BACKGROUNDSpinal muscular atrophy is an autosomal recessive neuromuscular disorder that is caused by an insufficient level of survival motor neuron (SMN) protein. Nusinersen is an antisense oligonucleotide drug that modifies pre-messenger RNA splicing of the SMN2 gene and thus promotes increased production of full-length SMN protein. METHODSWe conducted a randomized, double-blind, sham-controlled, phase 3 efficacy and safety trial of nusinersen in infants with spinal muscular atrophy. The primary end points were a motor-milestone response (defined according to results on the Hammersmith Infant Neurological Examination) and event-free survival (time to death or the use of permanent assisted ventilation). Secondary end points included overall survival and subgroup analyses of event-free survival according to disease duration at screening. Only the first primary end point was tested in a prespecified interim analysis. To control the overall type I error rate at 0.05, a hierarchical testing strategy was used for the second primary end point and the secondary end points in the final analysis. RESULTSIn the interim analysis, a significantly higher percentage of infants in the nusinersen group than in the control group had a motor-milestone response (21 of 51 infants [41%] vs. 0 of 27 [0%], P<0.001), and this result prompted early termination of the trial. In the final analysis, a significantly higher percentage of infants in the nusinersen group than in the control group had a motor-milestone response (37 of 73 infants [51%] vs. 0 of 37 [0%]), and the likelihood of event-free survival was higher in the nusinersen group than in the control group (hazard ratio for death or the use of permanent assisted ventilation, 0.53; P = 0.005). The likelihood of overall survival was higher in the nusinersen group than in the control group (hazard ratio for death, 0.37; P = 0.004), and infants with a shorter disease duration at screening were more likely than those with a longer disease duration to benefit from nusinersen. The incidence and severity of adverse events were similar in the two groups. CONCLUSIONSAmong infants with spinal muscular atrophy, those who received nusinersen were more likely to be alive and have improvements in motor function than those in the control group. Early treatment may be necessary to maximize the benefit of the drug. (Funded by Biogen and Ionis Pharmaceuticals; ENDEAR ClinicalTrials.gov number, NCT02193074.)

The origin of the coronavirus disease 2019 (COVID-19) in Wuhan China has been reported to be one of the lethal pandemics the world has ever faced. Though the first case was reported in December 2019, COVID-19 spread so rapidly to the majority of countries by March 2020 and was declared a global pandemic by the World Health Organization. COVID-19 pandemic led to increased morbidity and mortality within a very short period of time. COVID-19 pandemic caused schools, colleges, and universities to come to a closure in order to avoid further transmission and spread of the disease. The physical closure of schools, colleges, and universities has impacted students in several ways in that some students have reported suffering from anxiety, depression, and mood swings. COVID-19 has disrupted social interaction among students and has affected their family life. These impacts on students will eventually affect their academic performance and progression. Thus, learning institutions should put in measures to help students recover from the impacts of COVID-19.

Background: The issue of antibiotic resistance has become a global public health concern, with an extensive clinical and economic burden. The study aimed to assess the knowledge, attitude, and practices of antibiotic resistance among undergraduate medical students at the University of Zambia.Methods: This cross-sectional study was conducted at the University of Zambia Ridgeway Campus. A structured questionnaire was administered to 260 randomly selected undergraduate medical students. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0. Associations between dependent and independent variables were done using a Chi-square test. The statistical significance was done at 95% confidence level (p<0.05). Ethical approval was done by the University of Zambia Health Sciences Research Ethics Committee.Results: The study found that 227 of 260 (87.3%) of the medical students had good knowledge on antibiotic use and resistance. The majority of the medical students 252 of 260 (96.9%) had positive attitudes and 195 of 260 (75%) had good practices towards antibiotic resistance. There was a significant difference between the year of study and the level of knowledge (χ2=16.333, p=0.003). There was no significant difference between the year of study and the attitude of the participants (χ2=4.061, p=0.398). A significant difference was found between the year of study and the practices of the respondents (χ2=10.926, p=0.027).Conclusions: The medical students had good knowledge, a positive attitude, and good practices towards antibiotic resistance. Final year students had higher levels of knowledge and attitude but lower levels of practice compared to other years of study.

Lannea edulis (Sond.) Engl. commonly known as wild grape is used traditionally for the treatment of diabetes. It is only found in Eastern and Southern Africa. Phytochemical screening, antihyperglycemic and antihyperlipidemic effects of aqueous extracts of L. edulis in alloxan induced diabetic rats were carried out. We report herein the findings of this research work. Lannea edulis crude aqueous extracts were obtained by hot infusion and evaporation method. Phytochemical screening was carried out and subsequently toxicity studies of the aqueous extracts were performed to establish the Lethal Dose 50 (LD50) in albino rats. Alloxan monohydrate was used to induce diabetes in the rats. Lannea edulis positive control group doses of 100, 300, and 500 mg/kg were administered to 3 groups for 14 days. The positive control group was administered 5 mg/kg of glibenclamide. The negative and normal control groups were administered distilled water. To determine fasting blood glucose, blood was drawn on days 0, 1, 3, 5, 7, and 14 while it was drawn on days 0 and 14 for the determination of lipids. Phytochemical screening revealed the presence of flavonoids, saponins, tannins, cardiac glycosides, alkaloids and steroids. L. edulis diabetic positive control groups showed significant (P < 0.05) dose dependent reductions in fasting blood glucose levels. When day 0 mean blood glucose levels were compared to day 3 mean blood glucose levels of their respective groups, the 300 mg/kg L. edulis group showed a 23.3% drop and the 500 mg/kg L. edulis group showed a 52.6% drop. The 100 mg/kg L. edulis diabetic positive control group showed a 25.1% drop by day 5, the day on which it showed statistical significance (P < 0.05) compared to the diabetic control. In addition, administration of aqueous extracts of L. edulis to diabetic rats for 14 days significantly decreased (P < 0.05) the levels of serum total cholesterol, triglycerides, Low Density Lipoprotein (LDL) and Very Low Density Lipoprotein (VLDL) whilst increasing the levels of High Density Lipoprotein (HDL), when compared to the diabetic control group. It was concluded that L. edulis showed significant and dose dependent antihyperglycemic and antihyperlipidemic effects thus confirming its traditional use.

Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the "Access", "Watch", and "Reserve" (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely; Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23.