Concurrent use of prescription drugs and herbal medicinal products in older adults: a systematic review protocol

Background: There has been a global increase in the use of herbal medicinal products (HMPs). About a quarter of UK adults use HMPs, bought over the counter by self-prescription and often not disclosed to healthcare professionals. Potential herb-drug interaction is a clinical concern, with older people at greater risk because of co-morbidities and slower clearance of pharmacologically active compounds. While there is a good understanding of general herbal medicine use by older people, less is known about the extent and implications of concurrent use with prescription medicines. The aim of this systematic review is to assess the prevalence, patterns, safety issues and other factors associated with concurrent prescription and herbal medicines use among older adults. Methods/design: Systematic electronic searches of MEDLINE, PsychINFO, Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), Web of Science and Cochrane from inception till present for studies reporting the concurrent use of prescription medicines with HMPs in older adults (≥65 years). Lateral searching via related citation (PubMed) and checking reference lists of identified studies will be performed. Two reviewers will independently screen studies, extract data and appraise methodological quality using the Joanna Briggs Institute checklist for prevalence data and the Critical Appraisal Skills Programme (CASP) checklist. Qualitative and quantitative studies from all settings will be included. Non-empirical papers, in vitro experiments and animal studies will be excluded. Primary outcomes are prevalence and patterns of concurrent use, number and types of prescription and HMPs and adverse reactions reported. Secondary outcomes are disclosure of HMP use to healthcare professionals and cost of HMPs. A narrative synthesis of included studies will be performed to summarise the evidence. Discussion: This review will synthesise and critically appraise current knowledge on the concurrent use of drugs and HMPs by older adults and thus provide a better understanding of the issue. It will also identify any gaps in knowledge. By establishing safety issues associated with concurrent use, it will also inform strategies that can help practitioners to identify and manage older people at potential risk of herb-drug interactions. Systematic review registration: PROSPERO CRD4201400909

Antibacterial effect of Ocimum gratissimum against bacteria from paediatric diarrhoeal stool samples in the tropics

The upsurge in the prevalence of side effects of many synthetic antimicrobial agents and incidence of multidrug resistant bacteria has spurred scientists on the research for plant based antimicrobial of therapeutic potentials. Ocimum gratissimum presents such potential of high medicinal value. This plant is used in Nigeria traditionally as condiments and for the treatment of various ailments such as pyorrhea, dysentery and bronchitis. Aqueous and ethanolic leaf extracts of O. gratissimum was screened for antibacterial activity against bacteria recovered from paediatric diarrhoea stool samples. Both extracts were found to exhibit selective inhibition against the isolates. The diameter zones of inhibition exhibited by the extracts were between 2.50±0.50mm – 26.00±1.00mm. The ethanolic and aqueous extracts had minimum inhibitory concentrations that ranged between 15 and 25mg/ml, the extracts were bacteriostatic. Ethanolic extract showed more inhibitory effects compared to the aqueous extracts. The phytochemical analysis of both extracts revealed the presence of saponins, alkaloids, flavonoids, phenolics, tannins and glycosides, volatile oils, proteins and amino acids and terpernoids. In view of the efficacy of these extracts in inhibiting the growth of diarrhoea- causing organisms in paediatric stool samples, the utilization of the extracts in the formulation of new antibacterial drugs for the treatment of gastroenteritis caused by these organisms is strongly recommended especially when the availability and low cost of this medicinal plant are put into strong consideration.Keywords: Ocimum, diarrhoea, paediatric, stool, antibacteria

Concurrent use of prescription drugs and herbal medicinal products in older adults: A systematic review

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The use of herbal medicinal products (HMPs) is common among older adults. However, little is known about concurrent use with prescription drugs as well as the potential interactions associated with such combinations. Objective Identify and evaluate the literature on concurrent prescription and HMPs use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. Methods Systematic searches in MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults (≥65 years). Quality was assessed using the Joanna Briggs Institute checklists. The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) three stage approach to mixed method research was used to synthesise data. Results Twenty-two studies were included. A definition of HMPs or what was considered HMP was frequently missing. Prevalence of concurrent use by older adults varied widely between 5.3% and 88.3%. Prescription medicines most combined with HMPs were antihypertensive drugs, beta blockers, diuretics, antihyperlipidemic agents, anticoagulants, analgesics, antihistamines, antidiabetics, antidepressants and statins. The HMPs most frequently used were: ginkgo, garlic, ginseng, St John’s wort, Echinacea, saw palmetto, evening primrose oil and ginger. Potential risks of bleeding due to use of ginkgo, garlic or ginseng with aspirin or warfarin was the most reported herb-drug interaction. Some data suggests being female, a lower household income and less than high school education were associated with concurrent use. Conclusion Prevalence of concurrent prescription drugs and HMPs use among older adults is substantial and potential interactions have been reported. Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals can appropriately identify and manage patients at risk.Peer reviewedFinal Published versio

Genetic, environmental and stochastic factors in monozygotic twin discordance with a focus on epigenetic differences

PMCID: PMC3566971This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Microbial Deterioration of Tomato Fruit ( Lycopersicon esculentum ) Sold in Three Popular Markets in Ilorin, Kwara State, Nigeria

The economic loss as a result of spoilage and proliferation of microorganisms on tomato fruits with the possible health risks were the justification for this study. One hundred and fifty tomato fruit samples in different stages of spoilage from three different markets in Ilorin, Kwara State, Nigeria were collected within five weeks and the effect of moisture content on each sample and resulting microflora examined. The pH of the samples ranged from 4.90 - 5.40, while the moisture content ranged from 89.10% - 90.70%. The bacteria counts ranged from 4.00 x 106 - 7.50 x 106 cfu/ml, while the fungal counts ranged from 1.60 x 106 - 3.50 x 106 cfu/ml. A total number of sixteen bacteria and eleven fungi including yeasts were associated with the samples. The bacterial isolates included Aeromonas veronii, Bacillus sp., Neisseria sp., Corynebacterium renale, Pseudomonas fluorescens, Micrococcus varians, Moraxella sp., Bacillus polymyxa, Aeromonas hydrophila, Pseudomonas sp., Bacillus megaterium, Corynebacterium ulcerans, Vibrio sp., Proteus mirabilis, Corynebacterium xerosis, and Bacillus brevis while the fungal isolates included Alternaria sp., Botrytis sp., Candida albicans, Candida guilliermondii, Candida tropicalis, Chrysosporium tropicum, Curvularia sp., Doratomyces microsporus, Geotrichum candidum, Saccharomyces cerevisiae, and Rhizopus stolonifer. The high moisture content of the tomato samples provides an enabling environment for proliferation of the microbial load and hence its spoilage and potential to become health risk to human beings. Keywords: Spoilage, proliferation, economic loss, pH and moistur

Optimization of Conditions for Xylanase Production Using Aspergillus tubingensis Under Different Carbon Sources

Xylanases are hydrolytic enzymes with wide range of applications in food processing, bleaching of pulp in paper manufacturing industry, bio-conversion of biomass wastes to fermentable sugars and enhancing nutrient digestibility in animal feeds. The optimization of growth conditions and evaluation of an appropriate substrate as carbon source among cassava peels, corn cobs, wheat bran and rice husk on xylanase production by novel strain of Aspergillus tubingensis under Solid State Fermentation (SSF) was investigated. The fungal isolate was identified based on ribosomal RNA gene and ITS gene sequencing analysis as Aspergillus tubingensis. Results showed that Corn cobs had the highest xylanase production among the four substrates. Corn cobs recorded the highest value of xylanase production at pH of 6.0 (107.97 U/g), after incubation period of 72 hour (111.23 U/g), at temperature of 30 oC (44.26 U/g) and at ratio 1:3 (45.68 U/g). The optimum growth conditions for xylanase production by Aspergillus tubingensis were: pH 6.0, incubation period of 72 hours, temperature of 30 oC and substrate concentration of 1:3 (4g of substrate per 12mL of fermentation medium). Corn cobs showed the highest yield of xylanase activity (111.23±0.31 U/g), followed by Rice husk (101.91±0.72 U/g), Wheat bran (89.30±1.16 U/g) and Cassava peel (87.03±0.57 U/g). In conclusion, among the various agro residues that were used as carbon sources, Corn cobs had maximum xylanase activity. Various culture conditions were optimized by using one factor at a time method and the maximum xylanase production was obtained at pH of 6.0, incubation period of 72 hour, temperature of 30 oC and substrate concentration of 1:3 under solid state fermentation. It is therefore suggested that some other notable environmental and fermentation factors that influence metabolism-mediated production yields of xylanase like aeration, agitation, carbon and nitrogen sources, metal ion requirement,  inoculum size etc. should be optimized for maximum production of enzyme. Keywords: Solid State Fermentation, Cassava peels, Corn cobs, Wheat bran, Rice hus

Small-angle x-ray scattering to analyze the morphological properties of nanoparticulated systems

Small-angle X-ray scattering (SAXS) is a powerful technique that uses the scattering of a beam of X-rays to investigate the structure, morphology, and arrangement of submicron dimensions and particularly useful for studying systems at the nanometric scale. Herein, in this chapter book, we will examine the most representative features of several scattering intensity curves acquired from several nanoparticulated systems. We begin with the explanation of the most fundamental concepts behind the SAXS framework, to then introduce the principal features of a scattering pattern. Each section of this chapter is complemented with practical examples, many of which are simulations, while others come from real experimental data taken from real samples synthesized for this purpose in our labs. As an important part of this work, we present two models often used to fit SAXS curves acquired from granular nanoparticle samples, which are the fractal aggregate and the Beaucage models. In this last part of these sections, our goal is to explain how to obtain valuable structural information from systems consisting of either nanoparticles surrounded by liquids or solids. Finally, we present a complete description of the principal components needed to a SAXS instrument.Fil: Moscoso Londoño, Oscar. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Autónoma de Manizales; Colombia. Universidade Estadual de Campinas; BrasilFil: Tancredi, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ingeniería. Departamento de Física. Laboratorio de Sólidos Amorfos; ArgentinaFil: Rivas Rojas, Patricia Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ingeniería. Departamento de Física. Laboratorio de Sólidos Amorfos; ArgentinaFil: Muraca, Diego. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidade Estadual de Campinas; BrasilFil: Socolovsky, Leandro Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Transferencia de Santa Cruz. Universidad Tecnológica Nacional. Facultad Regional Santa Cruz. Centro de Investigaciones y Transferencia de Santa Cruz. Universidad Nacional de la Patagonia Austral. Centro de Investigaciones y Transferencia de Santa Cruz; ArgentinaFil: Knobel, Marcelo. Universidade Estadual de Campinas; Brasi