Acute and Sub-chronic Toxicity Studies of Methanol Leaf Extract of Cassia singueana F. (Fresen) in Wistar Rats

The aim of this study was to evaluate the toxicity profile of methanol leaf extract of Cassia singueana (fabaceae) in wistar rats. Fresh leaf of the plant was shade dried and pulverized to powder after which it was subjected to maceration with methanol and 9.2% yield was obtained at end of the extraction process. An acute toxicity study was carried out using lork’s method and sub-chronic toxicity study was also carried out using OECD guideline. In the acute toxicity study, the first phase of the method, nine (9) wistar rats were randomly divided into three groups (1-3) of three (3) animals each and they received 10,100 and 1000 mg/kg (po) Cassia singueana methanol leaf extract respectively and in the second phase four (4) animals were divided into four groups of one animal each which received 1200, 1600, 2900 and 5000 mg/kg (po) of extract respectively. In the sub-chronic toxicity study twenty (20) animals were divided randomly into four group each containing five animals, the first, second, third and fourth group received distilled water, 200, 400 and 800 mg/kg extract (po) respectively. There was no mortality observed in phase 1 of acute toxicity and in phase II there was mortality at 2900 and 5000 mg/kg group. The oral administration of methanol leaf extract of Cassia singueana for 28 days did not produce significant alteration in the renal function indices. The histological section of the rats indicates normal glumeruli and regular renal tubules. Also, this study reveals no significant increase in the level of liver enzyme. Also, the histology section reveals normal central vein and regular hepatocyte separated by sinusoid. The haematopoetic indices reveal no destruction of Red Blood Cell and no change in the rate of production of the RBCs and other haematopoetic parameters. The histology of the rat’s brain revealed no deleterious effect. It can be concluded that, the methanol leaf extract of Cassia singueana is relatively non- toxic

ARTESUNATE PLUS AMODIAQUINE (AS+AQ) VERSUS ARTEMETHER -LUMEFANTRINE (AL) FOR THE TREATMENT OF UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN SUB-SAHARAN AFRICA-A META-ANALYSIS

The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Register, Science Citation Index, Lilacs, African Index Medicus, Clusty, Google, Yahoo and Microsoft search engines. Randomized controlled clinical trials comparing Artesunate-Amodiaquine versus Artemether–Lumefantrine, in Sub-Saharan Africa from January 2004 to June 2009, and which had at least 30 patients per study arm. The authors independently applied the inclusion criteria, assessed methodological quality and extracted data into a pre-designed form. The outcome of interest was uncorrected day 28 parasitological failure. Data were then checked for agreement and double entered into RevMan version 5 for further analyses. Fifteen trials (4265 participants) met the inclusion criteria. Day 28 parasitological failure was lower for AL (286 of 2201 participants or 13.0 % failures) when compared with AS+AQ (446 of 2424 participants or 18.4% failures). The relative risk of parasitological failure with AS+AQ was higher when compared with AL (RR 1.65, 95% CI, 1.18-2.32). There were significant heterogeneity and inconsistencies in the studies. AL appears more effective at avoiding parasitological failure at days 28 than AS+AQ

Safety perception and knowledge of commonly used complementary and alternative medicine among physicians in Usmanu Danfodiyo University Teaching Hospital Sokoto, North-Western Nigeria

Background: Knowledge and safety perception of physicians concerning commonly used complementary and alternative medicine (CAM) may have influence on decisions of treatment and life of patients. This study determined the knowledge and safety perception of CAM among physicians in an Usmanu Danfodiyo University Teaching Hospital (UDUTH), a tertiary institution in Sokoto, North-Western Nigeria. Materials and Methods: A survey based on an anonymous questionnaire was performed among 221 doctors of UDUTH Sokoto, North-Western Nigeria using a 30-item validated questionnaire to examine their level of awareness and safety perception on CAM. Results: The lifetime prevalence of CAM use among doctors was 69.3% while current CAM use was about 12%. About half (47.5%) of the doctors think CAM use is unsafe. About 84.6%, 86.4%, and 64.3% of doctors think CAM use can cause adverse reactions/side effects, drug interactions, and noncompliance, respectively. Residents/consultants (84.5%) were more likely to correctly identify the standard definitions of CAM compared with house officers/medical officers (77.3%) (P = 0.02). A significantly higher percentage of consultants/residents were found to associate the use of CAM with poor adherence to conventional drugs compared with HO/MO (P = 0.02). Conclusion: This study demonstrates high degree of concern about the safety of CAM as it relates to adverse reactions/side effects, drug interactions, and noncompliance to orthodox medicine among physicians in UDUTH. There was an acceptable level of knowledge of CAM

Overview of Hepatitis B Vaccine Non-Response and Associated B Cell Amnesia: A Scoping Review

Background: The advent of the hepatitis B vaccine has achieved tremendous success in eradicating and reducing the burden of hepatitis B infection, which is the main culprit for hepatocellular carcinoma—one of the most fatal malignancies globally. Response to the vaccine is achieved in about 90–95% of healthy individuals and up to only 50% in immunocompromised patients. This review aimed to provide an overview of hepatitis B vaccine non-response, the mechanisms involved, B cell amnesia, and strategies to overcome it. Methods: Databases, including Google Scholar, PubMed, Scopus, Cochrane, and ClinicalTrials.org, were used to search and retrieve articles using keywords on hepatitis B vaccine non-response and B cell amnesia. The PRISMA guideline was followed in identifying studies, screening, selection, and reporting of findings. Results: A total of 133 studies on hepatitis B vaccine non-response, mechanisms, and prevention/management strategies were included in the review after screening and final selection. Factors responsible for hepatitis B vaccine non-response were found to include genetic, immunological factors, and B cell amnesia in healthy individuals. The genetic factors were sex, HLA haplotypes, and genetic polymorphisms in immune response markers (cytokines). Non-response was common in conditions of immunodeficiency, such as renal failure, haemodialysis, celiac disease, inflammatory bowel disease, hepatitis C co-infection, and latent hepatitis B infection. Others included diabetes mellitus and HIV infection. The mechanisms involved were impaired immune response by suppression of response (T helper cells) or induced suppression of response (through regulatory B and T cells). Discussion: A comprehensive and careful understanding of the patient factors and the nature of the vaccine contributes to developing effective preventive measures. These include revaccination or booster dose, vaccine administration through the intradermal route, and the use of adjuvants in the vaccine

Prevalence of diabetes mellitus and its risk factors among the suburban population of Northwest Nigeria

>Background: Diabetes mellitus (DM) was previously considered to be rare in sub-Saharan Africa. However, the prevalence is on the increase mainly because of urbanization and changes in lifestyle.Aim: The aim of our study was to determine the prevalence of DM and its correlates in the suburban population of Northwest Nigeria.Materials and Methods: A cross-sectional community-based study was carried out. Two hundred and eighty participants were recruited using a multistage sampling technique. Interviewer-administered questionnaire was utilized in obtaining demographic data from the participants. Anthropometric variables, fasting plasma glucose (FPG), and blood pressure measured using standard guidelines. The diagnosis of DM was based on the WHO guidelines.Results: The mean age was 42.3 ± 10.7 years. The overall prevalence of DM was 4.3% (males 4.5% and females 4.0%). The mean FPG was higher in the females (5.9 ± 1.2 mmol/L) than males (5.8 ± 2.5 mmol/L) though the difference was not statistically significant (P = 0.81). Obesity and increasing age were the major risk factors for DM among the suburban population.Conclusion: DM is common in suburban areas of Northwest Nigeria. We recommend increased awareness of the epidemic potential of this public health problem even in suburban areas

Pattern of sexually transmitted infections in human immunodeficiency virus positive women attending antenatal clinics in north-central Nigeria

Background: Sexually transmitted infections (STIs) are prevalent during pregnancy and may have adverse sequalae in both mother and fetus. Interactions between these infections and human immunodeficiency virus (HIV) synergize and may cause adverse pregnancy outcomes and reverse the gains of prevention of mother to child transmission of HIV. Objectives: The objective of this study is to determine the prevalence of candidiasis, trichomoniasis, gonococcal infection, syphilis, and bacterial vaginosis in HIV pregnant women and compare with HIV negative controls. Materials and Methods: A case-control study was conducted during the period from April to December 2010 at the Department of Obstetrics/Gynecology of University of Ilorin Teaching Hospital and three Primary Health Centers in Ilorin. A total of 160 HIV positive pregnant women attending antenatal clinics were recruited, along with the same number of HIV negative matched controls. A structured proforma was used to collect information from patients, vaginal examination was performed and samples were taken from the endocervix and the posterior vaginal fornix with swab sticks. Results: STIs were recovered from 142 women, giving overall prevalence of 44.4%. HIV infected women had a higher prevalence (60%) compared to uninfected (28.8%). The most prevalent STI was vaginal candidiasis (29.1%), followed by bacterial vaginosis (9.7%), and trichomoniasis (5.6%). The prevalence of candidiasis, bacterial vaginosis, and trichomoniasis was higher among HIV positive pregnant women compared to HIV negative controls (P < 0.05). No woman had syphilis or gonorrhea. Conclusion: The prevalence of candidiasis, bacterial vaginosis and trichomoniasis was higher in HIV infected pregnant women compared to uninfected. Routine screening of HIV infected pregnant women for these organisms is advocated