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Jan 2024 DOI 10.14302/issn.2642-9241.jrd-23-4809
Introduction People living with HIV (PLHIV) are susceptible to developing non- communicable chronic respiratory diseases. Our objective was to study the spirometric profile of this population. Material and methods This was a descriptive and analytical cross-sectional retro-prospective study conducted from March 15 to June 15, 2022 and relating to the analysis of the medical files of asymptomatic and eligible for spirometry PLHIV, aged 18 years and above. They were received in the voluntary counselling and testing (VCT) centres of one of the two pulmonology departments in Abidjan. Results The study involved 54 subjects including 22 men (40.7%) and 32 women (59.3%) with an average age of 48.9 years. The majority of patients were non-smokers (81.4%) and the main history was pulmonary tuberculosis (35.2%). Only 29.6% had chronic respiratory symptoms and 42.6% had a normal BMI. The frequency of spirometric abnormalities was 57.4%. These spirometric abnormalities included 40.7% peripheral obstructive pattern; 9.3% restrictive pattern; 3.7% asthma and 3.7% COPD. A more than 10 years duration of HIV infection (p=0.001 OR= 0.2 (0.1 – 0.7)) and a duration of ART of at least 10 years (p=0.001 OR= 0, 2 (0.1 – 0.7)) were significantly associated with the existence of ventilatory abnormalities. Conclusion The high frequency of ventilatory anomalies in PLHIV independently of the existence of chronic respiratory signs leads us to propose spirometry in the follow-up assessment of PLHIV while paying particular attention to those on ARVs for more than 10 years.
Dec 2021 DOI 10.14302/issn.2692-1537.ijcv-21-4045
Introduction In December 2019, cases of serious illness causing pneumonia and death were first reported in Wuhan, China.2 The clinical features of Corona Virus Disease-19 (COVID-19) are ranging from asymptomatic to multi organ dysfunction. The disease can progress to pneumonia, respiratory failure and death.4 Thus, a tool is needed that can predict the severity and in-hospital mortality risk of a patient with COVID-19 Pneumonia. The PIRO (predisposition, insult, response, and organ dysfunction) scoring was developed for use in the emergency department to risk stratify sepsis cases.15 Eventually it was adapted in pneumonia cases to predict its severity. Objective To validate PIRO score as an assessment tool for COVID-19 mortality risk among patients with confirmed COVID-19 RT-PCR test among patients aged 19 and above admitted in World Citi Medical Center from March 2020 to August 2020 Methods This study included 93 patients aged 19 and above admitted in World Citi Medical Center with a primary diagnosis of COVID-19 Confirmed with pneumonia between March 2020 to August 2020. The patients’ charts were retrieved from the hospital medical records and case notes were reviewed. A severity assessment score was developed based on PIRO score (Predisposition comorbidities and age; Insult multilobar opacities and viremia; Response shock and hypoxemia; Organ Dysfunciton) were extracted. The patients were stratified in four levels of risk: a)Low,0-2 points; b)Mild,3 points; c)High,4 points; d)Very High,5-8 points. The PIRO score and the clinical outcome were compared. The discriminative ability of PIRO score to predict mortality risk was evaluated under receiver operating characteristic curve (AUC). Results The PIRO score had an excellent predictive ability for in-hospital mortality (AUC0.9197). Analysis of variance showed that higher levels of PIRO scores were significantly associated with higher mortality (p<0.001). Patients with Mild PIRO risk category were 98.65% less likely to expire (p<0.001, 95%CI 0.0015) and High PIRO risk category were 94.47% less likely to expire (p<0.001, 95%CI 0.0124), both compared to patients with Very high PIRO risk category. Finally, Very High PIRO risk category were more than 44 times likely to expire compared to patients with Low, Mild and High PIRO risk category (p<0.001, 95%CI 11.738). Conclusions The PIRO score is a valid risk model that can be used to predict in-hospital mortality, that can help clinicians provide timely and accurate assessment, and hence appropriate management to patients with COVID-19 Pneumonia.
Jan 2021 DOI 10.14302/issn.2575-1212.jvhc-20-3467
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.
Mar 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2655
Reverse Shapiro’s syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro’s syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient’s convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.
Dec 2017 DOI 10.14302/issn.2641-7669.ject-17-1789
We aimed to study the effect of buspirone, an anxiolytic drug and 5-HT1A agonist on liver injury induced by carbon tetrachloride (CCl4) in rats. Rats were orally treated with CCl4 (2.8 mL/kg in olive oil) along with buspirone at 10, 20 or 30 mg/kg once daily starting with CCl4 and for one week thereafter. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as well as alkaline phosphatase (ALP) activities were determined in the serum. Markers of oxidative stress: lipid peroxidation (malondialdehyde; MDA), reduced glutathione (GSH), nitric oxide (nitrite/nitrate) levels were measured in the liver. Moreover, paraoxonase 1 activity was determined in the liver and serum. The administration of CCl4 led to significant increases in serum ALT, AST, and ALP activities. Results showed that there were significantly increased hepatic MDA, nitrite and decreased GSH levels. PON1 activity decreased both in the liver and serum, respectively. The immunohistochemical investigations using anti-caspase-3 antibody revealed that CCl4 caused apoptosis to many hepatocytes. DNA studies showed that CCl4 caused hypoploidy in hepatocytes. Rats treated with 20-30 mg/kg buspirone showed significant decrease in serum ALT and AST by 19.5-34.3% and 24.2-31.4%, respectively. Serum ALP decreased by 21.7% after 30 mg/kg buspirone. In the liver, the higher dose of the drug resulted in decreased MDA (by 15.8%), decreased nitric oxide (17.4%) and increased GSH (by 20.1%). Significantly increased serum PON1 activity by 43.9-53.5% was observed after treatment with 20-30 mg/kg buspirone. On histopathologic examination of liver sections, there was mild protective effect for the drug at 30 mg/kg. Sections stained with anti- caspase- 3 confirmed the results obtained from histopathological examination. Moreover, buspirone given at 30 mg/kg resulted in an increase in % of cells containing normal values of DNA. These results indicate that buspirone decreases liver oxidative stress and exerts protective effect against CCl4- toxicity. The study thus indicates more beneficial effects of buspirone as an anxiolytic drug and that the drug could be used safely in patients with liver disease.
Oct 2019 DOI 10.14302/issn.2691-6622.ijar-19-2991
The purpose of this study is to evaluate the impact of organic pollution of EL-Mahmodia canal on the fish (Oreochromis niloticus)muscles tissues collected from two sites at EL-Mahmodia canal in summer and winter 2017. EL-Mahmodia canal is exposed to excessive of effluents which impact fish. The present results showed high concentrations of organic pollutants, particularly in winter. Organic pollutants were analyzed using the gas-chromatography-mass spectrometry (GC-MS). A variety of environmental screening studies concerning varieties of water pollutants in Egypt, the target of the present study was to scan the organic pollutants of El-Mahmodia stream at El-Beheira Governorate, Egypt within the muscles of Tilapia fish. Within the present study, it was found that; the analysis of fish muscles in summer season showed a high level of organic pollutants. The organic pollutants that are reported in the muscle of fish in the polluted site were reported as; Dimethomorph-(E), Hexestrol, Diisobutyl phthalate, Diamyl phthalate, Di-n-propyl phthalate, Chlorpyrifos, Phorate sulfoxide, Exaltolide (15-Pentadecanolide), Chlorfenapyr, Pyridate, Ethofumesate, Bis (2-ethylhexyl)phthalate, Dicyclohexyl phthalate, Di-n-octyl phthalate, Tricresylphosphate, meta-, XMC (3, 4-Dimethylphenyl N-methyl, XMC (3,5-Dimethylphenyl N-methyl, Hexestrol, Thymol, Kinoprene, Diisobutyl phthalate, Diisobutyl phthalate, Di-n-hexyl phthalate, Di-n-hexyl phthalate, Carbofuran-3-keto, Tefluthrin, cis-, Carbofuran-7-phenol, Carbofuran, Dicyclohexyl phthalate, Di-n-propyl phthalate, Di-n-propyl phthalate, Bis(2-ethylhexyl)phthalate, Ethofumesate, Hexestrol, Kinoprene, Di-n-hexyl phthalate, Exaltolide (15-Pentadecanolide), Spiroxamine metabolite (4-tert-b), Chlorfenapyr, Tricresylphosphate, para, Tricresylphosphate, meta-, Tricresylphosphate, ortho-, XMC (3, 5-Dimethylphenyl N-methyl, XMC (3,4-Dimethylphenyl N-methyl, Fluroxypyr-1-methylheptyl ester, Cashmeran, Propargite metabolite (Cyclohexa), and Quinoclamine. The present results showed that Diisobutyl phthalate, Bis(2-ethylhexyl)phthalate, Pyridate and Ethofumesate were detected in winter season in the polluted site, whereas, Bis (2-ethylhexyl) phthalate, and Pyridate were the only organic pollutants that were found in winter in the reference site. The accumulation patterns of organic pollutants percentage in the polluted site in summer in the muscles of O. niloticus were in the following order: Chlorpyrifos> Diamyl phthalate> Diisobutylphthalate> Di-n-butylphthalate> Diamyl phthalate> Bis (2-ethylhexyl) phthalate, whereas, in the reference site in summer, it was Chlorpyrifos> Chlorfenapyr> Di-n-butylphthalate> Diisobutylphthalate> Hexestrol> Di-nhexyl phthalate. The accumulation patterns of organic pollutants in the polluted site in winter in the muscles of O. niloticus, were in the following order: Bis(2-ethylhexyl)phthalate> Pyridate> Ethofumesate, whereas in the reference site it was; Bis (2-ethylhexyl)phthalate> Pyridate.
Jun 2018 DOI 10.14302/issn.2372-6601.jhor-18-2139
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.