Type-2 Diabetes Mellitus (T2DM) is related to cardiac arrhythmias. The stellate ganglion (SG), part of the sympathetic nervous system, regulates heart function. Within the SG, satellite glial cells (SGCs) have gap junction channels (Cx43). Increased Cx43 permeability induces SGC depolarization and activates the PKC-MAPK14-ADAM17 signaling pathway, releasing some endogenous factors that stimulate nearby cardiac postganglionic sympathetic neurons (CPSN). This study investigated the activation of the PKC-MAPK14-ADAM17 signaling pathway in T2DM SGs and SGCs as a novel mechanism of sympathetic overactivation. A total of 56 Sprague-Dawley rats were randomly assigned to sham and T2DM groups, and T2DM was induced using a high-fat diet combined with low-dose streptozotocin. Real-time RT-PCR, Western blot, and ELISA quantified mRNA/protein expression and enzymatic activity. The patch clamp technique assessed neuronal voltage-gated Ca²⁺ currents and action potentials, while electrophysiological recording measured cardiac sympathetic nerve activity (CSNA). T2DM rats exhibited marked upregulation of MAPK14, PKC-α, and ADAM17 mRNA/protein in the SG, alongside elevated enzymatic activities of PKC and ADAM17. T2DM also increased Ca²⁺ currents and neuronal excitability in the CPSN and induced the elevation of the CSNA. Upregulated PKC-MAPK-ADAM17 signaling in the SG might contribute to cardiac sympathetic overactivation in T2DM rats by enhancing the cell excitability of the CPSN.

Pneumonia is the highest cause of death in children under five (5) especially in sub-Saharan Africa. It accounts for 16 % of all deaths in Africa, deadlier than Malaria. Sub-Saharan Africa carries about half of the burden of the world’s under-five deaths. Progress in the fight against pneumonia has slacked behind that of the others. Pneumonia mortality rates in children have fallen by just 50 per cent compared to an 85 per cent decline in measles deaths, and 60 per cent in deaths from malaria, AIDS and tetanus in the last 15 years. The global funding to address the burden of pneumonia in children is low and this is potentially hindering the effort to reduce the mortalities associated with the disease.

Background. Induced sputum (IS) is a sampling technique for obtaining lower airway samples for microbial investigations, including GeneXpert and culture for microbiological confirmation of Mycobacterium tuberculosis. Objectives. To investigate the safety and yield of IS in children admitted to a tertiary hospital in Ghana with presumed pulmonary tuberculosis (PTB). Methods. A prospective cross-sectional study was carried out in children aged 3 months - 14 years at Komfo Anokye Teaching Hospital in Kumasi, Ghana, over the 6-month period January - June 2022. All children with breathing difficulty and other signs of respiratory distress were given respiratory support, and IS samples were obtained when respiratory distress had resolved. One or two IS samples were collected from each child within 48 hours of admission by a trained nurse after at least 4 hours of fasting. Children were monitored during and for 30 minutes after the procedure, with recording of respiratory rate, oxygen saturation, temperature and pulse rate. They were also monitored for any adverse events such as vomiting, wheezing and nosebleeds. Results. A total of 144 children were sampled, with approximately two-thirds sampled a second time. Nearly half of the participants were aged <2 years (49.3%; n=71/144), and the median (interquartile range (IQR)) age was 2.5 (0.9 - 6.8) years. Ninety-eight children (68.1%) tested positive for PTB by Xpert Ultra, with 19/98 (19.4%) being rifampicin resistant; 47/102 (46.1%) were positive by Ziehl-Neelsen staining, and 57/102 (55.9%) were positive by Auramine O staining. Three children (2.1%) had an episode of epistaxis following the procedure. No other adverse events were observed. Measurements before and 30 minutes to 1 hour after the procedure (median (IQR)) were similar: temperature 36.5oC (36.5 - 37.5oC) v. 36.5oC (36.2 - 37.1oC), oxygen saturation 98% (92 - 99%) v. 98% (93 - 99%), pulse rate 120 (106 - 139) v. 125 (112 - 142) bpm, and respiratory rate 38 (30 - 48) v. 33 (30 - 45) cycles per minute. Conclusion. We found sputum induction to be a safe and well-tolerated procedure in the paediatric population, with minimal clinical risk and a high microbiological yield for PTB.

Worldwide the third leading cause of death among persons under 40 years is attributed to trauma(1). In Ghana road traffic accidents have a case fatality rate of about 17%(3). Over the years with interventions and policies by AO Alliance the burden and morbidity following trauma especially road traffic accidents have reduced; with a destination in sight where a broken bone is no longer a burden to carry.