Search results for “Laboratory”

Prevalence of Sexually Transmitted Infections in the United Kingdom from Home-Collected Samples: A Cross-Sectional Laboratory Analysis of over 6000 Cases

Background Sexually transmitted infections (STIs) continue to rise globally, with >1 million new cases reported daily in 2020. In England, newly diagnosed STIs increased by 23.8% in 2022 compared to 2021. Many infections remain asymptomatic yet contribute to infertility, pregnancy complications, and neonatal morbidity. While routine screening often focuses on Chlamydia trachomatis, broader detection is limited by laboratory turnaround times and restricted test panels. Methods We analysed 6003 home-collected urine and/or swab samples submitted for sexual health screening in the UK. Samples were tested in the laboratory for 10 bacterial and viral pathogens. A total of 5859 urine and 1627 swab samples were processed, with paired samples assessed for diagnostic agreement. Results The most common infections detected in urine were Ureaplasma urealyticum (12.1%), Mycoplasma hominis (8.6%), and Chlamydia trachomatis (2.4%). Swabs showed similar prevalence, with Ureaplasma urealyticum (11.6%) most frequent, followed by Mycoplasma hominis (10.4%) and HSV-2 (4.4%). Paired urine–swab samples demonstrated strong agreement, though swabs improved HSV detection. Conclusions Ureaplasma urealyticum was the most prevalent STI detected, yet only Chlamydia trachomatis is routinely screened in England. Comprehensive laboratory testing of home-collected samples could reduce the hidden burden of STIs, infertility, pregnancy complications, and neonatal infections, while offering confidential and accessible diagnostics.

Two Implant Mandibular Overdentures: Clinical and Laboratory Procedures

Edentulism is considered a poor health outcome and may compromise quality of life. Implant-supported overdentures provide a good opportunity for dentists to improve the quality of life and oral health. Atrophic mandible poses a significant challenge to successful oral rehabilitation with dental implants. The aim of this case report is to demonstrate the concept of immediate functional loading in the mandible using unsplinted implants to support a locator attachment supported overdenture.

Awareness of Personal Protective Equipment Among Laboratory Workers in Tertiary Health Centre, Ibadan

Introduction Health care personnel are exposed to a variety of material occupational health hazards while handling biological material and contaminated equipment. The use of appropriate and good qualitypersonal protective equipment in work places cannot be over emphasized. Several years ago, this need was highlighted to several physicians like Sir Thomas Morrison Legye. He identified the role of the employer of labour and those of the employee in reducing workplace hazards and consequently achieving a healthy workplace environment. Objectives This study was to determine level of awareness and utilization of Personal Protective Equipment among Medical Laboratory workers. Methods A questionnaire was structured with two sections and a total of 92 were administered. A pilot study was also carried out before the administration of the questionnaire. The data collected was analyzed on Microsoft excel spreadsheet in duplicate. It was then exported into EPI info version 3.4.1. Data was presented using frequency tables and chi square. Results About 77.3%, 72.9%, and 72.7% were aware of the use of goggle, gloves, and importance of hand washing in preventing exposure to Healthcare associated infections while working on patients’ samples. However, under the socio- demographic characteristics of the respondents and awareness level at P-value < 0.5 the results were 0.02. 0.5, 0.85, 0.92 for education, gender, years in service and age respectively. Hence, there is no significant relationship between respondents’ gender, age and year in service, and level of awareness. Conclusion The hospital management should ensure regular provision and supply of Personal Protective Equipment (PPE) to ensure continual usage. Also, regular training and re-training should be conducted to keep the laboratory workers at briefs with latest innovative and benefits of PPE developments to this end.

Laboratory Tests Used in the Diagnosis of Immune Thrombocytopenia and General Treatment Approaches

Immune thrombocytopenia currently called under its’ new name, immune thrombocytopenic purpura (ITP) is a disease characterized by thrombocytopenia, in which the body attacks its own platelets due to the disorders in immune system. The pathophysiology of this disease includes increased platelet destruction and most megakaryocyte production in bone marrow. The most common clinical manifestation of ITP is mild or severe progressive bleeding that could result in death. ITP is generally named as primary or secondary ITP according to thrombocytopenia severity, disease duration, bleeding status and secondary occurrence of the disease. Currently for diagnosis, despite the blood count, antiglobulin test and laboratory tests that can detect platelet-bound antibodies, they are not enough for definitive diagnosis. Like the difficulty in diagnosis, ITP treatment is quite complicated which varies depending on age, characteristics and risk of the patient. It is classified as first, second and third-line treatment options. Also, depending on the condition of patients, combined treatment might be an option which increases the complexity of the treatment. Unfortunately, discussions related to different clinical applications in diagnosis and treatments continue recently. For this reason, we considered that preparation of a review containing recent updates in diagnostic approaches and treatment options in ITP will be remarkable and beneficial for physicians interested in this subject. 

RETRACTED: Recent New Results and Achievements of California South University (CSU) BioSpectroscopy Core Research Laboratory for COVID-19 or 2019-nCoV Treatment: Diagnosis and Treatment Methodologies of “Coronavirus”

Coronavirus nanoparticles show a strong peak of Plasmon absorption in ultraviolet–visible zone. A strong interaction exists between the surface of Coronavirus nanoparticles and Bcr–Abl tyrosine–kinase inhibitors (TKI) such as Imatinib (STI571), Nilotinib (AMN107), Dasatinib (BMS–345825), Bosutinib (SKI–606), Ponatinib (AP–24534) and Bafetinib (INNO–406). Bcr–Abl tyrosine–kinase inhibitors (TKI) such as Imatinib (STI571), Nilotinib (AMN107), Dasatinib (BMS–345825), Bosutinib (SKI–606), Ponatinib (AP–24534) and Bafetinib (INNO–406) cause to aggregation of Coronavirus nanoparticles linked to DNA/RNA and hence, lead to widening of peak Plasmon of Coronavirus nanoparticles surface at 550 (nm) and emerging a new peak at higher wavelength. In the current project, this optical characteristic of Coronavirus nanoparticles is used to time investigate of interaction between different Bcr–Abl tyrosine–kinase inhibitors (TKI) such as Imatinib (STI571), Nilotinib (AMN107), Dasatinib (BMS–345825), Bosutinib (SKI–606), Ponatinib (AP–24534) and Bafetinib (INNO–406) and Coronavirus nanoparticles. The results were shown that Bcr–Abl tyrosine–kinase inhibitors (TKI) such as Imatinib (STI571), Nilotinib (AMN107), Dasatinib (BMS–345825), Bosutinib (SKI–606), Ponatinib (AP–24534) and Bafetinib (INNO–406) with shorter chain length interact faster with Coronavirus nanoparticles. Therefore, a simple and fast method for identification of Bcr–Abl tyrosine–kinase inhibitors (TKI) such as Imatinib (STI571), Nilotinib (AMN107), Dasatinib (BMS–345825), Bosutinib (SKI–606), Ponatinib (AP–24534) and Bafetinib (INNO–406) with various chain length using red shift in surficial Plasmon absorption is presented.

Retraction for Alireza Heidari et al., Recent New Results and Achievements of California South University (CSU) BioSpectroscopy Core Research Laboratory for COVID-19 or 2019-nCoV Treatment: Diagnosis and Treatment Methodologies of “Coronavirus”

Laboratory Studies on the Host Preference of Cotton Mealybug ‘Phenacoccussolenopsis’ Tinsely (Hemiptera: Pseudococcidae) in Khartoum State, Sudan

Cotton mealybug (Phenacoccussolenopsis) is a serious devastating pest which goes on a wide array of plant families. The pest spread all over the world from cool to dry hot regions. The main objective of this study was to investigate the food preference and behavior of P. solenopsis Tinseley (Hemiptera:Pseudococcidae) towards selected host plants in Khartoum State, Sudan, where a multi-choice experiment under laboratory conditions was adopted. Eight plant species were screened for attractiveness and food preference to Cotton mealybug. Where the proportions of the 1st, 2nd and 3rd nymphal instars and the adult females were recorded at 2, 8 and 24 hours after release, and compared with Chinese rose (Rosa chinensis) the control. The result revealed that the proportions of the 1st, 2nd and 3rd nymphal instars and adult females were maximum on plants of family Malvaceae, particularly the Okra (Hibiscus esculentus) followed by Cotton (Gossypium sp.) and Hambouk (Abutilon pannosum) as compared with the control. However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleyapentandra) and Eggplant (Solanum melongenaL.). However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleya pentandra) and Eggplant (SolanummelongenaL.). In conclusion, the most favorable host plants of the Cotton mealybug belonging to the family Malvaceae, while the families of Solanaceae [Egg plant (SolanummelongenaL.)] and Aizoaceae (Raba) were found to be the least preferred host plants.  

Clinical and Laboratory Predictors of Elevated TRV In Sickle Cell Anaemia

Pulmonary hypertension (PH) has become an increasingly recognized complication in sickle cell anaemia (SCA) and is a major cause of morbidity and mortality. Though the burden of SCA in sub-Saharan Africa is high, there is paucity of data on SCA-associated PH with little or no attention given to it in routine patient care. The current study therefore sought to determine the prevalence of PH and its associated risk factors among adult patients with SCA. This was a cross-sectional study involving 76 clinically stable, hydroxyurea-naive participants. We obtained socio-demographic and clinical history. Measurement of Tricuspid Regurgitant jet Velocity (TRV) was obtained via transthoracic echocardiography and lung function was assessed using spirometry and pulse oximetry. Other investigations were complete blood counts, free plasma haemoglobin, serum urea and creatinine. Twenty-five (32.9%) of study participants had elevated TRV (≥ 2.5m/s) on Doppler echocardiography, which was suggestive of raised pulmonary artery systolic pressure. There were significant associations between elevated TRV and steady-state haemoglobin (p < 0.001), blood urea level (p = 0.030), presence of chronic leg ulcers (p = 0.043) and oxygen saturation (p < 0.001) and these may be identifiable and modifiable risk factors for selective screening with echocardiography in a resource poor setting. 

Acquired Haemophilia: A Case Report and Literature Review

Acquired haemophilia (AHA) is a rare coagulation disorder secondary to autoantibodies against coagulation factor, most commonly factor VIII with potential for life threatening bleeding episodes. We report a case of an 88-year-old female presenting with frank haematuria three weeks after catheter insertion. Her background was of Alzheimer’s Dementia, Asthma and Bullous Pemphigoid for which she was on low dose maintenance prednisolone (5mg). Laboratory tests showed haemoglobin 98g/dl and partial thromboplastin time (PTT) of 60s, with corrected prothrombin time 52s. Fibrinogen 5.39. As such coagulation factors were tested which revealed factor VIII of 0%. Her case was complicated by urinary tract sepsis, as such she was treated with oral prednisolone 60mg without immunosuppressive agent usage. A pan-CT scan revealed likely mesothelioma for which she declined further investigation. This case report will describe a rare presentation of AHA associated with bullous pemphigoid and mesothelioma, complicated by infection and frailty.

A Decision Tree Ensemble Approach to Diabetes Prediction using the Framingham Heart Dataset, Exploring the Role of AI-Associated Interventions in Reducing Diabetes-Related Adverse Outcomes Between Men and Women

Objective Diabetes poses significant public health challenges, with many individuals remaining undiagnosed and at risk of complications. This study aimed to evaluate the performance of decision tree ensemble methods for predicting diabetes onset using the Framingham Heart Study Teaching Dataset and to explore sex-specific risk patterns relevant to AI-driven interventions. Methods We analyzed data from 11,627 participants, incorporating demographics, vital signs, smoking status, medication use, and laboratory measures. Random Forest classifiers were developed to predict diabetes incidence at approximately 6-year (Period 2) and 12-year (Period 3) follow-ups. Class imbalance was addressed using undersampling, oversampling, and the Synthetic Minority Over-sampling Technique (SMOTE). Results The models demonstrated robust performance, achieving an Area Under the Curve (AUC) of 0.856 in Period 2, and moderate predictive ability in Period 3 (AUC = 0.732 in males, 0.786 in females). Key predictors included glucose level, BMI, systolic blood pressure, age, and heart rate. Notably, differences emerged in predictive accuracy between men and women, suggesting potential sex-specific vulnerabilities that merit further study. Conclusion Machine learning approaches, particularly Random Forests, show promise for medium- and long-term diabetes risk prediction, supporting early identification and intervention efforts. Future work should focus on hyperparameter tuning and explainability techniques, such as SHapley Additive exPlanations (SHAP) values, to improve model precision, interpretability, and fairness. Equity-focused strategies remain critical to ensure AI-driven tools benefit diverse populations and do not exacerbate existing disparities in diabetes care.

Potential use of Ginger (Zinger officinale Rose) Extracts as Biopesticide against Myzuspersicae Sulzer (Hemiptera, Aphididae) on Pepper Crops

Chemical insecticides have been the primary method used by farmers to control pests. However, their negative environmental impacts, harmful effects on beneficial insects and human health, and prohibition in organic farming systems have driven the search for natural alternatives with insecticidal properties. These alternatives provide a safer and more sustainable way to control insect pests. Medicinal plants and their constituents play an important role in pest management. For example, ginger (Zingiber officinale) extracts contain bioactive compounds with insecticidal activities. The objective of this work was to track the population of the green peach aphid (Myzuspersicae) on pepper crops in a greenhouse, identify the active ingredients in ginger extracts, and evaluate the insecticidal effects of three concentrations of ginger-derived aqueous and essential oil extracts against M. persicae on pepper plants under laboratory and greenhouse conditions. The results demonstrate that M. persicae grows rapidly on pepper crops under greenhouse conditions, reaching high densities on leaves. The ginger extract contains two active ingredients with insecticidal effects against this pest. The significant reduction in aphid (M. persicae) populations indicates that Z. officinale aqueous extract (150 mL/L) and essential oil (2 mL/L) have strong potential for the biological control of this pest under greenhouse conditions. Thus, the use of ginger plant extract emerges as a promising alternative for reducing M. persicae infestations on pepper plants.  

Water Quality Analysis on Public and Household Water Sources – A Case Study of Sunyani-West District, Fiapre

Access to potable and quality water in most rural communities is low such that over 2.2 billion people worldwide are negatively affected. The increasing population in Fiapre and the inconsistent water supply by the Ghana Water Company Limited (GWCL) have forced most residents to resort to alternative groundwater sources such as boreholes, wells, etc. Yet, many residents use these sources of water unaware of the quality of the water and its potential health implications. This study assessed drinking water quality in Fiapre by calculating its Weight Average Water Quality Index (WAWQI) and investigating potential risk factors associated with contamination through a cross-sectional study and laboratory analysis of various physicochemical and microbiological water quality parameters. WAWQI was used to compute parameters using 10 factors including pH, electrical conductivity, temperature, TDS, phosphate, chloride, total hardness, nitrate, alkalinity, and faecal coliform. The findings revealed that the pH level of water, phosphate concentration, and fecal coliform count surpassed the recommended thresholds set by the World Health Organization (WHO) for safe drinking water. Although levels of electrical conductivity, TDS, nitrate, total hardness, and chlorine kept changing from one water source to another, the difference was not significant apart from phosphate and fecal coliform which shows a significant difference between the sachet water sources and other water sources (P<0.05). The study outcomes demonstrated that the overall water quality is predominantly categorized as good to fairly good, with the highest Water Quality Index (WQI) value reaching 87.84% and the lowest recorded at 54.81%. Therefore, to improve the water quality in the municipality, local management agencies should pay attention to the microbiological quality of the water sources. The study recommends regular handwashing practices, hygienic surroundings of the water source, and drinking water treatment to reduce the possible risk factors associated with the contamination of the water sources.

Pancreatic cancer in a Non-Tertiary Center: CEA and Bilirubin More Predictive than CA 19-9 at Initial Presentation

Background This study was undertaken to delineate the most predictive pattern at presentation for patients with non-metastatic pancreatic cancer compared to patients with metastatic pancreatic cancer who present to a medium sized hospital. Methods Data were collected at a medium sized hospital from 2009-2014 for patients with newly diagnosed pancreatic adenocarcinoma. Laboratory values, CT scans, pathology reports and ERCP results were obtained. Data are presented as mean (median +/- standard deviation). Results Fifty-two patients met the criteria for inclusion and were clinically diagnosed with pancreatic cancer. The median age was 71 years old. CEA levels for metastatic pancreatic cancer were 107.9 (20.6 +/- 166.7) ng/dl and 9 (6 +/- 11.6) ng/dl for non-metastatic cancer (P-value<0.05). Bilirubin levels for metastatic pancreatic cancer were 4.1 (0.7 +/- 6.6) mg/dl and 10.3 (10.4 +/- 8.1) mg/dl for non-metastatic cancer (p=0.009). CA19-9 levels for metastatic pancreatic cancer were 37,529 (644 +/- 88,352) U/ml and 5,150 (668 +/- 16,985) U/ml for non-metastatic cancer. Conclusion Elevated total bilirubin alongside low CEA appears to be a stronger predictor of non-metastatic disease at presentation compared to CA 19-9 alone.

Impact of Agricultural Land Use Practices on Water Quality in Lubigi Wetland

Wetland encroachment due to agricultural land use practices (LUPs) adversely affects water quality in wetlands mainly through agricultural runoff. This study was conducted in Lubigi wetland in Uganda to (1) determine the effect of the agricultural LUPs on water quality and (2) understand the relationships between different water quality indicators and different agricultural LUPs existing in the wetland. The eight LUPs included in this study were perennial crops i.e. banana farming and sugarcane farming, annual crops i.e. maize farming and tomato farming, livestock farming which included a mixture of cows, goats, and sheep, undisturbed dense natural vegetation, reference wetland and the river. Water samples collected from the different LUPs were analyzed in the laboratory for selected physicochemical and biological water quality parameters. The water samples were analyzed for a variety of properties, including pH, electrical conductivity, total hardness, Ca-hardness, Mg- hardness, and concentrations of dissolved oxygen, calcium, magnesium, fluoride, total nitrogen, nitrates, ammonium, phosphates, potassium, total coliform, and Escherichia coli (E. coli), chemical oxygen demand, biological oxygen demand, total organic carbon, total dissolved solids, chlorides, sulphates, total phosphorus, and turbidity levels. The results suggested that the different LUPs influenced several water quality parameters. Dissolved oxygen was lowest in banana fields and the river at 2.57 mg/L and 3.44 mg/L respectively than other LUPs which limits survival of aquatic organisms. Biological oxygen demand, chemical oxygen demand and total organic carbon were high in the river water with values = 69.67 mg/L, 351.67 mg/L, 117.33 mg/L respectively indicating high organic pollution. We detected nutrient pollution in water from tomato and sugarcane fields which showed high concentrations of nitrates. The concentration of ammonium in river water (10.40 mg/L) was high, indicating nitrogen contamination. In all LUPs, Escherichia coli and total coliforms had high counts exceeding 2000 CFU/100mL which indicated elevated microbial pollution from livestock waste and agricultural runoff. Cluster analysis revealed distinct clusters influenced by varying water quality parameters. These findings show that agricultural LUPs in Lubigi wetland are significantly contributing to water pollution through microbial contamination, nutrient, and organic matter accumulation, which increases the potential for eutrophication and renders the water unsafe for drinking and domestic use. Implementing best management practices (BMPs) is essential for the sustainable use and management of the wetland.

Malaria: A Driving Force to the Emergence and the Global Spread of Antibiotics Resistance

Malaria and bacteraemia are significant public health concerns and economic threats. In Africa, the intensity for simultaneous transmission and co-infection of Plasmodium spp and other bacteria pathogens are extremely high. It is believed that malaria suppress the immune system and enable the translocation of bacteria in the gastrointestinal tract to other cellular compartments in the body. Some of the factors that contributed to the co-emergence of these pathogens are poor access to clean water, sanitation and hygiene (WASH), poor infection control measures, inefficient health care systems. In addition, the similarities in the clinical signs and symptoms of these febrile diseases and the fact that the etiologic diagnostic testing can be complex, costly, and limited are the reasons why clinicians in resource-constrained setting often prescribe antibiotics empirically prior to or without laboratory testing to prevent severe outcomes in any patient hospitalized with malaria. However, this indiscriminate use of antibiotics has been identified as the driving force for antibiotic resistance, which is already at alarming rate in malaria endemic nations. In developed countries where malaria had been previously eradicated, there are increasing reports of imported malaria with concurrent bacteraemia. In this review, we emphasized the role of malaria in the indiscriminate use of antibiotics and the fact that eliminating malaria in Africa is one of the best strategies to address the emergence and the global spread of multi-drug resistance organisms.

COVID-19-Induced Changes in the Fibrin Network of Pulmonary and Renal Microthrombi

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection often causes coagulation disorders that affect highly vascularized organs, such as the lungs and kidneys. Objective The objective of this study was to report the histopathological findings of variations in the fibrin pattern of pulmonary and renal microthrombi in patients who died from SARS-CoV-2 infection. Methods Minimally invasive autopsies were performed on 40 patients to collect lung (n=40) and kidney (n=16) tissue samples. Histochemical and immunohistochemical staining techniques were used for histopathological analyses. Premortem laboratory data were obtained from the patients' electronic medical records. Results The lung tissue showed a patchy pattern, characterized by areas of both minimal and severe damage. The most significant histopathological finding was the detection of thrombi with fibrin structures organized into discrete star-shaped units, which were more frequently observed in areas with severe lung injury than in those with minimal lung injury (p = 0.012). Star-shaped fibrin structures were also observed in the renal glomerular capillaries. Immunohistochemical staining revealed the presence of platelets and the procoagulant proteins von Willebrand factor (VWF) and Factor VIII within the star-shaped fibrin thrombi. Patients with star-shaped fibrin thrombi had higher levels of the systemic inflammatory indicators C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Conclusion Our observations suggest that the inflammatory microenvironment resulting from SARS-CoV-2 infection may contribute to the formation of star-shaped fibrin units in the pulmonary and renal microthrombi.

Peripheral Third Cranial Nerve Palsy in A Patient With Pediatric Form of Multiple Sclerosis

Multiple Sclerosis has traditionally been considered an inflammatory and autoimmune disease of the central nervous system. However, peripheral cranial nerve involvement has been described previously in eight cases, raising the hypothesis of a disease spectrum between central and peripheral nervous system. We hereby present a case of a 12 years old girl diagnosed with Multiple Sclerosis who presents with complete unilateral third cranial nerve palsy. Complete clinical, laboratory and radiological work-up was consistent with demyelinating disease. We conclude that demyelination in Multiple Sclerosis can affect in some cases both the central and peripheral nervous system.

Evaluating the Effectiveness of Quality Improvement Strategies in Mid-Level Private Healthcare Facilities of Lagos State: A Donabedian Model-Based Approach

Background This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes. Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities. Methods A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 - 12-month quality improvement intervention. Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders. The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions. Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements. Renovations and heightened registration compliance further underscored commitment to regulatory standards. Challenges in service availability, particularly in family planning and laboratory services, were identified. Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas. Implications These findings highlight the success of QI interventions in transforming healthcare processes and structural components. Despite notable progress, persistent challenges in specific services call for targeted interventions. The substantial increase in patient satisfaction and overall QI scores underscores the transformative potential of sustained efforts and tailored interventions in mid-level private healthcare facilities in Lagos State. Conclusions This research comprehensively evaluates the effectiveness of quality improvement strategies implemented in mid-level private healthcare facilities in Lagos State, Nigeria, utilizing the Donabedian Model as a guiding framework. The findings provide valuable insights for policy recommendations, with the aim of aligning healthcare services with the Donabedian model to ensure the provision of high-quality care in mid-level private healthcare facilities in Lagos State. This study contributes to the ongoing efforts to improve healthcare quality in Lagos State. Contribution to Knowledge The research provides empirical insights into the effectiveness of quality improvement strategies in mid-level private healthcare facilities, particularly within the context of Lagos State, Nigeria. It highlights the significance of addressing structural components, optimizing healthcare processes, and monitoring healthcare outcomes to enhance the quality of care provided, aligning with the Donabedian model. These findings offer a valuable basis for policy recommendations and further research efforts aimed at improving healthcare quality in similar settings.

Duffy Red Cell Antigen Phenotype among Indigenous Pregnant Women attending Antenatal Clinic at Federal Teaching Hospital Gombe, Gombe State, North Eastern Nigeria

Background and Objectives Duffy (FY) blood group system is implicated in transfusion incompatibilities and haemolytic disease of the foetus and newborn (HDFN). The primary objective was to determine the Duffy phenotype among indigenous pregnant women in Gombe, Gombe State, Nigeria. Materials and Methods This was a Cross sectional study where simple random sampling was employed on consented participants. Two hundred and fifty nine pregnant women attending antenatal clinic at Federal Teaching Hospital Gombe were randomly recruited into the study. About 3mls of blood was taken, and Duffy antigen typed by standard tube technique (LORNE LABORATORY UK). Results Among the Indigenous tribe, the percentage of Fy(a+b+) was seen in 2.2% of Fulani and 3.4% of Tangale, Fy(a+b-) phenotype was seen in 4.3% of Tangale, 6.8% of Fulani,9.5% of Tera, 10.3% of Hausa and 10.5% of Waja. Fy(a-b+) phenotype was seen in 5.3% of Waja, 7.6% of Fulani,8.7% of Tangale, 9.5% of Tera and 12.5% of Bolawa. Fy(a-b-) phenotype was seen in 2.4% of Tula,6.4% of Bolawa,7.3% of Waja, 7.8% of Tera, 17.8% of Tangale, 11.8% of Hausa and 46.5% of Fulani. About 84.6% of the study population had the null Duffy phenotype. Conclusion The research showed the phenotypic distribution of Duffy blood group among the study participants with relatively high percentage of null Duffy phenotype hence possible risk of alloimmunisation.

A Study of Methods of Sample Collection and Identification in Uroscopy

Uroscopy is the first documented laboratory test in medicine and is a fundamental diagnostic tool in the Unani system of medicine. Proper sample collection, handling, and identification are important to insure valid results in uroscopy.There are certain do’s and don’ts about the sampling mentioned in the text of the Unani medicine that should be followed. Generally, a urine sample is collected by the patient himself or herself, hence they must be educated to avoid contamination to ensure the purity of the sample. Despite this, there is a chance for error or malpractice hence collected samples should be identified for sufficiency and originality. There is a certain factor that can cause an erroneous result that must be avoided. Unani scholars have mentioned that sometimes patients brought other similar fluids or animal urine to test the competence of the physician or to mislead the diagnosis. To deal with such a situation differentiation of urine with other liquors should be made. The method of sample collection and identification for uroscopy are systematically summarized in this paper.

Camel Brucellosis in Ethiopia: Seroprevalence and Associated Risk Factor

Camels are a significant source of income for nomadic populations in many developing countries, including Ethiopia. Camels are well adapted to dry and semi-dry regions, providing income, food security, and transportation. However, camel production and productivity are constrained by infectious diseases, such as brucellosis, which is a highly infectious bacterial disease that affects camels and humans worldwide. Brucellosis causes significant economic losses due to abortion, low herd fertility, and decreased milk production. In Ethiopia, the prevalence of camel brucellosis varies depending on factors related to the host, agent, climate, and management system, with a reported prevalence ranging from 0.5% to 11.9%. Accurate diagnosis of camel Brucellosis is essential for herd-based screening of animals. Although culturing the pathogen is the preferred method for diagnosis, serological tests such as Rose-Bengal plate test (RBPT), Enzyme-linked immunosorbent assay (ELISA), and Complement fixation test (CFT) and polymerase chain reaction (PCR) assays have been developed. Implementing effective diagnosis and surveillance systems to control the spread of brucellosis in animals and humans is very important, on top of awareness campaigns, vaccination programs, and suitable laboratory establishment recommended. Continued research is essential to maintain the health and productivity of camel populations, particularly in pastoral areas where camels play a significant role in the livelihood of communities. Therefore, the present paper views the seropositive prevalence and potential risk factors associated with camel brucellosis in Ethiopia.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.

Prevalence of Typhoid and Paratyphoid fever in a tertiary care hospital of Kathmandu valley

Typhoid or enteric fever is caused by Salmonella serotype typhi and paratyphi. It is one of the major public health problem in developing countries including Nepal. In recent years, increased urbanization and growing population within Kathmandu valley, attributed mainly to improper sanitary condition and fecal contamination of drinking water. These all factors contributes to a very high prevalence of typhoid fever through out the country. Methods This study was laboratory based study carried out six month period from march 2017 to August 2017 at microbiology lab in Nepal Medical college. Results and conclusion In the present study, the prevalence of enteric fever is mainly caused by Salmonella. Typhi than Salmonella Paratyphi A was observed.

Effect of Bio-Controlling Methods (Proplis and Bacteria) on the 3rd_larval Instar of Galleria mellonella (Lepidoptera: Pyralidae)

The greater wax moth (Galleria mellonella L.) is one of the most destructive insect pests that threaten apiculture. Laboratory experiments were conducted in the Research Laboratory, College of Agricultural Studies, Sudan University of Science and Technology during the period from the 2nd_ of April to 29th_ of October 2021 to evaluate the lethal effect of Bee glue (proplis) and Bacillus thuringiensis var. Kurstaki (Btk) on the G.mellonella. Five concentrations (5%, 7.5%, 10%, 12.5% and 15%) of proplis extract and (0.62,1.25,2.5,5 and 10 mg/ml) of Bt were used for each proplis extract and Bt in a Completely Randomized Design. Powder ethanol extract of proplis at 15% concentration caused 83.3% mortality after 96 hrs of application, where as 10mg//ml concentration of Bt gave 93.3% mortality after 72 hrs of exposure. The statistical analysis revealed significant differences between all treatments and control. Additionally, all treatments (proplis/ /Bt) increased the mortality %.  

Epidemiological Profile of Intestinal Protozoan Infection in Dakar, Senegal: Results from Hospital-Based Survey

Background  Intestinal parasitic infections, especially intestinal protozoan parasites remain significant public health problem in Senegal. Several studies have demonstrated the endemicity of the diseases. The study was carried out with the objective of assessing the epidemiolocal profile of intestinal protozoan infection diagnosed among patients attending to Fann University Hospital in Dakar, Senegal. Materials and Method A retrospective study was conducted from 2016 to 2020. Samples were collected from patients attending to the laboratory for parasitological confirmation. Fresh stool samples were observed using direct examination, formal-ether concentration method and modified Zeilh Nielsen staining method. Descriptive analysis was performed using Stata MP 16 software. The significance level was set at 5%. Results Among 3825 patients selected in the study, 1009 were found with at least one intestinal protozoan parasite representing an overall prevalence of 26.4% (CI 95% (24.7– 28)). Mono-parasitic and di-parasitic infection represent 81.6% and 18.2% respectively while polyparasitism was observed in 26 patients representing 2,6%. Among positive samples, 16 (8.7%) were associated with helminths. Blastocystis sp. (40.8%), Entamoeba Coli (38.2%), Endolimax nana (8.2%) and Giardia intestinalis (8.1%) were mainly observed. Trophozoites Entamoeba histolytica was observed with 2.3%. Frequency of intestinal protozoa was higher in the 15 – 30 age group (28.3%) and in male group (26.9%). The parasite carriage was most important during the wet season comparing the dry season (p = 0.65). Asymptomatic patients (29.5%) were more infected than symptomatic patients (23.5%) (p <10-3). The main clinical symptoms were diarrhea, abdominal pain, dysenteric syndrome, fever, dyspeptic disorders, and vomiting. Conclusion These results showed that intestinal protozoan infections remain prevalent in Senegal with a high proportion of asymptomatic who constitute an important reservoir of parasites. Effective control strategies such as water supply, hands washing, and mass deworming campaign could reduce the prevalence of these diseases.

Efficacy of Carumcarvi L. (Caraway), Eculaptuscamaldulensisdehnh (Red Gum) Andnigella Sativa (Black Seed) Against Greater Wax Mothgalleria Mellonellal.Innaeus (Lepidoptera:Pyralidae)

The greater wax moth considered one of the most worldwide-spread pests of the bee wax. This Study was designed to investigate the insecticidal activity of Carumcarvi, Eculaptus camaldulensis and Nigella sativa against 3rd larval instar of G.mellonellathrough laboratory screening. Five concentrations (5%, 7.5%, 10%, 12.5% and 15%) of each plant extract were used in this experiment. Mortality (%) was recorded after 24, 48, 72 and 96 hrs post treatment. The results showed C. carvi, E. camaldulensis and N.sativahave insecticidal activity against 3rd_ instar larvae of G. mellonella. The highest concentration (15%) caused 90% ,86.7% and 80% larval mortality after 96 hrs for C. carvi,E. camaldulensis and N.sativarespectively. The statistical analysis revealed that there is a significant difference (p< .001) between all treatments and control. The results also clearly demonstrate that the C. carvi are significantly more toxic than E. camaldulensis and N. sativa, whereas the LC50 values were 5.4% forC. carvi,6.0% for E. camaldulensis and 6.2% for N. sativa.

Serum Ferritin Level as a Prognostic Marker of 30 days In Hospital Mortality of Coronavirus Disease 2019 (COVID 19) Pneumonia at World Citi Medical Center: A Retrospective, Observational Cohort, Single Center Study

Introduction The COVID-19 pandemic continues to affect a large swath of the global population. The Philippine records four hundred seventy-four thousand sixty-four (474, 064) confirmed COVID 19 cases since December 31 2020. The COVID 19 pandemic recently highlighted the role of systemic hyperferritenemia as a major cause of death. In this study, we were able to correlate the serum ferritin level and predict 30 day in hospital mortality in COVID 19 pneumonia. Objective The aim of the study is to investigate the correlation between serum ferritin level and disease mortality in COVID19 pneumonia with subset analysis on demographics and co-morbidities of patients with COVID 19 pneumonia. Methodology We reviewed the records of all laboratory confirmed COVID 19 patients from World Citi Medical Center from April 2020 up to April 2021.A statistically significant sample size of seventy nine (79) admitted patients were used in this study. A serum ferritin level was assayed using electrochemilumenescence immunoassay with a Roche COBAS analyzer. Results Result showed that high ferritin level is associated with in hospital mortality. With ferritin level of 1437.07ng/ml, poor clinical outcome and in hospital mortality was considered. We also observed that demographics and co morbidities of patients in this study were significant to predict in hospital mortality. Further sub-analysis of co morbidities such as Hypertensive cardiovascular disease, Type 2 Diabetes Mellitus, Chronic kidney disease, Liver disease, Chronic obstructive pulmonary disease and Cerebrovascular disease showed poor outcome which were directly related to ferritin levels with p value of <0.0001. Conclusion This study has demonstrated that elevated ferritin levels were shown to correlate with 30 day in hospital mortality as well as medical comorbidities such as Hypertensive Cardiovascular disease, Type 2 Diabetes Mellitus, and chronic kidney disease have shown significant evidence for in hospital mortality.

Significance of Radiological Findings in Patients with Respiratory and Abdominal Manifestations of Covid-19

The autopsy findings of patients died from Covid -19 showed that pulmonary and multiorgan small vessels thromboembolism is an essential features of the disease. Small vessels thromboembolism is frequently not detected by means of laboratory and radiological investigations. The current perspective reviewed the different radiological findings in patients with covid -19 suffering from respiratory and/or abdominal symptoms and also reviewed the recent studies which used the contrast enhanced ultrasound in the diagnosis of patients with pulmonary and multiorgan small vessels thrombosis.

The Biology of Fall Army Worm (Spodopterafrugiperda. J. E. Smith) in Sudan

The Fall armyworm (Spodoptera frugiperda) is considered among the economic important pests in Sudan. Therefore, it became necessary to study and understand its biology and find out the appropriate control measure (s). To achieve the above objective, experiments based on Randomized Complete Block Design (RCBD) were carried out during the period from September 2018 to August 2019, where the Fall armyworm (FAW) was reared in the laboratory and fed on a nutrient médium composed of Corn leaves. The results displayed the ranges of eggs laid by a female was 890–1169. The egg incubation period ranged between 3-13 days. The larval duration ranged between (13-50) days and the pupal duration was between (7-20) days under a temperature of 21-300c and a Relative Humidity (RH) of 65 ± 5%. The longevity of the adults was 1-20 days, and the range of the full lifecycle was (24-100). However, six generations of FAW were obtained within one year. This study concludes that in Sudan FAW breeds continously throughtout the year and it recommends further studies on the biology and effective management of this invasive pest

The Pathologist's Story and the Colors

This essay reflects on the craft of diagnostic pathology, using color and pattern as a narrative lens. Through case vignettes, it illustrates how morphology, staining, and visual reasoning translate into clinical answers. The perspective emphasizes communication, uncertainty management, and the human dimension of laboratory work.

The Efficacy of Some Plants Extracts on Fallarmyworm (Spodopterafrugiperda, J.E. Smizh) in Sudan

The Fall armyworm worm (FAW) (Spodopterafrugiperda) is one of the important economic pests which goes on several field crops and causes serious damage. The aim of this study was to look for efficient, less cost and environmentally friend plant extract for controlling Fall armyworm worm in cereal crops. A Complete Randomized Block Design (CRBD) experiments with three replications were conducted in the laboratory to investigate the insecticidal effects of four plant extracts consisting of ethanolic extract of Neem (Azadirachta indica) seeds, Black pepper (Piper nigrum) seeds, Usher (Calotropis procera ) leaves and water extracts of Argel (Solenostemma argel) leaves on larvae of the Fall armyworm (FAW) (Spodoptera frugiperda). Newly emerged larvae of FAW were treated topically by 4 concentrations (10, 25, 50 and 75%) of each extract, and then the larval mortalities were calculated after 24, 48 and72 hrs. The results showed the highest concentrations (75%) of the three ethanolic extracts gave higher mortality percentages (100%) after 72 hrs of exposure, compared with other concentrations. Also, these were not significantly different from the recommended dose of the standard pesticide “Spinosad”. On the other hand, Argel water extract showed no effect on the (FAW) larvae. It is recommended that this experiment to be replicated under different environments.

Antimicrobial Resistance: A Situational Analysis in the Deido Health District, Douala, Cameroon

Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.  

Insecticidal Activity of Cyperus rotundus L. and Datura stramonium L. Co-Administered with Sesame Oil Against African Bollworm Helicoverpa armigera Hübner (Lepidoptera: Noctuidae)

African bollwormis a worldwide-spread species that shows a high degree of polyphagia and it is considered as one of the main agricultural pests in the world. Laboratory experiments were conducted in the Research Laboratory, College of Agricultural Studies, Sudan University of Science and Technology to evaluate the lethal effect of C. rotundusand D. stramonium on the H. armigeraand to investigate the synergistic effect of sesame oil and tested extracts by dipping methods. Five concentrations (4%, 6%, 8%, 10% and 12%) were used for each plant extract in a Completely Randomized Design. Tubers ethanolic extract of C. rotundus at 12% concentration caused 90% mortality after 72 hrs of application, whereas 12% concentration of seeds ethanolic extract of D. stramonium generate only 70% mortality after 72 hrs of exposure. When sesame oil was added to each concentration of ethanolic extract of C. rotundus and D. stramonium it exhibited a synergistic effect. In fact, the 10% concentration scored 53.3% and 76.7% mortality, however, when mixed with sesame oil the mortality increased significantly to 83.3% and 100% for D. stramonium and C. rotundus respectively after 72 hrs of exposure. This  study clearly demonstrates that both tested plants have a lethal effect on the larvae of the African bollworm. However, tubers ethanolic extract of C. rotundus seems to be significantly more toxic than the seeds ethanolic extract of D. stramonium. This study also revealed that sesame oil has a synergistic effect when added to these plant extracts.  

Efficacy of Ricinus communis L., Cassia occidentalis L. and Bacillus thuringiensis against Helicoverpa armigera Hübner (Lepidoptera: Noctuidae)

Helicoverpaarmigera is one of the most destructive pests of field crops worldwide. The Study was designed to investigate through laboratory screening the insecticidal activity of Ricinus communis, Cassia occidentalis and Bacillus thuringiensis var. Kurstaki (Btk) and their combinations against 2nd larval instar of H. armigera. Five concentrations (4%, 6%, 8%, 10% and 12%) of each plant extract and (0.62, 1.25, 2.5, 5, and 10 mg/ml) of Bt were used in this experiment. Mortality (%) was recorded after 24,48,72 and 96 hrs post treatment. The results showed that R. communis, C. occidentalis and Btkhave insecticidal activity against 2nd instar larvae of H. armigera. The highest concentration (12%) caused 80% and 70% larval mortality after 96 hrs for R. communis and C. occidental respectively. The statistical analysis revealed that there is a significant differences between all treatments and control. Additionally, all combinations (plant/plant or plant/Bt) increased the mortality %. The results also clearly demonstrate that the R. communis are significantly more toxic than C. occidental where the LC50 values were 6.4 % for R. communis and 8.1% for C. occidental. On the other hand LC50 value for Bt was 0.41 mg/ml. The binary mixture of R. communis and C. occidental have a potentiation effect after 48 hrs. Regarding the mixture of Bt and plant extracts the results revealed that R. communis and Bt mixture induced a potentiation effect whereas C. occidental and Bt mixture induced a an additive effects.  

Use of the Remaining Sample from the Panbio COVID-19 Antigen Rapid Test Device for the Molecular Screening of the SARS-CoV-2 Variant of Concern B.1.1.7

Objective Real-time surveillance of SARS-CoV-2 variants of concern (VOC) is of essential public health importance. Rapid Antigen Detection Tests (RAgDT) have become first-line COVID-19 diagnostic methods in many regions, but this strategy can hamper the surveillance of the virus variants due to their decentralized performance. The aim of this study was to assess the usefulness of the remaining sample of a widely used RAgDT (Panbio) for the surveillance of the B.1.1.7 VOC using molecular methods. Methods Symptomatic individuals and asymptomatic close contacts of confirmed cases were routinely screened for SARS-CoV-2 infection using the RAgDT in Primary Health Care Centers. After performing the test, the extraction tubes containing the remaining biological material of RAgDT-positive cases were sent to the clinical microbiology laboratory where RT-PCRs detecting key mutations of the VOC were conducted. Results A valid result was obtained in 1770/1812 (97.7%) RAgDT-positive cases. Variant B.1.1.7 was detected in 34.7% of the patients, increasing from 0% to 87.7% between the weeks beginning January 4 and March 15, 2021. Conclusion The sample remaining after performing the Panbio RAgDT allowed to monitor the emergence and circulation of the B.1.1.7, greatly improving the population screened for the molecular study of SARS-CoV-2 variants.  

Community Health Needs Assessment in Urban Communities in Kigali City In Rwanda: A Cluster-Randomized Trial

Introduction Reporting of suspected or confirmed communicable diseases is paramount. Although physicians have primary responsibility for reporting, school nurses, laboratory directors, infection control practitioners, daycare center directors, health care facilities, state institutions and any other individuals providing health care services are also required to report communicable disease. Therefore, community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the national health regulations and other communicable diseases of public health importance, including emerging or re-emerging infections. Purpose of the Study Todescribe relevant medical needs of townspeople so that treatment plans can be developed accordingly. Methods The Study was a cross-sectional with qualitative approach. In-depth interviews and focus group interviews was used as research technique. Data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically. Results Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only. Conclusion The patient waiting time, dental services in health centers, and the way of dissemination new health information, mutual health insurance and insufficient human resources are the major concerns of townspeople that they wish improvement.

Development and Testing of Long-Lasting IRS Products While Revising the WHO Test Protocol

The paper describes the development of a long-lasting product for Intra-domicile residual spray (IRS) and shows it is possible to obtain a residual effect of nearly 2 years. However, to obtain that the methods currently recommended by WHO for laboratory evaluation had to be modified and approached methods closer to the semi-field and field evaluations as applied in later phases of WHO procedures. Surfaces with high pH resulted in short residual effect unless the formulations were mixed with a silicone coating. Screening in huts constructed for the purpose was realised by dividing the wall surfaces in 25 test plots of 0.5 m² where formulations were applied randomly with more repeats the closer to the final formulation. Mud and concrete surface were more challenging than wood surface and stones and these could be dropped for screening. Wall surfaces heated by sun were repellent to non-blood fed mosquitoes, and the test in huts were limited to the mornings. However, blood fed mosquitoes were not repelled. Cone tests on mud-walls are complicated by the uneven structure of the surface and a better way of attaching cones to avoid mortality errors was developed. Formulations that can be applied and last for two mosquito seasons produce big cost savings for IRS programs, since program costs are mostly application costs.

Assessment of Physical, Thermal and Spectral Properties of Consciousness Energy Treated Cholecalciferol

Cholecalciferol (vitamin D3) is used nowadays in nutraceuticals regarding the prevention and treatment of vitamin D deficiency and associated diseases. This study was done to analyse the effect of the Trivedi Effect® - Energy of Consciousness Treatment on the physicochemical, thermal, and spectral properties of cholecalciferol using PSA, PXRD, DSC, TGA/DTG, FT-IR, and UV-Vis analysis. For this study, the cholecalciferol sample was divided into control/ untreated and Biofield Energy Treated vitamin D3. The treated vitamin D3 sample received Biofield Energy Treatment (the Trivedi Effect®) remotely for ~3 minutes by Mr. Mahendra Kumar Trivedi, who was located in the USA, while the test samples were located in the research laboratory in India. The treated sample was designated as the Biofield Energy Treated sample. The PSA analysis showed that the particle size values at d10, d50, d90, and D(4, 3) of the treated sample were significantly decreased by 5.80%, 16.49%, 17.52%, and 16.23%, respectively compared to the control sample. However, the specific surface area of the treated cholecalciferol was significantly increased by 7.26% compared to the control sample. Besides, the PXRD analysis revealed that the relative intensities regarding the characteristic diffraction peaks in the treated sample were significantly altered from -42.56% to 22.42%, along with -41.69% to 72.71% alterations in the crystallite sizes, compared with the control sample. Also, the treated sample showed 2.80% decrease in the average crystallite size. The DSC analysis showed a slight increase (0.24%) in the melting point of the treated sample along with 3.68% increase in the latent heat of fusion (ΔH) compared to the control sample. Also, the decomposition temperature of the treated sample was decreased by 0.29%, whereas the ΔH was increased by 5.79%, compared to the control sample. Moreover, the TGA/DTG analysis revealed the significant decrease in weight loss in the 1st and 3rd step of degradation of the treated sample by 18.58% and 89.81%, respectively, along with 1.83% increase in the maximum thermal degradation temperature compared with the control sample. Overall, the thermal stability of the treated cholecalciferol sample was observed to be increased in comparison to the control sample. Thus, the Trivedi Effect® might be used to produce a different polymorph of cholecalciferol, which possesses the improved qualities in terms of appearance, dissolution, absorption, bioavailability, and thermal stability as compared with the untreated sample. Thus, the Biofield Energy Treated cholecalciferol might be used in designing of better nutraceutical and pharmaceutical formulations possessing improved therapeutic response regarding the treatment of vitamin D deficiency associated diseases.

Culture of Cyclops for Use the First Intermediate Host in Experimental life Cycle of SpirometraSpecies

Background In natural conditions Cyclops are the first intermediate hosts in the life cycle of Spirometra species. In this paper we describe simple method of culturing Copepod of the genus Cyclops for use the first intermediate host in experimental life cycle of Spirometra species. Methods Paramecium was first cultured to be used as food for Cyclops. Sample of water was collected from a pond within Sokoine University. About 100 ml of water and pre-boiled wheat grains were transferred in a Petri dish and kept under laboratory conditions for 7 days, a swarm of Paramecium was formed. An adult female egg sacked Cyclops from a natural water pond in Tarangire National Park, Tanzania was added in a new Petri dish containing tap water, 0.3 ml of Paramecium suspension and 4 pre-boiled wheat grains. The mixture was kept under laboratory conditions temperature 26-29⁰C and observed daily. Results Eggs from the single Cyclops hatched to nauplius. The average time of developing to nauplius I was 1.2 days, nauplius I to copepodite I was 6.9 days, and copepodite I to adult female Cyclops was 26.3 days. The average measurements of naupliusI were 120.2µm length and 80.0µm width while the adult female was 846.3µm length and 284.6µm width. The adult female produced 1 to 8 broods (mean 4.3). The life span of Cyclops averaged 43.1 days. Conclusion The Cyclops cultured in the laboratory were fed Paramecium and used as first intermediate host in the experimental life cycle of Tanzanian Spirometra species.

Prevalence and Risk Factors of Metabolic Syndrome Among Teaching Staff of Engineering Colleges in Central India

Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.

The Feasibility of Enzyme Immunoassay Tests in the Absence of a Conventional Source of Electricity

Background of the Study African  countries are facing frequent blackout. Thus in sub Saharan region, due to frequent power cut, the laboratory professionals find sometimes difficulty to carry out earlier diverse diagnostic tests. Objective The  aim of this work is to evaluate the feasibility of enzyme immunoassay tests in the absence of a conventional source of electricity. Methods We  developed a battery-powered experimental device, which was then applied to diagnose measles. The samples included 45 sera randomly selected from non-haemolysed serum samples received and stored at the National Public Health Laboratory of Benin. The experimental device is composed of two devices (Devices 1 and 2). The Device 1 provided an average temperature of 34.47 °C, 20 min after starting. With Device 2 an average temperature of 20.32 °C is obtained 15 min after starting. Results With  the experimental device the same rate of measles antibody-positive sera (44.68%) was obtained as recorded from the test using the standard equipment of laboratory. The experimental device detected 18 negative and 8 intermediate results against respectively 19 and 7 by the standard equipment. The analysis of the results of both equipments shows a concordance rate of 93.33% with a kappa reproducibility coefficient of 0.89. Conclusion The  device conceived in our study is a simply equipment allowing the realization of the enzyme immunoassay tests, in this case the ELISA anti-measles test. The rate of concordance obtained shows that this device can be used with commercial kits and at temperatures close to those recommended by the manufacturer without altering the results.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.

Clinical Evaluation of Significance of 25(Oh)D (Vitamin D) Status in Swine Flu (H1N1)

Background Since swine flu has been declared pandemic in 2009 it has become a major challenging public-health problem associated with high morbidity and mortality. 25(OH)D deficiency is also pandemic and has been reported to be clinically correlated with decreased immunity and respiratory infections. The possible role of vitamin D in infections is implied from its impact on the innate and adaptive immune responses. This study is planned to evaluate clinical significance of 25(OH)D status on course and outcome in hospitalized cases of swine flu and to compare it with normal healthy subjects living in the same vicinity to evaluate if vitamin D is having any protective effect. Material & Methods Present prospective cross-sectional study was conducted on 79 RT-PCR confirmed cases of swine flu admitted during recent epidemic. All patients were evaluated thoroughly by clinical history physical examination and laboratory investigations as per Performa and followed-up during hospital stay. 25-hydroxyvitamin D (25(OH)D) estimation was done by electro-chemiluminescent Assay in all the cases and it was also done in 36 normal healthy family members of study patients living in the same vicinity (control group). Results High prevalence (70.9%) of low (≤30ng/ml) status of 25(OH)D was observed in cases of swine flu as compared to control group. 25(OH)D status was associated with severity of illness. Mean value of 25(OH)D in mechanically ventilated patients was 9.81±6.43 while it was 22.76±11.35 ng/ml in patients who do not required ventilation (p<0.05). Mean 25(OH)D level in patients who stayed in hospital for <5 days was 28.60±8.79 ng/ml, 24.18±11.67 for 6-10 days and 8.23±2.12 for >10 days (p<0.01). Mean value of 25(OH)D in patients who died was 9.59±5.90 ng/ml as compared to 23.13±11.62 ng/ml who survived (p<0.01). Conclusion Our study suggests that 25(OH)D may have preventive role for swine flu infection. Low level of 25(OH)D is associated with high morbidity in terms of increase requirement for mechanical ventilation, multiorgan dysfunction and long duration of hospital stay. 25(OH)D deficiency is associated with high mortality in swine flu. 25(OH)D status should be given due consideration in high risk patients especially during winter season.

Reactive Stepping Responses Mediated by Predictable Manual Waist-Pull Perturbations are Associated with Fall History in Older Adults

Background and Purpose The ability to respond effectively to perturbations is a key element of reactive postural control and is a crucial mediator of falls. Several studies exist in the literature that determine older adults’ responses to perturbations, however those studies typically involve procedures that lack objectivity or applicability outside a laboratory. A study involving waist-pull perturbations with a spring-scale (SS) is an exception. In that study, fall history was most accurately differentiated by a reactive stepping response to a perturbing force of 10% total body weight. Using data from that study, we retrospectively examined the association between fall history and the number of steps accompanying a SS perturbing force of 10% total body weight in older adults. For perspective, the association of fall history with Timed-Up-and-Go (TUG) and single limb stance (SLS) times was also determined. Methods Fifty-eight healthy older adults (mean age = 80.7 years) participated in the study. Their 2-year fall history (yes, no) was recorded. All participants underwent SS testing with one-pound incremental, horizontal sagittal plane manual waist-pull perturbations. The number of steps in response to perturbation with 10% total body weight was recorded; TUG and SLS tests were performed. Associations between variables were examined using Spearman (rank-biserial) correlations. Results The median number of steps for fallers was 5 in both anterior and posterior directions. For non-fallers, the median number of steps was 1 and 2 in the anterior and posterior directions, respectively. The significant correlations between fall status and number of steps were 0.772 and 0.813 for the anterior and posterior directions, respectively. Similarly, the significant correlations between fall status and balance tests were 0.722 and -0.456 for the TUG and the SLS, respectively. Conclusions The number of steps accompanying waist-pull perturbations with forces of 10% of body weight were highly explanatory of experiencing a fall during the preceding 2 years.

Use of Microfluidic Assays to Develop Reliable and Economic Nucleic Acid Application Technologies, Employing MicroRNAs for the Diagnostic Screening of Colon Cancer in Human Stool in Low-Resource Settings

Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.  

Invivo Impact of Malaria and HIV Co-Infection on CD4 Cell Count of Infected Patients of Niger Delta Extraction

The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.

Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges in Toxicology Practice

This article reviews toxicology practice challenges during COVID‑19, including laboratory safety, chemical exposures, therapeutics, and public health messaging. It identifies research needs and operational adaptations to support preparedness for future events.

Study of Hypercoagulability in Patients with Acute Leukaemia in the Hematology Department of Teaching Hospital of Yopougon (Abidjan)

Introduction Acute leukaemia are the clonal and malignant proliferation of immature hematopoietic cells (blast), blocked in their differentiation process. There is an interaction between cancer cells and the clotting process. This could be the expression of Tissue Factor (TF) on the surface of tumor cells; or a lesion of the vascular endothelium and platelet activation. The result is an activation of clotting that can lead to disseminated Intravascular Coagulation (DIC). The objective of this study was to assess the risk of DIC occurring in patients with acute leukaemia. Methods This was a cross-sectional study for analytical purposes that took place on 40 frozen samples from the biobank of the haematology laboratory of Teaching Hospital Yopougon for which the diagnosis of acute leukaemia had been taken from myelogram. The myelogram results were accompanied by hemogram data. PTTa, QT, fibrinogen and D-Dimers were performed on these samples. The risk assessment of DIC occurred was determined on the recommendations of the International Society of Thrombosis and Hemostasis (ISTH). Results We noted a female predominance with a Sex Ratio (M / F) of 0.90. The average age of the patients was 38 years (± 23 years) with extremes ranging from 2 to 84 years. ALL represented 20 % of cases against 80 % for AMLs. Hemogram parameters were characterized by severe anaemia (Tx Hb < 6 g / dL) in 52.5 % of cases; hyperleukocytosis > 100.103 / mm3 in 35 % of cases; thrombocytopenia < 25.103 / mm3 in 40 % of case; and significant blood and spinal cord blastosis (> 80 %). The lengthening of the PTTa was observed in 50 % of cases, compared to 40% for the QT. Similarly, hyperfibrinemia was present in 65% of cases. D-Dimers were high in almost all subject (95 % of cases). According to the ISTH criteria, 17.5 % of subjects were at risk of developing a DIC. Conclusion The risk of occurrence of DIC is indeed present during acute leukaemia. The parameters of haemostasis are thus found to be crucial data in the follow-up assessment during the diagnosis of acute leukaemia.

Interest of Confirmation Tests in the Diagnosis of Viral Hepatitis C to Blood Donors in Abidjan-Côte d'Ivoire

Introduction The anti-HCV RIBA test verifies the presence of anti-HCV serum antibodies detected by the Elisa test. In Côte d'Ivoire, screening for hepatitis C is done exclusively by enzyme immunoassays. In order to reduce the number of HCV positive blood donor exclusions on ELISA, we conducted this study which aimed to demonstrate the value of the RIBA test in confirming diagnosis of viral hepatitis C to blood donors. Methods Our study, which took place from 02 to 23 February 2008 in the laboratory of Abidjan NBTC, focused on 200 sera of blood donors anti-HCV positive (Elisa test) selected according to the ratio. The DECISCAN HCV PLUS confirmation test of BIORAD was used. Results Among the 200 HCV samples positive by EIA, 49% (98/200) were confirmed positive. RIBA gave an indeterminate result in 40% of cases (80/200); and negative in 11% of cases (22/200) corresponding to false ELISA devices. In RIBA 96 samples had a low ELISA ratio of which 21% (20/96) were RIBA negative, and 79% (76/96) were indeterminate. RIBA positive samples (98/200) had a high ratio in 82% of cases (80/98). The presence of NS3 (C33) and NS4 (C100) was noted in 100% of cases (98/98, C2 in 37% (36/98) of cases and C1 in 18% of cases (18/98). RIBA indeterminate noted the presence of NS3 in 98% of cases (78/80) and NS4 in 30% of cases (24/80). Proteins C1, C2 and NS4 are essential for the diagnosis of confirmation of viral hepatitis C by RIBA. Conclusion These results attest to the lower specificity of enzyme immunoassays (ELISAs); hence the benefit of using RIBA confirmatory tests. A significant number of donors are excluded from blood donation in Côte d'Ivoire on the basis of false positive results obtained by the ELISA technique.

Impact of Aluminum Phosphide on the Transferases in Liver and muscle of Parophiocephalus obscurus

This study assessed the effect of aluminum phosphide on transferases in liver and muscle of Parophiocephalus obscurus (with mean weight of 42.20±1.5 gSD and mean length of 16.50± cmSD, respectively). The fish were obtained from a private fish farm in Yenagoa Metropolis, Nigeria, and the fish was allowed acclimatized to laboratory condition for 7 days, and then exposed to sublethal concentrations (0.00mg/L, 4.20mg/L, 6.30mg/L and 8.40mg/L) of aluminum phosphide for 14 days. Renewal bioassay was adopted in this study. At the end of the experimental period, the fish was dissected and the muscle and liver were collected, processed and analyzed for alanine aminotransferase and aspartate aminotransferase using colorimetric method. Results of the phosphatase at 0.00mg/L, 4.20mg/L, 6.30mg/L and 8.40mg/L were 94.50±6.44µ/L, 134.47±15.27 µ/L, 106.47±9.21 µ/L and 31.00±3.46 µ/L, respectively (liver), 107.50±9.24, 92.00±6.93 µ/L, 116.50±8.95 µ/L and 146.33±9.33 µ/L respectively (muscle) for aspartate aminotransferase; and 40.00±1.15µ/L, 26.50±3.18µ/L, 14.50±2.02µ/L and 9.80±1.44 µ/L, respectively (liver) and 17.00±1.75µ/L, 8.50±0.87µ/L, 21.00±2.89µ/L and 5.50±0.87 µ/L, respectively (muscle) for alanine aminotransferase. Statistically, there were significant variations (p<0.05) among the various concentration in the transferances. In addition, at some concentration, there was significant variations (p<0.05) between the level of the transferases in the muscle and liver. The significant alteration observed in the various concentrations is an indication that aluminum phosphide is lethal to fish. Therefore, caution should be exercise during the use of aluminum phosphide near biological system.

Comparison of Dipper and Non-Dipper Hypertension Patterns According to Chronic Kidney Disease Stage

Introduction Hypertension is a major cardiovascular risk factor. There is a strong relationship between blood pressure (BP) elevation and stroke, myocardial infarction, heart failure and mortality due to kidney disease. It is known that the loss of the dipping pattern in hypertension is associated with increased target organ damage. In our study, we aimed to investigate the prevalence of dipper hypertension (DHT) and nondipper hypertension (NDHT) and related factors in patients with stage 1 and 2 chronic kidney disease (CKD). Materials and Methods A total of 158 patients diagnosed with stage 1 or stage 2 CKD were included in the study. Demographic characteristics, anthropometric measurements, physical examination findings and laboratory results of the patients were recorded. Ambulatory BP monitoring was performed in all patients. Results Of the 158 patients (female n: 98), 78 (49%) were in the stage 1 CKD group and 80 (51%) were in the stage 2 CKD group. No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The rate of NDHT was 59.5% (94/158 patients). Female patients had more DHT in the general population and in the stage 1 group than male patients (p=0.05, p=0.01, respectively). Conclusion No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The prevalence of DHT in female patients was significantly higher in both groups than in men in both groups, but especially in the stage 1 CKD group.

Neuroscience Theories, Hypothesis and Approaches to ASD Physiopathology. A Review

According to the results of our laboratory the theory of immune dysfunction, the theory on the genetic architecture of ASD, the disrupted cortical connectivity theory and the theory on the contribution of cerebellum to ASD have shown fundamental experimental evidences to support the core symptoms of the complex and enigmatic physiopathology of autism spectrum disorder. The additional hypothesis about the neurogenesis in the amygdala, the contribution of oxytocin, vasopressin, the mirror neuron network, and mitochondrial dysfunction described are stimulating and interesting approaches that deserve further systematic basic and clinical neuroscience research.

A Triple-Blind, Placebo-Controlled Randomized Trial of the Effect of Bilateral Alternating Somatosensory Stimulation on Reducing Stress-Related Cortisol and Anxiety During and After the Trier Social Stress Test

The aim of this clinical study was to determine the efficacy of bilateral alternating somatosensory stimulation for the management of stress and anxiety during and after the Trier Social Stress Test (TSST), a laboratory procedure for reliably inducing stress in human subjects. For this, a randomized, placebo-controlled, triple-blinded clinical trial of 80 qualified subjects was conducted. Subjects were randomized into two groups, a treatment group (n=40) and a control (placebo) group (n=40). Metrics of emotional stress assessed were a subjective rating of the level of emotional stress and salivary cortisol levels, both obtained at 3 timepoints: before treatment (baseline), immediately following completion of the TSST, and after 20 minutes of rest following completion of the TSST. Results showed that the treatment group had a statistically greater decrease in the subjective rating of stress relative to the control group both immediately following the TSST and 20 minutes after the TSST. Salivary cortisol levels in the treatment group were also lower than the control group at those same time points. These results suggest that bilateral alternating somatosensory stimulation may be effective in reducing subjective levels of stress and anxiety. It also may actively attenuate stress-related cortisol levels, which may reflect a mechanism for reducing cortisol-induced inflammation back to baseline after exposure to stressful situations.

Effectiveness of Endoparsitoid Wasp AenasiusArizonensis (Girault) as a Successful Bio-Control of Cotton Mealy Bug, PhenacoccusSolenopsis Tinsley, in Khartoum State, Sudan.

The objective of this study was to evaluate the effectiveness of endophagous Encyrtid parasitic wasp Aenasiusarizonensis (Girault) (Hymenoptera, Chalcidoidea), as a natural enemy for controlling the Mealybug, Phenacoccussolenopsis Tinsley (Hemiptera: Pseudococcidae). Where a Randomized Complete Block Design (RCBD) was adopted. Both, field survey and Laboratory experiments were conducted to study some biological characteristics of the parasitoid A. arizonensis. The results of field study revealed that, the parasitioid was available most of the year, and was highly effective on adults and last larval instar of the mealy bug, P. Solenopsis, with a total percentage of parasitism of 31.26%. While the laboratory results showed that, the duration from oviposition to adult emergence were similar for both male and female. Longevity of male was 23± 2.33 days and female 23.37±1.89 days. Mean daily fecundity in terms of number of Parasitized hosts /female / day ranged from 20 to 24. The sex ratio was 1:1.6 for the male and female in the progeny. Generally, a mass rearing of this parasitoid, with a conservation and augmentation releases could help in the application of an effective management strategy for the control of the cotton mealy bug in the field.

Maternal Behavior Affects Child’s Attachment-Related Cortisol Stress Response

Background Mothers with a history of childhood maltreatment (CM) are likely to transmit their own experiences to the next generation. This is highly influenced by the quality of maternal behavior that enables to buffer infant’s hypothalamic-pituitary-adrenal (HPA) axis response to stress. From a transgenerational perspective the research question is, if infant’s cortisol stress response is influenced by maternal CM experiences or rather by the behavioral pathways during the first year of life. Methods 53 mother-child-dyads were measured at 12 months of infant’s age in a laboratory visit assessing the maternal quality of interactive behavior using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) measured during the strange situation procedure (SSP). Maltreatment experiences were assessed using the childhood trauma questionnaire (CTQ). Salivary cortisol of mother and infant were collected prior to and directly, 15 and 30 minutes after the SSP. Results Infants of disruptive mothers showed a significant increase in cortisol (F (3; 147) = 2.897, p= 0.048) after the SSP compared to infants of mothers with sensitive caregiving. Maternal CM did not influence the infant’s cortisol stress response due to the SSP. However maternal cortisol response was altered by trend due to CM (F (1.392; 71.008) = 3.157, p= 0.066). Conclusions Our data indicate that infant’s cortisol stress reactivity is influenced by the quality of maternal behavior and not by the transgenerational transmission of maternal CM experiences per se. These findings implicate that helping mothers to improve their caregiving behavior may help to improve stress-reactivity of their infant.

Quantification of Micrornas by Absolute Dpcr for the Diagnostic Screening of Colon Cancer

There is currently no validated micro(mi)RNA diagnostic stool test to screen for colon cancer (CC) on the market because of the complexity of fecal density, vulnerability of stool to daily changes, and the presence of three sources of miRNAs in stool (cell-free from fecal homogenates, exsosomal miRNAs from fecal exosomes, and fecal colonocytes). To address these complexities, we have first carried out a microarray miRNA experiment, using Affymetrix GeneChip miRNA 2.0 Arrays, on immunocaptured and enriched stool colonocytes of 15 subjects (three healthy controls and twelve colon cancer patients [three TNM stage 0-1 (e.g., polyps◻ ³ 1 cm, villous or tubvillous, or with high grade dysplasia), three stage 2, three stage 3, and three stage 4 in triplicates to select a smaller panel of 14 preferentially expressed mature miRNAs associated with colon cancer (12 Up-Regulated, miR-19a, miR-20a, miR-21, miR-31, miR-34a, miR-96, miR-106a, miR-133a, miR-135b, miR-206, miR-224 and miR-302; and 2 Down-Regulated, miR-143 and miR-145). In a subsequent validation study carried out on total small RNA extracted by immunocapture, followed by RT that employed TaqMan® miRNA Reverse Transcription (RT) Kit and a Custom TaqMan RT Primer Pool, absolute quantification of miRNAs, in copies/µl, was measured using a chip-based Absolute QuantStudio 3D Digital PCR analysis. To ensure that we have chosen human and not bacterial small total RNA, we have carried out coextraction protocols with E. coli K1 strain RS18, compare Agilent electrophoretic patterns, and also sequenced random samples throughout this research using mRNA/miRNA sequencing. Our initial quantitative dPCR miRNA data presented herein showe that the quantitative changes in the expression of a few mature miRNA genes in stool, which are associated with right and left colon cancer, would provide for a more convenient, sensitive and specific diagnostic screening markers thatare more useful than those test markers currently available on the market, such as the low-sensitivity (<15%) fecal occult blood test (FOBT); result in better compliance; and is more economical than the invasive and expensive colonoscopy exam in colon cancer, which can be cured if that cancer is detected at the early TNM stages, and that becomes incurable and deadly if not diagnosed before metastasis. Initial test performance characteristics of the miRNA approach showed that the test has a high numerical predictive value in colon cancer. Moreover, underpinning of the miRNA markers as a function of total RNA showed that the test can numerically differentiate between control subjects and colon cancer patients, particularly at the early stages of that curable cancer. We propose to extend our initial research results to a larger prospective and randomized five-years nested case-control study, to validate the expression of the above 14 miRNAs, in stool of 180 individuals in an epidemiologically designed study, using (30 controls and 150 colon cancer patients (thirty precancerous polyps (stage 0-1), forty five stage 2, and seventy-five colon cancer stages 3 or 4). chosen randomly by an epidemiological method from 900 control and CC subjects to allow for an adequate time to collect the required 900 stool samples, as well as allowing for statistically valid analysis, standardized test conditions, and to provide a mean for determining the true sensitivity and specificity of a miRNA-screening approach in noninvasive human stool. Power-analysis has indicated that a total of 180 individuals, which will take us 5 years to enroll in testing, is an appropriate number of subjects to standardize and validate our proposed miRNA screening test. We may find out at the end of the proposed validation study in stool that fewer miRNAs, or even one miRNA, may suffice to serve as an efficient and a quantitative marker for the non-invasive diagnostic screening of colon cancer in human stool. The above approach when combined with bioinformatics analysis, to correlate miRNA seed data with our previously published messenger (m)RNA target data in stool, allows for a thorough mechanistic understanding of how miRNA genes regulate mRNA expression, and would offer a better comprehensive diagnostic screening test for the non-invasive early detection stage (0-1) of colon cancer. In order to show the clinical sensitivity and specificity of the proposed miRNA test, the absolute miRNA PCR values, in copies/µl, will be correlated with FOBT, colonoscopy, and pathology data. Standardization will establish test’s performance characteristics (sample selection, optimal sample running conditions, preservation and storage) to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in the World. Ultimately, a smaller number of selected validated miRNAs (<10) showing increased and reduced expression could suffice to give quantitative miRNAs colon cancer expression values, useful for the early diagnostic screening of that curable cancer.

Physiological Features of Pennisetum Purpureum or Panicum Maximum Consumption in Guinea Pigs (Cavia Porcellus)

Guinea pig diet is essentially based on the use of grasses associated with protein sources. Then, in to improve the herbivores nutrition, the evaluation of intake and In vivo digestibility of Pennisetum purpureum or Panicum maximum in guinea pigs (Cavia porcellus) was carried out in January 2017 at the University of Dschang research and experimental farm and animal production and nutrition laboratory. 20 adult animals of local breed on average weight 450 ± 50g and aged about 5 months were used. They were organized into two batches of 10 animals each (5 males and 5 females). The first batch received 250g of fresh matter of Pennisetum purpureum + 60g concentrate/animal/day, while the second received the same treatment with Panicum maximum as grasses. Leftover and animals were weighed every morning before food distributions, and drinking water containing vitamin C was served ad libitum. According to the results, the highest ingestion was obtained with Panicum maximum. However, the digestibility different nutrients was comparable between treatments; nevertheless, males fed on P. maximum digested crude cellulose (63.78%) better than males fed on P. purpureum (51.17%). With regard to the variation of the bacterial rate of the caecal flora, enterobacteria of animals fed P. maximum was high (11.20 CFU/ml) compared to those of the animals receiving P. purpureum (7.27 CFU/ml), although regardless of the treatment, the level of lactobacilli was higher than that of enterobacteria. In view of the results obtained, these grasses can be alternatively used in feeding guinea pigs.

Assessment of Water Quality of Blue Nile River in Sudan

The objectives of this study were to quantify the fresh water quality of Blue Nile River before processing, identify the pollutants, and to determine the most polluted areas, and their impacts on living organisms as well as the surrounding environment. Thus, random water samples were collected and analyzed at the laboratory of the Ministry of Irrigation and Water Resources, Ground water and Wadis Directorates - Khartoum. The outcomes were compared with the World Health Organization standardization. The results revealed variations in the concentration of the studied elements taken from the different locations. But, the results indicated that the water quality is good, and it is within the permissible water use. However, further study is recommended to include seasonal variation as well as the biological analysis.

Granulomatous Gastritis: A Clinicopathologic Analysis of 39 Biopsy Cases

Introduction: Granulomas in gastric biopsy specimens are extremely rare. The final diagnosis of granulomatous gastritis is based on morphological findings, clinical and laboratory data. The aim of our study is to evaluate the clinical fields and to determine the etiology of gastric granulomatosis in our experience Patients and Methods: Thirty nine patients were reviewed retrospectively in the department of pathology of Habib Thameur between 2000 and 2018. Slides from all cases were stained by hematoxylin and eosin. The clinic-pathologic findings and the associated lesions were analyzed and the final etiology of the gastric granulomatosis was noted. Results: Biopsies from the 39 patients diagnosed as having granulomatous gastritis were reviewed. Mean age was 49 years (24 – 96) and sex ratio was 0,25 (M/F=8/31). Indication of endoscopy was gastric pain in 12 cases, chronic diarrhea in 6 cases, anemia in 2 cases, vomiting in 4 cases. Other symptoms were rare. Upper endoscopy was normal in 8 cases, showed antral gastropathy in 20 cases (erythematous in 6 cases, nodular in 8 cases and ulcerated in 6 cases). In four cases, fundic lesions were observed. Granuloma was unique in 14 cases and multiple in 25 cases. Localisation of granuloma was the antrum in 25 cases, the fundus in 7 cases, and both of them in 7 cases. An associated chronic gastritis was noted in 25 cases. Concerning the etiology, 10 of our patients had Crohn's disease while 6 of them had gastric tuberculosis. In five cases, H Pylori was the retained cause of gastric granulomatosis. In the other patients, the final diagnosis was sarcoidosis (n=3), foreign body reaction (n=1), yersiniosis (n=1). In our series, thirteen cases were unclassifiable. Conclusion: Although many cases remain unclassified, in most cases of granulomatous gastritis, a diagnosis of Crohn's disease or tuberculosis could be established. If this cases are excluded, an association between H. pylori and granulomatous gastritis cannot be ruled out. The others causes are extremely rare.

The Biological Basis of Cellular Diabetes Mellitus

This letter presents a clinician's perspective on the biological basis of diabetes mellitus at the cellular level. Drawing on neurosurgical practice, the author argues that persistent dysglycemia hinders recovery and may reflect long-standing intracellular processes, calling for causal, interdisciplinary management beyond symptomatic care. The piece outlines testable hypotheses and invites further laboratory validation.

Is the Measles Virus Indeed Involved in Carcinogenesis? – Commentary

Objectives: An association between the measles virus and Hodgkin lymphoma has been disclosed by our laboratory in Beer-Sheva, starting in 2003. We question the refutation of our study and the absence of interest among experts. Methodology: It was based on immunohistochemistry with commercial, as well as experimental anti-measles antibodies. It relied also on RT-PCR and in situ hybridization evidence of measles virus RNA. Key Results: At this stage (2004), the link between the virus and the lymphoma was essentially descriptive. The first and last response to our challenge appeared in 2007, in the form of doublet articles, in the same issue of a major cancer journal. The two European research groups responding, rejected categorically our findings by proposing different arguments. Major Conclusion: As reservations to these reactions became soon apparent, a series of papers from our laboratory were published. These articles concerned the evidence of a relationship between the measles virus and additional categories of cancers. Different malignancies in which this virus was not expressed at all, were also described. A further study suggested a mechanism by which the measles virus may activate lymphomagenesis in classic Hodgkin lymphoma. To our dismay, and in spite of repeated calls to verify the various results, no further response was obtained from international experts.

Evaluation of Co-morbidities among Different Chronic Obstructive Pulmonary Disease Phenotypes

Background: Co-morbidities are associated with increasing risk of mortality, hospitalizations and costs of treatment in Chronic Obstructive Pulmonary Disease patients. Identification of Co- morbidities related to COPD phenotypes may guide individualized therapies and achieve better prognosis. Methods: A prospective study of one hundred ten patients of confirmed COPD diagnosis were carried out and divided into five different phenotypes with related co-morbidities. History taking, clinical examination, Chest X-ray, Computed chest Tomography, laboratory investigations, arterial blood gas, Echocardiography and Electrocardiography were done for all patients. St. George’s Respiratory Questionnaire, COPD assessment test (CAT score) and BODEx (BMI, FEV1, dyspnea and exacerbations) were used for assessment of disease impact on quality of life, severity, and exacerbation respectively. Results: Emphysema group were 31% among all cases with mean age 61.8±9.1, frequent exacerbator group and Chronic bronchitis phenotype were 18% with mean age 64.4±11.3, and 48.8±9 respectively. COPD with bronchiectasis group were 19% with mean age 60.3±6 and Asthma COPD Overlap Syndrome (ACOS) were 12% with mean age 62.8±15.8. There was significant difference as regards age between different group of phenotypes P- value <0.001. There was significance difference in BODEx index and in (CAT) score among different COPD phenotypes P-value 0.020, 0.001 respectively. There was significant difference in all items of SGRQ among different COPD phenotypes P–value 0.001. Diabetes was commonly presented in 50 % ACOS cases, Ischemic heart disease was present more in Emphysema 22.9%, Osteoporosis was more in COPD with bronchiectasis 28.6%, Cor-pulmonale was more present in frequent excerbator 65%, and Anemia more common in COPD with bronchiectasis 23.8%. Depression was more common in frequent excerbator phenotype (45.0 %). Gastro-esophageal reflux was the most common co-morbidities (58 %) then cor-pulmonale 41.8%, systemic hypertension 40 % and pulmonary hypertension 28%. Conclusion: The presence of significant co-morbidities is important modifying risk factors for severity in COPD. They contribute to the overall severity in individual patients, have a major impact on quality of life, and major causes of hospitalization. Co-morbidities can be associated with any clinical phenotype.

Iga Myeloma with Increased Anion Gap, Pseudo hyperphosphatemia and Pseudohyponatremia

A myeloma case is described with laboratory artifacts including increased anion gap, pseudohyperphosphatemia, and pseudohyponatremia. The report explains mechanisms behind paraprotein‑related assay interference and diagnostic pitfalls.

Narcolepsy With or Without Cataplexy In The Pediatric Population: A Systematic Review

Study Objectives: Narcolepsy diagnosis has been associated with a long lag time between the onset of the disorder and the diagnosis itself among patients with the disorder. This article reviews the childhood epidemiology of idiopathic narcolepsy, including its prevalence, subtypes, and disease progression. Methods: A literature review was conducted to include both published and unpublished data on pediatric narcolepsy. All English language articles were included through April, 2015. Results: Time from symptom onset to diagnosis for children is approximately three years. The prevalence of cataplexy appears to be lower in children compared to adults, suggesting a later onset of cataplexy. The presence of cataplexy, however, was unrelated to demographic factors and laboratory findings. Conclusion: There is a substantial lag-time between initial symptom presentation and diagnosis in children with narcolepsy. A less quintessential presentation of narcolepsy might occur in children relative to adults, making diagnosis more challenging. Continued improvements in narcolepsy education for both pediatricians and parents might facilitate earlier identification and diagnosis of the disease, thus leading to improved outcome.

Towards Precision Rheumatology?

The possibility of tailoring treatment on specific characteristics of patients – i.e. personalized medicine – has received attention in the field of rheumatic diseases since biological DMARDs targeting a unique pathway have become available. However the idea of personalized rheumatology has advanced slowly, at different paces in different disease groups, and it is only now surfacing in the recommendations for assessment and treatment of rheumatoid arthritis (RA). Many of the difficulties encountered stem from the recognition that many rheumatic diseases are not a single entity but encompass different subsets identified on the basis of genetic traits, cellular and molecular characterization both in blood and in tissues, laboratory markers and clinical manifestations (most notably in SLE). These differences suggest a multiplicity of pathogenetic triggers, whose various combination results in slightly or very diverse presentations. Developments in companion diagnostics and the identification of distinct subsets within complex syndromes are going to allow the definition of predictive biomarkers able to reduce poor treatment outcome, thus ensuring that we are treating “the right patient with the right drug”.

Social Capital and Health Outcomes of Elderly People

Greater social capital has been shown to be associated with improved mental health, general wellbeing and reduced risk of premature mortality, cancer mortality and cardiovascular mortality. However, most of these studies found a positive relationship between social capital and health are limited to descriptive studies. This project is performing a theoretical approach to the role of social capital in producing health outcome based on Becker’s household production function. We are testing whether social capital has a positive impact on health both directly through a more effective production of health and indirectly through utilizing the health care system better, using several measurements of social capital from ‘social support’ module in the National Health and Nutrition Examination Survey (NHANES) 2007-2008 for a sample of those 60 years old and above. NHANES is a unique data set in terms of collecting both subjective self-rated health status and several objective health outcome measurement through medical and laboratory examination. Finding from 2SLS with instrumental variable was a bit surprising – various social capital measures do not show significant results in different experiments. The only exception is that more resources of emotional support can promote better overall health status.

Evaluation of an External Quality Assessment Program for HIV Testing in Tigray North Ethiopia 2016

Background: Point-of-care diagnostic tests (POCTs) are increasingly used in both developing and developed countries. They allow same day testing and treatment at remote locations where no laboratory support is available. Quality control measures, which are routinely used in laboratories, have not been widely implemented for POCTs. This aimed to assess the integrity of the entire laboratory testing process, and aims to educate and improve performance in quality of HIV rapid testing. Methods: A health facility based cross section study was conducted from April to June 2016.Randomly selected health facilities were participated in the external quality assessment. Onsite evaluation and panel test were used to collect data using structured checklists and formats. Data was entered and analyzed using SPSS version 16. Results: Between April to June 2016, a total of 60 health facilities (145 testing points) from governmental health facilities (hospitals and health centers) were participated in the study. Among the participated testing points 41% have no designated area, 40% have no clean water for hand washing and 51% have no national test algorithm. The average performance of testing points was varies from 89.6% to 99.1% (Laboratory 99.1%, ANC 90.4%, TB clinic 91.4% and VCT 89.6%). In a multivariable logistic regression model, didn’t follow national testing algorithm to report client test results have statistical significance. Conclusions: High quality test results underpin accurate diagnosis and appropriate treatment for patients. But in the study area the score of proficiency testing result and coverage of training is slightly low comparing to other findings. Therefore following national testing algorithm to report client test results, training and monitoring are critical points to improve the proficiency testing score of testing points.

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Objective: Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design: Systematic literature review and meta-analysis. Methods: Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results: Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence. Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence. Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion: OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS. Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist

Template Independent Synthesis of Nucleic Acid Libraries

Though, directed evolution/In vitro evolution has greatly enhanced the applicability of natural biomolecules, there is still a big void in synthetic biology, which could be filled only when we are able to make novel/synthetic functional biomolecules. Terminal deoxyribonucleotidyl transferase (TdT) is the only known DNA polymerase, which can add deoxyribonucleotides without the requirement of a DNA template. Here, we are introducing the concept of Template-Independent Synthesis of Nucleic Acids (TISNA), where we have exploited the property of terminal deoxyribonucleotidyl transferase to add deoxyribonucleotides to the 3’ end of an oligonucleotide for the generation of de novo libraries of ssDNA, dsDNA coding sequences and RNA. We are able to generate libraries that have diversity not only in sequence but also in length in a single library itself. The length of double stranded random gene libraries generated using this approach ranges from 200 base pairs to 10 kilobase pairs. The ability to make random nucleic acid libraries from scratch (independent of any template information) in the laboratory could open up new avenues and holds promise for the pharmaceutical and biotechnological sectors.

Development of a Chronic Obstructive Pulmonary Disease Severity Classification System Using A Japanese Health Insurance Claims Database

Background: Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database. Methods: Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validity was evaluated using a linear trend test to predict COPD treatment costs and acute exacerbation events. Results: Using records from 880 patients, ten variables were created: acute exacerbation events, emphysema diagnoses, laboratory test and oxygen therapy procedures, prescribed anticholinergic, inhaled corticosteroid (ICS), short acting beta-agonist, and long acting bronchodilator (LABA) agents, asthma diagnosis and patient birth years. Factor loadings from LABA and ICS prescriptions had the strongest impacts on estimated severity scores (0.50 and 0.49, respectively). Among 300 validation group patients, scores were found to associate with increasing trends of median costs and exacerbation risks (p for trend < 0.05). Conclusions: Estimatedseverity scores would help to predict COPD-related medical costs and exacerbation events. For further clinical implementation, this classification system should be re-evaluated using clinical lung functions information indicative COPD severity and treatment choices.

Juvenile Idiopathic Arthritis in a New Rheumatology Clinic in Nigeria

Objectives: To describe the frequency, clinico-laboratory characteristics and treatment outcomes of patients with juvenile idiopathic arthritis (JIA) in Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria. Methods: This is a retrospective review of patients with JIA seen over a five-year period at the rheumatology clinic and children ward of LASUTH. We reviewed the folders of 28 patients from our unit records. The demographics, baseline clinical and laboratory characteristics, treatment given and patient outcomes were extracted and analyzed. Results: A total of 28 patients with JIA were managed over the study period. Twenty one (75%) patients among our JIA cases were female and the mean age at presentation was 9.8±3.9 years. The mean duration of symptoms before diagnosis was 21.8±5.7 months. Polyarticular JIA (PJIA) constituted 14 (50%) cases, while oligoarticular and systemic-onset JIA (SoJIA) constituted 9 (39.3%) and 5 (17.9%) of the JIA cases respectively. Anaemia was present in 20 (71.4%) patients, leucocytosis in 16 (57.1%) and thrombocytosis in 11 (39.2%). Twenty five (89.2%) patients had elevated erythrocyte sedimentation rates (ESRs), 21 (75%) had elevated C-reactive protein levels and 23 (82.1%) patients had hyperferritinaemia. Positive antinuclear antibody (ANA) was found in 5 (17.8%) patients. Mortality was documented in 2 (7.1%) patients both of whom were SoJIA cases. Eleven (39.3%) patients were lost to follow up. Conclusion: Unlike the common report of oligoarticular JIA (OJIA) being the most frequent subtype of JIA in various series from North America and Europe, PJIA was the most frequent subtype seen among our patients and this variant accounted for half of all JIA cases seen. There were no cases of psoriatic, enthesitis-related or undifferentiated JIA and most patients had haematological abnormalities and high levels of inflammatory markers at presentation.

Supporting Quality Data Systems:  Lessons Learned from Early Implementation of Routine Viral Load Monitoring at a Large Clinic in Lilongwe, Malawi

Successful viral load programs rely on the presence of data systems and high quality of patient data. Using a cohort of 49 patients at Partners in Hope, a large, urban HIV clinic in Malawi, we performed a quality improvement assessment of a new viral load program with a focus on accuracy of data collected from patients as well as adherence to Malawi HIV Guidelines in regard to response to elevated viral loads (≥1,000 copies/mL). Data were obtained from three parallel medical record systems to investigate the proportion of patients with a repeat viral load and whether the three data systems agreed in regard to sociodemographic and clinical data. Fewer than 30% of patients had a repeat viral load within six months, as recommended in the Malawi HIV Guidelines. There were significant problems with data agreement across the three parallel databases used for care.  Date of birth was consistent for 55.1% (N=27) of patients, while a different date of birth was noted in all three sources for 10.2% of patients (N=5). Viral load data from all three sources agreed for only 2.0% of patients (N=1).  For 65.3% (N=32), the viral load from the laboratory did not match the recorded viral load in the electronic or paper record. Scale-up of viral load monitoring must be accompanied by the development of data systems that support workflow from sample collection to lab and back to provider. Education of providers and strategies for data collection with minimal errors can facilitate scale-up of high quality programs.

Performance Assessment of Some Operational Aspects of Revised National Tuberculosis Control Programme in Tuberculosis Unit, Nagpur, India

Background : DOTS is the current international strategy for tuberculosis control endorsed by the World Health Organization and the International Union against Tuberculosis and Lung Diseases. Maharashtra achieved full coverage under RNTCP in October 2003. The programme was launched in Nagpur in the last quarter of 2002. Three years after its launch, it is the ideal time to assess the performance of programme to identify the operational challenges. Methods: This is a cross sectional study carried out in 'Sadar Tuberculosis Unit' of Nagpur Municipal Corporation with the objective to study performance of some aspects of RNTCP. Programme performance was explored through laboratory records review and non participant observations of all four designated microscopy centres. DOT centres were observed for accessibility, identifiability and the facilities provided to patients visiting for treatment. Performance of some operational aspects of RNTCP was assessed using standards, norms, procedures etc described in programme guidelines. Results: It was observed that the TB unit was manned with RNTCP- trained supervisory team. Three of four microscopy centres were established in multispecialty health facilities. Adequate space for sputum microscopy was available at two centres. Laboratory technician was available at three centres. Separate tables for smearing and staining were available at three centres. Sink, staining racks, spirit lamp, binocular microscope and drugs in patient - wise boxes were available in all four centres. Laboratory registers were completely and correctly filled in all centres. No false positive or false negative error was found in rereading of AFB smears. Conclusions: It is concluded that the performance of the programme at the unit is satisfactory. Still some aspects of the programme components need to be strengthened at microscopy centres for better performance of RNTCP.

Analysis of Effects of Kale Powder Consumption among Subjects with Potential Metabolic Syndrome: A Prospective Single-Arm Clinical Study

Objective: The prospective intervention study was conducted to investigate the effects of kale powder (Kale juice mixed with water or milk) consumption on metabolic syndrome in subjects with potential metabolic syndrome. Method: In Arita-cho, 149 male and female subjects with potential metabolic syndrome were instructed to consume kale powder for 8 weeks, and its effects on blood pressure, HbA1c, BMI, abdominal circumference, and blood triglycerides, LDL-C, HDL-C, and fasting blood sugar levels were assessed. Additionally, the safety of kale powder was examined. Results: After the 8-week long intake of kale powder, a significant decrease was observed in laboratory and home test-based blood pressure, abdominal circumference, and levels of LDL-C, HDL-C, and fasting blood sugar. Additionally, a hypotensive effect was observed on conducting stratified analysis, in which patients with blood pressure-related diseases were excluded. Furthermore, no safety concerns were identified regarding kale powder. Conclusion: Kale powder had a beneficial effect to maintain optimal blood pressure, blood sugar, and abdominal circumference in subjects with potential metabolic syndrome. Additionally, a hypotensive effect was observed within the normal range in subjects without blood pressure-related diseases.

Prevalence of Campylobacter Species in Out-Patients and Pregnant Women Attending Government Clinics in Sokoto State, Nigeria

Campylobacter infection has been detected in poultry processors at live bird markets in Sokoto, however the prevalence of Campylobacter species in more diverse group of the population is uncertain. For this purpose, 292 human fecal swabs from patients in four Government Hospitals in Sokoto State were analyzed for Campylobacter species using culture and phenotypic typing method. The prevalence rate of 55% was revealed in the tested samples while 56% and 55% were for males and females respectively. Campylobacter jejuni, C. coli and C. lari had 20%, 40% and 40% in males and 38%, 35% and 27% in females respectively. The prevalence rates of 60%, 52%, 45%, 41% and 80%,were revealed in age range of (less than 1-6, 7-13, 14-20, 21-55 and 56-76) yrs respectively. Furthermore, 70% and 43% prevalence rates were recorded in pregnant and non-pregnant women of reproductive age respectively. There was no statistical significant association (P>0.05) between Campylobacter infection and age range and sex, but the statistical association between infection and pregnancy was significant (P<0.05). The prevalence of Campylobacter species in patients as found in the various hospitals has revealed the level of environmental contamination in different homes in the state and the need to include Campylobacter in screening routine laboratory diagnosis of gastroenteritis in humans for appropriate treatment and management especially in young children, old adult and pregnant women.

A Case of Pernio Associated with Cold Agglutinin Positivity in an Unusual Location

Pernio is an inflammatory disease that is usually characterized by the development of cold-induced erythrocyanotic skin lesions located in acral regions. Diagnosis is difficult if lesions are present in rare locations. A 21-year-old female suffering from fatigue presented with a 4-day history of painful, purple lesions on both thighs. She worked as a cashier, wore tight clothing, and was otherwise healthy except for mild obesity. Dermatological examination revealed tender and painful edematous papules and plaques on the outer aspects of her thighs. The patient was diagnosed with pernio based on her medical history, and clinical and histological findings. Laboratory tests were normal except for her cold agglutinin titer (1:4). Pernio rarely occurs on the thigh, except in people who ride horses. However, it sometimes occurs in non-riders depending on lifestyle and environmental conditions. Therefore, lesions in this region must be confirmed by a thorough medical history and evaluation of clinical and histopathological findings. Cold agglutinins may be associated with this disease.

Branch Retinal Vein Occlusion in Factor V Leiden Mutation

A previously healthy 25 year old Chinese male presented with left eye blurring of vision and was diagnosed to have left eye branch retinal vein occlusion. Initial blood investigations and thrombophilia screen were negative. The patient subsequently improved with observation and conservative management, with no further events over a 2 year follow up period. The blood investigations were repeated 2 years later as part of a health check-up and he was then tested to be heterozygous for the factor V leiden mutation. This was confirmed by sequencing of his genome that identified the mutation. The laboratory was contacted to provide details regarding the testing methods and was noted to have performed the two tests via different methods. While false negative rates in genetic testing are low, we believe that there is greater need to standardize testing methods as ascertaining genetic conditions play a great role in clinical diagnosis, treatment and prognosis. Clinicians should be aware of the limitations of these tests. When clinical suspicion is high, there may be a role for repeat tests with different methods or in different laboratories.

Comparison of Two Analytical Methods used for the Measurement of Total Antioxidant Status

Background: Antioxidants play an important role in maintenance of human health and prevention of disease. Effective supplementation of antioxidants requires laboratory monitoring of antioxidant status. An understanding of the methods used to determine the TAS helps in better interpretation of values obtained using a particular method and also to select a suitable method. Material and Methods: Forty subjects including 25 healthy volunteers and 15 patients diagnosed with rheumatoid arthritis were studied. All samples were analysed for TAS using Ferric reducing ability of plasma (FRAP) method and Trolox equivalent antioxidant capacity (TEAC) assay. Results: Mean TAS values obtained by TEAC method were higher than those obtained by FRAP method (p<0.0001); no difference was observed when TEAC values were corrected for proteins and FRAP values were corrected for uric acid (p=0.420). No correlation was found between TEAC and FRAP methods (p=0.102). However, when TEAC was corrected for proteins, positive correlation was observed with FRAP (p=0.044). There was agreement between the two methods when TEAC values were corrected for proteins. Conclusion: Although the reaction conditions differ, similar compounds react in both the assays and thus TEAC and FRAP assays are comparable. However, the two methods differ with respect to –SH groups and uric acid contributions. This contributes to the higher TAS values obtained by TEAC assay. Thus, in conditions with altered protein or uric acid levels, the two methods may not be used interchangeably. The TEAC assay is to be corrected for protein for comparison of reports of the two assays.

Pseudotumor Tuberculosis Of Liver: A Rare Entity

We present a rare case of a 46-year-old man who presented with recurrent fever and abdominal pain without other symptoms. Laboratory data were no specific for diagnosis. Abdominal imaging revealed a pseudotumor liver. A diagnosis of isolated liver tuberculosis with abscess component was confirmed with US-guided liver biopsy and histopathological examination. The patient received antibacillous drugs with success.

Correlation of Cryptococcal Antigen Assay with C-reactive Protein as Serum and Urine Biomarker in Cryptococcal Meningitis: Experience in a Tertiary Hospital

Aims and Objectives: The incidence of cryptococcal meningitis caused by Cryptococcus neoformans has risen markedly over the past 20 years as a result of theHIV epidemic and increasing use of immunosuppressive therapies. The objectives of this study were to isolate and identify Cryptococcus neoformans from clinically suspected cases of fungal meningitis by conventional techniques and evaluate the role of C-reactive protein (CRP) as a serum or urine biomarker for the diagnosis and monitoring of patients with cryptococcal meningitis. Materials and Methods: Direct microscopic examination of the CSF samples from clinically suspected cases of fungal meningitis was done by India Ink staining for the capsule demonstration and isolation of the Cryptococcus neoformans was done by inoculation of the sample on Sabourauds dextrose agar. Latex agglutination test for the presence of cryptococcal antigen was done on sera, CSF and urine samples. C Reactive Protein levels were estimated in sera and urine. Result: Cryptococcal meningitis was diagnosed in 12 cases by culture and/or India Ink staining and/or latex agglutination assay for antigen detection in CSF. Only 8 (66.67%) and 1 (8.33 %) out of 12 samples were positive for cryptococcal antigen in sera and urine respectively. Whereas all the 12 patients were positive in the sera for CRP above the detection threshold limit, only 1 (8.33 %) patient had raised CRP in urine. CRP was raised two weeks after initiation of antifungal therapy in 3 of the above 12 sera and all these 3 cases turned out to be recurrent cases of cryptococcal meningitis. Conclusion Given the high incidence, morbidity and mortality associated with cryptococcal meningitis, it would be ideal if a screening test could be used to exclude this diagnosis based on the presence of biomarkers in serum or urine which would mean less discomfort for the patient in addition to decreased laboratory examination costs.