Multi-functional xylanase from Aspergillus sydowii: biosynthesis of nanoconjugates, optimization by Taguchi approach and biodeinking potential.

The search for effective production of xylanase which is an important industrial enzyme led to the present study that explored xylanase production by Aspergillus sydowii SF through Taguchi optimization that incorporated nanoconjugates in submerged fermentation. Calcium and zinc oxide nanoconjugates biosynthesized by xylanase were characterized via UV-Vis spectroscopy, Fourier transform infrared spectroscopy, and Transmission electron microscopy (TEM). The xylanase-mediated calcium oxide and zinc oxide nanoconjugates with λmax of 374 and 316 nm, respectively, and were 5.32-17.69 nm in size. Xylanase production was improved by 2.90-10.58 folds (64.24-234.15 U/mL) through Taguchi optimization cum nanoconjugates, and ANOVA showed that nanoconjugates contributed 13.62-65.97% to improved production. The xylanase had up to 88.38% deinking activity, with 49.60-84.64% removal of blue color. The remarkable xylanase production, its use to biosynthesize nanoconjugates and biodeinking potentials contribute to the development of versatile biocatalysts with applications in biotechnology, nanotechnology, and sustainable paper production. To the best of our knowledge, this represents the first report of xylanase for biosynthesis of calcium oxide and zinc oxide nanoparticles, as well as nanosupplementation to induce xylanase production, which can open new vista in bioprocess optimization.

Evaluation of urban solid-waste generation and safety consciousness of waste collectors amidst COVID-19 pandemic.

This study investigates solid-waste handling practices by municipal waste collectors during COVID-19 pandemic period in Osogbo urban areas with the intention of assessing measures put in place for preventing possible spread of the disease. Data for the study were obtained from primary and secondary sources. Primary data were acquired through questionnaire administration on the 5% of waste collectors selected through snowball technique of chain referral. Data collected were analyzed using descriptive statistical methods. Adopted under this technique are cross-tabulation, percentages, index that was used determine waste generation (WGI), and protective material index (PMI) used by waste collectors before and during the lockdown periods. The result showed that rate of waste generation before the pandemic was WGI = 0.69 and during the pandemic was WGI = 0.75. The use of protective materials before COVID-19 was PMI = 2.9 as against (PMI = 3.58) during the lockdown period, with face mask recorded lowest occurrence of use (PMI = - 2.91). Crude materials that cannot guarantee the safety of waste collectors are used for transfer of waste into disposal vehicle. The study concludes that solid-waste collectors in the study area are not adequately catered for during COVID-19 pandemic.

Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus.

OBJECTIVE: To examine longitudinal associations of active lupus nephritis with organ damage accrual in patients with systemic lupus erythematosus (SLE). METHODS: This study was performed using data from a large multinational prospective cohort. Active lupus nephritis at any visit was defined by the presence of urinary casts, proteinuria, haematuria or pyuria, as indicated by the cut-offs in the SLE Disease Activity Index (SLEDAI)-2K, collected at each visit. Organ damage accrual was defined as a change of SLICC-ACR Damage Index (SDI) score >0 units between baseline and final annual visits. Renal damage accrual was defined if there was new damage recorded in renal SDI domains (estimated glomerular filtration rate <50%/proteinuria >3.5 g per 24 h/end-stage kidney disease). Time-dependent hazard regression analyses were used to examine the associations between active lupus nephritis and damage accrual. RESULTS: Patients (N = 1735) were studied during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1087) days. Forty per cent of patients had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was observed in 3030 (24%) visits. Forty-eight per cent of patients had organ damage at baseline and 14% accrued organ damage. Patients with active lupus nephritis were 52% more likely to accrue any organ damage compared with those without active lupus nephritis (adjusted hazard ratio = 1.52 (95% confidence interval (CI): 1.16, 1.97), p < 0.02). Active lupus nephritis was strongly associated with damage accrual in renal but not in non-renal organ domains (hazard ratios = 13.0 (95% CI: 6.58, 25.5) p < 0.001 and 0.96 (95% CI: 0.69, 1.32) p = 0.8, respectively). There was no effect of ethnicity on renal damage accrual, but Asian ethnicity was significantly associated with reduced non-renal damage accrual. CONCLUSION: Active lupus nephritis measured using the SLEDAI-2K domain cut-offs is associated with renal, but not non-renal, damage accrual in SLE.

Microangiopathic antiphospholipid antibody-associated syndrome in a pregnant lady.

We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin. She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted. Day 5 post-delivery, she developed HELLP, with hemolytic anaemia (Hb 10.1 g/dL, haptoglobin <30 g/L, LDH 2206 U/L), elevated transaminases (AST 1196 U/L, ALT 1130 U/L) and thrombocytopenia (platelet 28 × 10^9/L). There were also episodes of acute severe headache and abdominal pain assessed to be secondary to microvascular ischemia as CT did not reveal any thrombosis. Her blood pressure hovered persistently above systolic 180 mmHg, and required at least three anti-hypertensives. These were coupled with a new onset proteinuria of 2 to 3 g/day. There was no evidence of disseminated intravascular coagulation. She was assessed to have microangiopathic antiphospholipid syndrome and was started on plasmapheresis. On Day 10 post-partum, the patient complained of foul-smelling vaginal discharge and was found to have retained products of conception, which was immediately evacuated. Her course was followed by poly-microbial sepsis secondary to Enterococcus fecalis, Klebsiella Pneumoniae and Escherichia coli. The patient was further treated with imipenem and she completed eight exchanges of plasmapheresis followed by five days of intravenous immunoglobulins with good clinical and biochemical improvement.

Building pharmacogenetics into a pharmacovigilance program in Singapore: using serious skin rash as a pilot study.

To study the possible genetic associations with adverse drug reactions (ADR), the Singapore Health Sciences Authority (HSA) has piloted a program to collect DNA and phenotype data of ADR cases as part of its pharmacovigilance program. Between 2009 and 2012, HSA screened 158 cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). To assess the association between HLA-B*1502 and carbamazepine (CBZ)-induced SJS/TEN, 13 cases and 26 drug-tolerant controls were analyzed. All 13 CBZ-SJS/TEN cases and 3/26 controls were HLA-B*1502 positive (odds ratio 181, 95% confidence interval: 8.7-3785, P=6.9 × 10(-8)). Discussions of the finding with the Ministry of Health and an expert panel led to the decision to make HLA-B*1502 testing the standard of care prior to first use of CBZ in Asians and to subsidize the genotyping test at public hospitals. This program illustrates the role of a regulatory authority in advancing the use of pharmacogenetics for drug safety.

Bacterial biota associated with the invasive insect pest Tuta absoluta (Meyrick).

Tuta absoluta (the tomato pinworm) is an invasive insect pest with a highly damaging effect on tomatoes causing between 80 and 100% yield losses if left uncontrolled. Resistance to chemical pesticides have been reported in some T. absoluta populations. Insect microbiome plays an important role in the behavior, physiology, and survivability of their host. In a bid to explore and develop an alternative control method, the associated microbiome of this insect was studied. In this study, we unraveled the bacterial biota of T. absoluta larvae and adults by sequencing and analyzing the 16S rRNA V3-V4 gene regions using Illumina NovaSeq PE250. Out of 2,092,015 amplicon sequence variants (ASVs) recovered from 30 samples (15 larvae and 15 adults), 1,268,810 and 823,205 ASVs were obtained from the larvae and adults, respectively. A total of 433 bacterial genera were shared between the adults and larval samples while 264 and 139 genera were unique to the larvae and adults, respectively. Amplicon metagenomic analyses of the sequences showed the dominance of the phylum Proteobacteria in the adult samples while Firmicutes and Proteobacteria dominated in the larval samples. Linear discriminant analysis effect size (LEfSe) comparison revealed the genera Pseudomonas, Delftia and Ralstonia to be differentially enriched in the adult samples while Enterococcus, Enterobacter, Lactococcus, Klebsiella and Wiessella were differentially abundant in the larvae. The diversity indices showed that the bacterial communities were not different between the insect samples collected from different geographical regions. However, the bacterial communities significantly differed based on the sample type between larvae and adults. A co-occurrence network of significantly correlated taxa revealed a strong interaction between the microbial communities. The functional analysis of the microbiome using FAPROTAX showed that denitrification, arsenite oxidation, methylotrophy and methanotrophy as the active functional groups of the adult and larvae microbiomes. Our results have revealed the core taxonomic, functional, and interacting microbiota of T. absoluta and these indicate that the larvae and adults harbor a similar but transitory set of bacteria. The results provide a novel insight and a basis for exploring microbiome-based biocontrol strategy for this invasive insect pest as well as the ecological significance of some of the identified microbiota is discussed.

Exploring Serum Vitamin D, Sex Hormones, and Lipid Profile Disparities in Women With and Without Polycystic Ovarian Syndrome: A Case-Control Study.

Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by dyslipidemia, hormonal imbalances, and metabolic dysfunctions. Vitamin D deficiency may be implicated in the pathogenesis of PCOS, potentially exacerbating its metabolic syndrome. However, the exact interplay between these factors remains underexplored. Aim This study aimed to evaluate serum levels of vitamin D and its association with modalities of PCOS among women with PCOS and healthy controls.  Methods This was a hospital-based case-control study where 60 women newly diagnosed with PCOS and 56 non-PCOS controls were consecutively recruited within a 10-month period. The women aged 20-40 were recruited at the gynecology clinics of Lagos State University Teaching Hospital and Lagos Island Maternity Hospital. PCOS was diagnosed using the Rotterdam's criteria. The biodata, anthropometry, clinical features, serum vitamin D, cortisol, progesterone, testosterone, estradiol, prolactin, anti-Mullerian hormone (AMH), thyroid-stimulating hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and very-low-density lipoprotein cholesterol (VLDL-C) levels of PCOS-diagnosed women were assessed and compared with those of women without PCOS. The exclusion criteria comprised known diabetics, women with gynecological pathologies such as fibroids, and women on medications affecting the study analytes or hormones. Statistical analyses included chi-square or Fisher's exact tests for categorical variables, student t-test for continuous variables, and Pearson's correlation for assessing relationships between continuous variables. The significance level was set at p<0.05 and a confidence interval of 95%. Results Individuals with PCOS exhibited a younger mean age (26.90±3.73 versus 29.95±5.00 years, p=0.001) and a higher prevalence of irregular menstrual patterns (46.7% versus 14.3%, p=0.0001) and acne (58.3% versus 37.5%, p=0.025). Moreover, PCOS was associated with elevated levels of TC (p = 0.03), TG (p = 0.03), LDL-C (p = 0.014), FBG (p = 0.001), LH:FSH ratio (p = 0.002), AMH (p = 0.0001), and testosterone (p = 0.003), but low progesterone (p = 0.001) and vitamin D (p = 0.033), alongside a higher incidence of vitamin D deficiency (33.3% versus 26.1%) and insufficiency (66.7% versus 56.5%). Additionally, significant but weak correlations were observed between serum vitamin D levels and waist-hip ratio (r = 0.4, p = 0.016) and FBG (r = -0.4, p = 0.036) in the PCOS group, suggesting potential metabolic implications. Conclusion The PCOS subjects in this study had decreased vitamin D and progesterone levels, with elevated concentrations of testosterone, AMH, lipid profile (TC, LDL, and TG), FBG, and LH:FSH ratio. Studies on the therapeutic effect of vitamin D administration in managing PCOS will need to be further evaluated.

Spatio-temporal assessment of the impacts of the trends in physical and biogeochemical parameters on the primary production of the Gulf of Guinea.

This study applied ocean models data from Copernicus Marine Environment Monitoring Service (CMEMS) in assessing the impacts of the trends in key ocean parameters on the primary production of the Gulf of Guinea (GoG). Trend analyses, from 1993 to 2020, were done using linear regression and Mann-Kendall significance test methods to ascertain inter-annual and inter-seasonal variations and check the significance of the trends, respectively. Results affirm that temperature, salinity, nutrients, and oxygen play significant roles in the primary production of the GoG. Also, parameters such as temperature, salinity, chlorophyll-A, net primary production, phosphate, and dissolved oxygen have been experiencing increases between the study duration while silicate and nitrate have been declining in the GoG. However, there are regions and years with contrary values to the average trends. The varying level of significance of the trend showed that the impacts of the climate on the primary production of the GoG vary basin-wide.

Histopathologic patterns of intracranial neoplasms at Lagos University Teaching Hospital, Nigeria. A ten-year hospital-based retrospective study.

Background: The most common intracranial neoplasm worldwide is meningioma, followed by gliomas, and then pituitary adenomas. There are geographical differences in the pattern of occurrence of intracranial neoplasms.The purpose of this study is to establish the pattern of occurrence of different histological types of intracranial neoplasms with their age and sex distributions in our environment - Lagos, Nigeria.The histological patterns, age, and gender distributions of all the intracranial neoplasms diagnosed within the study period at the Department of Anatomic and Molecular Pathology, LUTH, Lagos, Nigeria were noted and analysed with SPSS version 23. Result: There were 296 patients (165 females, 131 males; mean age of 37.0 years) diagnosed with an intracranial neoplasm within the study period. The most frequently diagnosed intracranial neoplasm was meningioma (105 cases; 35%, median age of 42 years, male to female ratio of 1:2.2), followed by pituitary adenoma (78 cases; 26%, median age of 47 years, male to female ratio of 1.3:1), and then gliomas (71 cases; 24%, median age of 28, male to female ratio of 1:1.39). Conclusion: The result of the study shows pituitary adenoma to be more common than gliomas, unlike what is seen in Caucasians where the reverse is the case.

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis.

BACKGROUND:  Motorcycle is a popular and growing form of intracity transportation in many Nigerian cities owing mainly to poorly developed transport systems. It contributes significantly to road traffic injuries (RTIs), which are a leading cause of death and disabilities in low- and middle-income countries. There is a lack of information on the quality of care received and the treatment outcome in patients with motorcycle RTIs in Ibadan and many cities in Nigeria. This study evaluated the characteristics of motorcycle-related RTIs, the quality of care received, and the outcome of the patients managed in a trauma reference center in Ibadan, Nigeria. METHODS:  This is a prospective cohort study. All patients involved in motorcycle road traffic crashes who presented to the emergency department of the University College Hospital, Ibadan, between August 2020 and May 2021, were included in the study. Data on patients' demographics, history of the crash, injuries sustained, definitive care, and the outcome of in-hospital care were obtained from patients (and/or their carers) and the medical records. RESULTS:  A total of 156 patients were seen, out of which 74.4% were males. About 76.2% were less than 45 years with a mean age of 35.7 ± 16.3 years, and the peak age group was 18-44 years. About 37 (23.7%) patients were involved in motorcycle/motorcycle collisions, whereas 67 (42.9%) were involved in motorcycle/car collisions. Riders accounted for 59.6% (93), and although 62% (97) of the patients presented within six hours of the crash, only 10.9% (17) presented within one hour. About 48% received some form of prehospital care rendered by officials of the Federal Road Safety Corps, police officers, or passers-by, and none was attended by a dedicated emergency ambulance team. The head and the limbs were the most affected anatomical areas, while orthopedic and neurosurgical procedures were the most required emergency surgical interventions. About 66.7% were discharged home with only 21.2% of them fit to return to pre-trauma function at discharge, and the mortality rate was 17.3%. Patients who presented at 7-24 hours (AOR = 2.99; 95% CI = 1.04-8.62; p-value = 0.043) and >24 hours after the accident (AOR = 5.65; 95% CI = 1.64-19.53; p-value = 0.006) were 2.99 and 5.65 times, respectively, more likely to die from motorcycle-related accident compared to those who presented within the first six hours. CONCLUSION:  This study identified the growing burden of disabilities and mortalities related to motorcycle RTIs. It highlights the lack of prehospital trauma care, which is a reflection of the deficiency of a national, regional, or jurisdictional trauma system and the critical need to develop a functional trauma system.

Achieving treat to target in gout: a clinical practice improvement project.

OBJECTIVE: Gout care is suboptimal because of lack of translation of knowledge into real-world practice, despite evidence-based guidelines. We have developed processes to ensure systematic care for gout patients and determined the predictors for achievement of a target serum uric acid (SUA) concentration of < 360 µmol/L in a prospective cohort of Asian gout patients requiring allopurinol therapy. METHODS: A 1-year clinical practice improvement project was undertaken using evidence-based guidelines and quality planning tools. Interventions included comprehensive patient education, enhanced telephone access, reappointments and refills, upward titration of allopurinol with no limitation specified by renal function, and increased frequency of visits until the target SUA concentration was achieved. The primary outcome was the time to achieve an SUA level of <360 µmol/L. RESULTS: We recruited 126 gout patients. The median time to achieving the target SUA concentration was 36.9 weeks [95% confidence interval (CI) 29.3-44.4]. Based on survival analysis, the proportion of patients achieving the target was 8.1% (95% CI 3.2-13.0), 40.6% (95% CI 31.4-50.8), and 72.0% (95% CI 61.2-82.8) at 3, 6, and 12 months, respectively. On average, our patients who achieved the target were seen once every 2 months and achieved the target after a mean of 2.5 (SD = 1.1) visits. Frequency of follow-up visits and older patients not taking aspirin were independent predictors associated with achieving the target outcome, regardless of renal function. CONCLUSIONS: Optimization of control of SUA is achievable, even in the setting of renal impairment, by redesigning and implementing processes involving changes in physician prescribing habits, enhanced nursing interventions, and patient empowerment and education.

Recent advances in functionalization of nanotextiles: A strategy to combat harmful microorganisms and emerging pathogens in the 21st century.

The textile industry can benefit from nanotechnology as new properties are conferred on functionalized nanotextiles beyond what a fabric can traditionally offer. These properties include extermination of microorganisms by nanotextiles to curtail their growth and dissemination in the environment and in healthcare facilities. The emergence and thriving of multi-drug resistance (MDR) phenomenon among microbes are threats at achieving good health and well-being (goal 3) of sustainable development goals (SDG) of UN. In addition, MDR strains emerge at a higher rate than the frequency of discovery and production of potent antimicrobial drugs. Therefore, there is need for innovative approach to tackle MDR. Among recent innovations is functionalization of textiles with metal nanoparticles to kill microorganisms. This paper explores strategies in nanotextile production to combat emerging diseases in the 21st century. We discussed different nanotextiles with proven antimicrobial activities, and their applications as air filters, sportswear, personal wears, nose masks, health care and medical fabrics. This compendium highlights frontiers of applications of antimicrobial nanotextiles that can extend multidisciplinary research endeavours towards achieving good health and well-being. Until now, there exists no review on exploitation of nanotextiles to combat MDR pathogens as included in this report.

Use of rituximab in the treatment of refractory systemic lupus erythematosus: Singapore experience.

We performed a retrospective study of 10 patients with refractory systemic lupus erythematosus treated with rituximab to determine the efficacy, safety and impact on hospitalization days. Patients received rituximab according to a standardized protocol, all achieved B-cell depletion with clinical improvement in nine patients. At 12 months, BILAG scores improved significantly from a median of 13.5 (range 3-20) at baseline to 1 (range 0-27) (p < 0.05). There was significant reduction in urinary total protein excretion with stabilization of renal function in patients with nephritis. Two out of three patients with thrombocytopenia had normalization of platelet counts. The median duration of B-cell depletion was 6 months (range 6-18). Two patients required retreatment and responded well. There were no adverse outcomes following rituximab therapy. Patients with lupus nephritis spent a median of 17.1 days per year (range 1.9-49) in hospital on conventional treatment which was reduced to 0 days (range 0-14.8, p = 0.027) post-rituximab treatment. The cost of hospitalization was 5989 Singapore dollars per patient-year while on conventional treatment and 5792 Singapore dollars per patient-year post-rituximab. This study adds to the growing literature of rituximab efficacy with potential cost saving in lupus nephritis.

Akara Ogbomoso: microbiological examination and identification of hazards and critical control points.

Akara Ogbomoso was examined toward the establishment of hazard analysis and critical control point (HACCP). The akara was produced in residential buildings with the attendant consequence of contamination. There was ample growth of aerobes, coliforms, staphylococci, Shigella and yeast/mold from the samples, water and cowpea pastes. Microbial contaminations occur through the processing, which can be corrected through education by adopting good hygienic and manufacturing practices. The critical control points were identified as frying, storage and refrying. It may be heated in the microwave for 10 s before consumption. Akara, prepared in the laboratory through the implementation of HACCP was not contaminated. Several bacterial isolates, namely; Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Citrobacter freundii, Serratia marcescens, Proteus vulgaris, Bacillus cereus, Streptococcus pyogenes, Bacillus sp. and Shigella sp., showed multiple resistance to antibiotics ranging from two to nine. Seven strains were not resistant to the antibiotics, while five were resistant to one type of antibiotic.

Multifunctional titanium dioxide nanoparticles biofabricated via phytosynthetic route using extracts of Cola nitida: antimicrobial, dye degradation, antioxidant and anticoagulant activities.

First study of phytosynthesis of TiO2 NPs using the leaf (KL), pod (KP), seed (KS) and seed shell (KSS) extracts of kola nut tree (Cola nitida) is herein reported. The TiO2 NPs were characterized and evaluated for their antimicrobial, dye degradation, antioxidant and anticoagulant activities. The nearly spherical-shaped particles had λmax of 272.5-275.0 nm with size range of 25.00-191.41 nm. FTIR analysis displayed prominent peaks at 3446.79, 1639.49 and 1382.96 cm-1, indicating the involvement of phenolic compounds and proteins in the phytosynthesis of TiO2 NPs. Both SAED and XRD showed bioformation of crystalline anatase TiO2 NPs which inhibited multidrug-drug resistant bacteria and toxigenic fungi. The catalytic activities of the particles were profound, with degradation of malachite green by 83.48-86.28 % without exposure to UV-irradiation, scavenging of DPPH and H2O2by 51.19-60.08 %, and 78.45-99.23 % respectively. The particles as well prevented the coagulation of human blood. In addition to the antimicrobial and dye-degrading activities, we report for the first time the H2O2 scavenging and anticoagulant activities of TiO2 NPs, showing that the particles can be useful for catalytic and biomedical applications.

Photo-assisted bio-fabrication of silver nanoparticles using Annona muricata leaf extract: exploring the antioxidant, anti-diabetic, antimicrobial, and cytotoxic activities.

Green synthesis of metal nanoparticles is reputed to have a robust range of biomedical applications. Silver nanoparticles (AgNPs) bio-fabricated using aqueous leaf extract of Annona muricata were characterized and evaluated for in-vitro antioxidant, lipid peroxidation inhibition, anti-diabetic and antimicrobial activities as well as cytotoxicity in human keratinocyte cells (HaCaT). The extract induced colour change of silver salt solution which absorbed at 420 nm and confirmed the formation of AgNPs. FTIR showed that free amide and hydroxyl groups were responsible for the synthesized nanoparticles. Both XRD and SAED confirmed the crystalline nature of the particles with face centered cubic (FCC) phase. The zeta potential revealed -27.2 mV potential and average distribution size of 35 nm. DLS indicated that the majority of the particles were 86.78 nm size and with a polydispersity index (PDI) of 0.329. AgNPs displayed strong activities against DPPH (IC50 = 51.80 µg/ml), ABTS (IC50 = 30.78 µg/ml), α-amylase (IC50 = 0.90 µg/ml) and α-glucosidase (IC50 = 3.32 µg/ml). The particles exhibited a dose-dependent inhibition of Fe2+-induced lipid peroxidation with effective antimicrobial activity against a battery of bacterial strains and cytotoxicity in HaCaT cell line. These findings revealed the potential biomedical applications of the particles and further work will be required to establish its molecular mechanism of action.

Atherogenic serum lipid profile is an independent predictor for gouty flares in patients with gouty arthropathy.

OBJECTIVE: Atherogenic serum lipid profile possesses pro-inflammatory properties and is associated with more active RA. While prevalent in patients with gout, whether atherogenic lipid profile is associated with gouty flares is unknown. This study aims to investigate whether atherogenic serum lipid predicts gouty flares in patients with gout. METHODS: Adult patients (age > or =21 yrs) who suffered from gout were prospectively followed between September 2006 and November 2007 and their demographic, clinical and laboratory data were collected. Episodes of gouty flares over this observation period were recorded and factors predictive of gouty flares were studied by regression models. RESULTS: Of the 100 patients, 80 were men, 65 were ethnic Chinese, 31 were Malay and the rest were Indian and Caucasian. The mean age and duration of gout (+/-S.D.) were 61.9 +/- 14.0 and 6.6 +/- 7.8 yrs, respectively. The mean serum uric acid and creatinine levels were 537.6 +/- 142.8 and 173.6 +/- 119.9 micromol/l, respectively. In univariate analysis, longer duration of gout, higher adjusted mean serum creatinine, lower adjusted mean fasting serum, total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels were associated with gouty flares. After adjustment for potential confounders in multivariate regression models, longer duration of gout and lower adjusted mean fasting serum HDL-C level remained independently predictive of gouty flares. CONCLUSIONS: Low serum high-density lipoprotein cholesterol level was an independent predictor for gouty flares. Whether optimizing serum HDL-C level can benefit patients with gout in terms of reducing gouty flares needs to be addressed by controlled trials.

Alterations of Antioxidant Status and Mitochondrial Succinate Dehydrogenase Activity in the Liver of Wistar Strain Albino Rats Treated with by Ethanol Extracts of Annona senegalensis Pers (Annonaceae) Stem Bark.

Numerous ethnomedicinal uses have been attributed to different parts of Annona senegalensis (ASE), including its uses as food and food additives. The present study investigated toxicological and antioxidant effects of 28 days administration of ethanol extracts of ASE stem bark to Wistar strain albino rats. Acute toxicity test was done to determine lethal dose in Wistar rats while sub-acute toxicity test was conducted on rats divided into four groups (A - control, B - 50 mg/kg, C - 100 mg/kg, D - 150 mg/kg, respectively and treated for 28 days. Oxidative stress markers in liver and kidney as well as hepatic succinate dehydrogenase activity in the mitochondrial and post mitochondrial fractions (PMF) were evaluated. The LD50 value of ASE was > 2,000 mg/kg. White blood cell counts gradually increased, but red blood cell counts and haematocrits level decreased significantly (p < 0.05) by about 50%. Liver enzymes in the serum and mitochondrial succinate dehydrogenase activity increased significantly (p < 0.05). Superoxide dismutase and catalase activities also increased in liver mitochondria and PMF while malondialdehyde (MDA) and reduced glutathione levels increased only in the PMF. Furthermore, only MDA levels increased significantly in the kidney after 28 days extract administration. Histopathological examination showed hepatic necrosis and no obvious signs of nephrotoxicity. Anona senegalensis is relatively safe, but prolonged ingestion could induce oxidative stress and impair ATP synthesis through the modulation of the activity of mitochondrial succinate dehydrogenase.

Evaluation of the efficacy and safety of artemether-lumefantrine in the treatment of acute uncomplicated Plasmodium falciparum malaria in Nigerian infants and children.

BACKGROUND: The six-dose regimen of artemether-lumefantrine (AL) is now considered the gold standard for the treatment of uncomplicated Plasmodium falciparum malaria. There are few reports evaluating co-artemether in very young Nigerian infants and children. Results of the evaluation of the six-dose regimen in very young infants and children in Nigeria are presented in this report. METHODS: As part of a larger African study, this open label, non-comparative trial, assessed the efficacy and safety of six-dose regimen of AL tablets in 103 Nigerian infants and children weighing between five and 25 kg suffering from acute uncomplicated malaria. Treatment was administered under supervision over three days with children as in-patients. 12-lead ECG tracings were taken pre-treatment and at day 3. RESULTS: Ninety-three infants and children completed the study as stipulated by the protocol. Mean fever and parasite clearance times for the intent to treat population (ITT) were 24.9 h +/- (1.28) and 26 h +/- (4.14) and the corresponding figures for the per-protocol population (PP) were 19.24 h +/- 13.9 and 25.62 h +/- 11.25 respectively. Day 14 cure rates for the ITT and PP were 95.1% and 100% respectively while day 28 cure rates were 91.3% and 95.7% respectively. The overall PCR corrected day 28 cure rate was 95.1% for the ITT. The six-dose regimen of AL was well tolerated with no drug-related serious adverse events. Although six patients recorded a QTc prolongation of > 60 ms on D3 over D0 recording, no patient recorded a QTc interval > 500 ms. CONCLUSION: The six-dose regimen of AL tablets is safe and effective for the treatment of acute uncomplicated malaria in Nigerian infants and children weighing between five and 25 kg. TRIAL REGISTRATION: NCT00709969.