Accelerated Generation of Extra-Islet Insulin-Producing Cells in Diabetic Rats, Treated with Sodium Phthalhydrazide.

ß-cells dysfunction plays an important role in the pathogenesis of type 2 diabetes (T2D), partially may be compensated by the generation of extra-islet insulin-producing cells (IPCs) in pancreatic acini and ducts. Pdx1 expression and inflammatory level are suggested to be involved in the generation of extra-islet IPCs, but the exact reasons and mechanisms of it are unclear. Macrophages are key inflammatory mediators in T2D. We studied changes in mass and characteristics of extra-islet IPCs in rats with a streptozotocin-nicotinamide model of T2D and after i.m. administration of 20 daily doses of 2 mg/kg b.w. sodium aminophthalhydrazide (APH). Previously, we found that APH modulates macrophage production and increases the proliferative activity of pancreatic ß-cells. Expressions of insulin and Pdx1, as well as F4/80 (macrophage marker), were detected at the protein level by immunohistochemistry analysis, the concentration of pro- and anti-inflammatory cytokines in blood and pancreas-by ELISA. Diabetic rats treated with APH showed an increasing mass of extra-islet IPCs and the content of insulin in them. The presence of Pdx1+ cells in the exocrine pancreas also increased. F4/80+ cell reduction was accompanied by increasing TGF-ß1 content. Interestingly, during the development of diabetes, the mass of ß-cells decreased faster than the mass of extra-islet IPCs, and extra-islet IPCs reacted to experimental T2D differently depending on their acinar or ductal location.

Esophageal cancer epidemiology, diagnosis, and management in Sudan - A review.

INTRODUCTION: In Sudan, cancer a common health challenge, is the leading cause of death after malaria and viral pneumonia. The aim of the review is to determine the risk factors associated with esophageal cancer (EC) among Sudanese population. METHODS: All published online data concerning EC epidemiology, diagnosis, and management in Sudan were studied. RESULTS: The prevalence of EC in Sudan is ranked fourth among cancer types in males and fifth in females. The squamous cell carcinoma is more predominant than adenocarcinoma. The dietary, dysplasia and teeth loss, cigarette smoking, age, sex, GERD, genetic and environmental interactions remain a risk for developing EC in clinical practice. A significant challenge for treatment is that most of EC patients were often diagnosed in advanced stages due to the lack of early clinical symptoms. Management of EC depends on patient fitness and tumor stage, endoscopic removal was used for early tumors, while chemotherapy, chemo-radiotherapy, surgical resection, or combinations of these were used for advanced tumors. Despite improvements in the management and treatment of EC patients, the general outcome remains very poor. Furthermore, using molecular techniques to better understand the etiology of EC, it may assist in identifying complicated and critical issues and improve therapy towards a new treatment strategy. CONCLUSION: The remarkable factors associated with EC among Sudanese are geographical variation, environmental factors, ethnic differences, dietary and social habits.

Factors associated with Scrub Typhus infection: A case-control study from Luhe, China.

INTRODUCTION: Scrub typhus (ST) is an acute febrile infection and remains a significant health problem globally. This study aimed to determine the factors associated with ST infection in Luhe District, China. MATERIAL AND METHODS: The case-control study was conducted among 116 cases identified through passive surveillance systems over three years.The control subjects were 232 living in the same village for more than six months without any history of ST infection were selected by matching to the age (within 5-years) and identified through active surveillance. Statistical analyses were performed using SPSS v. 25.0 for Windows (IBM SPSS, Chicago, IL, USA). RESULTS: The mean age of confirmed persons was 58.1(SD=10.15) years, while control subjects were 56.14 (11.57).There is no significant difference in gender, age, education, and occupations between case and control. Farmers had the most significant number of cases among occupational groups. The three factors that were significantly associated with an increased odds of having ST infection are bundling or moving waste straw (OR: 1.94, 95%CI; 0.99,381), morning exercise in the park or field (OR: 4.74 95%CI; 1.19, 18.95), and working as labourer in the vegetable field (OR:1.02, 95%CI:1.02,3.19). CONCLUSIONS: Our findings suggested establishing a prevention and control strategy for these groups to lower ST development risk.

Impact of recurrent outbreaks of Ebola virus disease in Africa: a meta-analysis of case fatality rates.

OBJECTIVES: Between 2010 and 2020, Africa witnessed several outbreaks of Ebola virus disease (EVD), each presenting with varying case fatality rate (CFR) and other socio-economic impacts. This study aims to summarize the CFR and identify potential factors that influenced the severity of EVD outbreaks in Africa. STUDY DESIGN: This was a systematic review and meta-analysis of EVD outbreaks published between January 2010 and March 2020, using Web of Science, Scopus, and PubMed databases. METHODS: Only English-language articles and reports, including the number of cases and deaths during the outbreak in Africa, were considered. The quality of the included articles was assessed using Murad's quality assessment tool. The analysis was conducted using Stata (version 12), pooled effect sizes were calculated using the random-effects model, and heterogeneity was tested for using the I2 statistic. RESULTS: Thirteen studies with 32,300 cases and 13,727 deaths were identified, whose pooled CFR was 60% (95% confidence interval [CI]: 47-73%). The most EVD-affected countries were the Democratic Republic of Congo with five outbreaks and a pooled CFR of 65% (95% CI: 59-71%), followed by Uganda with three outbreaks and CFR of 83% (95% CI: 60-99%). Zaire ebolavirus caused the most outbreaks (10), with a CFR of 58% (95% CI: 45-71%). Besides, outbreaks with fewer than 1000 cases reported a higher CFR rate (65%, 95% CI: 54-75%) compared with those with more cases (51%, 95% CI: 33-69%). CONCLUSION: The study has revealed a considerably high CFR caused by the recurrent EVD outbreaks in Africa. It also notes an implementation gap in the prevention and control strategies and thus identifies a need to strengthen the surveillance systems and response mechanisms to enable early detection and prompt control of future outbreaks.

Determinants of Outcome among Under-Five Children Hospitalized with Pneumonia at a Tertiary Health Facility in South-West Nigeria.

BACKGROUND: Pneumonia contributes largely to mortality among children particularly in developing countries. In 2018, about 15% of all deaths in children aged less than 5 years were attributed to pneumonia globally. This study aimed to identify factors at presentation that determine mortality among children less than 5 years of age hospitalized with pneumonia. METHODS: This was a prospective observational study conducted at the Children emergency unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Subjects were consecutive children aged between 1-60 months with clinical and radiological pneumonia. Treatment outcome and determinants of mortality were studied. RESULTS: A total of 129 subjects were studied with a male to female ratio of 1.5: 1. Thirteen subjects died, giving a case fatality rate of 10.1%. Mortality was associated with age <24 months (p= 0.001), severe wasting (p< 0.001), temperature >38.30C (p= 0.001), grunting (p< 0.001), central cyanosis (p < 0.001), hypoxaemia (p < 0.001), loss of consciousness (p = 0.007), severe anaemia (p < 0.001), and leucopaenia (p = 0.001). Among the significant variables, temperature >38.30C [adjusted odds ratio (OR) 34.241, 95% confidence interval (CI) 2.496 - 469.815], grunting (OR 19.444, 95% CI 1.744 - 216.725), central cyanosis (OR 43.984, 95% CI 2.001- 966.729), hypoxaemia (OR 41.883, 95% CI 1.918 - 914.495) and severe anaemia (OR 48.201, 95% CI 3.351 - 693.432) were the independent determinants of mortality. CONCLUSION: Children hospitalized for pneumonia with temperature >38.30C, grunting, cyanosis, hypoxaemia, and severe anaemia are more likely to die. Hence, they must be treated intensively.

COVID-19 in Sudan: Response towards control and prevention.

No abstract provided.

Accelerated liver recovery after acute CCl4 poisoning in rats treated with sodium phthalhydrazide.

Pharmacotherapy of hepatobiliary disorders is an important issue due to the high prevalence of liver failure, toxic and viral hepatitis and cirrhosis. The number of stimuli that can potentially induce or accelerate liver recovery is limited; in our study we selected sodium phthalhydrazide, which has been found to promote liver regeneration after partial hepatectomy. We examined the effects of phthalhydrazide on liver morphometric, histological and biochemical parameters in rats intoxicated with CCl4. Accelerated liver recovery after CCl4 intoxication in phthalhydrazide-treated animals was evidenced by increased number of liver sinusoidal cells, reduced focal necrosis of hepatocytes and reduced perifocal leukocyte infiltration. Decreased plasma levels of pro-inflammatory cytokines TNF-α and IL-18 and decreased concentrations of IL-6 and IFN-γ in liver homogenates were associated with reduced severity of cholestasis and normalized hepatic protein synthesis in CCl4-intoxicated rats exposed to phthalhydrazide. Anti-inflammatory and immunomodulating properties of phthahlhydrazide can be an important factor contributing to accelerated liver recovery at early stages of acute CCl4-toxic liver impairment.

Recruitment of macrophages and bone marrow stem cells to regenerating liver promoted by sodium phthalhydrazide in mice.

Pharmacological interventions which could be hepatoprotective, depending on bioavailability, anti-inflammatory and macrophage-targeting potential of drugs, are still at early preclinical stages. Existing evidence from many animal models of liver injury, as well as from human data, indicate that pharmacological and/or phytochemical interventions have limited impact on liver recovery. Recent studies on stem cell therapies focused on different cell subsets involved in tissue repair, including monocytes/macrophages and bone marrow cells migrating to the injured liver. Partial hepatectomy (PH) resulted in a rapid increase of monocytes/macrophages in bone marrow and liver, which could be further enhanced by prior treatment of animals with sodium phthalhydrazide. Increased number of proliferating Ki67+ hepatocytes, increased total protein and albumin content in regenerating liver, recruitment of CD172a+ macrophages and more differentiated CD45lowCD117+ bone marrow cells, could be further promoted by the treatment of animals with 2 mg/kg b.w. phthalhydrazide, considered immunomodulatory, antioxidant and macrophage-silencing. Phenotypic polarization of macrophages can possibly explain the macrophage reparative capacities, protective against liver injury. Enhanced macrophage cell recruitment from bone marrow to regenerating liver can be possibly one of important events in hepatic recovery.

Aphrodisiac Effects of Aqueous Extracts of Pausinystalia yohimbe, Cassia sieberiana and Cissus populnea Roots In Paroxetine-Induced Sexual Dysfunction Male Rats: A Comparative Study:

@#There is a folkloric claim that Pausinystalia yohimbe,Cassia sieberiana and Cissus populnearoots can be used to enhance sexual behaviour in male rats. However, there is still dearth of scientific evidence that substantiated the acclaimed efficacy of separate and combined use of the plant as sex enhancer. Therefore, the aims of this study were to compare the separate and combined effects of aqueous extracts of Pausinystalia yohimbe, Cassia sieberiena and Cissus populnearoots in paroxetine-induced sexually impaired male rats.Thirty five male rats were assigned into seven groups (A-G) such that rats in group A received orally 1.0 ml of distilled water for 7 days, while those in groups B -G which were induced into sexual dysfunction (administration of 10 mg/kg of paroxetine) also received equal volume of distilled water, 7.14 mg/kg body weight of PowmaxM (a reference drug), 50 mg/kg body weight of P. yohimbe, 50 mg/kg body weight of C. sieberiana, 50 mg/kg body weight of C. populneaand 50 mg/kg body weight of 1:1:1 mixture of the three extracts, once daily for seven days respectively. The sexual behavior indices of the male rats and the levels of their reproductive hormones were evaluated by standard procedures. The paroxetine-treatment related reductions (P<0.05) in the sexual behaviour indices of Mount Frequency, Intromission Frequency and Ejaculatory Frequency, levels of serum reproductive hormones of testosterone, luteinizing hormone and follicle stimulating hormone were progressively attenuated by the separate administration of the plant extracts. Furthermore, the increases in the Mount Latency, Intromission Latency, Ejaculatory Latency and Post-ejaculatory Interval were also gradually reduced, following the administration of the plant extracts. The male rat sexual behaviour indices and the levels of the male reproductive hormones following the administration of the 1:1:1 mixture of the extracts were not significantly different (P>0.05) from the effects of the separate extracts. All these changes compared favourably (P>0.05) well with those of the sexual dysfunction rats that received PowmaxM (Group G). The results obtained in the present study indicate that the extracts of these plants may have the potentialfor the management of sexual dysfunction in male rats. The combined use of the plants was not significantly better than the individual use of the plants thereby, each and any of the three plants readily available might be used for this purpose.

Association of normative values of grip strength with anthropometric variables among students, in Jiangsu Province.

Handgrip strength is one of the most universal and powerful indices of nutritional and health status. This study was aimed at presenting norms of grip strength values and their association with anthropometric characters among students in Jiangsu Province. Cross-sectional studies were carried out among 255,157 males and females aged 7-22 years in 2010-2013. Weight and height were obtained and handgrip strength was measured. The sample was stratified by sex, age and residential area. Data were analyzed using chi-squared test and Spearman's correlation coefficient, calculated using SPSS version of 20.0. Grip strength increased with age and was significantly stronger in males than in females across all age groups (P < 0.001). Among males the strong association existed between grip strength and body weight (r = 0.858, P < 0.001), height (r = 0.807, P < 0.001), BMI (r = 0.508, P < 0.001), and age (r = 0.842, P < 0.001). Among females grip strength was strongly associated with weight (r = 0.748, P < 0.001), height (r = 0.730, P < 0.001), BMI (r = 0.524, P < 0.001) and age (r = 0.717, P < 0.001). The results of this study can be used for comparisons while determining benchmarks for handgrip strength.

Effects of hyperaemia on left ventricular longitudinal strain in patients with suspected coronary artery disease : A first-pass stress perfusion cardiovascular magnetic resonance imaging study.

AIMS: Myocardial perfusion imaging during hyperaemic stress is commonly used to detect coronary artery disease. The aim of this study was to investigate the relationship between left ventricular global longitudinal strain (GLS), strain rate (GLSR), myocardial early (E') and late diastolic velocities (A') with adenosine stress first-pass perfusion cardiovascular magnetic resonance (CMR) imaging. METHODS AND RESULTS: 44 patients met the inclusion criteria and underwent CMR imaging. The CMR imaging protocol included: rest/stress horizontal long-axis (HLA) cine, rest/stress first-pass adenosine perfusion and late gadolinium enhancement imaging. Rest and stress HLA cine CMR images were analysed using feature-tracking software for the assessment of myocardial deformation. The presence of perfusion defects was scored on a binomial scale. In patients with hyperaemia-induced perfusion defects, rest global longitudinal strain GLS (-16.9 ± 3.7 vs. -19.6 ± 3.4; p-value = 0.02), E' (-86 ± 22 vs. -109 ± 38; p-value = 0.02), GLSR (69 ± 31 vs. 93 ± 38; p-value = 0.01) and stress GLS (-16.5 ± 4 vs. -21 ± 3.1; p < 0.001) were significantly reduced when compared with patients with no perfusion defects. Stress GLS was the strongest independent predictor of perfusion defects (odds ratio 1.43 95% confidence interval 1.14-1.78, p-value <0.001). A threshold of -19.8% for stress GLS demonstrated 78% sensitivity and 73% specificity for the presence of hyperaemia-induced perfusion defects. CONCLUSIONS: At peak myocardial hyperaemic stress, GLS is reduced in the presence of a perfusion defect in patients with suspected coronary artery disease. This reduction is most likely caused by reduced endocardial blood flow at maximal hyperaemia because of transmural redistribution of blood flow in the presence of significant coronary stenosis.

Partial recovery from alloxan-induced diabetes by sodium phthalhydrazide in rats.

In the commonly used experimental model of diabetes, a cytotoxic glucose analogue alloxan can selectively destruct pancreatic ß-cells, with characteristics similar to the type-1 diabetes (T1D) in humans. Treatment of diabetic rats with sodium phthalhydrazide partially reversed diabetogenic pathology in the alloxan-induced diabetes. The alloxan-treated rats with permanent hyperglycemia, which further received i.p. twenty daily doses 2mg/kg b.w. phthalhydrazide, showed at 60days of the experiment a significant amelioration of the diabetes status. Hyperglycemia was decreased by 52%, glycated haemoglobin HbA1c returned to control value, insulin concentration significantly increased from 45,4% (alloxan group) to 59,5% (alloxan+phthalhydrazide) of the control values. Importantly, phthalhydrazide treatment of alloxan-treated diabetic rats markedly decreased the concentrationof interleukin-6 (IL-6) and corticosterone level. Morphometric analysis revealed a marked increase in the number of pancreatic islets/mm2, and a number of cells/mm2 in the pancreatic islets. These changes, including 3-fold increase in the number of insulin-producing cells and 2-fold decrease in blood glucose levels, correlated with the increased proliferative activity of pancreatic ß-cells in the diabetic phthalhydrazide-treated animals. Interestingly, the number of CD68+ cells/macrophages in the pancreatic islets, which was relatively high in the alloxan group (63,9+- 16.4/mm2), markedly decreased after the phthalhydrazide treatment (23,6+-7,2/mm2). Taking together with the previous data on the phthalhydrazide-related macrophage silencing, restriction of macrophage quantity in the alloxan-affected pancreatic islets can be possibly one of important events leading to the partial recovery from the ß-cell disruption.

Hemolymph coagulation and phenoloxidase activity in Uca tangeri induced by Escherichia coli endotoxin.

Uca tangeri is a marine fiddler crab found commonly in the West African coast and is often exposed to Gram-negative pathogens upon injury. The aim of this study was to document the patterns of endotoxin-induced protein coagulation and phenoloxidase (PO) activity in hemolymph fractions of Uca tangeri. Hemolymph from live crabs was obtained by carapace puncture, pooled. and then separated into plasma, hemocyte Lysate (HL), hemocyte lysate supernatant (HLS) and hemocyte lysate debris (HLD). The effect of Escherichia coli (O1111:B4) endotoxin and calcium ion (Ca(2+)) on protein coagulation in the presence/absence of endotoxin and the endotoxin dose-dependence of coagulation and PO activity were each studied in the plasma, HL, HLS and HLD. The results showed Ca(2+) was required to induce coagulation, and was endotoxin concentration-dependent in the plasma. PO activity was highest in the HLS but PO specific activity was highest in HLD. PO activity remained relatively constant with increased LPS concentration in the range studied 0-10 EU/ml. From the data we conclude that endotoxin-induced protein coagulation occurs in the plasma alone and might be mediated by trans-glutaminases, while PO activity is localized inside hemocytes and cell membranes in Uca tangeri.

Social determinants of health in selected slum areas in Jordan: challenges and policy directions.

BACKGROUND: The unplanned urbanization in Jordan has over time created many informal settlements "slums" around big cities as Amman, Zerka and Aqaba. The purpose of this study was to highlight the most common challenges related to social determinants of health in two selected slum areas in Amman and Aqaba and suggest policy directions and interventions to meet these challenges. METHODS: In addition to a prestructured interview with all household heads living in the two slum sites, focus group meetings with a purposefully selected sample of 12 slum dwellers in each site were used to assess the structural and intermediary determinants of health as perceived by slum residents in the two study locations. RESULTS: The study found that slum residents in the two locations suffer from many challenges as severe poverty; unemployment; illiteracy and low education attainments; gender discrimination; insufficient and poor diet; social and official exclusion; unhealthy environment; lack of water supply, electricity and basic sanitation facilities; high prevalence of diseases; and insufficient and inappropriate health services. Specific policy directions to meet these challenges were recommended and grouped into three main clusters: social protection, social inclusion and empowerment. CONCLUSION: New plans and tools should be developed by local authorities in Jordan to understand, protect, include and empower those vulnerable people who are forced to live in these unhealthy and inhuman environments.

Aqueous root extract of Lecaniodiscus cupanioides restores nitric oxide/cyclic guanosine monophosphate pathway in sexually impaired male rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Aqueous root extract of Lecaniodiscus cupanioides is widely used in the management of sexual dysfunction in Nigeria. The effect of aqueous root extract of L. cupanioides root on the concentrations of penile cyclic Guanosine Monophosphate (cGMP) and plasma nitric oxide in paroxetine-induced sexually impaired male rats was evaluated. METHODS: Thirty (30) albino rats were assigned into six groups (A, B, C, D, E and F) of five rats each such that animals in Group A (control) received distilled water while those in Groups B, C, D, E and F which were induced into sexual dysfunction (p.o 10mg/kg of paroxetine hydrochloride suspension in Tween-80) and in addition received distilled water, 7.14 mg/kg body weight of a reference herbal drug (PowmaxM), 25, 50 and 100mg/kg body weight of the extract respectively, orally, once daily for five days. RESULTS: Administration of paroxetine significantly reduced the levels of penile cyclic Guanosine Monophosphate (cGMP) and plasma nitric oxide. These decreases were dose dependently reversed by the aqueous extract of L. cupanioides root. The reversal by the 25 and 50mg/kg body weight of the extract compared favorably with the PowmaxM, whereas the 100mg/kg body weight of the extract compared favorably with the non-sexually impaired distilled water treated control animals. CONCLUSION: The results of this study show that aqueous extract of L. cupanioides root restored the levels of cGMP and nitric oxide in sexually impaired rats. This study further lends credence to the use of aqueous root extract of L. cupanioides in the management of sexual dysfunction in Nigeria.