Highly enhanced chloramphenicol adsorption performance of MIL-53-NH2(Al)-derived porous carbons modified with tannic acid.

The worldwide demand for antibiotics has experienced a notable surge, propelled by the repercussions of the COVID-19 pandemic and advancements in the global healthcare sector. A prominent challenge confronting humanity is the unregulated release of antibiotic-laden wastewater into the environment, posing significant threats to public health. The adoption of affordable carbon-based adsorbents emerges as a promising strategy for mitigating the contamination of antibiotic wastewater. Here, we report the synthesis of novel porous carbons (MPC) through a direct pyrolysis of MIL-53-NH2(Al) and tannic acid (TANA) under N2 atmosphere at 800 °C for 4 h. The effect of TANA amount ratios (0%-20%, wt wt-1) on porous carbon structure and adsorption performance was investigated. Results showed that TANA modification resulted in decreased surface area (1,600 m2 g-1-949 m2 g-1) and pore volume (2.3 cm3 g-1-1.7 cm3 g-1), but supplied hydroxyl functional groups. Adsorption kinetic, intraparticle diffusion, and isotherm were examined, indicating the best fit of Elovich and Langmuir models. 10%-TANA-MPC obtained an ultrahigh adsorption capacity of 564.4 mg g-1, which was approximately 2.1 times higher than that of unmodified porous carbon. 10%-TANA-MPC could be easily recycled up to 5 times, and after reuse, this adsorbent still remained highly stable in morphology and surface area. The contribution of H bonding, pore-filling, electrostatic and π-π interactions to chloramphenicol adsorption was clarified. It is recommended that TANA-modified MIL-53-NH2(Al)-derived porous carbons act as a potential adsorbent for removal of pollutants effectively.

Pseudocedrela kotschyi: a review of ethnomedicinal uses, pharmacology and phytochemistry.

CONTEXT: Pseudocedrela kotschyi (Schweinf) Harms (Meliaceae) is an important medicinal plant found in tropical and subtropical countries of Africa. Traditionally, P. kotschyi is used in the treatment of various diseases including diabetes, malaria, abdominal pain and diarrhoea. OBJECTIVE: To provide an overview of traditional medicinal claims, pharmacological properties, and phytochemical principles of P. kotschyi as a basis for its clinical applications and further research and development of new drugs. METHODS: Through interpreting already published scientific manuscripts retrieved from different scientific search engines, namely, Medline, PubMed, EMBASE, Science Direct and Google scholar databases, an up-to-date review on the medicinal potentials of P. kotschyi from inception until September, 2020 was compiled. 'Pseudocedrela kotschyi', 'traditional uses', 'pharmacological properties' and 'chemical constituents' were used as search words. RESULTS: At present, more than 30 chemical constituents have been isolated and identified from the root and stem bark of P. kotschyi, among which limonoids and triterpenes are the main active constituents. Based on prior research, P. kotschyi has been reported to possess anti-inflammatory, analgesic, antipyretic, anthelminthic, antimalaria, anti-leishmaniasis, anti-trypanosomiasis, hepatoprotective, antioxidant, antidiabetic, antidiarrheal, antimicrobial, and anticancer effects. CONCLUSIONS: P. kotschyi is reported to be effective in treating a variety of diseases. Current phytochemical and pharmacological studies mainly focus on antimalaria, anti-leishmaniasis, anti-trypanosomiasis and anticancer potential of the root and stem bark of P. kotschyi. Although experimental data support the beneficial medicinal properties of this plant, there is still a paucity of information on its toxicity profile. Nonetheless, this review provides the basis for future research work.

Recent illness, feeding practices and father's education as determinants of nutritional status among preschool children in a rural Nigerian community.

Good nutrition is necessary for the growth and development of preschool children. In sub-Saharan Africa, however, data on the determinants of their nutritional status are lacking. A cross-sectional survey of 366 preschool children was conducted in a rural community in northern Nigeria. Anthropometric measurements of the children were taken and information about feeding practices, immunization and parental education was obtained from their mothers. Fifty-two percent were stunted, 30% were underweight and 25% were wasted. Recent history of diarrhea was associated with wasting (OR = 2.66, p < 0.001). Children whose fathers had postsecondary education were less likely to be stunted (OR = 0.45, p = 0.01) or underweight (OR = 0.37, p = 0.005). Promoting exclusive breastfeeding, preventing recurrent diarrhea and including fathers in community interventions will improve the health of children in this community.

A diverse set of Enterococcus-infecting phage provides insight into phage host-range determinants.

Enterococci are robust Gram-positive bacteria that pose a significant threat in healthcare settings due to antibiotic resistance, with vancomycin-resistant enterococci (VRE) most prominent. To tackle this issue, bacteriophages (bacterial viruses) can be exploited as they specifically and efficiently target bacteria. Here, we successfully isolated and characterised a set of novel phages: SHEF10, SHEF11, SHEF13, SHEF14, and SHEF16 which target E. faecalis (SHEF10,11,13), or E. faecium (SHEF13, SHEF14 & SHEF16) strains including a range of clinical and VRE isolates. Genomic analysis shows that all phages are strictly lytic and diverse in terms of genome size and content, quickly and effectively lysing strains at different multiplicity of infections. Detailed analysis of the broad host-range SHEF13 phage revealed the crucial role of the enterococcal polysaccharide antigen (EPA) variable region in its infection of E. faecalis V583. In parallel, the discovery of a carbohydrate-targeting domain (CBM22) found conserved within the three phage genomes indicates a role in cell surface interactions that may be important in phage-bacterial interactons. These findings advance our comprehension of phage-host interactions and pave the way for targeted therapeutic strategies against antibiotic-resistant enterococcal infections.

Cardiotoxicity in Cancer Patients: The Prevalence, Risk Factors, and Cardioprotective Measures in a Cancer Centre in Saudi Arabia.

BACKGROUND: Chemotherapy-related cardiotoxicity can exhibit several patterns of functional, structural, and vascular complications. This study aims to identify the patterns and the factors associated with cardiotoxicity in cancer patients. METHOD: A retrospective cross-sectional analysis of 96 adult cancer patients undergoing anticancer therapy was investigated at King Khalid Hospital in Najran, Saudi Arabia, from May 2022 to April 2023. The data on patient and cancer characteristics, treatment, and outcomes were collected and analyzed. Factors associated with cardiotoxicity were investigated through univariate analyses using odds ratio (OR) and 95% confidence interval (CI). RESULTS:  Among the 96 cancer patients in the study, cardiotoxicity occurred in 12 individuals (12.5%). The mean age was 57.0 ± 13.3 years (range: 32-81 years), with 32 (33.3%) being above 65 years. The most common comorbidities were diabetes (n=48; 50%), followed by hypertension (n=32; 33.3%), and dyslipidemia (n=20; 20.8%). The most common cancers were gastrointestinal cancer (n=32; 33.3%), followed by breast cancer (n=22; 22.9%) and lymphoma (n=14; 14.6%). Females were disproportionately affected (64.6%), with 57.3% of them in the metastatic stage. The majority of patients (90.6%) had normal ejection fraction before chemotherapy initiation. In univariate analysis, current smoking (OR: 7.00; 95%CI: 1.94-25.25, p= 0.003), history of percutaneous cardiac intervention (OR: 40.24; 95%CI: 1.80-896.26, p= 0.019), diabetes (OR: 6.05; 95%CI: 1.24-29.32, p= 0.025), renal failure (OR: 8.20; 95%CI: 0.91-74.88, p= 0.046), dyslipidemia (OR: 5.00; 95 CI: 1.38-18.32, p=0.012), anthracycline use (OR: 18.33; 95%CI: 4.36-126.55, p <0.001), trastuzumab use (OR: 25.00; 95%CI: 6.25-129.86, p < 0.001), and increased chemotherapy cycles number (> 10 cycles) (OR: 73.00; 95%CI: 8.56- 622.36, p < 0.001) were associated with cardiotoxicity. Additionally, beta-blocker use was associated with lower rates of cardiotoxicity (OR: 0.17; 95%CI: 0.036-0.84, p= 0.029). CONCLUSIONS: The incidence of cardiotoxicity among cancer patients treated with chemotherapy is modest, difficult to predict, and independent of baseline cardiac systolic functions. Factors associated with cardiotoxicity include smoking, history of percutaneous cardiac intervention, diabetes, renal failure, dyslipidemia, anthracycline or trastuzumab use, and increased chemotherapy cycle numbers. A combination of various anticancer drugs and chemotherapy may dramatically raise the risk of cardiotoxicity in cancer patients. As a result, patients receiving high-risk cardiotoxic drugs should be monitored with caution to avoid drug-related cardiotoxicity. Furthermore, proactive treatment techniques aiming at reducing the possible cardiotoxic effects of anticancer therapy are critical.

Enterococcal bacteriophage: A survey of the tail associated lysin landscape.

Bacteriophages are viruses that exclusively infect bacteria which require local degradation of cell barriers. This degradation is accomplished by various lysins located mainly within the phage tail structure. In this paper we surveyed and analysed the genomes of 506 isolated bacteriophage and prophage infecting or harboured within the genomes of the medically important Enterococcus faecalis and faecium. We highlight and characterise the major features of the genomes of phage in the morphological groups podovirus, siphovirus and myovirus, and explore their categorisation according to the new ICTV classifications, with a focus on putative extracellular lysins chiefly within tail modules. Our analysis reveals a range of potential cell-wall targeting enzyme domains that are part of tail, tape measure or other predicted base structures of these phages or prophages. These largely fall into protein domains targeting pentapeptide or glycosidic linkages within peptidoglycan but also potentially the enterococcal polysaccharide antigen (EPA) and wall teichoic acids of these species (i.e., Pectinesterases and Phosphodiesterases). Notably, there is a great variety of domain architectures that reveal the diversity of evolutionary solutions to attack the Enterococcus cell wall. Despite this variety, most phage and prophage possess a putative endopeptidase (70%), reflecting the ubiquity of this cell surface barrier. We also identified a predicted lytic transglycosylase domain belonging to the glycosyl hydrolase (GH) family 23 and present exclusively within tape measure proteins. Our data also reveal distinct features of the genomes of podo-, sipho- and myo-type viruses that most likely relate to their size and complexity. Overall, we lay a foundation for expression of recombinant TAL proteins and engineering of enterococcal and other phage that will be invaluable for researchers in this field.

Profitable Fischer Tropsch realization via CO2-CH4 reforming; an overview of nickel-promoter-support interactions.

Environmental pollution, climate change, and fossil fuel extinction have aroused serious global interest in the search for alternative energy sources. The dry reforming of methane (DRM) could be a good technique to harness syngas, a starting material for the FT energy process from greenhouse gases. Noble metal DRM catalysts are effective for the syngas generation but costly. Therefore, they inevitably, must be replaced by their Ni-based contemporaries for economic reasons. However, coking remains a strong challenge that impedes the industrialization of the FT process. This article explains the secondary reactions that lead to the production of detrimental graphitic coke deposition on the surface of active nickel catalyst. The influence of nickel particle size, impact of extra surface oxygen species, interaction of Ni catalysts with metal oxide supports/promoters, and larger fraction of exposed nickel active sites were addressed in this review. Size of active metal determines the conversion, surface area, metal dispersion, surface reactions, interior diffusion effects, activity, and yield. The influence of oxygen vacancy and coke deposition on highly reported metal oxide supports/promoters (Al2O3, MgO and La2O3) was postulated after studying CIFs (crystallographic information files) obtained from the Crystallography open database (COD) on VESTA software. Thus, overcoming excessive coking by La2O3 promotion is strongly advised in light of the orientation of the crystal lattice characteristics and the metal-support interaction can be used to enhance activity and stability in hydrogen reforming systems.

Prevalence and associated factors of pediatric hypertension in Jazan region, south of the Kingdom of Saudi Arabia. A pilot cross-sectional study.

Hypertension (HTN) is a primary global health concern. Moreover, according to the 2010 Global Burden of Disease, hypertension accounted for roughly a quarter of cardiovascular disease fatalities and 1.9 percent of all deaths in Saudi Arabia in 2010. Also, hypertension is a significant risk factor for cardiovascular disease, morbidity, and mortality. However, assessing blood pressure (BP) and preventing hypertension among children and adolescents has become a global priority. This study aims to determine the prevalence of hypertension among children in the Jazan region of Saudi Arabia. Also, to determine the common risk factors associated with pediatric hypertension. We conducted this cross-sectional study among boys and girls aged 6-14 years visiting Al-Rashid Mall, one of the two main malls in Jazan city, the capital of Jazan region, Saudi Arabia, between November 2021 and January 2022. We included children willing to participate in the study after obtaining their parents' consent and children's assent. We used a standardized questionnaire to interview the parents to collect the children's data. We also measured the children's resting BP. Then we classified the measurements according to the updated International Pediatric Hypertension Association (IPHA) chart. We also measured the height and weight of the children and calculated their BMI. We used SPSS version 25 for the data entry and analysis. Our results showed that the prevalence of hypertension and prehypertension was insignificantly higher in females (11.84% and 12.65%) compared to males (11.52% and 11.52%), respectively. Our participants' main associated factors with prehypertension and hypertension were overweight, obesity, and family income. Pediatric hypertension and prehypertension were highly prevalent in Jazan region. Therefore, being overweight and obese should be considered risk factors for pediatric hypertension. Our study emphasizes the need for early intervention to prevent pediatric HTN, particularly among overweight and obese children.

Unraveling the Complex Relationship Between Gastroesophageal Reflux Disease, Lifestyle Factors, and Interstitial Lung Disease: Insights From Two-Sample Mendelian Randomization Analyses.

Background Although the cause of interstitial lung disease (ILD) remains uncertain, it is believed to be a combination of genetic and non-inherited factors, such as smoking and diet. This research aims to evaluate the impact of gastroesophageal reflux disease (GERD) and other modifiable risk factors on the likelihood of developing ILD by utilizing two-sample Mendelian randomization. Methodology The research utilized publicly accessible single-nucleotide polymorphisms (SNPs) that were deemed significant on a genome-wide scale. These SNPs were chosen from prior studies conducted by various consortia. The study examined GERD and a wide range of smoking habits, including the age at which individuals started smoking, the intensity of their smoking, and whether their mothers smoked. Additionally, the study considered other relevant risk factors such as key dietary factors, coffee consumption, body mass index (BMI), and physical activity. The study focused on self-reported ILD as its outcome measure. The genetic information for ILD was sourced from the FinnGen and UK Biobank (UKB) cohorts. Results The study encompassed a wide range of sample sizes, varying from 64,949 to 632,802, for each risk factor collected from multiple consortia. In total, 593 SNPs were included for all risk factors. The findings revealed significant associations between genetically estimated GERD, dietary factors, BMI, and the risk of ILD within the FinnGen consortium. The odds ratios (ORs) indicated an increase in the risk of ILD per unit of GERD (OR = 1.17, p = 0.001), smoking initiation (OR = 1.10, p < 0.05), BMI (OR = 1.15, p = 0.006), and low-density lipoprotein (LDL) (OR = 1.10, p = 0.02). On the other hand, there was a decrease in the risk of ILD per unit increase in coffee intake (OR = 0.64, p = 0.01) and physical activity (OR = 0.79, p=0.03). Additionally, the results demonstrated a significant association between genetically estimated GERD (OR = 1.01, p < 0.05), coffee intake (OR = 1.14, p=0.03), and high-density lipoproteins (HDL) (OR = 1.01, p=0.04) and increased risk of ILD specifically within the UKB. Conclusions This research indicates that the development of ILDs may be causally associated with GERD and various factors such as coffee intake, smoking, BMI, physical activity, LDL, and HDL These results hold great importance in terms of devising effective strategies for the treatment and prevention of ILDs.

Environmental sanitary interventions for preventing active trachoma.

BACKGROUND: Trachoma is a major cause of avoidable blindness. It is responsible for about six million blind people worldwide, mostly in the poor communities of developing countries. One of the major strategies advocated for the control of the disease is the application of various environmental sanitary measures to such communities. OBJECTIVES: To assess the evidence for the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL in The Cochrane Library (Issue 2, 2007), MEDLINE (1966 to July 2007), EMBASE (1980 to July 2007), LILACS (July 2007), reference list of trials and the Science Citation Index. We also contacted agencies, experts and researchers in trachoma control. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials comparing any form of environmental hygiene measures with no measure. These hygiene measures included fly control, provision of water and health education. Participants in the trials were people normally resident in the trachoma endemic areas. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the quality of trials. Study authors were contacted for additional information. Four trials met the inclusion criteria but meta-analysis was not conducted due to heterogeneity of the studies. MAIN RESULTS: Two studies that assessed insecticide spray as a fly control measure found that trachoma is reduced by at least 55% to 61% with this measure compared to no intervention. However, another study did not find insecticide spray to be effective in reducing trachoma. One study found that another fly control measure, latrine provision, reduced trachoma by 29.5% compared to no intervention; this was, however, not statistically significantly different. Another study revealed that health education on personal and household hygiene reduced the incidence of trachoma such that the odds of reducing trachoma in the health education village was about twice that of the no intervention village. However, all the studies have some methodological concerns relating to concealment of allocation and non-consideration of clustering effect in data analysis. AUTHORS' CONCLUSIONS: The role of insecticide spray as a fly control measure in reducing trachoma remains unclear. Latrine provision as a fly control measure has not demonstrated significant trachoma reduction. Health education may be effective in reducing trachoma. There is a dearth of data to determine the effectiveness of all aspects of environmental sanitation in the control of trachoma.

Effects of wastewater discharge on heavy metals pollution in Fadama soils in Kano City, Nigeria.

OBJECTIVE: To present the results of a research project on 6 heavy metals (Cd, Cu, Zn, Pb, Hg, and Cr) at 30 Fadama fields scattered around Kano. METHODS: Following a reconnaissance conducted, 30 representative Fadama lands being irrigated with wastewater were selected from zones of the city under residential, industrial, commercial, and mixed but largely residential landuses. Five additional Fadama lands not being irrigated with wastewater were selected to serve as control. Using grid sampling procedure, soil samples were selected from 0-15 cm and 20-30 cm depths and analyzed for the above listed heavy metals using atomic absorption spectrophotometry. T-test was used to compare the mean values of the metals for the Fadama lands under different landuse zones with those of the control. RESULTS: Analyses of the soil data collected showed that the metals were concentrated in higher amounts in the lower (20-30 cm) than the upper (0-15 cm) depths, which was an indication of downward movement of the metals in profile of the soils. In the two soil depths, Zn was generally the most abundant, followed by Cr, then Pb, Cu, and Cd while Hg was the least. The Fadama soils in areas of mixed landuses with industrial as the dominant ones maintained the highest concentrations of the various metals. CONCLUSIONS: These results indicate clearly that the Fadama soils are significantly polluted by industrial and household wastewater and that there is a particular threat from Cr and Pb pollution. There is also evidence that the metals are accumulating at lower layers of the soil profile, suggesting that not only plants and soil, but even water bodies could be under the threat of heavy metal pollution in the area.

An in silico approach in predicting the possible mechanism involving restoration of wild-type p53 functions by small molecular weight compounds in tumor cells expressing R273H mutant p53.

R273H mutant p53 is a DNA-contact mutant that renders p53 dysfunctional due to a single substitution of Arg273 for His273. Rescuing R273 mutant p53 implies that a competent molecule would have to bind to the site of DNA-contact hot spots to complement the loss of contact with the DNA-binding domain. Here, curcumin, flavokawain B, and alpinetin were docked against the crystal structure of R273H mutant p53 in silico. Consequently, all the compounds bind to the cavity of R273H mutant p53 with a dissociation constant estimated to have 36.57, 70.77, and 75.11 µM for curcumin, flavokawain B, and alpinetin, respectively. Subsequently, each molecule was able to bind to the R273H mutant p53 by interacting with the DNA-contact hot spot Arg248 and mutant R273H, thereby compensating for the loss of direct contact with the DNA-binding domain. Furthermore, all the molecules were able to induce a direct contact with the consensus site of the DNA binding domain, thus maintaining DNA-contact residues with the DNA. The present findings offer preliminary indirect supporting evidence that small molecular weight compounds may certainly rescue DNA-contact mutant p53, which may lay a foundation for designing a competent and effective molecule capable of rescuing mutant p53 in tumor cells expressing R273H mutant p53.

Environmental sanitary interventions for preventing active trachoma.

BACKGROUND: Trachoma is the second or third major cause of blindness. It is responsible for about six million blind people worldwide, mostly in the poor communities of developing countries. One of the major strategies advocated for the control of the disease is the application of various environmental sanitary measures to such communities. OBJECTIVES: To assess the evidence for the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) on The Cochrane Library (Issue 4, 2004), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), LILACS (April 2004), the reference list of trials and the Science Citation Index. We also contacted agencies, experts and researchers in trachoma control. SELECTION CRITERIA: This review included randomised and quasi-randomised controlled trials comparing any form of environmental hygiene measures with no measure. These hygienic measures included fly control, provision of water and health education. Participants in the trials were people normally resident in the trachoma endemic areas. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the quality of trials. Study authors were contacted for additional information. Three trials met the inclusion criteria but meta-analysis was not conducted due to heterogeneity of the studies. MAIN RESULTS: Two studies that assessed insecticide spray as a fly control measure found that trachoma is reduced by at least 55% to 61% with this measure compared to no intervention. One study found that another fly control measure, latrine provision, reduced trachoma by 29.5% compared to no intervention; this was, however, not statistically significantly different. Another study revealed that health education on personal and household hygiene reduced the incidence of trachoma such that the odds of reducing trachoma in the health education village was about twice that of the no intervention village. However, all the studies have some methodological concerns relating to concealment of allocation and non-consideration of clustering effect in data analysis. AUTHORS' CONCLUSIONS: There is evidence that insecticide spray as a fly control measure reduces trachoma significantly. Latrine provision as a fly control measure has not demonstrated significant trachoma reduction. Health education may be effective in reducing trachoma. There is a dearth of data to determine the effectiveness of all aspects of environmental sanitation in the control of trachoma.

Normal values of echocardiographic parameters of apparently healthy adult Nigerians in Zaria.

The usefulness of echocardiography as a non invasive tool in the assessment of cardiac function is well established. Ninety two (54 males and 38 females) apparently healthy adult Nigerians were assessed echocardiographically to determine the normal values for the commonly measured parameters in our area of clinical practice. The mean age, body mass index (BMI), cardiothoracic ratio (CTR) and electrocardiographic left ventricular hypertrophy (ECG - LVH) were 51.4 +/- 11.15 years, 23.85 +/- 4.91 kg/m2, 0.49 +/- 0.05, and 27.3 +/- 7.46 mm respectively. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure ('MAP) were 125.0 +/- 9.94, 79.7 +/- 6.23 and 94.7 +/- 6.54, mmHg respectively. While the results of the echocardiographic measurements followed the same pattern as other published reports from outside Nigeria especially with relation to age, there were still some differences in terms of absolute values. This emphasizes the need to have our own normal reference values. A multicenter study across the country involving much larger number of subjects is required to establish normal reference values for Nigeria.

Audit of outcome of an extracapsular cataract extraction and posterior chamber intraocular lens training course.

BACKGROUND: A training course for cataract surgery with intraocular lens implantation was organised in April 1997 at the National Eye Centre, Kaduna, Nigeria. Operations were performed by six Nigerian consultant ophthalmologists under the supervision of two surgeons from Aravind Eye Hospital, India. METHODS: A total of 175 eyes with uncomplicated cataracts were operated on after careful selection. All but six patients had extracapsular cataract extraction with posterior chamber intraocular lens insertion during the training programme. RESULTS: The mean age of the patients at operation was 54. 2 years. One hundred and forty five of the operated eyes (85.8%) were blind before surgery of which six (3.6%) remained blind postoperatively. An uncorrected visual acuity of 6/60 or better was achieved in 87.3% eyes after surgery. Forty one patients (24.3%) were blind before surgery, two of whom (1.2%) remained blind afterwards. The most common intraoperative complication was posterior capsular rent which occurred in 10 eyes (5.7%); striate keratopathy/corneal oedema and cortical remnant were the most common immediate postoperative complications, occurring in 44.6% and 8.0%, respectively. CONCLUSION: With adequate surgical skills, extracapsular cataract extraction with posterior chamber intraocular lens implantation offers good visual rehabilitation even under training conditions.

Trial of Trachoma Rapid Assessment in a subdistrict of northern Nigeria.

PURPOSE: To assess the usefulness of Trachoma Rapid Assessment (RA) in priority ranking of trachoma areas. METHODS: RA was conducted concurrently with a cross-sectional trachoma prevalence survey in some villages selected from the communities at risk for trachoma in the Kaita Local Government Area of northern Nigeria. The RA team consisted of two ophthalmic nurses. Pen torches and loupes were used for the examination. Data were collected on the seven components of the RA 'information pyramid' for all the selected villages. The data were analyzed using the RA methodology guidelines to determine the priority villages for trachoma intervention. This was compared with the ranking from the cross-sectional trachoma prevalence survey. RESULTS: The results of RA were found to be in agreement with the cross-sectional survey in 53.3% of the villages in the priority ranking of trichiasis, while in the priority ranking of active trachoma the agreement between the two methods was found to be 60%. The risk factors for trachoma were shown to be of high magnitude in all the villages using both the RA method and the prevalence survey. CONCLUSION: RA may be a more useful tool when applied to a vast area where the risk of trachoma is likely to differ greatly between different parts of the area. In the determination of the trichiasis pattern of a community by RA, it may be more useful to use the actual number of trichiasis cases in the area rather than the prevalence of trichiasis. The operational definition of some risk factor indicators seems very subjective and vague. The RA method needs more validation to sharpen the indicators used.

Face washing promotion for preventing active trachoma.

BACKGROUND: Trachoma remains a major cause of avoidable blindness among underprivileged populations in many developing countries. It is estimated that about 146 million people have active trachoma and nearly six million people are blind due to complications associated with repeat infections. OBJECTIVES: The objective of this review is to assess the effects of face washing on the prevalence of active trachoma in endemic communities. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group trials register) on The Cochrane Library (Issue 2, 2004), MEDLINE (1966 to February 2004), EMBASE (1980 to February 2004), the reference lists of identified trials and the Science Citation Index. We also contacted investigators and experts in the field to identify additional trials. SELECTION CRITERIA: We included randomised or quasi-randomised controlled trials, comparing face washing with no treatment or face washing combined with antibiotics against antibiotics alone. Participants in the trials were people normally resident in endemic trachoma communities. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. Study authors were contacted for additional information. Two clinically heterogeneous trials are included, therefore a meta-analysis was considered inappropriate. MAIN RESULTS: This review includes two trials with data from a total of 2560 participants. Face washing combined with topical tetracycline was compared to topical tetracycline alone in three pairs of villages in one trial. The trial found a statistically significant effect for face washing combined with topical tetracycline in reducing 'severe' active trachoma compared to topical tetracycline alone. No statistically significant difference was observed between the intervention and control villages in reducing ('non-severe') active trachoma. The prevalence of clean faces was higher in the intervention villages than the control villages and this was statistically significant. Another trial compared eye washing to no treatment or to topical tetracycline alone or to a combination of eye washing and tetracycline drops in children with follicular trachoma. The trial found no statistically significant benefit of eye washing alone or in combination with tetracycline eye drops in reducing follicular trachoma amongst children with follicular trachoma. REVIEWERS' CONCLUSIONS: There is some evidence that face washing combined with topical tetracycline can be effective in reducing severe trachoma and in increasing the prevalence of clean faces. Current evidence does not however support a beneficial effect of face washing alone or in combination with topical tetracycline in reducing active trachoma.

Case report: dextrocardia with situs inversus; two cases presenting differently.

Two patients presented to our centre with dextrocardia and complete situs inversus. The first a 35-year-old presented for the first time with respiratory symptoms but no cardiac symptoms and the second patient (14-year-old) presented with cardiac symptoms. Dextrocardia and situs inversus were confirmed by the chest radiograph, electrocardiograph, and abdominal ultrasound and computerised axial tomography in the two patients. Echocardiography established atrio-ventricular great arteries ventricular concordance and bicuspid aortic valve in the second patient that presented with cardiac symptoms.

Phenotypic detection of extended Spectrum ß-Lactamase and Metallo-ß-Lactamase produced by Escherichia Coli on automated teller machines within Sokoto Metropolis, Nigeria

It is no longer a fallacy that environmental objects are grossly contaminated by pathogenic microbes. ATMs especially which is used on daily basis by thousands of people have been reported to be potential habitat for these microbes. The worst-case scenario is the presence and ease of spread of Muti-Drug Resistant (MDR) and Extended Spectrum Beta Lactamase (ESBL) producing pathogens via these machines as a result of their huge patronage. The prevalence and fast spread of these MDR and ESBL producing strains constitute an emerging public health concern. This study was conducted to determine the prevalence of ESBL and MBL producing E. coli isolated on ATMs within Sokoto metropolis. A total of 194 isolates were obtained from the culture samples of 100 ATM swabs. The isolated E. coli were subjected to antimicrobial susceptibility tests using the modified Kirby Baeur disc diffusion method on six (6) commercial antimicrobial discs (Oxoid, UK): Ceftazidime (CTZ, 30µg), Cefotaxime (CTX, 30µg), Gentamycin (CN, 10µg), Augumentin(AMC, 30µg), Ciprofloxacin(CIP, 5µg) and Imipenem(IPM, 10µg). The isolates were further screened for ESBL production and phenotypic confirmatory test. Confirmation of MBL production was also performed using antibiotic discs containing two Carbapenems (Imipenem IPM, 10µg and Meropenem MEM, 10µg). The result was interpreted using CLSI guideline 2015. Proteus spp (43%) were the most frequently isolated bacteria, followed by Shigella spp (31%) and E. coli 31(16%). Drug Resistant (MDR) ESBL producing E. coli of 93.3% and 4% MBL producer was recorded. It can be concluded that MDR and ESBL producing Escherichia coli (E. coli) are the most prevalent species isolated and that the species isolated are more sensitive to Gentamycin, Ciprofloxacin and Imipenem