Troponin C gene mutations on cardiac muscle cell and skeletal Regulation: A comprehensive review.

BACKGROUND: The troponin complex plays a crucial role in regulating skeletal and cardiac contraction. Congenital myopathies can occur due to several mutations in genes that encode skeletal troponin. Moreover, there is limited information regarding the composition of skeletal troponin. This review specifically examines a comprehensive review of the TNNC gene mutations on cardiac and skeletal regulations. MAIN BODY: Troponin C (TNNC) has been linked to a newly discovered inherited muscle disorder. Genetic variations in genes that encode skeletal troponin can impair the function of sarcomeres. Various treatment approaches have been employed to mitigate the impact of variations, including the use of troponin activators, the injection of wild-type protein via AAV gene therapy, and myosin modification to enhance muscle contraction. The processes responsible for the pathophysiological implications of the variations in genes that encode skeletal troponin are not fully understood. CONCLUSION: This comprehensive review will contribute to the understanding of the relationship between human cardiomyopathy and TNNC mutations and will guide the development of therapy approaches.

Addressing the Dengue fever challenges in Nigeria: A narrative review and recommendations for control.

Dengue fever is a mosquito-borne viral infection that continues to pose a significant public health threat globally, including Nigeria. Here, we provided a review of dengue fever outbreaks in Nigeria from 1972 to 2023, examining the epidemiology, prevention strategies, challenges faced in combating the disease, and recommendations to mitigate its spread and transmission. We utilized scholarly databases such as PubMed and Google Scholar in writing this paper. The search keywords like, "dengue fever", "break-bone fever", "dengue fever virus" "outbreak", "Nigeria", "prevalence", and "epidemiology", were used to get appropriate published articles about the subject areas. Over the past five decades, Nigeria has experienced intermittent outbreaks of dengue fever, with varying degrees of severity and geographic distribution. Factors such as urbanization, climate change, and inadequate healthcare infrastructure have contributed to the resurgence and spread of the disease in the country. Despite efforts to control dengue transmission through vector control measures and public health interventions, challenges persist, including limited surveillance capacity, diagnostic delays, and gaps in vector control strategies. The emergence of new dengue virus serotypes and the potential for co-circulation with other arboviruses further complicate control efforts. This review highlights the importance of strengthening surveillance systems, enhancing vector control measures, improving diagnostic capabilities, and increasing public awareness to effectively mitigate the burden of dengue fever in Nigeria. Collaboration between government agencies, healthcare providers, researchers, and international partners is crucial in addressing the growing threat of dengue fever and reducing its impact on public health in Nigeria.

Navigating Nigeria's Health Landscape: Population Growth and Its Health Implications.

This comprehensive analysis examines the multifaceted impacts of population growth on public health in Nigeria. Drawing parallels with Omran's epidemiological transition model (that focuses on the intricate means that patterns of health and illness are changing, as well as the relationships that exist between these patterns and the sociological, demographic, and economic factors that influence them) and referencing experiences from Chile and Ceylon. The study highlights a substantial rise in Nigeria's population causing a double burden of infectious and non-communicable diseases, leading to higher morbidity, and mortality rates, increased healthcare costs, decreased productivity, and health inequalities, posing significant challenges to the country's healthcare system. Furthermore, the correlation between low education levels and health outcomes underscores the importance of addressing systemic deficiencies in Nigeria's educational sector. The article emphasizes the urgent need for strategic interventions to mitigate the adverse effects of population growth on health. Recommendations include revitalizing primary healthcare centers, fostering public-private partnerships to enhance healthcare accessibility, leveraging technological advancements like telemedicine, and promoting initiatives to improve nutrition and environmental sustainability. Moreover, prioritizing education on reproductive health and family planning emerges as a crucial strategy to manage population growth sustainably. In conclusion, the article underscores the imperative for collaborative efforts across sectors to navigate Nigeria's evolving health landscape amidst increasing population growth. By implementing targeted policies and interventions, Nigeria can strive toward achieving universal health coverage, enhancing health outcomes, and ultimately raising the standard of living for its populace.

The potential application of artificial intelligence in veterinary clinical practice and biomedical research.

Artificial intelligence (AI) is a fast-paced technological advancement in terms of its application to various fields of science and technology. In particular, AI has the potential to play various roles in veterinary clinical practice, enhancing the way veterinary care is delivered, improving outcomes for animals and ultimately humans. Also, in recent years, the emergence of AI has led to a new direction in biomedical research, especially in translational research with great potential, promising to revolutionize science. AI is applicable in antimicrobial resistance (AMR) research, cancer research, drug design and vaccine development, epidemiology, disease surveillance, and genomics. Here, we highlighted and discussed the potential impact of various aspects of AI in veterinary clinical practice and biomedical research, proposing this technology as a key tool for addressing pressing global health challenges across various domains.

Barriers and Facilitators of Premarital Genetic Counseling for Sickle Cell Disease in Northern Nigeria.

In high-income countries, premarital genetic counseling for Sickle Cell Disease (SCD) is a standard practice. However, in Nigeria, there is no formal premarital genetic counseling program available for SCD. We conducted a series of focus group discussions with health care professionals, patients with SCD, and parents of the patients with or without SCD to gain an understanding of their attitudes and beliefs towards SCD/Sickle Cell Trait and premarital genetic counseling for SCD. Data were analyzed using Charmaz's constructivist grounded theory approach. Two themes were highlighted in the analysis as follows: (1) the difference between the perception of premarital sickle cell screening among individuals with SCD versus the general population, and (2) the personal beliefs and physical challenges that could lead to the avoidance of premarital screening within the general community. Lack of disease-related knowledge, testing facilities, transportation, and stigma associated with the disease were the most commonly perceived barriers to premarital testing. Also, a willingness to receive premarital testing for SCD exists within our community to reduce the spread of the disease and advocate for improved health-related quality of life of patients with SCD. The content and structure of a premarital genetic counseling program in Kano, Northern Nigeria, needs to be developed.

Langya virus outbreak: current challenges and lesson learned from previous henipavirus outbreaks in China, Australia, and Southeast Asia.

Background and aims: A new novel virus, Langya virus (LayV), was detected in China in August 2022, 3 years after the COVID-19 pandemic. LayV is similar to the previously discovered Mojiang henipavirus. Other zoonotic henipaviruses include the Hendra and Nipah viruses. The emergence of the zoonotic Langya virus is attributed to climate change and wildlife encroachment, as LayV is detected in shrews. Those who are infected in China showed various symptoms, but no deaths have been recorded yet. This review aims to shed light on the current state of Langya virus outbreak, its infection control efforts, and the remaining challenges that need to be addressed to curb the outbreak. Methods: We utilized online publication databases such as PubMed, Google Scholar, and Scopus in writing this review article. Results: A surveillance study on thirty-five febrile patients in Eastern China identified the Langya virus outbreak. The current efforts from the Chinese government and health authorities to reduce the transmission and spread of Langya virus such as isolation and characterization of LayV, challenges associated with the increase in cases of LayV, and trackable recommendations such as strengthening the healthcare system in China, sensitization of people about risks associated with Langya virus outbreaks, creating an intensive surveillance system network, etc. were discussed. Conclusion: It is germane and pertinent that the Chinese government and health authorities continue to intensify efforts against Langya virus and address the challenges to effectively reduce transmission.

Public health concerns surrounding the cVDPV2 outbreak in Africa: Strategies for prevention and control with a special focus on Nigeria.

Background and Aim: Poliovirus is a global health issue that affects children in different parts of the world. Despite the efforts of national, international, and nongovernmental organizations to eradicate the disease, it is re-emerging in Africa due to poor sanitation, vaccine hesitancy, new ways of transmission, and poor surveillance among others. Circulating vaccine-derived poliovirus type 2 (cVDPV2) is a major step in eradicating poliovirus and preventing outbreaks in developing countries. Strengthening African healthcare systems, increasing surveillance, hygiene and sanitation, and proper mass vaccination to achieve herd immunity are required in the fight against polio disease. This paper discusses the outbreak of cVDPV2, public health challenges, and recommendations in Africa with a special emphasis on Nigeria. Methods: We searched for articles documenting the incidence of cVDPV2 in Nigeria and other African countries on Pubmed, Google Scholar, and Scopus. Results: A total of 68 distinct cVDPV2 genetic emergences were found across 34 nations between April 2016 to December 2020, and in Nigeria, three cVDPV2 emergences were found. Also, 1596 instances of acute flaccid paralysis linked to cVDPV2 outbreaks were reported in four areas of the World Health Organization where Africa contributed 962 cases out of 1596 cases. Available data indicate that Africa has the most cVDPV2 cases and is associated with various challenges like the unidentified virus source, poor sanitation system, and inability to achieve herd immunity of the cVDPV2 vaccine. Conclusion: Collaborative efforts of stakeholders are crucial in combating infectious diseases, especially those transmitted via environments such as water and air, like poliovirus. Therefore, a collaboration between environmental health workers, veterinarians, community health workers, laboratory scientists, policymakers, and other professionals is required.

Tomato flu 2022 outbreak in India: Issues, challenges, and possible solutions.

Background and Aims: The outbreak of Tomato flu in India has affected the children making the parents tremble in worry and pain. The outbreak of this disease first occurred in India affecting young children below 5 years of age, thereby causing a threat to the country, neighboring countries, and the rest of the world-although no death is yet recorded. The aim of this research is to discuss the issues, challenges, and possible solutions associated with 2022 Tomato flu outbreaks in India. Results: Tomato flu is caused by Coxsackievirus A16 as confirmed in the United Kingdom. The health authorities are currently monitoring the spread of the virus and trying to understand it to develop strategies to contain it. But they are left with some challenges relating to the health system, surveillance, and adherence to preventive protocols among others. Conclusion: To prevent the spread of Tomato flu to other neighboring countries like China, Bangladesh, Pakistan, Sri Lanka, Myanmar, Afghanistan, Bhutan, Nepal, and the Maldives, the Indian Government must provide adequate public health control measures to contain the disease in children. Various recommendations have been given below.

Knowledge, attitudes and practices of infection prevention and control among healthcare workers during the COVID 19 pandemic: a descriptive cross-sectional study in three Nigerian states.

BACKGROUND: Emergence of the COVID-19 pandemic created unexpected challenges for health care workers. The global and national supply chain system was disrupted, and affected infection, prevention and control (IPC) practices. This study aimed at documenting health workers knowledge, attitudes and practices (KAP) on IPC in Nigeria during the COVID-19 pandemic. METHODS: The descriptive, mixed-methods cross-sectional study was conducted in Ebonyi, Ondo and Niger states in October 2020. A structured questionnaire was administered to the health workers, complemented by semi-structured interviews that were audio recorded, transcribed and analyzed in Atlas.ti. Quantitative data were entered into REDCap and cleaned, transformed and analyzed using descriptive statistics in SPSS version 25.0 Findings from the qualitative interviews were used to explain the trends observed from quantitative study. RESULTS: There were demographic differences between community and facility-based health workers in our population. A greater proportion of facility-based providers reported having IPC training compared to community-based health workers ever (p < 0.01) and during the pandemic (p < 0.05). Health care workers had moderate knowledge of general IPC, and attitudes toward and practice of IPC during COVID-19 pandemic. However, the knowledge of the relative effectiveness of prevention measures was low. The mean knowledge scores were greater among facility-based workers compared to community based healthcare workers (p = 0.001). Self-reported IPC practices increased during the pandemic compared to prior to the pandemic, with the exception of the use of N-95 masks and hand sanitizer. CONCLUSION: This study found moderate IPC knowledge, attitudes and practices in our study population during the pandemic as compared to pre-pandemic for the study found gaps in correct hand hygienevaried application of different IPC practices to ensure adherence to COVID-19 preventive measures. The study recommends sustained training for IPC and encourages policy makers that budget line specific to COVID-19 response across all the levels of health care delivery will enhance compliance and emergency readiness.

Determinants of mortality among hospitalized patients with COVID-19 during first and second waves of the pandemic: A retrospective cohort study from an isolation center in Kano, Nigeria.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as an important cause of morbidity and mortality worldwide. The aim of this study is to identify the clinical predictors of mortality among patients with COVID-19 pneumonia during first and second waves in a treatment center in northwestern Nigeria. METHODS: This was a retrospective cohort study of 195 patients hospitalized with COVID-19 between April 2020 to March 2021 at a designated COVID-19 isolation center in Kano State, Northwest Nigeria. Data were summarized using frequencies and percentages. Unadjusted odds ratios and 95% confidence intervals and p-values were obtained. To determine independent determinants of mortality, we performed a stepwise multivariate logistic regression model. RESULTS: Of 195 patients studied, 21(10.77%) patients died. Males comprised 158 (81.03%) of the study population. In the adjusted stepwise logistic regression analysis, age>64 years (OR = 9.476, 95% CI: 2.181-41.165), second wave of the pandemic (OR = 49.340, 95% CI:6.222-391.247), cardiac complications (OR = 24.984, 95% CI: 3.618-172.508), hypertension (OR = 5.831, 95% CI:1.413-24.065) and lowest systolic blood pressure while on admission greater than or equal to 90mmHg were independent predictors of mortality (OR = 0.111, 95%CI: 0.021-0.581). CONCLUSION: Strategies targeted to prioritize needed care to patients with identified factors that predict mortality might improve patient outcome.

Current efforts and challenges facing responses to Monkeypox in United Kingdom.

Despite the extraordinary and exceptional advances in drugs and vaccine development, sophisticated diagnostic facilities in health care settings, strategies in disease prevention and control, emerging and re-emerging infections are still the leading cause of death and suffering amongst human and animal populations with great impact on the world economy. Monkeypox is a viral disease with the potential to spread across the globe through international travel and movements of animals from endemic areas to susceptible populations. Monkeypox virus is an uncommon but endemic viral disease in Africa, but recent outbreaks occurred in Europe, the US, UK, Spain, Portugal, Sweden, and Italy. There is a need to refurbish the healthcare settings and get prepared for future outbreaks, especially in developing countries with poor healthcare delivery services. Scientists and researchers should also focus on developing vaccines, treatment, and preventive measures before the virus spread further.

Utilization of YouTube and Twitter as source of information for research by medical students at Usmanu Danfodiyo University, Sokoto

YouTube and Twitter have been used as a social media handles for a number of purposes; however, using same tools for research purposes among undergraduate medical students is the major reason for this study. The study investigated the utilization of YouTube and Twitter as sources of information among undergraduate's medical students in Usmanu Danfodiyo University, Sokoto (UDUS),Nigeria. Descriptive survey was used with the population of 65,469 medicals students drawn from three (3) faculties' namely, Health sciences, Medical sciences and Laboratory sciences. A sample size of 398 undergraduates was drawn using Slovene's formula. Questionnaire was used as a data collection instrument and distributed to 398 undergraduate medical students, out of which a total of 379 copies was returned and used for analysis. Data collected were analyzed with the use of Statistical Package for Social Sciences (SPSS). It was found that medical students in UDUS make use of YouTube and Twitter to a great extent and they use it majorly for academic purposes. Furthermore, information overload, epileptic power supply and Spam and false news media platforms werefound to be the most prominent challenges faced by medical students in UDUS using YouTube and Twitter as sources of information for research. The recommendations proffered include: lecturers should ensure that they engage the students in tasks that can require them to visit and search for academic information on YouTube and Twitter among others.

Epidemiology and treatment of priapism in sickle cell disease.

Ischemic priapism is a common but underrecognized morbidity affecting about 33% of adult men with sickle cell disease (SCD). The onset of priapism occurs in the prepubertal period and tends to be recurrent with increasing age. Significantly, priapism is associated with an unrecognized high burden of mental duress and sexual dysfunctions. The diagnosis of priapism is clinical. Many episodes of priapism will resolve spontaneously, but when an episode lasts longer than 4 hours, the episode is considered a urologic emergency requiring quick intervention with either corporal aspiration or shunt surgery. Only 3 randomized clinical trials (stilbesterol, ephedrine or etilefrine, and sildenafil) have been conducted for secondary priapism prevention in SCD. All 3 trials were limited with small sample sizes, selection biases, and inconclusive results after completion. The current molecular understanding of the pathobiology of priapism suggests a relative nitric oxide (NO) deficiency secondary to chronic hemolysis in SCD and associated phosphodiesterase type 5 dysregulation. We posit an increase in NO levels will restore the normal homeostatic relationship between voluntary erection and detumescence. Currently, 2 randomized phase 2 trials (1 double-blind, placebo-controlled trial and 1 open-label, single-arm intervention) are being conducted for secondary priapism prevention in men at high risk for recurrent priapism (NCT03938454 and NCT05142254). We review the epidemiology and pathobiology of priapism, along with mechanistic therapeutic approaches for secondary prevention of priapism in SCD.

Incidence and predictors of priapism events in sickle cell anemia: a diary-based analysis.

We conducted one of the first prospective studies to test the hypothesis that the clinical history of priapism underestimates priapism incidence compared with a priapism pain diary. Eligibility criteria were men with sickle cell anemia (SCA) between 18 and 40 years of age who have had at least 3 episodes of priapism in the past 12 months. Seventy-one men with SCA completed the diary for at least 3 months. The first 3 months of the priapism diary were included in the analysis. A total of 298 priapism episodes were recorded, and 80% (57 of 71) of the participants had at least 1 priapism event. Priapism severity was reported in the range of moderate to the worst imaginable pain in 81.5% (263 of 298), and a total 57 participants (80%) had a median pain rating of 6 (interquartile range: 5-8) on a scale from 1 to 10. The monthly incidence rate of priapism per participant based on history versus self-report pain diary was 2.0 (95% confidence interval, 1.9-2.1) and 1.4 (95% confidence interval, 1.2-1.6), respectively (P < .001). For participants that had a prior priapism episode, 80% had another episode during the 3-month interval follow-up. The median time to that second episode was 27.5 days. Major priapism occurred in 9.9% of episodes and was associated with the sum of all prospective priapism events. Men with SCA and at least 3 priapism episodes in the past 12 months are at significant risk for recurrent priapism in the following 3 months.

Sickle cell disease as an accelerated aging syndrome.

Sickle cell disease (SCD) is characterized by vaso-occlusion, hemolysis, and systemic manifestations that form the hallmark of the disease. Apart from morbidity, SCD is also associated with increased mortality and decreased quality of life. Aging is a natural phenomenon that is associated with changes at cellular, tissue, and organ levels, in addition to the loss of physical fitness, increased susceptibility to diseases, and a higher likelihood of mortality. Some of the cellular mechanisms involved in normal (or physiological) aging include abnormalities of sphingolipids (ceramides) and reduced length of the telomere. These changes have also been documented in SCD. Cellular, organs, and physical manifestations of SCD resemble an accelerated aging syndrome. Sickle erythrocytes also acquire morphological features similar to that of aged normal erythrocytes and are thus picked up early by the macrophages for destruction. Brain, kidney, heart, innate and adaptive immune system, and musculoskeletal system of patients with SCD exhibit morphological and functional changes that are ordinarily seen in the elderly in the general population. Stroke, silent cerebral infarcts, cardiomegaly, heart failure, pulmonary hypertension, nephropathy with proteinuria, osteopenia, osteoporosis, osteonecrosis, gout, and infections are exceedingly common in SCD. In this review, we have attempted to draw parallels between SCD and accelerated aging syndromes.

Psychometric Impact of Priapism on Lives of Adolescents and Adults With Sickle Cell Anemia: A Sequential Independent Mixed-Methods Design.

Despite priapism being one of the most frequent complications of sickle cell anemia (SCA) in male individuals, little has been reported about the impact of priapism in this population. The authors used a sequential independent mixed-methods design, which used both international multicenter focus group discussions (n=35) and a quantitative patient-reported outcome measure (n=131) to determine the impact of priapism on men with SCA in Nigeria and the United States. The authors analyzed data from focus groups using an iterative inductive-deductive approach. Comparison of the Priapism Impact Profile data was done using the Kruskal-Wallis H test. Our result showed that priapism, across cultures, is associated with shame and embarrassment. These emotions interfere with timely clinical and family communication about priapism symptoms and complications. Participants were dissatisfied with the quality of care at emergency facilities. The quality of life and physical wellness of men with SCA-related priapism were significantly different for the 3 groups: (1) priapism condition getting better, (2) priapism condition getting worse, and (3) priapism condition remain the same (P=0.002 and P=0.019, respectively). Psychological, sexual, and physical wellbeing are all adversely affected by priapism. Evidence-based methods are necessary for adequate medical, educational, and psychological treatment for recurrent priapism.

High Systolic Blood Pressure, Anterior Segment Changes and Visual Impairment Independently Predict Sickle Cell Retinopathy.

Sickle cell disease is often complicated by retinopathy, which can be proliferative or non proliferative. Proliferative sickle cell retinopathy potentially leads to blindness. There is a paucity of data on sickle cell disease-related retinopathy from Africa, where the disease is most prevalent. We aimed to determine the clinical, ophthalmic, and laboratory predictors of sickle cell retinopathy in an African population. We conducted a cross-sectional study of 262 participants, aged 13 years and above, with sickle cell disease. Demographic and clinical data were collected using a structured questionnaire and standard physical examinations. Vitreo-retinal specialists performed eye examinations on all the participants. Hematological and biochemical assessments were conducted using standard methods. A multivariate stepwise forward logistic regression was performed to determine the predictors of retinopathy. The median age of the participants was 20 years (interquartile range: 17-25 years). Most of the participants had a homozygous Hb S (HBB: c.20A>T) genotype (96.9%), with 3.1% who carried a Hb S/Hb C (HBB: c.19G>A) genotype. The prevalence of non proliferative sickle cell retinopathy was 24.4%. Only 1.9% had proliferative sickle cell retinopathy (PSCR). Elevated systolic blood pressure (BP) [odds ratio (OR): 6.85, 95% confidence interval (95% CI): 1.05-44.45, p = 0.059], moderate visual impairment (OR: 5.2, 95% CI: 1.39-19.63, p = 0.015), and anterior segment changes (OR: 2.21, 95% CI: 1.19-4.13, p = 0.012) were independently predictive of retinopathy. This study provides new insight into predictors of retinopathy in sickle cell disease, with implications on early screening and prevention.