Antibiotic-resistant genes have become a threat to synthetic or conventional medications and because of this much work has been done on using plants and plants part to treat disease caused by bacteria, Herbal medicine...Antibiotic-resistant genes have become a threat to synthetic or conventional medications and because of this much work has been done on using plants and plants part to treat disease caused by bacteria, Herbal medicine has served as effective treatment against various diseases caused by pathogenic bacteria and multi drug-resistant strains of bacteria which made it advantageous over synthetic medications. This study aimed to reveal the sensitivity of Streptococcus pneumoniae from clinical isolate and perform antibacterial assay on the organism using plants leaf extracts of Ocimum gratissimum, Sida acuta, Newbouldia laevia and Mimosa pudica. Gram staining and various biochemical test were used for the identification of Streptococcus pneumoniae. The plants leaves were aseptically washed, dried and ground into fine powder and diluted in varying concentration and agar well diffusion method was used to test for the antimicrobial properties of this plants on Streptococcus pneumoniae at various concentrations as follows 0.1 g/ml, 0.4 g/ml, 0.6 g/ml and 1 g/ml. The plants extract of Ocimum gratissimum showed a greater antibacterial effects on Streptococcus pneumoniae in high concentration more than other plant extracts while Sida acuta and Newbouldia laevia plant extract showed weak antibacterial properties to the organism. This proves that Ocimum gratissimum and Mimosa pudica leaves have good and strong antibacterial properties against Streptococcus pneumoniae than Sida acuta and Newbouldia laevia and can be used as antibacterial agent at adequate concentrations.展开更多
The Antibiogram of the bacterial isolates from Tuberculosis (TB) patients attending hospitals within Izzi-Abakaliki was evaluated. The bacterial isolates were isolated and identified from the sputum samples according ...The Antibiogram of the bacterial isolates from Tuberculosis (TB) patients attending hospitals within Izzi-Abakaliki was evaluated. The bacterial isolates were isolated and identified from the sputum samples according to microbiological principles while the antibiotics susceptibility test was done by disc diffusion method using Ofloxacin, Pefloxacin, Ciprofloxacin, amoxicillin/clavulanate, Gentamycin, Streptomycin, Cephalosporin, Cotrimoxazole, Nalidixic acid and Ampicillin. Bacteria isolated include 5 E. coli (25%), 3 Streptococcus pyogenes (15%), 2 Streptococcus pneumoniae (10%), 1 Klebsiella spp. (5%), 3 Haemophilus influenza (15%), 2 Pseudomonas (10%), 3 Proteus spp. (15%), 1 Staphylococcus aureus (10%). The result of Antibiogram shows that E. coli was 100% resistant to Amoxicillin/clavulanate and cotrimoxazole, followed by Streptomycin (80%) and 100% susceptible to Pefloxacin with inhibition zone diameter of 18 mm and 18 mm for Ofloxacin (60%). S. pneumoniae and Klebsiella spp. were highly resistant to Amoxicillin/clavulanate (100%), Gentamycin (100%) and Ampicillin (100%) and 100% susceptible to Pefloxacin with inhibition zone 18 mm, Ciprofloxacin (17 mm). S. pyogenes was resistant to streptomycin and Ceporex, with 100% sensitivity to Ofloxacin, Ciprofloxacin and Pefloxacin. Pseudomonas spp. and S. aureus were both 100% resistant to all antibiotics except Ofloxacin, Ciprofloxacin, and Pefloxacin respectively. Proteus spp. was susceptible to Pefloxacin (100%), Ofloxacin (66.7%) and Ciprofloxacin (66.7%) but highly resistant to Streptomycin (100%) and Ampicillin (100%). Haemophilus influenzae were susceptible to Ofloxacin (100%) and Pefloxacin (100%), with high resistance to Amoxicillin/clavulanate (100%) and Ceporex (100%). From the study, Ofloxacin and Pefloxacin are susceptible to all bacteria isolated and are recommended for treatment of the bacterial infection with TB patient.展开更多
BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship b...BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship between hypertension and CKD.There remains variability in antihypertensive treatment practices.AIM To analyze data from the Salford Kidney Study database in relation to antihypertensive prescribing patterns amongst CKD patients.METHODS The Salford Kidney Study is an ongoing prospective study that has been recruiting CKD patients since 2002.All patients are followed up annually,and their medical records including the list of medications are updated until they reach study endpoints[starting on renal replacement therapy or reaching estimated glomerular filtration rate(eGFR)expressed as mL/min/1.73 m2≤10 mL/min/1.73 m2,or the last follow-up date,or data lock on December 31,2021,or death].Data on antihypertensive prescription practices in correspondence to baseline eGFR,urine albumin-creatinine ratio,primary CKD aetiology,and cardiovascular disease were evaluated.Associations between patients who were prescribed three or more antihypertensive agents and their clinical outcomes were studied by Cox regression analysis.Kaplan-Meier analysis demonstrated differences in survival probabilities.RESULTS Three thousand two hundred and thirty non-dialysis-dependent CKD patients with data collected between October 2002 and December 2019 were included.The median age was 65 years.A greater proportion of patients were taking three or more antihypertensive agents with advancing CKD stages(53%of eGFR≤15 mL/min/1.73 m2 vs 26%of eGFR≥60 mL/min/1.73 m2,P<0.001).An increased number of patients receiving more classes of antihypertensive agents was observed as the urine albumin-creatinine ratio category increased(category A3:62%vs category A1:40%,P<0.001),with the upward trends particularly noticeable in the number of individuals prescribed renin angiotensin system blockers.The prescription of three or more antihypertensive agents was associated with all-cause mortality,independent of blood pressure control(hazard ratio:1.15;95%confidence interval:1.04-1.27,P=0.006).Kaplan-Meier analysis illustrated significant differences in survival outcomes between patients with three or more and those with less than three antihypertensive agents prescribed(log-rank,P<0.001).CONCLUSION Antihypertensive prescribing patterns in the Salford Kidney Study based on CKD stage were consistent with expectations from the current United Kingdom National Institute of Health and Care Excellence guideline algorithm.Outcomes were poorer in patients with poor blood pressure control despite being on multiple antihypertensive agents.Continued research is required to bridge remaining variations in hypertension treatment practices worldwide.展开更多
BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can result in clinically significant multi-system disease including involvement in the kidney.The underlying histopathological processes were unkno...BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can result in clinically significant multi-system disease including involvement in the kidney.The underlying histopathological processes were unknown at the start of the pandemic.As case reports and series have been published describing the underlying renal histopathology from kidney biopsies,we have started to gain an insight into the renal manifestations of this novel disease.AIM To provide an overview of the current literature on the renal histopathological features and mechanistic insights described in association with coronavirus disease 2019(COVID-19)infection.METHODS A systematic review was performed by conducting a literature search in the following websites-‘PubMed’,‘Web of Science’,‘Embase’and‘Medline-ProQuest’with the following search terms-“COVID-19 AND kidney biopsy”,“COVID-19 AND renal biopsy”,“SARS-CoV-2 AND kidney biopsy”and“SARS-CoV-2 AND renal biopsy”.We have included published data up until February 15,2021,which includes kidney biopsies(native,transplant and postmortem)from patients with COVID-19.Data on clinical presentation,histopathological features,management and outcome was extracted from the reported studies.RESULTS The total number of biopsies reported on here is 288,of which 189 are postmortem,84 native and 15 transplants.The results are varied and show underlying pathologies ranging from collapsing glomerulopathy and acute tubular injury(ATI)to anti-nuclear cytoplasmic antibody associated vasculitis and pigment nephropathy.There was variation in the specific treatment used for the various renal conditions,which included steroids,hydroxychloroquine,eculizumab,convalescent plasma,rituximab,anakinra,cyclophosphamide and renal replacement therapy,amongst others.The pathological process which occurs in the kidney following COVID-19 infection and leads to the described biopsy findings has been hypothesized in some conditions but not others(for example,sepsis related hypoperfusion for ATI).It is important to note that this represents a very small minority of the total number of cases of COVID-19 related kidney disease,and as such there may be inherent selection bias in the results described.Further work will be required to determine the pathogenetic link,if any,between COVID-19 and the other renal pathologies.CONCLUSION This report has clinical relevance as certain renal pathologies have specific management,with the implication that kidney biopsy in the setting of renal disease and COVID-19 should be an early consideration,dependent upon the clinical presentation.展开更多
Coronavirus disease 2019(COVID-19)is a highly infectious disease which emerged into a global pandemic.Although it primarily causes respiratory symptoms for affected patients,COVID-19 was shown to have multi-organ mani...Coronavirus disease 2019(COVID-19)is a highly infectious disease which emerged into a global pandemic.Although it primarily causes respiratory symptoms for affected patients,COVID-19 was shown to have multi-organ manifestations.Elevated liver enzymes appear to be commonly observed during the course of COVID-19,and there have been numerous reports of liver injury secondary to COVID-19 infection.It has been established that patients with pre-existing chronic liver disease(CLD)are more likely to have poorer outcomes following COVID-19 infection compared to those without CLD.Co-morbidities such as diabetes,hypertension,obesity,cardiovascular and chronic kidney disease frequently co-exist in individuals living with CLD,and a substantial population may also live with some degree of frailty.The mechanisms of how COVID-19 induces liver injury have been postulated.Hepatorenal syndrome(HRS)is the occurrence of kidney dysfunction in patients with severe CLD/fulminant liver failure in the absence of another identifiable cause,and is usually a marker of severe decompensated liver disease.Select reports of HRS following acute COVID-19 infection have been presented,although the risk factors and pathophysiological mechanisms leading to HRS in COVID-19 infection or following COVID-19 treatment remain largely unestablished due to the relative lack and novelty of published data.Evidence discussing the management of HRS in highdependency care and intensive care contexts is only emerging.In this article,we provide an overview on the speculative pathophysiological me-chanisms of COVID-19 induced HRS and propose strategies for clinical diagnosis and management to optimize outcomes in this scenario.展开更多
Introduction:The COVID-19 pandemic has changed the way telemedicine is utilized globally,with most countries reporting an increase in its adoption.The first review of teledermatology in Nigeria reported poor service u...Introduction:The COVID-19 pandemic has changed the way telemedicine is utilized globally,with most countries reporting an increase in its adoption.The first review of teledermatology in Nigeria reported poor service use.This present report outlines an improvement in the adoption of telemedicine and factors that may account for this increased utilization.Methods:We performed a retrospective review of all patients who registered through 2 telemedicine platforms to access dermatology services during a 1-year period.Data were collated with an online questionnaire and analyzed by t test and chi-square test.Results:Sixty patients booked appointments through the platform,with 38 and 22 patients booking virtual and physical consultations,respectively.The response rate was 68.4%and 50.0%for those that booked virtual and physical consultations,respectively,with no significant age difference between the groups(P=0.42).More women booked appointments,and all respondents were educated to at least college level.The majority learned about booking a dermatologist appointment through social media.There was no difference in the clinical outcome between patients who booked a virtual or physical consultation(P=0.89).Conclusion:More patients are resorting to teledermatology services because of the convenience;however,most of these patients are situated in urban areas.Because this study showed no significant differences in the clinical outcome between patients who booked virtual and physical consultations,the adoption of teledermatology may be the answer to increasing coverage of dermatology services in developing countries where specialists are limited.Efforts must be made to increase the reach of teledermatology to rural areas.展开更多
To the Editor,Anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)is an autoimmune condition that mainly affects small vessels of the body.AAV is a condition that may have multisystem manifestations a...To the Editor,Anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)is an autoimmune condition that mainly affects small vessels of the body.AAV is a condition that may have multisystem manifestations and has an increased prevalence among older individuals.1 AAV patients conventionally present with symptoms at 65 years of age or older.Previous studies have demonstrated worse clinical outcomes in the aging population.Many older patients live with various comorbidities in addition to potentially relapsing AAV.Dealing with the pathophysiological impact of AAV can be burdensome,as this multifaceted condition may lead to impairment of physical function and contribute to significant mental and emotional stress.The impact of aging on the pathophysiology of AAV is not fully known.Immune dysregulation induced by cell senescence is hypothesized to be a key factor,alongside a mixture of genetic and environmental factors2.展开更多
文摘Antibiotic-resistant genes have become a threat to synthetic or conventional medications and because of this much work has been done on using plants and plants part to treat disease caused by bacteria, Herbal medicine has served as effective treatment against various diseases caused by pathogenic bacteria and multi drug-resistant strains of bacteria which made it advantageous over synthetic medications. This study aimed to reveal the sensitivity of Streptococcus pneumoniae from clinical isolate and perform antibacterial assay on the organism using plants leaf extracts of Ocimum gratissimum, Sida acuta, Newbouldia laevia and Mimosa pudica. Gram staining and various biochemical test were used for the identification of Streptococcus pneumoniae. The plants leaves were aseptically washed, dried and ground into fine powder and diluted in varying concentration and agar well diffusion method was used to test for the antimicrobial properties of this plants on Streptococcus pneumoniae at various concentrations as follows 0.1 g/ml, 0.4 g/ml, 0.6 g/ml and 1 g/ml. The plants extract of Ocimum gratissimum showed a greater antibacterial effects on Streptococcus pneumoniae in high concentration more than other plant extracts while Sida acuta and Newbouldia laevia plant extract showed weak antibacterial properties to the organism. This proves that Ocimum gratissimum and Mimosa pudica leaves have good and strong antibacterial properties against Streptococcus pneumoniae than Sida acuta and Newbouldia laevia and can be used as antibacterial agent at adequate concentrations.
文摘The Antibiogram of the bacterial isolates from Tuberculosis (TB) patients attending hospitals within Izzi-Abakaliki was evaluated. The bacterial isolates were isolated and identified from the sputum samples according to microbiological principles while the antibiotics susceptibility test was done by disc diffusion method using Ofloxacin, Pefloxacin, Ciprofloxacin, amoxicillin/clavulanate, Gentamycin, Streptomycin, Cephalosporin, Cotrimoxazole, Nalidixic acid and Ampicillin. Bacteria isolated include 5 E. coli (25%), 3 Streptococcus pyogenes (15%), 2 Streptococcus pneumoniae (10%), 1 Klebsiella spp. (5%), 3 Haemophilus influenza (15%), 2 Pseudomonas (10%), 3 Proteus spp. (15%), 1 Staphylococcus aureus (10%). The result of Antibiogram shows that E. coli was 100% resistant to Amoxicillin/clavulanate and cotrimoxazole, followed by Streptomycin (80%) and 100% susceptible to Pefloxacin with inhibition zone diameter of 18 mm and 18 mm for Ofloxacin (60%). S. pneumoniae and Klebsiella spp. were highly resistant to Amoxicillin/clavulanate (100%), Gentamycin (100%) and Ampicillin (100%) and 100% susceptible to Pefloxacin with inhibition zone 18 mm, Ciprofloxacin (17 mm). S. pyogenes was resistant to streptomycin and Ceporex, with 100% sensitivity to Ofloxacin, Ciprofloxacin and Pefloxacin. Pseudomonas spp. and S. aureus were both 100% resistant to all antibiotics except Ofloxacin, Ciprofloxacin, and Pefloxacin respectively. Proteus spp. was susceptible to Pefloxacin (100%), Ofloxacin (66.7%) and Ciprofloxacin (66.7%) but highly resistant to Streptomycin (100%) and Ampicillin (100%). Haemophilus influenzae were susceptible to Ofloxacin (100%) and Pefloxacin (100%), with high resistance to Amoxicillin/clavulanate (100%) and Ceporex (100%). From the study, Ofloxacin and Pefloxacin are susceptible to all bacteria isolated and are recommended for treatment of the bacterial infection with TB patient.
基金the National Institute of Health Research Manchester Biomedical Research Centre for their funding support in the SKS(NIHR203308).
文摘BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship between hypertension and CKD.There remains variability in antihypertensive treatment practices.AIM To analyze data from the Salford Kidney Study database in relation to antihypertensive prescribing patterns amongst CKD patients.METHODS The Salford Kidney Study is an ongoing prospective study that has been recruiting CKD patients since 2002.All patients are followed up annually,and their medical records including the list of medications are updated until they reach study endpoints[starting on renal replacement therapy or reaching estimated glomerular filtration rate(eGFR)expressed as mL/min/1.73 m2≤10 mL/min/1.73 m2,or the last follow-up date,or data lock on December 31,2021,or death].Data on antihypertensive prescription practices in correspondence to baseline eGFR,urine albumin-creatinine ratio,primary CKD aetiology,and cardiovascular disease were evaluated.Associations between patients who were prescribed three or more antihypertensive agents and their clinical outcomes were studied by Cox regression analysis.Kaplan-Meier analysis demonstrated differences in survival probabilities.RESULTS Three thousand two hundred and thirty non-dialysis-dependent CKD patients with data collected between October 2002 and December 2019 were included.The median age was 65 years.A greater proportion of patients were taking three or more antihypertensive agents with advancing CKD stages(53%of eGFR≤15 mL/min/1.73 m2 vs 26%of eGFR≥60 mL/min/1.73 m2,P<0.001).An increased number of patients receiving more classes of antihypertensive agents was observed as the urine albumin-creatinine ratio category increased(category A3:62%vs category A1:40%,P<0.001),with the upward trends particularly noticeable in the number of individuals prescribed renin angiotensin system blockers.The prescription of three or more antihypertensive agents was associated with all-cause mortality,independent of blood pressure control(hazard ratio:1.15;95%confidence interval:1.04-1.27,P=0.006).Kaplan-Meier analysis illustrated significant differences in survival outcomes between patients with three or more and those with less than three antihypertensive agents prescribed(log-rank,P<0.001).CONCLUSION Antihypertensive prescribing patterns in the Salford Kidney Study based on CKD stage were consistent with expectations from the current United Kingdom National Institute of Health and Care Excellence guideline algorithm.Outcomes were poorer in patients with poor blood pressure control despite being on multiple antihypertensive agents.Continued research is required to bridge remaining variations in hypertension treatment practices worldwide.
文摘BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can result in clinically significant multi-system disease including involvement in the kidney.The underlying histopathological processes were unknown at the start of the pandemic.As case reports and series have been published describing the underlying renal histopathology from kidney biopsies,we have started to gain an insight into the renal manifestations of this novel disease.AIM To provide an overview of the current literature on the renal histopathological features and mechanistic insights described in association with coronavirus disease 2019(COVID-19)infection.METHODS A systematic review was performed by conducting a literature search in the following websites-‘PubMed’,‘Web of Science’,‘Embase’and‘Medline-ProQuest’with the following search terms-“COVID-19 AND kidney biopsy”,“COVID-19 AND renal biopsy”,“SARS-CoV-2 AND kidney biopsy”and“SARS-CoV-2 AND renal biopsy”.We have included published data up until February 15,2021,which includes kidney biopsies(native,transplant and postmortem)from patients with COVID-19.Data on clinical presentation,histopathological features,management and outcome was extracted from the reported studies.RESULTS The total number of biopsies reported on here is 288,of which 189 are postmortem,84 native and 15 transplants.The results are varied and show underlying pathologies ranging from collapsing glomerulopathy and acute tubular injury(ATI)to anti-nuclear cytoplasmic antibody associated vasculitis and pigment nephropathy.There was variation in the specific treatment used for the various renal conditions,which included steroids,hydroxychloroquine,eculizumab,convalescent plasma,rituximab,anakinra,cyclophosphamide and renal replacement therapy,amongst others.The pathological process which occurs in the kidney following COVID-19 infection and leads to the described biopsy findings has been hypothesized in some conditions but not others(for example,sepsis related hypoperfusion for ATI).It is important to note that this represents a very small minority of the total number of cases of COVID-19 related kidney disease,and as such there may be inherent selection bias in the results described.Further work will be required to determine the pathogenetic link,if any,between COVID-19 and the other renal pathologies.CONCLUSION This report has clinical relevance as certain renal pathologies have specific management,with the implication that kidney biopsy in the setting of renal disease and COVID-19 should be an early consideration,dependent upon the clinical presentation.
文摘Coronavirus disease 2019(COVID-19)is a highly infectious disease which emerged into a global pandemic.Although it primarily causes respiratory symptoms for affected patients,COVID-19 was shown to have multi-organ manifestations.Elevated liver enzymes appear to be commonly observed during the course of COVID-19,and there have been numerous reports of liver injury secondary to COVID-19 infection.It has been established that patients with pre-existing chronic liver disease(CLD)are more likely to have poorer outcomes following COVID-19 infection compared to those without CLD.Co-morbidities such as diabetes,hypertension,obesity,cardiovascular and chronic kidney disease frequently co-exist in individuals living with CLD,and a substantial population may also live with some degree of frailty.The mechanisms of how COVID-19 induces liver injury have been postulated.Hepatorenal syndrome(HRS)is the occurrence of kidney dysfunction in patients with severe CLD/fulminant liver failure in the absence of another identifiable cause,and is usually a marker of severe decompensated liver disease.Select reports of HRS following acute COVID-19 infection have been presented,although the risk factors and pathophysiological mechanisms leading to HRS in COVID-19 infection or following COVID-19 treatment remain largely unestablished due to the relative lack and novelty of published data.Evidence discussing the management of HRS in highdependency care and intensive care contexts is only emerging.In this article,we provide an overview on the speculative pathophysiological me-chanisms of COVID-19 induced HRS and propose strategies for clinical diagnosis and management to optimize outcomes in this scenario.
文摘Introduction:The COVID-19 pandemic has changed the way telemedicine is utilized globally,with most countries reporting an increase in its adoption.The first review of teledermatology in Nigeria reported poor service use.This present report outlines an improvement in the adoption of telemedicine and factors that may account for this increased utilization.Methods:We performed a retrospective review of all patients who registered through 2 telemedicine platforms to access dermatology services during a 1-year period.Data were collated with an online questionnaire and analyzed by t test and chi-square test.Results:Sixty patients booked appointments through the platform,with 38 and 22 patients booking virtual and physical consultations,respectively.The response rate was 68.4%and 50.0%for those that booked virtual and physical consultations,respectively,with no significant age difference between the groups(P=0.42).More women booked appointments,and all respondents were educated to at least college level.The majority learned about booking a dermatologist appointment through social media.There was no difference in the clinical outcome between patients who booked a virtual or physical consultation(P=0.89).Conclusion:More patients are resorting to teledermatology services because of the convenience;however,most of these patients are situated in urban areas.Because this study showed no significant differences in the clinical outcome between patients who booked virtual and physical consultations,the adoption of teledermatology may be the answer to increasing coverage of dermatology services in developing countries where specialists are limited.Efforts must be made to increase the reach of teledermatology to rural areas.
文摘To the Editor,Anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)is an autoimmune condition that mainly affects small vessels of the body.AAV is a condition that may have multisystem manifestations and has an increased prevalence among older individuals.1 AAV patients conventionally present with symptoms at 65 years of age or older.Previous studies have demonstrated worse clinical outcomes in the aging population.Many older patients live with various comorbidities in addition to potentially relapsing AAV.Dealing with the pathophysiological impact of AAV can be burdensome,as this multifaceted condition may lead to impairment of physical function and contribute to significant mental and emotional stress.The impact of aging on the pathophysiology of AAV is not fully known.Immune dysregulation induced by cell senescence is hypothesized to be a key factor,alongside a mixture of genetic and environmental factors2.