Phytoconstituents evaluation and antimicrobial efficacy of the crude flavonoids and saponins rootbark extracts of Terminalia avicennioides and Ficus polita

Introduction: Plant is a friend to man in survival as it gives him food, shelter and medicine beyond the ages of human civilization. This paper evaluates the phytochemical constituents and the antimicrobial activities undertaken on Terminalia avicennioides and Ficus polita. Methods: Phytochemical screening was conducted on the root extracts according to the standard procedures. The hole-in-plate disc diffusion technique was used to determine the antimicrobial activities of the crude saponins and crude flavonoids against the tested microorganisms used in this study. Results: The results revealed the presence of alkaloids flavonoids, saponins, sterols, phlobatannins and terpenoids. The antimicrobial activities presented as diameter of inhibition zones showed high activity value of 34.70±0.57 mm against Staphylococcus aureus and Pseudomonas aeruginosa at a concentration of 100 mg/mL and by crude flavonoids portion of T. avicennioides while the least activity was shown by crude saponins portion of F. polita at a concentration of 25 mg/mL with value of 9.67±0.58 mm against Shigella dysenteriae. The crude flavonoids inhibited the growth of Candida albicans at all concentrations while resisitances were found towards the crude saponins portion of both plants. Hence, flavonoids extractives from the two plants appeared to be more effective than the saponins against the tested microorganisms. Conclusion: These findings justify their potential use as drug-plant against bacterial-related infections in African traditional medical system and also suggest a possible insight for the isolation of bioactive chemotherapeutic agents from T. avicennioide

Breast Imaging Reporting and Data Systems category 3 (probably benign) breast lesions detected on diagnostic breast ultrasound: The prevalence, outcome and malignancy detection rate in Zaria, Nigeria

Background: Probably benign breast lesions in the Breast Imaging Reporting and Data Systems (BI-RADS 3) constitute a crucial category and a considerable number of all palpable breast masses. Local data concerning the outcome of such lesions in the Nigerian environment is almost non-existent. Objectives: The goal of this article is to report the frequency, outcome and malignancy detection rate among palpable breast masses that were categorised on ultrasound as BI-RADS category 3 (probably benign) according to the American College of Radiology (ACR). Methods: Between January 2015 and July 2017, 603 patients had diagnostic whole-breast ultrasound scans. There were 277 women who complained of palpable breast masses, of whom 151 women were diagnosed as having BI-RADS 3 lesions. The final lesion outcome was determined by either biopsy or ultrasound follow-up examination for a total of 2 years. All data were recorded and analysed with Statistical Package for the Social Sciences (SPSS) version 20 (Chicago, USA). Results: The frequency of BI-RADS category 3 lesions among all the women who underwent breast ultrasound was 25% (151/603); and 54% (151/277) in patients with palpable breast masses. There were 25 patients who were excluded because of incomplete data or who were lost to follow-up. A total of 122 patients had both ultrasound examination and histopathologic diagnosis, while only 4 were followed up for 2 years on ultrasound alone. Of the 122 women biopsied, 117 (95.9%) had benign histologic outcomes, and of the remaining 5, cancer was confirmed in 2 (1.6%), while the remaining 3 patients (2.5%) had lesions considered intermediate at histology (juvenile papillomatosis, borderline phylloides and atypical ductal hyperplasia). Three out of four patients who had ultrasound follow-up alone had stable lesions after 2 years, while one patient had complete resolution. Conclusion: This study found a significantly high biopsy rate of 80% (122/151) for probably benign lesions but a low detection rate for malignancy (1.6%). Follow-up with imaging rather than biopsy for lesions sonographically described as probably benign, will reduce medical costs and unwarranted invasive procedures

Phytoconstituents evaluation and antimicrobial efficacy of the crude flavonoids and saponins rootbark extracts of Terminalia avicennioides and Ficus polita

Introduction: Plant is a friend to man in survival as it gives him food, shelter and medicine beyond the ages of human civilization. This paper evaluates the phytochemical constituents and the antimicrobial activities undertaken on Terminalia avicennioides and Ficus polita. Methods: Phytochemical screening was conducted on the root extracts according to the standard procedures. The hole-in-plate disc diffusion technique was used to determine the antimicrobial activities of the crude saponins and crude flavonoids against the tested microorganisms used in this study. Results: The results revealed the presence of alkaloids flavonoids, saponins, sterols, phlobatannins and terpenoids. The antimicrobial activities presented as diameter of inhibition zones showed high activity value of 34.70±0.57 mm against Staphylococcus aureus and Pseudomonas aeruginosa at a concentration of 100 mg/mL and by crude flavonoids portion of T. avicennioides while the least activity was shown by crude saponins portion of F. polita at a concentration of 25 mg/mL with value of 9.67±0.58 mm against Shigella dysenteriae. The crude flavonoids inhibited the growth of Candida albicans at all concentrations while resisitances were found towards the crude saponins portion of both plants. Hence, flavonoids extractives from the two plants appeared to be more effective than the saponins against the tested microorganisms. Conclusion: These findings justify their potential use as drug-plant against bacterial-related infections in African traditional medical system and also suggest a possible insight for the isolation of bioactive chemotherapeutic agents from T. avicennioides

Acute flaccid quadriparesis and distal symmetrical polyneuropathy complicating tuberculosis of the urinary tract

Acute flaccid quadriparesis and distal symmetrical polyneuropathy (DSP) are neurological conditions associated with sudden compression of the cervical spinal cord and damage to peripheral nerves, respectively. Although quadriparesis can result from compressive myelopathy by tuberculosis (TB) of the cervical spine, it has not been reported in patients with TB of the urinary tract, either alone or in combination with DSP. We therefore report the case of a 28-year-old man who developed sudden weakness of the four limbs after 2 months of low grade fever, night sweats, malaise, and weight loss; followed by 2 weeks of low back pain, tingling sensations, and numbness of both hands and feet; all without evidence of compressive myelopathy. A diagnosis of TB of the urinary tract was made following positive Mantoux test and isolation of acid fast bacilli from one of six urine samples, and patient underwent 12 months course of antituberculous therapy with resolution of symptoms and signs of both TB infection and neurological diseass. This report has shown that anti TB therapy is effective in both TB of the urinary tract and the associated neurological complications. This report demonstrates a rare neurological complication of urinary tract Tb and the efficacy of anti TB therapy in both condition

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways