Modelling Differential Diagnosis of Febrile Diseases with Fuzzy Cognitive Map.

The report of the World Health Organization (WHO) about the poor accessibility of people living in low-to-middle-income countries to medical facilities and personnel has been a concern to both professionals and nonprofessionals in healthcare. This poor accessibility has led to high morbidity and mortality rates in tropical regions, especially when such a disease presents itself with confusable symptoms that are not easily differentiable by inexperienced doctors, such as those found in febrile diseases. This prompted the development of the fuzzy cognitive map (FCM) model to serve as a decision-support tool for medical health workers in the diagnosis of febrile diseases.

Nutrition in City Ecosystems (NICE): Protocol of a multi-sectoral development project to improve food and nutrition security of secondary city populations in Bangladesh, Kenya and Rwanda.

Background: Secondary cities tend to be better linked with local food systems than primate cities, acting as important platforms to trade agricultural produce with rural surrounding. COVID-19, conflicts and climate change continue to expose inefficiencies in food systems and have further exacerbated malnutrition, calling for substantial food systems transformations. However, tackling current food systems' challenges requires new approaches to ensure food and nutrition security.

Cassava-maize intercropping systems in southern Nigeria: Radiation use efficiency, soil moisture dynamics, and yields of component crops.

Efficient utilization of incident solar radiation and rainwater conservation in rain-fed smallholder cropping systems require the development and adoption of cropping systems with high resource use efficiency. Due to the popularity of cassava-maize intercropping and the food security and economic importance of both crops in Nigeria, we investigated options to improve interception of photosynthetically active radiation (IPAR), radiation use efficiency (RUE), soil moisture retention, and yields of cassava and maize in cassava-maize intercropping systems in 8 on-farm researcher-managed multi-location trials between 2017 and 2019 in different agro-ecologies of southern Nigeria. Treatments were a combination of (1) maize planting density (low density at 20,000 maize plants ha versus high density at 40,000 maize plants ha, intercropped with 12,500 cassava plants ha); (2) fertilizer application and management targeting either the maize crop (90 kg N, 20 kg P and 37 kg K ha) or the cassava crop (75 kg N, 20 kg P and 90 kg K ha), compared with control without fertilizer application.

Thoracoabdominal injury with evisceration from a chainsaw assault: a case report.

The usual cause of penetrating thoracoabdominal injuries with evisceration are stab wounds with knives and other sharp weapons used during fights and conflicts. Evisceration of the abdominal viscera as a result of trauma, with its attendant morbidity and mortality, requires early intervention. Gunshot wounds can also cause penetrating thoracoabdominal injuries.

Vitamin D replacement in children with acute wheeze: a dose-escalation study.

https://bit.ly/3J43Ouo.

Risk factors for some tropical diseases in an African country.

Background: Often, non-clinical risk factors could affect the predisposition of an individual to diseases. Understanding these factors and their impacts helps in disease prevention and control. This study identified risk factors for malaria, yellow fever, typhoid, chickenpox, measles, hepatitis B, and urinary tract infection in a population in an African country.

Developing recommendations for increased productivity in cassava-maize intercropping systems in Southern Nigeria.

Cassava-maize intercropping is a common practice among smallholder farmers in Southern Nigeria. It provides food security and early access to income from the maize component. However, yields of both crops are commonly low in farmers' fields.

Malrotation of the midgut associated with horseshoe kidney presenting as gastric outlet obstruction in a 15-year-old boy.

Malrotation occurs in approximately 1 in 500 live births. However, the true incidence of malrotation is unknown since many asymptomatic patients fail to present. Approximately 90% of patients with malrotation are diagnosed within the 1 year of life.

Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: a national survey of paediatric surgeons.

Introduction: The novel coronavirus disease has had significant impact on healthcare globally. Knowledge of this virus is evolving, definitive care is not yet known and mortality is increasing. We assessed its initial impact on paediatric surgical practice in Nigeria, creating a benchmark for recommendations and future reference.

Identification of a novel cystic fibrosis mutation in three patients of South Asian descent.

Introduction: The cystic fibrosis (CF) clinical profile and associated CFTR mutation spectrum is poorly understood in the South Asian population. This is likely due to the lack of diagnostic resources and the absence of a centralised CF database and screening programme, despite a relatively large proportion of the global population.

Methods: Following identification of a previously unreported CFTR mutation (c.

Quality Improvement Project to Evaluate Discharge Prescriptions in Children With Cystic Fibrosis.

Unlabelled: Cystic Fibrosis (CF) requires multiple pharmaceutical treatments, elevating the risk of medication errors (ME), which may compromise patient safety. This study aimed to improve the quality of discharge prescriptions (DPs) using indicators following admissions for IV antibiotics in pediatric CF patients.

Methods: This project involved a longitudinal observational retrospective descriptive study followed by a longitudinal quasi-experimental prospective phase between January 2013 and December 2016 in CF patients admitted to a London Children's Hospital.

Vitamin D for secondary prevention of acute wheeze attacks in preschool and school-age children.

Introduction: Vitamin D is best known for its role in bone health; however, the discovery of the vitamin D receptor and the expression of the gene encoding the vitamin D 1α-hydroxylase (CYP27B1) enzyme in a wide variety of tissues including immune cells and respiratory epithelium has led to the discovery of potential roles for vitamin D in the prevention of acute wheeze.

Methods: We review here the literature concerning the relationships between circulating 25-hydroxyvitamin D (25(OH)D) concentration and secondary prevention of acute wheeze attacks in preschool and school-age children.

Results: Epidemiological data suggest that vitamin D insufficiency (25(OH)D <75 nmol/L) is highly prevalent in preschool and school-age children with wheeze.

[Real-world effectiveness of ivacaftor in children with cystic fibrosis and the G551D mutation].

Introduction: Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator that has been shown to improve the nutritional status and lung function of cystic fibrosis patients with the G551D mutation in clinical trials. The objective of this study was to describe the real-world progress of children receiving ivacaftor.

Methods: We describe the real-world progress of four children with cystic fibrosis and the F508del/G551D genotype comparing data during ivacaftor treatment with baseline and with the year before commencing treatment.

Preschool wheeze, genes and treatment.

Preschool wheeze is a common but poorly understood cause of respiratory morbidity that is both distinct from and overlaps with infantile bronchiolitis and school age asthma. Attempts at classification by epidemiology, pathophysiology, therapeutic response and clinical phenotype are imperfect and yet fundamental to both treatment choice and research design. The four main therapeutic classes for preschool wheeze, namely beta agonists, anticholinergics, corticosteroids and leukotriene modifiers are employed with variable and often scanty evidence base, with evidence for a genetic influence on response variations.

Cystic fibrosis newborn screening: outcome of infants with normal sweat tests.

Newborn babies positively screened for cystic fibrosis (CF) (high serum immunoreactive trypsin (IRT) with DNA analysis) are referred for a diagnostic sweat test, which may be normal (sweat chloride <30 mmol/L). Unless two gene mutations are identified during Newborn screening (NBS), the babies are discharged from follow-up. We wished to check that none had subsequently developed symptoms suggestive of CF.

Infantile hypertrophic pyloric stenosis with unusual presentations in Sagamu, Nigeria: a case report and review of the literature.

A 24-day old female Nigerian neonate presented with protracted vomiting, fever and dehydration but without palpable abdominal tumour or visible gastric peristalsis. There was no derangement of serum electrolytes. The initial working diagnosis was Late-Onset Sepsis but abdominal ultrasonography showed features consistent with the diagnosis of IHPS.

Highlights of the 28(th) North American Cystic Fibrosis Conference 2014.

This is a selection of papers presented at the 28(th) North American Cystic Fibrosis Conference held in Atlanta in October 2014. The papers discussed are thought to be of particular interest to CF caregivers in the UK. Topics discussed include recent progress in the modification of the cystic fibrosis transmembrane regulator (CFTR), the potential of OligoG, a novel inhaled alginate mucolytic, and the changing approach to cystic fibrosis-related diabetes screening.

Intermittent montelukast in children aged 10 months to 5 years with wheeze (WAIT trial): a multicentre, randomised, placebo-controlled trial.

Background: The effectiveness of intermittent montelukast for wheeze in young children is unclear. We aimed to assess whether intermittent montelukast is better than placebo for treatment of wheeze in this age group. Because copy numbers of the Sp1-binding motif in the arachidonate 5-lipoxygenase (ALOX5) gene promoter (either 5/5, 5/x, or x/x, where x does not equal 5) modifies response to montelukast in adults, we stratified by this genotype.

Maternal and fetal effect of misgav ladach cesarean section in nigerian women: a randomized control study.

Background: The poor utilisation of the Misgav-Ladach (ML) caesarean section method in our environment despite its proven advantage has been attributed to several factors including its non-evaluation. A well designed and conducted trial is needed to provide evidence to convince clinician of its advantage over Pfannenstiel based methods.

Aim: To evaluate the outcome of ML based caesarean section among Nigerian women.

Recruiting ethnic minority participants to a clinical trial: a qualitative study.

Objectives: To compare the motives and experiences of different ethnic groups participating in a randomised double blind placebo-controlled trial of montelukast in preschool wheeze, and to assess parents' or guardians' understanding of trial procedures and their implications, including the collection of genetic material.

Design: Qualitative interviews with parents or guardians.

Setting: Interviews occurred in the homes of London children recruited to a national multicentre clinical trial following primary and secondary care attendance with wheeze.