Yobe in Nigeria. METHODS: The TAS comprised two phases: the Pre-iTAS and the iTAS itself. Three states (Cross River, Taraba and Yobe), comprising five LGAs and 20 communities that have completed five rounds of combined treatment with ivermectin and albendazole for LF and 12 total rounds of ivermectin, were selected for inclusion in the study. All participants were tested with the Filariasis Test Strip (FTS; Alere Inc.) and the Biplex rapid Diagnostic Test (RDT; identifying filaria antigens Ov16/Wb123; Abbott diagnosctics Korea Inc.). Pre iTAS included 100 children ages 5-9 in each 4 communities and 300 individuals ages 10 and older in a subset of two communities.  For the iTAS, only LGAs where antigenemia prevalence in all sampled communities during the Pre-iTAS was < 2% for LF were selected. RESULTS: Of the five LGAs included in the study, four met the cutoff of the Pre-iTAS and were included in the iTAS; the Ikom LGA was excluded from the iTAS due to antigenemia prevalence. A total of 11,531 school-aged children from 148 schools were tested for LF and onchocerciasis across these four LGAs, including 2873 children in Bade, 2622 children in Bekwara, 3026 children in Gashaka and 3010 children in Karim Lamido. Using the FTS, all samples from Bade and Karim Lamido were negative, whereas 0.2% of the samples from Bekwara and Gashaka were positive. Using the Biplex RDT, LF prevalence in Bade, Bekwara, Gashaka and Karim Lamido was < 0.1%, 0.5%, 0.4% and < 0.1%, respectively. Moreover, all samples from Bade and Karim Lamido were negative for onchocerciasis, whereas 3.1% and 1.8% of the samples from Bekwara and Gashaka were positive, respectively. CONCLUSION: This study has provided additional information on the current burden of onchocerciasis and LF in the four IUs sampled where mass drug administration (MDA) for both infections has been ongoing for years. The study identifies that LF-MDA can be safely stopped in all four of the IUs studied, but that MDA for onchocerciasis needs to continue, even though this may pose a challenge for LF surveillance. Based on the preliminary results from all four sites, this study has fulfilled the primary objective of determining the programmatic feasibility of an iTAS as a tool to simultaneously assess onchocerciasis and LF prevalence in areas co-endemic for the two infections that have completed the recommended treatment for one or both infections, and to make decisions on how to proceed.

Humoral immunological kinetics of severe acute respiratory syndrome coronavirus 2 infection and diagnostic performance of serological assays for coronavirus disease 2019: an analysis of global reports.

As the coronavirus disease 2019 (COVID-19) pandemic continues to rise and second waves are reported in some countries, serological test kits and strips are being considered to scale up an adequate laboratory response. This study provides an update on the kinetics of humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and performance characteristics of serological protocols (lateral flow assay [LFA], chemiluminescence immunoassay [CLIA] and ELISA) used for evaluations of recent and past SARS-CoV-2 infection. A thorough and comprehensive review of suitable and eligible full-text articles was performed on PubMed, Scopus, Web of Science, Wordometer and medRxiv from 10 January to 16 July 2020. These articles were searched using the Medical Subject Headings terms 'COVID-19', 'Serological assay', 'Laboratory Diagnosis', 'Performance characteristics', 'POCT', 'LFA', 'CLIA', 'ELISA' and 'SARS-CoV-2'. Data from original research articles on SARS-CoV-2 antibody detection ≥second day postinfection were included in this study. In total, there were 7938 published articles on humoral immune response and laboratory diagnosis of COVID-19. Of these, 74 were included in this study. The detection, peak and decline period of blood anti-SARS-CoV-2 IgM, IgG and total antibodies for point-of-care testing (POCT), ELISA and CLIA vary widely. The most promising of these assays for POCT detected anti-SARS-CoV-2 at day 3 postinfection and peaked on the 15th day; ELISA products detected anti-SARS-CoV-2 IgM and IgG at days 2 and 6 then peaked on the eighth day; and the most promising CLIA product detected anti-SARS-CoV-2 at day 1 and peaked on the 30th day. The most promising LFA, ELISA and CLIA that had the best performance characteristics were those targeting total SARS-CoV-2 antibodies followed by those targeting anti-SARS-CoV-2 IgG then IgM. Essentially, the CLIA-based SARS-CoV-2 tests had the best performance characteristics, followed by ELISA then POCT. Given the varied performance characteristics of all the serological assays, there is a need to continuously improve their detection thresholds, as well as to monitor and re-evaluate their performances to assure their significance and applicability for COVID-19 clinical and epidemiological purposes.

Routine Ultrasonography for Intensified Tuberculosis Case Finding in High Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) Burdened Countries: A Proposed Frame Work.

Sonography has proven to be valuable diagnostic imaging equipment in the work-up of patients infected with acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) coinfection. An extensive literature search was conducted between 1994 and 2021 for original peer-reviewed articles in the English language on ultrasound application in the diagnosis of extrapulmonary TB (EPTB), ultrasound application in infectious diseases in resource-constrained settings, point-of-care ultrasound in resource-scarce settings among others, across various electronic databases including MEDLINE, PubMed, POPLINE, Scopus and Google Scholar, among others and some gray literature were also retrieved. Emerging themes were identified by their recurrence in literature. Ultrasound imaging is a rapid diagnostic tool and can accurately identify and characterize pathologic findings in patients infected with HIV/AIDS and TB co-infection, such as enlarged lymph nodes, pericarditis, and pleural effusion, among others for prompt patient management. Ultrasonography is cheaper and portable; interfacing software has become more users friendly and image quality significantly improved, making it possible for the provision of imaging services in an increasing number of clinical settings in resource-limited settings where access to diagnostic imaging is scarce. The use of focused assessment with sonography for HIV (FASH) for prompt diagnosis of EPTB in regions with a high incidence of HIV/AIDS and TB co-infection will aid in prompt diagnosis and treatment of patients with undifferentiated TB, thus impacting on morbidity and mortality. The training and deployment of sonographers in endemic regions with a high prevalence of HIV/AIDS and TB co-infection, to diagnose EPTB using FASH protocol is a viable option that is in line with the global drive for intensified case finding and treatment algorithm, with a view to meeting the sustainable development goals target of ending HIV and TB epidemics and achieving universal health coverage.

Features and roles of T helper 22 cells in immunological diseases and malignancies.

T helper 22 (Th22) cell populations are a newly identified subset of CD4+  T cells that primarily mediate biological effects on the epithelial barrier through interleukin (IL)-22. Although, new studies showed that both Th22 and IL-22 are closely associated with the pathogenesis of inflammatory, autoimmune and allergic disease as well as malignancies. In this review, we aim to describe the development and characteristics of Th22 cells as well as their roles in the immunopathogenesis of immune-related disorders and cancer.

Sero-epidemiology of human T-cell lymphotropic viruses-1 and -2 infection among pregnant women attending Abuja Teaching Hospital, Nigeria.

BACKGROUND: There is the paucity of HTLV-1/-2 studies on Nigerian pregnant women despite the medical and public health significance of maternal-to-child transmission of HTLV-1/-2. OBJECTIVE: This study aims to determine the seroprevalence and risk factors of HTLV-1/-2 infections among pregnant women attending the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. MATERIALS AND METHODS: Blood samples were collected from consented pregnant women and analysed for ant-HTLV-1/-2 total antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Pretested structured questionnaires were used to collate participants' socio-demographic variables and risk factors of HTLV infection. RESULTS: Out of the 156 pregnant women tested for HTLV-1/-2 antibodies, 16 (10.3%) were seropositive. There was no significant association between the socio-demographic variables collated and seroprevalence of HTLV-1/-2 infection among pregnant women (p> 0.05). Pregnant women with HIV infection had a lower prevalence of HLTV-1/-2 infection than those without HIV infections (7.5% versus 11.7%). Pregnant women with multiple sexual partners had a higher risk of HTLV-1/-2 infection than those who had single (OR = 2.08, 95% CI: 0.53-8.18). Women with a history of needles injury had a higher risk of HTLV-1/-2 infection than those who do not (OR = 1.24, 95% CI: 0.38-4.08). The history of blood transfusion was significantly associated with HTLV-1/-2 infection (p= 0.027). However, no significant association existed between other risk factors of HTLV-1/-2 infection among pregnant women (p> 0.05). CONCLUSION: Considering the 3% pooled national prevalence of HTLV-1/-2 infection in Nigeria, the seroprevalence reported in this study is relatively high. Thus, there is a need for more large cohort studies and routine screening of population at increased risk of infection.

Polymorphism Analysis of pfmdr1 and pfcrt from Plasmodium falciparum Isolates in Northwestern Nigeria Revealed the Major Markers Associated with Antimalarial Resistance.

Suspicion of failure in the effectiveness of artemisinin-based combination therapies (currently the first-line treatment of malaria, worldwide) is leading to the unofficial use of alternative antimalarials, including chloroquine and sulfadoxine/pyrimethamine, across northern Nigeria. To facilitate evidence-based resistance management, antimalarial resistance mutations were investigated in Plasmodium falciparum multidrug resistance-1 (pfmdr1) and chloroquine resistance transporter (pfcrt), in isolates from Kano, northwestern Nigeria. Out of the 88 samples genotyped for pfmdr1N86Y mutation using PCR/restriction fragment length polymorphism, one sample contained the 86Y mutation (86Yfrequency = 1.14%). The analysis of 610 bp fragments of pfmdr1 from 16 isolates revealed two polymorphic sites and low haplotype diversity (Hd = 0.492), with only 86 Y mutations in one isolate, and 184 F replacements in five isolates (184Ffrequency = 31.25%). The analysis of 267 bp fragments of pfcrt isolates revealed high polymorphism (Hd = 0.719), with six haplotypes and seven non-synonymous polymorphic sites. Eleven isolates (61.11%) were chloroquine-resistant, CQR (C72V73I74E75T76 haplotype), two of which had an additional mutation, D57E. An additional sequence was CQR, but of the C72V73M74E75T76 haplotype, while the rest of the sequences (33.33%) were chloroquine susceptible (C72V73M74N75K76 haplotype). The findings of these well characterized resistance markers should be considered when designing resistance management strategies in the northwestern Nigeria.

Coronavirus disease 2019 (COVID-19): An overview of the immunopathology, serological diagnosis and management.

SARS-CoV-2 is a novel human coronavirus responsible for the Coronavirus disease 2019 (COVID-19) pandemic. Pneumonia and acute respiratory distress syndrome are the major complications of COVID-19. SARS-CoV-2 infection can activate innate and adaptive immune responses and result in massive inflammatory responses later in the disease. These uncontrolled inflammatory responses may lead to local and systemic tissue damage. In patients with severe COVID-19, eosinopenia and lymphopenia with a severe reduction in the frequency of CD4+ and CD8+ T cells, B cells and natural killer (NK) cells are a common feature. COVID-19 severity hinges on the development of cytokine storm characterized by elevated serum levels of pro-inflammatory cytokines. Moreover, IgG-, IgM- and IgA-specific antibodies against SARS-CoV-2 can be detected in most patients, along with the viral RNA, forming the basis for assays that aid in patient diagnosis. Elucidating the immunopathological outcomes due to COVID-19 could provide potential targets for immunotherapy and are important for choosing the best clinical management by consultants. Currently, along with standard supportive care, therapeutic approaches to COVID-19 treatment involve the use of antiviral agents that interfere with the SARS-CoV-2 lifecycle to prevent further viral replication and utilizing immunomodulators to dampen the immune system in order to prevent cytokine storm and tissue damage. While current therapeutic options vary in efficacy, there are several molecules that were either shown to be effective against other viruses such as HIV or show promise in vitro that could be added to the growing arsenal of agents used to control COVID-19 severity and spread.

Leucocytes and Th-associated Cytokine Profile of HIV-Leishmaniasis Co-Infected Persons Attending Abuja Teaching Hospital, Nigeria.

OBJECTIVE: T-helper cells (Th)-1& -2 cytokines homeostasis control or predict clinical outcome of infected persons, especially those with HIV /AIDS. This case-control study evaluated the leucocytes differentials, TNF-alpha, interleukin (IL)-2 and -10 levels among HIV infected persons with serological evidence of leishmaniasis attending University of Abuja Teaching Hospital, Nigeria. MATERIALS AND METHODS: Blood samples from 28 HIV infected persons who had Leishmania donovani rK39 and Immunoglobulin-G (IgG) positive (group 1), 30 age- & -sex matched HIV infected persons without Leishmania antibodies (group 2) and 30 apparently healthy persons without HIV and Leishmania antibodies (group 3). Full blood counts, TNF alpha, IL-2 and -10 levels were analyzed using automated hematology analyzer and ELISA, respectively. Structured questionnaires were used to collate biodata and clinical presentations of participants. RESULTS: Ten (35.7%) participants in group 1 were on ART, 15 (50%) in group 2 were on ART, while group 3 were ART naïve. There were significantly higher values in basophil (4.4±2.5%) and eosinophil counts (12.9±3.8%) in HIV/leishmania coinfected persons (p<0.005). However, other white cells subpopulation was significantly lower in HIV/leishmania co-infected participants (p<0.05). There was significantly reduced CD4+ T cell counts ([119±26 versus 348±63 versus 605±116 cells/mm3]), TNF-alpha ([36.82±8.21 versus 64.67±12.54 versus 254.98±65.59 pg/mL]) and IL-2 levels ([142.14±20.91 versus 507.6±84.42 versus 486.62±167.87 pg/mL]) among HIV/Leishmania co-infected participants compared to group 2 and group 3 participants, respectively. However, higher IL-10 level (80.35±14.57 pg/mL) was found in HIV/Leishmania co-infected participants as opposed to the HIV monoinfected (62.2±10.43 pg/mL) and apparently healthy persons (23.97±4.88 pg/mL) (p<0.001). CONCLUSION: Eosinophil, basophil counts and serum IL-10 level were high in HIV/Leishmania coinfected persons, demonstrating parasite-induced hypersensitivity and immunosuppression.

Impact of physical activity and traumatic exposure on occurrence of gestational hypertension: a survey of pregnant women in an armed-conflict region in Nigeria.

OBJECTIVE: To compare physical activity level and traumatic exposure between normotensive and hypertensive pregnant women in an armed conflict region of Nigeria. METHODS: 130 normotensives and hypertensive pregnant women comprising of 65 participants per group participated in the study. Harvard Trauma Questionnaire and Pregnancy Physical Activity Questionnaire were used to assess traumatic events and physical activity respectively. RESULTS: Significant difference was observed on total traumatic event (p = 0.008) and all domains and intensities of physical activity except inactivity and sedentary (p > 0.05). Household activities (OR: 0.989; 95% CI: 0.981-0.996), occupational activities (OR: 0.936; 95%CI: 0.879-0.996) and sport/exercise activities (OR: 0.898; 95%CI: 0.832-0.969) were associated with a decrease hypertensive pregnancy. CONCLUSION: Despite exposed to traumatic events, physical activity is associated with normotensive pregnancy in an armed conflict region.

Identification of Mutations in Antimalarial Resistance Gene Kelch13 from plasmodium falciparum Isolates in Kano, Nigeria.

Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 in P. falciparum isolates from Kano, Nigeria was investigated in this study. Microscopic examination of 154 blood samples obtained from patients revealed a high prevalence of P. falciparum infection (114 positive individuals, slide positivity rate = 74.03%). The 114 patients were administered Cartef® (ACT) and out of the 50 patients that returned for the 14-day follow up, 11 were positive for P. falciparum (slide positivity rate = 22%). On day 0, 80 samples out of 114 and 11 samples on day 14 (91 out of 125 microscopy-positive samples) were positive with Plasmodium according to the PCR of cytochrome oxidase I, which corresponds to 72.8%. A fragment of the kelch13 gene encompassing the propeller domains was sequenced in 49 samples, alongside samples of the susceptible strain pf_3D7. Low polymorphism was observed, suggesting a lack of selection on this gene, and only six mutations (Glu433Gly, Phe434Ile, Phe434Ser, Ile684Asn, Ile684Thr and Glu688Lys) were found. The epidemiologic impact of these mutations and their potential role in ACT resistance needs to be investigated further.

Mandibular reconstruction with autogenous non-vascularised bone graft.

BACKGROUND: Reconstruction of mandibular defects can be challenging because an acceptable aesthetic and functional outcome must be achieved simultaneously. AIM: To evaluate the pattern of mandibulectomy and reconstruction materials used in the reconstruction of mandibular defects. MATERIALS AND METHODS: This was a retrospective study of mandibulectomies with reconstruction in Sokoto, Nigeria between 2012 and 2016. Data such as demographics, type of tumour, type of resection and type of reconstruction materials used were extracted and stored. RESULTS: Fifty-two cases of mandibulectomies were done comprising 24 males and 28 females (ratio 1:1.2). Age ranged 5-80 years with mean±SD (37.8±15). Most of the cases 30 (57.7%) were on the right. There are 35 (67.3%) benign and 17 (32.7%) malignant cases. Thirty (57.7%) lateral, 16 (30.8%) condylar, 1 (1.9%) central and 5 (9.6%) combined mandibular defects were seen. Reconstruction plate alone was used in 11 (21.2%) cases, reconstruction plate with rib and tibia grafts in 16 (30.8%) cases, reconstruction plate with Iliac crest and tibia grafts in 15 (28.8%) cases. Graft length ranged from 0-20cm. There was satisfactory outcome altogether in 32 (80.0%). CONCLUSION: This study has shown the types of mandibulectomies and reconstruction materials used in our centre.