Dye degradation performance, bactericidal behavior and molecular docking analysis of Cu-doped TiO2 nanoparticles.

Copper-doped TiO2 was prepared with a sol-gel chemical method. Various concentrations (3, 6, and 9 wt%) of Cu dopant were employed. Several techniques were implemented to assess the structural, optical, morphological and chemical properties of the synthesized samples. Evaluation of elemental composition using SEM-EDS and XRF techniques showed the presence of dopant element in the prepared samples. XRD analysis confirmed the presence of anatase (TiO2) phase with interstitial doping. Incorporation of dopant was observed to enhance the crystallinity and increase the crystallite size of the synthesized products. SAED profiles revealed a high degree of crystallinity in the prepared specimens, which was also evident in the XRD spectra. Optical properties studied using UV-vis spectroscopy depicted a shift of the maximum absorption to the visible region (redshift) that signified a reduction in the band gap energy of Cu-doped TiO2 samples. Examination of morphological features with scanning and high-resolution transmission electron microscopes revealed the formation of spherical nanoparticles with a tendency to agglomerate with increasing dopant concentration. Molecular vibrations and the formation of Ti-O-Ti bonds were revealed through FTIR spectra. PL spectroscopy recorded the trapping efficiency and migration of charge carriers, which exhibited electron-hole recombination behavior. Doped nanostructures showed enhanced bactericidal performance and synergism against S. aureus and E. coli. In summary, Cu-doped TiO2 nanostructures were observed to impede bacteria effectively, which is deemed beneficial in overcoming ailments caused by pathogens such as microbial etiologies. Furthermore, molecular docking analysis was conducted to study the interaction of Cu-doped TiO2 nanoparticles with multiple proteins namely ß-lactamase (binding score: -4.91 kcal mol-1), ddlB (binding score: -5.67 kcal mol-1) and FabI (binding score: -6.13 kcal mol-1) as possible targets with active site residues. Dye degradation/reduction of control and Cu-doped samples were studied through absorption spectroscopy. The obtained outcomes of the performed experiment indicated that the photocatalytic activity of Cu-TiO2 enhanced with increasing dopant concentration, which is thought to be due to a decreased rate of electron-hole pair recombination. Consequently, it is suggested that Cu-TiO2 can be exploited as an effective candidate for antibacterial and dye degradation applications.

Retrospective morphometric analysis of the infraorbital foramen with cone beam computed tomography.

OBJECTIVE: The aim of our study is to examine the morphometric characteristics of the infraorbital foramen (IOF) and its anatomic localization by using cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: In our study, the anatomic characteristics of the IOF were identified by studying retrospectively the CBCT images of one hundred twenty-five (125) patients. These characteristics were assessed statistically in terms of age, gender, and right-left side. RESULTS: In our study, 42% of them had IOF in circular form and 58% in oval form. Of them 66.90% of those in oval form were in oblique direction, 28.30% of them were in vertical direction, and 4.80% of them were in horizontal direction. The mean vertical diameter of the IOF was found as 3.71 ± 0.61 mm and its mean horizontal diameter was found as 3.17 ± 0.56 mm. The mean distance of IOF to midline were measured as 25.10 ± 2.17 mm, distance to upper edge of the orbita was measured as 41.91 ± 2.77 mm, distance to infraorbital edge was measured as 5.63 ± 1.77 mm, distance to the lateral nasal wall was measured as 9.32 ± 2.68 mm, distance to spina nasalis anterior was measured as 17.97 ± 3.99 mm, thickness of the soft tissue on the foramen was measured as 11.52 ± 2.40 mm, and distance between the right and the left IOF was measured as 50.20 ± 3.90 mm. Accessory foramen was found in 56.60% ratio. CONCLUSION: This study reveals that CBCT may guide for local anesthesia applications and for other invasive procedures in order to prevent the damage of the neurovascular structures during maxillofacial surgery by identifying the distances of anatomic points such as IOF having surgically importance.

HIV Disclosure: Parental dilemma in informing HIV infected Children about their HIV Status in Malawi.

BACKGROUND: Increasingly many perinatally HIV-infected children are surviving through adolescence and adulthood as a result of improvements in the management of paediatric HIV infection, particularly the increased use of combination therapy. It is usually the parents or guardians of these children who are faced with the task of informing the child living with HIV about his or her positive status. However, many parents-particularly biological parents -find this disclosure process difficult to initiate, and this study explored some of the difficulties that these parents encounter. OBJECTIVE: This study set out to explore potential factors that challenge parents and guardians when informing their perinatally HIV-infected child about the child's HIV status. DESIGN: This was a qualitative narrative study that employed in-depth interviews with parents or guardians of children perinatally infected with HIV. A total of 20 parents and guardians of children who attend the outpatient HIV clinic at the Baylor College of Medicine-Abbott Fund Children's Clinical Centre of Excellence (COE) in Lilongwe, Malawi were interviewed. Of these, 14 were biological parents and six were guardians. RESULTS: Guardians and parents expressed uneasiness and apprehension with the disclosure conversation, whether or not they had already told their child that he or she had HIV. Participants who had not told their children recounted that they had contemplated starting the conversation but could not gather enough courage to follow through with those thoughts. They cited the fear of robbing their child of the happiness of living without the knowledge of being positive, fear of making their own status known to more people, and fear of confrontation or creating enmity with their child as impediments to disclosing their child's positive HIV status to him or her. CONCLUSIONS: It is apparent that guardians-more particularly biological parents-of children perinatally infected by HIV find it difficult to inform their children about their children's HIV status. From this disempowered position, parents dread the disclosure of a positive HIV status to a child as a psychosocial process that has the potential to disturb a family's previously established equilibrium with threats of stigmatization, marginalization, and parent-child conflict. This calls for strategies that could support parents to make disclosure to the child less challenging.

Should female health providers be involved in medical male circumcision? Narratives of newly circumcised men in Malawi.

BACKGROUND: The Malawi government has endorsed voluntary medical male circumcision (VMMC) as a biomedical strategy for HIV prevention after a decade of debating its effectiveness in the local setting. The "policy" recommends that male circumcision (MC) should be clinically based, as opposed to the alternative of traditional male circumcision (TMC). Limited finances, acceptability concerns, and the health system's limited capacity to meet demand are among the challenges threatening the mass rollout of VMMC. In terms of acceptability, the gender of clinicians conducting the operations may particularly influence health facility-based circumcision. This study explored the acceptability, by male clients, of female clinicians taking part in the circumcision procedure. METHODS: Six focus group discussions (FGDs) were conducted, with a total of 47 newly circumcised men from non-circumcising ethnic groups in Malawi participating in this study. The men had been circumcised at three health facilities in Lilongwe District in 2010. Data were audio recorded and transcribed verbatim. Data were analysed using narrative analysis. RESULTS: Participants in the FGDs indicated that they were not comfortable with women clinicians being part of the circumcising team. While few mentioned that they were not entirely opposed to female health providers' participation, arguing that their involvement was similar to male clinicians' involvement in child delivery, most of them opposed to female involvement, arguing that MC was not an illness that necessitates the involvement of clinicians regardless of their gender. Most of the participants said that it was not negotiable for females to be involved, as they could wait until an all-male clinician team could be available. Thematically, the arguments against female clinicians' involvement include sexual undertones and the influences of traditional male circumcision practices, among others. CONCLUSION: Men preferred that VMMC should be conducted by male health providers only. Traditionally, male circumcision has been a male-only affair shrouded in secrecy and rituals. Although being medical, this study strongly suggested that it may be difficult for VMMC to immediately move to a public space where female health providers can participate, even for men coming from traditionally non-circumcising backgrounds.

Street children's vulnerability to HIV and sexually transmitted infections in Malawian cities.

BACKGROUND: Street children have largely been ignored in the fight against HIV and AIDS. While some initiatives exist, the nature of street life, probably has not allowed viable interventions to be implemented. However, this is a group of people that could qualify as a "most at risk" group. This study set out to explore street children's vulnerability to sexual exploitation in the cities of Blantyre and Lilongwe in Malawi. OBJECTIVE: The objective for this study was to explore street children's vulnerability to HIV and STIs infection. DESIGN: This qualitative study employed In-depth interviews with street children in the two main cities of Malawi. A total of 23 street children were interviewed. RESULTS: The study strongly suggests that street children could be vulnerable to HIV and other sexually transmitted infections. This is due to various factors which include low knowledge levels of STI and HIV, high risk sexual practices, lack of safer place to spend their nights for both boys and girls rendering them vulnerable to sexual abuses and the use of sex as a tool to secure protection and to be accepted especially for the newcomers on the street. CONCLUSIONS: This study highlights street children's vulnerability to sexual exploitation which predisposes them to risk of HIV and AIDS as well as Sexually Transmitted infections. Furthermore, the street environment offers no protection against such vulnerability. There is need to explore potential and context sensitive strategies that could be used to protect street children from sexual exploitation and HIV and AIDS infection.

Street Children's Vulnerability to HIV and Sexually Transmitted Infections in Malawian Cities

"Background: Street children have largely been ignored in the fight against HIV and AIDS. While some initiatives exist; the nature of street life; probably has not allowed viable interventions to be implemented. However; this is a group of people that could qualify as a ""most at risk"" group. This study set out to explore street children's vulnerability to sexual exploitation in the cities of Blantyre and Lilongwe in Malawi.Objective The objective for this study was to explore street children's vulnerability to HIV and STIs infection. Design This qualitative study employed In-depth interviews with street children in the two main cities of Malawi. A total of 23 street children were interviewed. Results The study strongly suggests that street children could be vulnerable to HIV and other sexually transmitted infections. This is due to various factors which include low knowledge levels of STI and HIV; high risk sexual practices; lack of safer place to spend their nights for both boys and girls rendering them vulnerable to sexual abuses and the use of sex as a tool to secure protection and to be accepted especially for the newcomers on the street. Conclusions This study highlights street children's vulnerability to sexual exploitation which predisposes them to risk of HIV and AIDS as well as Sexually Transmitted infections. Furthermore; the street environment offers no protection against such vulnerability. There is need to explore potential and context sensitive strategies that could be used to protect street children from sexual exploitation and HIV and AIDS infection."

HIV and AIDS workplace interventions; gaps between policy and practice at the College of Medicine.

INTRODUCTION: This study set out to identify gaps between policy and practice of HIV and AIDS workplace interventions in the University of Malawi, in particular College of Medicine in line with the UNIMA HIV and AIDS policy. OBJECTIVES: The main objective was to establish whether the HIV and AIDS workplace interventions at College of Medicine were in line and guided by the University of Malawi HIV and AIDS policy. METHODS: This was a cross sectional qualitative study. A random sample of 25 students and 15 members of staff were interviewed using in-depth interviews. Interviews were tape-recorded and data was analyzed using thematic content analysis. RESULTS: There are a number of activities relating to HIV and AIDS in place while others are still in the pipeline, however the majority of respondents did not know about the UNIMA HIV and AIDS policy or any HIV and AIDS activities that are guided by the policy. This is due to lack of interest on their part or lack of knowledge on the existence of the workplace programme. CONCLUSION: The COM HIV and AIDS committee should strive to fast track key programme areas such as VCT centre and clinic and coordination of different activities to increase programme visibility and patronage.

A prospective study of psychological distress among mothers of children admitted to a nutritional rehabilitation unit in Malawi.

OBJECTIVES: Accompanying guardians (usually the mother) have a pivotal role in promoting recovery from childhood severe acute malnutrition on Nutritional Rehabilitation Units (NRUs). We describe the prevalence of maternal distress at an NRU in Malawi and identify factors associated with this. We tested the hypothesis that maternal distress during admission would be associated with reduced child weight gain over the 4-week post-discharge period. METHODS: Maternal distress was measured using the Self Reporting Questionnaire (SRQ) administered to mothers of consecutive children during NRU admission. Repeat SRQ was administered to mothers attending a follow-up clinic 4 weeks post discharge. Maternal, child and psychosocial variables were also measured. Child weight change from discharge to follow-up was compared between children of mothers scoring SRQ ≥ 8 and those scoring SRQ < 8. FINDINGS: A total of 244 mothers and their children were recruited. In total, 71% of mothers scored SRQ ≥ 8 during admission. In all, 155 of 222 mothers eligible to complete repeat SRQ did so, and 33.5% scored SRQ ≥ 8. Maternal distress at recruitment was associated with older child age, no confiding relationship with spouse, having had a previous child die, and the child having diarrhoea. Maternal distress at follow-up was associated with older child age, the child having diarrhoea or fever since discharge, and the child being HIV sero-positive. Maternal distress during admission was not associated with child weight gain at 4-week post-discharge follow-up. CONCLUSION: Levels of maternal distress are very high during child admission to an NRU. Persistent distress is associated with child health factors including HIV. Nutritional rehabilitation programmes should pay increased attention to carer psychological wellbeing using targeted evidence-based interventions.

Perspectives of normal child development in rural Malawi - a qualitative analysis to create a more culturally appropriate developmental assessment tool.

BACKGROUND: Child development in developing countries is often evaluated using assessment tools created for 'Western' settings. Recent work has demonstrated that, for certain developmental milestones, 'Western' tools may be inaccurate as they include items unfamiliar to children of different cultural settings. METHODS: We used qualitative methods to gather information about normal development in an African setting. Ten village and two professional focus group discussions (FGDs) were conducted. We used purposive sampling methods to recruit groups of mothers, grandmothers and men in four areas of Southern Malawi for village FGDs. Separate FGDs were carried out with professionals working in areas relating to child development. A thematic content analysis established main patterns and themes and dissemination of results and continued feedback allowed for respondent validation and reflection of results. The information then gathered was used to create questions for a revised Malawian developmental assessment tool. RESULTS: Social and gross motor milestones were the main focus of interest for village and professional FGDs with the latter creating new language and fine motor concepts. Social milestones highlighted included 'duties and chores', 'sharing' and 'taking up leadership roles'. Language milestones included 'reporting events' and 'shrugging to indicate no' and fine motor milestones included 'peeling bananas', 'sorting maize' and 'making patterns with bottle tops'. Intelligence was described in relation to social and community integrity rather than 'Western' concepts of numeracy and literacy. CONCLUSIONS: Concepts, ideas and language relating to normal development in a sub-Saharan African setting have been gathered in this study. These have been used to create items for a more culturally appropriate developmental assessment tool.

Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania.

An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.

Efficacy of a multi-micronutrient dietary intervention based on haemoglobin, hair zinc concentrations, and selected functional outcomes in rural Malawian children.

OBJECTIVE: To investigate the efficacy of enhancing the content and bioavailability of micronutrients in diets of stunted rural Malawian children on their growth and body composition, morbidity, anaemia and hair zinc concentrations. DESIGN: A quasi-experimental design with non-equivalent control group involving 410 intervention and 220 control children aged 30-90 months. SETTING AND SUBJECTS: Children from two intervention and two control villages in Mangochi District, Southern Malawi participated in a 6 month dietary intervention. Anthropometry, malarial screening, haemoglobin, and hair zinc were measured at baseline and after 12 months, as well as socio-economic status at baseline, and common infections monthly post-intervention. RESULTS: Groups were comparable at baseline. Post-intervention children had greater Z-scores for lean body mass (mid-upper arm circumference -0.75 vs -1.05; arm muscle area: 0.63 vs -1.03, P<0.001) than controls but Z-scores for weight-for-height and height-for-age were similar. After controlling for baseline variables, mean haemoglobin was higher (107 vs 102 g/l, P<0.01), whereas the incidence of both anaemia (62 vs 80%) and common infections (based on a median overall illness score for fever, diarrhoea, upper and lower respiratory infections) were lower in intervention compared to controls, with no change in hair zinc concentrations or malaria status post-intervention. CONCLUSION: Improvements in the micronutrient adequacy of diets of post-intervention children were associated with a favourable increase in indices of lean body mass and reductions in the incidence of anaemia and common infections in these rural Malawian stunted children.