Caesarean section wound infiltration with local anaesthetic for postoperative pain relief – any benefit?

Delivery by caesarean section (CS) is becoming more frequent. Childbirth is an emotion-filled event, and the mother needs to bond with her baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Local anaesthetics have been employed as an adjunct to other methods of postoperative pain relief, but reports onthe effectiveness of this strategy are conflicting. This review attempted to assess the effects of local anaesthetic agent wound infiltration and/or abdominal nerve blocks on pain after CS and the mother’s well-being and interaction with her baby.Methods. We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (April 2009).The selection criteria were randomised controlled trials of local analgesia during CS to reduce pain afterwards. Twenty studies (1 150 women) were included.Results. Women who had wound infiltration after CS performed under regional analgesia had a decrease in morphine consumption at 24 hours compared with placebo (morphine dose -1.70 mg; 95% confidence interval (CI) –2.75 to –0.94). Women who had wound infiltration and peritonealspraying with local anaesthetic after CS under general anaesthesia (1 study, 100 participants) had a reduced need for opioid rescue (risk ratio (RR) 0.51; 95% CI 0.38 to 0.69). The numerical pain score (0 -10) within the first hour was also reduced (mean difference (MD) -1.46; 95% CI –2.60 to –0.32). Women with regional analgesia who had local anaestheticand non-steroidal anti-inflammatory cocktail wound infiltration consumed less morphine (1 study, 60 participants; MD –7.40 mg; 95% CI –9.58 to –5.22) compared with those who had local anaesthetic control. Women who had regional analgesia with abdominal nerve blocks had decreased opioidconsumption (4 studies, 175 participants; MD –25.80 mg; 95% CI –50.39 to –5.37). For outcome in terms of the visual analogue pain score (0 - 10) over 24 hours, no advantage was demonstrated in the single study of 50 participants who had wound infiltration with a mixture of local analgesia and narcotics versus local analgesia.Conclusions. Local anaesthetic infiltration and abdominal nerve blocks as adjuncts to regional analgesia and general anaesthesia are of benefit in CS by reducing opioid consumption. Non-steroidal anti-inflammatory drugs may provide additional pain relief.S Afr Med J 2010; 100: 313-319

Economic, nutritional and medicinal values of African walnut (Tetracarpidium conophorum) in Nigeria (Hutch. & Dalziel): a review

The Nigeria Walnut (Tetracarpidium conophorum) is a climber crop species that help in poverty reduction through improvement of the purchasing power of families and their standard of living. African walnut has proven evidence that leads to general acceptability to its protective effects against certain diseases majorly the cardiovascular disease (CDV). It has many other medicinal values such as treatment of Diabetic, maintenance of healthy bone, Anti-malarial, diseases prevention, pregnancy protection and sperm improvement, weight management and so on. The consumption of this fruit is not only effective for the health of man but contributes to other lifestyles characteristics backed up by evidence from certain scientific investigations. However, the challenges facing its year round availability have not been fully documented and data related to its contributions to livelihoods of rural farmers and it nutritional value is not readily available to the populace, thereby places the plant in danger of genetic extinction and disappearance which have the potential to restrict its development options. Therefore, this paper reviewed the monetary contribution of African Walnut, its potential roles in poverty reduction, commitment to national advancement and value added exports from Nigeria, hence the investigation is expected to bridge some of this gap, giving an overview of the present information encompassing the economic commitment of Walnut, it nutritional and medicinal values in Nigeria. Key words: Economics, Nutrition, Medicinal Benefits, Chemical composition, Walnu

Identification of compounds with cytotoxic activity from the leaf of the Nigerian medicinal plant, Anacardium occidentale L. (Anacardiaceae)

Cancer is now the second-leading cause of mortality and morbidity, behind only heart disease, necessitating urgent development of (chemo)therapeutic interventions to stem the growing burden of cancer cases and cancer death. Plants represent a credible source of promising drug leads in this regard, with a long history of proven use in the indigenous treatment of cancer. This study therefore investigated Anacardium occidentale, one of the plants in a Nigerian Traditional Medicine formulation commonly used to manage cancerous diseases, for cytotoxic activity. Bioassay-guided fractionation, spectroscopy, Alamar blue fluorescence-based viability assay in cultured HeLa cells and microscopy were used. Four compounds, zoapatanolide A (1), agathisflavone (2), 1,2-bis(2,6-dimethoxy-4-methoxycarbonylphenyl)ethane (anacardicin, 3) and methyl gallate (4), were isolated, with the most potent being zoapatanolide A with an IC50 value of 36.2 ± 9.8 µM in the viability assay. To gain an insight into the likely molecular basis of their observed cytotoxic effects, Autodock Vina binding free energies of each of the isolated compounds with seven molecular targets implicated in cancer development (MAPK8, MAPK10, MAP3K12, MAPK3, MAPK1, MAPK7 and VEGF), were calculated. Pearson correlation coefficients were obtained with experimentally-determined IC50 in the Alamar blue viability assay. While these compounds were not as potent as a standard anticancer compound, doxorubicin, the results provide reasonable evidence that the plant species contains compounds with cytotoxic activity. This study provides some evidence of why this plant is used ethnobotanically in anticancer herbal formulations and justifies investigating Nigerian medicinal plants highlighted in recent ethnobotanical surveys

Assessment of Extension Officers Contribution to Cocoa Production in Nigeria

This study was carried out to evaluate the extension officer contribution to cocoa production in Nigeria. Multistage sampling technique was used, where two hundred and sixteen questionnaires were distributed in Osun and Ondo state , the information gathered were analyzed using descriptive statistic such as; frequency and percentage, while chi-square analysis was used to analyze the data obtained. From the results, married (77.6%), male (84.0%), secondary school holders (52.0%), between 40-49 (34.4%) years old farmers were seen as the highest cocoa producers. Extension training(64.0%), commercial agents(64.0%), fellowship(52.8%), self observation(76.0%) were the best source of information on extension service of cocoa farming , most respondents (65.0%); get extension training programme at regular basis, identified Constraints facing cocoa production in the study area includes deficient credit facilities, high cost of labour, bad road, poor marketing/storage facilities, lack of technical knowledge / assess to technical tools and so on. in view of afore mentioned result it is therefore recommended that the government should make loan available to the cocoa famers at very low interest rate and urge cocoa farmers to form cooperative society, strengthen their agricultural extension agents so that they will be able to rain cocoa farmers on the basic things they should know about primary processing such as fermentation and drying of cocoa beans in improving the quality in Nigeria to meet international market

Saddle Block for Transrectal Prostate Biopsy: A Comparison of the Analgesic Efficacy of 0.25% Bupivacaine and 0.375% Ropivacaine

Background: Prostate biopsy is a painful procedure, and the degree of pain is related to the number of core biopsies taken. Objective: To compare the analgesic properties of hyperbaric bupivacaine 0.25% with 0.375% ropivacaine for saddle block in transrectal prostate biopsy. Methods: This was a randomised double-blinded study. Eighty patients with indications for prostate biopsy presenting at the Day-Case Theatre in a Nigerian tertiary facility were randomised into two equal groups: B (Bupivacaine) and R (Ropivacaine). Group B received 1ml of 0.25% bupivacaine, while Group R received 1ml of 0.375% ropivacaine for saddle block, respectively. Pain assessment, home readiness, patients' satisfaction, and time to first analgesic request were assessed and compared between the two groups. Results: The Bupivacaine group had an earlier onset of sensory block (11.90±4.10 minutes vs 23.70±8.65 minutes, p = 0.000), slower sensory block regression (48.73±9.32 minutes vs 24.88±4.21 minutes, p = 0.000), but delayed home readiness (47.23±15.93 minutes vs 29.88±8.58 minutes, p = 0.000), than patients in the Ropivacaine group. The pain scores during, immediately after and 30 minutes post-biopsy were lower in the Bupivacaine group: p = 0.010, p = 0.028 and p = 0.023 respectively. The time to first analgesic request was also longer in the Bupivacaine group (48.73±9.33 minutes) than for those in the Ropivacaine group (24.88±4.21 minutes) with statistical significance (p = 0.000). Conclusion: Intraoperative analgesic properties were better in the Bupivacaine group than in the Ropivacaine group. However, home readiness was earlier in the Ropivacaine group