Pathophysiology and Management of Onychomycosis and Novel Approaches for Effective Transdermal Applications.

Onychomycosis is the most common fungal nail infection accounting for 50% of nail disorders. This infection is most common in the toenails than in the nails of the fingers. It is caused by various fungal species like Trichophyton rubrum, Trichophyton mentagrophytes, Scopulariopsis brevicaulis, Aspergillus spp, Fusarium spp, Acremonium spp, Alternaria spp, and Neoscytalidium. Among them, dermatophyte fungus is involved in 70% to 80% of infections. Clinically, there are five types of onychomycosis classified based on causative organism and location of infection origin. Diagnosis of this infection uses a mycological study of nail samples using multiple staining techniques like periodic acid-Schiff, calcofluor, Grocott methenamine silver, fluorescence, and microscopy. The major risk factors of this infection include diabetes mellitus, psoriasis, peripheral vascular diseases, obesity, metabolic syndrome, nail trauma, human immunodeficiency virus and/or acquired immunodeficiency syndrome, immune-compromised individuals, chronic kidney failure, athletic activity, smoking, and hyperlipidemia. The treatment options for onychomycosis include topical and systemic antifungal agents, nanoparticles, laser therapy, photodynamic therapy, and nail avulsion. This article describes several types of onychomycosis, symptoms, diagnosis, currently available therapy and its drawback, current research to rectify the issues, and future medicinal approaches to improve patient health.

Results on Certain Biopolymers Using M-Polynomial and NM-Polynomial of Topological Indices.

Topological indices are numerical descriptors that aid in the prediction of chemical molecules' physiochemical properties and biological actions. It is often helpful to forecast numerous physiochemical attributes and biological actions of molecules in chemometrics, bioinformatics, and biomedicine. In this paper, we establish the M-polynomial and NM-polynomial of some very familiar biopolymers, which are xanthan gum, gellan gum, and polyacrylamide. The uses of these biopolymers can increasingly take the place of traditional admixtures for the application of soil stability and enhancement. We recover the important topological degree-based indices. Also, we give diverse graphs of topological indices and their relations with the parameters of structures.

Knowledge, Attitude and Practice (KAP) Assessment on LifeStyle, Public Health Measures Practiced by Society and Their Impact to Contain COVID-19 Transmission Among Afar Community in Selected Parts of Afar Region, Ethiopia.

Introduction: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, RNA family. It has continued to spread across the world after its first outbreak in China in 2019. On 11 March 2020 the WHO declared COVID-19 a pandemic given its global public health and economic impacts. Objective: To assess knowledge, attitude and practice (KAP) on lifestyle, public health measures practiced by society and their impact to contain COVID-19 transmission in the Afar community, Afar Region, Ethiopia. Methods: Community-based cross-sectional study design was conducted from May to July, 2020, on purposively selected districts and the Peasant Association (PA). Simple random sampling was applied to select households and study participants. Structured and semi-structured questionnaire was used to collect information from study participants. The collected data were entered into Microsoft Excel and transferred to SPSS version 20 for analysis. Both descriptive and analytical analysis was provided and a p-value of less than 0.05 was considered as statistically significant. Results: Of the total (266) study participants, most of them had no formal education (61.7%) and were aged from 35-40 (34.2%). More than half, 67.7% and 56.8%, of participants did not know chewing chat and smoking cigarettes as a risk factor for COVID-19, respectively. Almost half, 49.6%, of participants live in a house which is non-partitioned and without ventilation. The participants were took part in public gatherings such as funerals (27.1%), weddings (13.9%), meetings (13.5%) and went to a market (9%) during the pandemic. Nearly half (47.7%) of the study participants did not wear facemasks. Of the total, 27.4% and 71.4% participants lost their daily income more than and less than half, respectively. Conclusion: This study revealed knowledge, attitude and practice of the community in the area to contain COVID-19 spread were minimal. Therefore, more improvement of public health measures will be required.

Isolation, identification and antimicrobial susceptibility profile of Salmonella isolated from poultry farms in Addis Ababa, Ethiopia.

BACKGROUND: Salmonella has been found to be the major cause of foodborne diseases and a serious public health problem in the world, with an increasing concern for the emergence and spread of antimicrobial-resistant strains. METHOD: A cross-sectional study was conducted on poultry and poultry farms in Addis Ababa from February 2016 to April 2016 to determine the occurrence and evaluate the antimicrobial susceptibility profile of Salmonella isolates. A total of 200 samples consisting of the cloacal swab (n = 168), pooled litter (n = 12), hand swab (n = 8), pooled feed and water (n = 12) were collected separately from six poultry farms. The samples were examined for the presence of Salmonella through culturing on bacteriological media. Descriptive statistics, Pearson's Chi-square (X2 ) and bivariate logistic regression were used in the analysis of the data. Accordingly, out of 200 samples, 23 (11.50%) were Salmonella positive, of which 21(12.50%) were in cloacal swab and 2(16.67%) in the pooled litter. There was no statistical association between the bacteriological status of sample type and Salmonella positivity (X2  = 3.07, P = 0.545). However, there was a statistical association between farms and the rate of Salmonella isolation (X2  = 22.21, P ≤ 0.00). The antimicrobial susceptibility testing for Salmonella isolates was conducted following the Kirby-Bauer disc diffusion method (1961). RESULTS: Out of 23 samples tested, 95.65% of them were resistant to at least one or more antimicrobials. Multiple drug resistances were observed for 69.56% of Salmonella isolates. The highest resistance (73.9%) was observed in kanamycin followed by tetracycline (65.2%) and streptomycin (56.3%). gentamycin was the most effective antibiotic (95.7%; sensitivity) followed by ciprofloxacin (78.3% sensitivity) and ampicillin (69.6% sensitivity. CONCLUSION: This current study finding indicated that further detailed epidemiological and molecular studies are essential on the frequency and sources of acquisition of resistant genes.

A randomised controlled feasibility trial of a BabyWASH household playspace: The CAMPI study.

BACKGROUND: Water, sanitation and hygiene (WASH) interventions should support infant growth but trial results are inconsistent. Frequently, interventions do not consider behaviours or transmission pathways specific to age. A household playspace (HPS) is one intervention component which may block faecal-oral transmission. This study was a two-armed, parallel-group, randomised, controlled feasibility trial of a HPS in rural Ethiopia. It aimed to recommend proceeding to a definitive trial. Secondary outcomes included effects on infant health, injury prevention and women's time. METHODS: November 2019-January 2020 106 households were identified and assessed for eligibility. Recruited households (N = 100) were randomised (blinded prior to the trial start) to intervention or control (both n = 50). Outcomes included recruitment, attrition, adherence, and acceptability. Data were collected at baseline, two and four weeks. FINDINGS: Recruitment met a priori criteria (≥80%). There was no loss to follow-up, and no non-use, meeting adherence criteria (both ≤10%). Further, 48.0% (95% CI 33.7-62.6; n = 24) of households appropriately used and 56.0% (41.3-70.0; n = 28) cleaned the HPS over four weeks, partly meeting adherence criteria (≥50%). For acceptability, 41.0% (31.3-51.3; n = 41) of infants were in the HPS during random visits, failing criteria (≥50%). Further, the proportion of HPS use decreased during some activities, failing criteria (no decrease in use). A modified Barrier Analysis described good acceptability and multiple secondary benefits, including on women's time burden and infant injury prevention. INTERPRETATION: Despite failing some a priori criteria, the trial demonstrated mixed adherence and good acceptability among intervention households. A definitive trial to determine efficacy is warranted if recommended adjustments are made. FUNDING: People In Need; Czech Development Agency. TRIAL REGISTRATION: RIDIE-ID-5de0b6938afb8.

Review on the Role of Host Immune Response in Protection and Immunopathogenesis during Cutaneous Leishmaniasis Infection.

Cutaneous leishmaniasis (CL) is a major public health problem worldwide and spreads to human via the bite of sand flies during blood meal. Following its inoculation, the promastigotes are immediately taken up by phagocytic cells and these leishmania-infected host cells produce proinflammatory cytokines that activate other immune cells and these infected host cells produce more cytokines and reactive nitrogen and oxygen species for efficient control of leishmania infection. Many experimental studies showed that resistance to infection with leishmania paraites is associated with the production of proinflammatory cytokines and activation of CD4+ Th1 response. On the other hand, vulnerability to this parasitic infection is correlated to production of T helper 2 cytokines that facilitate persistence of parasites and disease progression. In addition, some studies have also indicated that CD8+ T cells play a vital role in immune defense through cytokine production and their cytotoxic activity and excessive production of proinflammatory mediators promote amplified recruitment of cells. This could be correlated with excessive inflammatory reaction and ultimately resulted in tissue destruction and development of immunopathogenesis. Thus, there are contradictions regarding the role of immune responses in protection and immunopathogenesis of CL disease. Therefore, the aim of this paper was to review the role of host immune response in protection and its contribution to disease severity for CL infection. In order to obtain more meaningful data regarding the nature of immune response to leishmania, further in-depth studies focused on immune modulation should be conducted to develop better therapeutic strategies.

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia.

BACKGROUND: Tumor lysis syndrome (TLS) is a life-threatening emergency disorder, caused by an abrupt release of intracellular metabolites after tumor cell death. It is characterized by a series of metabolic manifestations, especially hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The aim of this study was to evaluate and characterize the incidence of tumor lysis syndrome among pediatric oncology patients before and after treatment. METHODS: Hospital based prospective cohort study was conducted for 6 months on 61 newly diagnosed pediatric oncology patients. Socio-demographic data was collected by interview administered questionnaire. Patients were followed and the physical diagnosis, imaging and laboratory results were interpreted by senior physicians. Data was entered to and analyzed by SPSS version 23. RESULTS: Among 61 pediatric oncology patients 39(63.9%) were males. The mean (±SD) age of the pediatric patients was 6.39 (± 3.67) years ranging from 2 months to 14 years. 29.5% of patients were found to have TLS. There were 11.5% and 18.0% of laboratory TLS (LTLS) and clinical TLS (CTLS) cases respectively. There were72.2% spontaneous and 27.8% treatment induced TLS cases with 23% and 21.3% cases of hyperuricemia and 4.9% and 6.6% cases of hyperkalemia incidence before and after treatment respectively. Only two patients died, in the study period, due to TLS. CONCLUSION: There was high incidence of TLS irrespective of socio-demographic variation among study participants, suggesting that children with cancer are at risk of developing TLS. As TLS is a life-threatening complication of malignancies, early identification of patients at risk and reducing morbidity and mortality is crucially important.

[The Role of School Nurses]. / El papel de los enfermeros escolares.

The school comes the second place where children's lives developed. Their ability to learn is closely related to their welfare and health. this paper aimed to define the roles that school nurses can play in the schools to help the children reach their educational goals through keeping them healthy and safe, and on the other hand, it will help us to evaluate the significance of school nurses and find out whether it is needed in the schools or not.

Rhodococcus equi pneumonia in a live related renal transplant recipient.

Rhodococcus equi has emerged as a serious pathogen in immunocompromised patients, including solid organ transplant recipients. Primary pulmonary involvement is the most common presentation. However, this opportunistic pathogen is often not considered in the differential diagnosis of pneumonia in transplant recipients. Furthermore, in cultures, Rhodococcus can be misinterpreted by microbiologists in laboratories as a contaminant due to its morphology on gram staining if they have not been provided sufficient clinical information. We report a case of a young Asian male, 19 months post-live related renal transplantation who presented with a five-day history of productive cough, fever and weight loss. Chest radiography revealed bilateral basal infiltrates. Blood cultures and bronchoalveolar lavage yielded heavy pure growth of unbranched gram-positive rods which were identified as Rhodococcus equi (R. equi).