Predictors of Undernutrition among School-Age Children in Abakaliki, Nigeria.

BACKGROUND: Undernutrition remains a major public health problem, especially in developing countries. Identification of factors affecting undernutrition among school-age children will guide prioritization of interventions. We determined the predictors of underweight, thinness and stunting among this age group. METHODS: A descriptive, cross-sectional study was conducted among 780 school children aged 6 to 12 years using a multistage probability sampling method. An interviewer-administered questionnaire was used to document sociodemographic information and potential predictors of undernutrition. Weight and height were measured using SECA® weighing scale and stadiometer. Body Mass Index (BMI), Z scores of the weight-for-age, BMI-for-age and height-for-age were calculated using the WHO Anthro plus software. Data was entered and analyzed using the Epi Info version 7.2. Multiple logistic regression was used to identify the predictors of undernutrition at 5% level of significance. RESULTS: Of a total of 751 pupils, 397 (52.9%) were females and 595 (79.2%) were in public schools. Significant predictors of underweight were lower maternal education (adjusted odds ratio (aOR) 2.7; 95%CI: 1.33-5.44) and age 10-12years (aOR 5.0; 95%CI:1.49-17.05). Thinness was predicted by age 10-12years (aOR 3.1; 95%CI 1.32-7.27) and rural dwelling (aOR 2.2; 95%CI:1.2-4.08) whereas stunting was predicted by age 10-12 years (aOR 5.2; 95%CI:2.14-12.68) and rural dwelling (aOR 2.3; 95%CI 1.3-4.1). CONCLUSION: Undernutrition was higher among rural dwellers, at age 10 to 12 years and with low maternal education.

BACKGROUND: La dénutrition reste un problème majeur de santé publique, en particulier dans les pays en développement. L'identification des facteurs affectant la dénutrition chez les enfants d'âge scolaire guidera la priorisation des interventions. Nous avons déterminé les prédicteurs de l'insuffisance pondérale, de la maigreur et du retard de croissance dans ce groupe d'âge. MÉTHODES: Une étude descriptive et transversale a été menée auprès de 780 écoliers âgés de 6 à 12 ans en utilisant une méthode d'échantillonnage probabiliste à plusieurs degrés. Un questionnaire administré par un enquêteur a été utilisé pour documenter les informations sociodémographiques et les prédicteurs potentiels de la dénutrition. Le poids et la taille ont été mesurés à l'aide d'un pèsepersonne SECA® et d'un stadiomètre. L'indice de masse corporelle (IMC), les scores Z du poids pour l'âge, de l'IMC pour l'âge et de la taille pour l'âge ont été calculés à l'aide du logiciel Anthro plus de l'OMS. Les données ont été saisies et analysées à l'aide du logiciel Epi Info version 7.2. La régression logistique multiple a été utilisée pour identifier les prédicteurs de la dénutrition au niveau de signification de 5%. RÉSULTATS: Sur un total de 751 élèves, 397 (52,9%) étaient des femmes et 595 (79,2%) étaient dans des écoles publiques. Les prédicteurs significatifs de l'insuffisance pondérale étaient le faible niveau d'éducation de la mère (odds ratio ajusté (aOR) 2,7 ; 95%CI :1,33-5,44) et l'âge de 10-12 ans (aOR 5,0 ; 95%CI:1,49-17,05). La maigreur était prédite par l'âge de 10-12 ans (aOR 3,1 ; 95%CI 1,32-7,27) et le logement rural (aOR 2,2 ; 95%CI:1,2-4,08) tandis que le retard de croissance était prédit par l'âge de 10-12 ans (aOR 5,2 ;95%CI:2,14-12,68) et le logement rural (aOR 2,3 ; 95%CI 1,3-4,1). CONCLUSION: La dénutrition était plus élevée chez les habitants des zones rurales, à l'âge de 10 à 12 ans et avec une faible éducation maternelle. Mots clés: Prédicteur ; Dénutrition; Enfants d'âge scolaire; Retard de croissance; Maigreur; Insuffisance pondérale.

Nutritional immunity: targeting fungal zinc homeostasis.

Transition metals, such as Zn2+, are essential dietary constituents of all biological life, including mammalian hosts and the pathogens that infect them. Therefore, to thrive and cause infection, pathogens must successfully assimilate these elements from the host milieu. Consequently, mammalian immunity has evolved to actively restrict and/or pool metals to toxic concentrations in an effort to attenuate microbial pathogenicity - a process termed nutritional immunity. Despite host-induced Zn2+ nutritional immunity, pathogens such as Candida albicans, are still capable of causing disease and thus must be equipped with robust Zn2+ sensory, uptake and detoxification machinery. This review will discuss the strategies employed by mammalian hosts to limit Zn2+ during infection, and the subsequent fungal interventions that counteract Zn2+ nutritional immunity.

The Kidney and Adrenal Gland of the African Palm Squirrel Epixerus ebii: A Microanatomical Observation / El Riñón y la Glándula Adrenal de la Ardilla de la Palma Africana Epixerus ebii: Una Observación Microanatómica

The kidneys and adrenal glands of the African palm Squirrel (Epixerus ebii), were subjected to histological and mucin histochemical studies. The kidney was covered by a capsule of periodic acid of shiff (PAS) positive connective tissue fibres. The kidney parenchyma was composed of large peripheral cortex and smaller centrally placed medulla. The cortex contained renal corpuscle, proximal convoluted tubules, distal convoluted tubules and juxtaglomerullar complex. At the hilus, the renal artery and vein, ureters, and nerve fibres were surrounded by adipose tissue. The renal medullar was composed of Henles’ loop and collecting ducts. The adrenal gland cortex contained zona glomerulosa, zona fasciculate and zona reticulata. The zona fasciculata was the largest of the zones containing polyhedrally shaped cells with less basophilic nuclei and very foamy cytoplasm. Some cells of zona fasciculate were binucleated. The adrenal medulla contained mostly glandular cells, few ganglion cells and capillaries. This study establishes that the organs investigated are typical of mammals. It will fill the knowledge gap, help wildlife clinicians in disease diagnosis of these organs in this species.

Los riñones y las glándulas adrenales de la ardilla de la Palma Africana (Epixerus ebii) fueron objeto de estudios histológicos y de estudios histoquímicos con mucina. El riñón estaba cubierto por una cápsula de fibras de tejido conectivo que resultaron positivas a la coloración con ácido peryódico de Schiff (PAS). El parénquima renal estaba constituido por una gran corteza periférica y una médula más pequeña, ubicada centralmente. La corteza contenía el corpúsculo renal, los túbulos contorneados proximales, los túbulos contorneados distales y un complejo yuxtaglomerular. A nivel del hilio del órgano, la arteria y vena renales, los uréteres y las fibras nerviosas estaban rodeados de tejido adiposo. La médula renal estaba compuesta por el asa de Henle y los túbulos colectores. La corteza de la glándula adrenal contenía las zonas glomerular, fasciculada y reticular. La zona fasciculada era la mayor de las tres y contenía células con forma poliédrica con núcleos menos basofilícos y citoplasma muy esponjoso. Algunas células de la zona fasciculada eran binucleadas. La médula adrenal contenía principalmente células glandulares y pocas células ganglionares y capilares. Los resultados de este estudio establecieron que los órganos investigados son típicos de los mamíferos. Esta investigación llenará la brecha de conocimiento existente y ayudará a los clínicos de fauna silvestre en el diagnostico de enfermedades de estos órganos en esta especies.

Liver function assessment in malaria, typhoid and malaria-typhoid co-infection in Aba, Abia State, Nigeria.

Malaria and typhoid fever are among the most endemic diseases in the tropics and are associated with poverty and underdevelopment with significant morbidity and mortality. Both diseases can lead to liver damage if not properly treated. The liver function assessment was therefore conducted on (90) volunteer patients; comprising (30) patients with malaria only, (30) with typhoid only and (30) with malaria-typhoid co-infection randomly selected from Abia State University Teaching Hospital, Aba, Abia State, Nigeria and (20) healthy individuals were used as control. Blood samples collected from these subjects were screened for malaria parasite and Staphylococcus typhi using standard methods. Mean serum levels of ALP (112.55±84.23), AST (31.33±12.80), ALT (23.10±11.84), TB (19.43±5.02), CB (5.91±3.03) and ALP (116.69±48.68), AST (28.33±11.72), ALT (22.8±5.94), TB (19.31±5.84),CB (5.60±2.50) were obtained for those subjects with malaria and typhoid respectively and subjects with malaria-typhoid co-infection recorded the following; ALP (134.33±56.62), AST (33.97±8.43), ALT (24.40±4.37),TB (21.27±2.96),CB (6.58±3.10) while the control subjects had mean serum levels ofALP (71.05±18.18), AST (16.65±7.45), ALT (13.85±6.09), TB (10.05±4.85) and CB (3.00±1.67). These mean values were subjected to a statistical test using students t-test which revealed a significant increase (p<0.05).The results suggest that malaria, typhoid and malaria-typhoid co-infection can elevate ALP, AST, ALT, TB and CB serum levels and can lead to liver damage if not properly treated.

Nuclear Architecture in the Medulla Oblongata of the Adult African Giant Pouched Rat (Cricetomys gambianus, Waterhouse - 1840) / Arquitectura Nuclear en la Médula Oblonga de la Rata Gigante de Carillos Africana Adulta (Cricetomys gambianus, Waterhouse - 1840)

The architecture of cranial and non-cranial nerve nuclei in the medulla oblongata of the African giant pouched rat was studied by means of light microscopy. Serial sections of the medulla oblongata, in coronal and saggital planes, were stained with the cresyl fast violet and silver stains, respectively. Sections in the saggital plane were used as a guide, while coronal sections were used to identify the nuclei in the rostrocaudal extent of the medulla oblongata. With the obex serving as the landmark, nuclei rostral and caudal to the obex were delineated. Cranial nerve nuclei whose architecture were defined were the motor nucleus of hypoglossal nerve, motor nucleus of vagus nerve, cochlear nucleus, vestibular nucleus and nucleus ambiguus, while non-cranial nerve nuclei identified were the olivary nucleus, solitary tract nucleus, gracile nucleus, cuneate nucleus, spinal nucleus of trigeminal nerve, motor nucleus of corpus trapezoideum, lateral nucleus of reticular formation and gigantocellular nucleus. The olivary nucleus was the most prominent nucleus, while the solitary tract nucleus was faint, and thus, less developed. The rostrocaudal extent of the solitary tract nucleus, olivary nucleus and motor nucleus of hypoglossal nerve were 3.81 mm, 2.36 mm and 3.50 mm in length, respectively. The prominent olivary nucleus, pyramidal tract and vestibular nucleus are indicative of a good motor coordination and balance, while the poorly developed solitary tract nucleus points to less efficient autonomic functions in this rodent. The present study will serve as a lead for future neuro-behavioural studies necessary for an effective domestication and adaptation of the African giant pouched rat.

Se estudió mediante microscopía de luz la arquitectura de los núcleos de los nervios craneales y no craneales en la médula oblonga de la rata gigante de carillos africana. Secciones seriales de la médula oblonga, en los planos coronal y sagital, se tiñeron con violeta de cresil rápida y tinción de plata, respectivamente. Como guías se utilizaron secciones en el plano sagital, mientras que, secciones coronales se utilizaron para identificar los núcleos en la extensión rostrocaudal de la médula oblonga. Fueron delineados, con el óbex que actúa como punto de referencia, los núcleos rostral y caudal a éste. Los núcleos de los nervios craneales cuya arquitectura se definió fueron los núcleos: motor del nervio hipogloso, motor del nervio vago, coclear, vestibulares y ambiguo, mientras que los núcleos de los nervios craneales no identificados fueron: olivar, del tracto solitario, grácil, cuneiforme, espinal del nervio trigémino, motor del cuerpo trapezoide, lateral de la formación reticular y gigantocelular. El núcleo olivar fue el más importante, mientras que el núcleo del tracto solitario fue tenue, y por lo tanto, menos desarrollado. Las longitud rostrocaudal de los núcleos del tracto solitario, olivar y motor del nervio hipogloso fueron 3,81 mm, 2,36 mm y 3,50 mm, respectivamente. El núcleo prominente olivar, el tracto piramidal y el núcleo vestibular fueron indicativos de una buena coordinación motora y equilibrio, mientras que el escaso desarrollo de los puntos del núcleo del tracto solitario indican una menor eficiencia de las funciones autonómicas en este roedor. El presente estudio servirá para conducir futuros estudios sobre el neuro-comportamiento necesario para una efectiva domesticación y adaptación de la rata gigante de carillos africana adulta.

Microscopic anatomy of the lower respiratory system of the African giant pouched rat (Cricetomys gambianus, Waterhouse 1840) / Anatomía microscópica del sistema respiratorio inferior de la rata gigante Africana (Cricetomys gambianus, Waterhouse 1840)

A qualitative and quantitative study, by light microscopy, was undertaken on the lower respiratory system of the African Giant pouched rat. Specifically, the trachea, bronchi and lungs were stained with Haematoxylin and eosin, Alcian blue at a pH of 2.5 and Periodic Acid-Schiff stains. Three cell types were identified in saggital sections of the trachea: the ciliated cells, basal cells and mucous cells. Fibers of the trachealis muscles in the laminar propria separated the underlying cartilages from the basal cells. Mucous cells were visible only in the membranous portion of the trachea and they were predominant in the rostral and caudal portion of the trachea. Lobar bronchi consisted of cuboidal epithelium and a layer of one or two smooth muscle cells and opened into segmental bronchi and respiratory bronchiole. Some tracheal cartilaginous rims stained blue with AB while most glandular cells stained red with PAS. The diameter of respiratory bronchiole, alveoli duct and alveoli were 24.93 µm (+/- 1.27), 21.14 um (+/- 0.66) and 12.95 um (+/- 0.21), respectively. These and other findings were compared with similar report in other rodents.

Se realizó un estudio cualitativo y cuantitativo, mediante microscopía de luz, en el sistema respiratorio inferior de la rata gigante Africana. La tráquea, los bronquios y los pulmones fueron teñidos con hematoxilina y eosina, azul Alcián a pH de 2,5 y ácido periódico de Schiff. Tres tipos de células fueron identificadas en las secciones sagitales de la tráquea: células ciliadas, basales y mucosas. Las fibras del músculo traqueal en la propia laminar separados los cartílagos subyacente de las células basales. las células mucosas son visibles sólo en la porción membranosa de la tráquea y predominan en la parte rostral de la porción caudal de la tráquea. Los bronquios lobares consistían en epitelio cúbico y una capa de una o dos células de músculo liso y abierto en los bronquios y bronquiolos segmentarios respiratorias. Algunos bordes azules cartilaginoso traqueal manchada con AB, mientras que la mayoría de las células glandulares teñido de rojo con PAS. El diámetro de los bronquiolos respiratorios, conductos alveolares y los alvéolos fueron 24,93 m (+/- 1,27), 21,14 m (+/- 0,66) y 12,95 m (+/- 0,21), respectivamente. Estos y otros resultados se compararon con el informe similar en otros roedores.

Comparative osteometric study of long bones in Yankasa sheep and red Sokoto goats / Estudio osteométrico comparativo de los huesos largos entre oveja Yankasa y las cabras rojas Sokoto

A morphometric study was undertaken on the long bones in the two predominant breeds of small ruminant in Northern Guinea Savanna zone of Nigeria, to determine their anatomical differences and thus, provide a means of differentiating the remains of these two species during zooarchaeological studies and gross anatomy practical session. The pelvic and pectoral limbs from thirty animals (15 Yankasa sheep and 15 Red Sokoto goats) of both sexes were used for this study. The long bones of the pectoral limbs considered were the humerus, radius, ulna and metacarpal III while those of the pelvic limbs were the femur, tibia and metatarsal III. The parameters considered were the mean weights, lengths and diameters of the proximal extremity, mid-shaft and distal extremities of these bones. The result of this study showed that there is a very high statistically significant difference (p < 0.001) in the length of long bones between the two species, with that of the Yankasa sheep being significantly longer than the Red Sokoto goat. Also, the differences in weights as well as diameters of the proximal, middle and distal shafts of the tibia between the two species are of a very high statistical importance (p < 0.001). Conversely, the differences in the proximal and distal diameters of the femur between the two species are not statistically significant (p > 0.05). Factors that may be responsible for these differences were discussed. It is concluded that the bones of the Yankasa sheep and Red Sokoto goat can be differentiated by the disparity in the length of these long bones or the disparity in the entire morphometry of the tibia bone.

Se realizó un estudio morfométrico en los huesos largos en las dos razas predominantes de pequeños rumiantes del norte de Guinea, zona de Sabana de Nigeria, para determinar sus diferencias anatómicas y proporcionar un medio de que permita diferenciar los restos, de estas dos especies, durante los estudios zooarqueológico y en además en práctica de anatómica. Se utilizaron los miembros pélvicos y pectorales de treinta animales (15 ovejas Yankasa y 15 cabras rojas de Sokoto) de ambos sexos. Los huesos largos de los miembros pectorales considerados fueron: húmero, radio, ulna y III metacarpiano, mientras que en los miembros pélvicos fueron: fémur, fíbula y el III metatarso. Los parámetros considerados fueron los pesos medios, longitudes y diámetros de la extremidad proximal y tercios medio y distal de estos huesos. Los resultados mostraron que existe una diferencia altamente significativa (p <0,001) en la longitud de los huesos largos entre las dos especies. Los huesos en las ovejas Yankasa son significativamente más largos que los de la cabra roja de Sokoto. Además, de las diferencias en el peso, así como los diámetros de los ejes proximal, media y distal de la fíbula entre las dos especies son estadísticamente significativos (p <0,001). Por el contrario, las diferencias en los diámetros proximal y distal del fémur entre las dos especies no son estadísticamente significativas (p> 0,05). Fueron discutidos los factores que pueden ser responsables de estas diferencias. Se concluye que los huesos de las ovejas y cabras Yankasa Red Sokoto, se pueden diferenciar por la disparidad en la longitud de los huesos largos o en la morfometría de la tibia.

Macroscopic anatomy of the lower respiratory system in a nocturnal burrowing rodent: African giant pouched rat (Cricetomys gambianus, Waterhouse 1840).

Cricetomys gambianus is a rat that lives principally in burrows, coming out at night in search of food. The design and structure of the lower respiratory system reflects its oxygen and metabolic demand which can be attributed to its habitat. A morphological and morphometric investigation of its lower respiratory system was undertaken to document the normal anatomical features and assess its morpho-functional paradigm. Specifically, an anatomical detail of the lungs and conductive airway was described, the structures being elucidated by dissection and radiography. Evaluation of dissected specimens showed that tracheal cartilages ranged from 21 to 33 rings with an average of 25.5. They exhibited a random pattern of anastomoses between adjacent rings. Transverse diameters of the principal bronchus in the male and female rats were 3.767 and 3.759 mm respectively. The right lung consisted of four lobes while the left lung was not lobed. Bronchogram revealed that lung lobation corresponded with bronchial tree division. Inter-lobar fissures were absent on the right lung except for the ventral boarder separating the cranial lobe from the caudal lobe. The entire lungs provided stability to the heart in situ, through the cardiac notch. This study also included correlation analysis of the dimensions, weights and volumes of the lower respiratory organs with the nose-rump length and body weight of 18 African giant pouched rats of both sexes. The relationship of the anatomy of the lower respiratory system of the rodent to the oxygen tension in their burrow and to their energy utilization is discussed.

Sexual dimorphism in the whole brain and brainstem morphometry in the African giant pouched rat (Cricetomys gambianus, Waterhouse 1840).

The study was conducted to evaluate the sexual dimorphism in the morphometric parameters of the whole brain and the brainstem in adult captive African giant pouched rats. Twenty-nine brain samples, comprising 15 females and 14 males, were utilized. Following brain extraction by standard procedures, the mean values of the weights, lengths, diameters, and volumes of the intact brains and the brainstem structures were compared in male and female rats using quantitative analytical statistical methods. The absolute brain weight obtained in the male was significantly higher (p < 0.01) than that of the female while the relative brain weight obtained in the female (0.636 +/- 0.049%) was higher than that of the male rats (0.564 +/- 0.032%), although the difference in the values was not statistically significant (p > 0.05). The lengths of the brain and myelencephalon, as well as the weights of the myelencephalon and mesencephalon, did not differ between the two sexes (p > 0.05). The weights and lengths of the pons did not differ between the two sexes (p > 0.05). There was a significant difference (p < 0.05) in the pyramidal length and a highly significant difference (p < 0.01) in the pyramidal width between the two sexes, with the male rats having higher values. This pioneering sexual dimorphic brain morphometry provides information for further research.

Direct detection of genomic DNA with fluidic force discrimination assays.

Herein, we describe the direct detection of genomic DNA using fluidic force discrimination (FFD) assays. Starting with extracted bacterial DNA, samples are fragmented by restriction enzymes or sonication, then thermocycled in the presence of blocking and labeling sequences, and finally detected with microbead-based FFD assays. Both strain and species identification of extracted Bacillus DNA have been demonstrated in <30 min, without amplification (e.g., PCR). Femtomolar assays can be achieved with this rapid and simple procedure.

Haematological values in pregnant women in Port Harcourt, Nigeria.

BACKGROUND: Conflicting results have been documented regarding the statistical significance of variations in some haematological parameters at different trimesters of pregnancy. Environmental factors, ethnic and tribal peculiarities have variously been implicated. The values of eight important haematological parameters: Haematocrit (Hct), Haemoglobin concentration (Hbc), Red Blood Cell (RBC) count, White Blood Cell (WBC) count, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC) and Erythrocyte Sedimentation Rate (ESR) were therefore determined in healthy pregnant subjects receiving antenatal care at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. METHOD: Cross-sectional prospective study involving 130 pregnant subjects aged between 18 and 43 years. The subjects were divided into three groups consisting of 46 subjects in the first trimester, 36 subjects in the second trimester and 48 subjects in the third trimester of pregnancy. The height, weight and body mass index of all subjects were also determined. RESULTS: Results obtained for the haematological parameters indicate that only Haematocrit (Hct) showed significant differences amongst the three groups; highest amongst subjects in the third trimester and lowest amongst subjects in the second trimester (p < 0.05). Haemoglobin concentration (Hbc), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), and Erythrocyte Sedimentation Rate (ESR) were found to be highest amongst subjects in the second trimester; Red Blood Cell (RBC) count and White Blood Cell (WBC) count were highest amongst subjects in the first trimester of pregnancy. These differences were however, not statistically significant (p > 0.05). Among the anthropometric parameters studied, only weight showed significant differences in the three groups of pregnant subjects (p < 0.05); being highest amongst subjects in the third trimester and lowest in subjects in the first trimester. CONCLUSION: The present study provides additional baseline data for basic haematological parameters in healthy pregnant Nigerian women. This would be of immense benefit especially in the antenatal assessment of pregnant Nigerian women.

Achieving a paradigm shift in environmental and living resources management in the Gulf of Guinea: the large marine ecosystem approach.

The Gulf of Guinea is situated in the narrow protrusion of eastern Equatorial Atlantic between latitudes 2 degrees S and 5 degrees N and longitudes 8 degrees W to 12 degrees E, spanning a coastline length of approximately 130 nautical miles. The dominant feature of this shallow ocean off the coast of countries in Western Africa is the Guinea Current. The distinctive bathymetry, hydrography, productivity and trophodynamics of this shallow ocean qualify it as a large marine ecosystem (LME) and is indeed recognized as the number 28 of the 64 delineated LMEs globally. This area is one of the world's productive marine areas that is rich in fishery resources, oil and gas reserves, precious minerals and an important global reservoir of marine biological diversity. Unfortunately, pollution from residential and industrial sources has affected the waters of the Gulf of Guinea resulting in habitat degradation, loss of biological diversity and productivity, and degenerating human health. In reversing this trend of marine environmental degradation, the countries of the region adopted an integrated and holistic approach using the LME concept to sustainably manage the environmental and living resources of the region. The concept is predicated on the fact that marine environmental pollution and living resources respect no political or geographical boundaries and so require a holistic and regional approach for its management. The Gulf of Guinea countries through the Global Environment facility funded regional/communal project on water pollution control and biodiversity conservation achieved a paradigm shift in living resources and environmental management in the region using the LME concept.

Use of extracts of Picralima nitida bark in the treatment of experimental trypanosomiasis: a preliminary study.

The effect of a boiling water extract of Picralima nitida bark against trypanosomes (T. brucei) in rats was compared with that of diminazene aceturate at 8 mg/kg i.p. Results showed that the extract had a definite trypanocidal effect which was statistically comparable to that of diminazene aceturate. Further work is needed to identify the active pharmacological agent and to standardise the usage of the agent in practice.