IS CHLOROQUINE BETTER THAN ARTEMISININ COMBINATION THERAPY AS FIRST LINE TREATMENT IN ADULT NIGERIANS WITH UNCOMPLICATED MALARIA?-A COST EFFECTIVENESS ANALYSIS.

The current case management and drug policy of malaria in Nigeria recommended by the Federal ministry of health may not be appropriate for all age categories. This suspicion was tested by running a cost effectiveness analysis of two possible and alternative strategies: Artemisinin Combination Therapy (ACT) or Chloroquine and ACT only if CQ fails (CANACT), in adult non pregnant Nigerians aged 20-45yrs. The result confirms that ACT is indeed more effective but also more costly with an incremental cost effectiveness ratio (ICER) of #2,546,527.00 per QALY that is much higher than the estimated upper limit of #25,000.00 that either patients or provider may be willing to pay. The CANACT strategy may be the most cost effective strategy in this subgroup of Nigerian patients and also provides better value for money

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

Ficus platyphylla promotes fertility in female Rattus norvegicus Wistar strain: a preliminary study

<p>Abstract</p> <p>Background</p> <p><it>Ficus platyphylla </it>Delile (family- Moracea) commonly called gutta percha tree is a deciduous plant found in savannah areas. It grows widely in the Northern part of Nigeria, up to 60 ft. high and is known as 'gamji' by the Hausas. The seeds, bark and leaves have been used traditionally in combination to promote fertility. Scientifically, the plant has been shown to have analgesic, anti-inflammatory and CNS effects. The present study was to validate the use of this plant to promote fertility in female Rattus norvegicus Wistar strain using various fertility parameters.</p> <p>Methods</p> <p>Female Rattus norvegicus Wistar strain weighing between 150-180 g were randomly selected and divided into two major groups. Each group was subdivided into 5 treatment groups of 100, 200, 400 mg/kg BW of aqueous extract of <it>F. platyphylla </it>and a control group of 5 ml/kg of distilled water. A positive control of clomiphene citrate was used. Treatment of the first group was discontinued after 15 days prior to mating (pre-mating treatment group), while the other was treated continuously till delivery (continuous treatment group). At the 10^thday, females were sacrificed and implantation sites were checked and embryos counted. Upon delivery, litter sizes were determined and the pups weighed and checked for deformities. Other reproductive indices were calculated. Data were analyzed by one-way analysis of variance and students T-test. Proportions were analysed by Chi square. Statistical evaluations were performed using STATS programs and Graphpad prism, and a difference was considered statistically significant at P < 0.05.</p> <p>Results</p> <p>There was a significant reduction in the percentage post implantation losses of both the pre-treatment and the continuous treatment groups when compared to their distil water controls. The litter size of the pre-treatment group was similar to the distil water group while at 400 mg/kg, the continuous treatment group showed an increase in the litter size similar to that of the clomiphene group. There were no observed external deformities in the pups.</p> <p>Conclusions</p> <p>Administration of aqueous extract of <it>F. platyphylla </it>promotes fertility by reducing post implantation loss and by increasing litter size in female Rattus norvegicus Wistar strain.</p

Anticonvulsant and sedative activities of aqueous leave extract of Leucas martinicensis (Jacq.) R. Br

Leucas martinicensis is a medicinal plant used in traditional medicine to treat convulsions and epilepsy. The present study was to evaluate the anticonvulsant and sedative effects of the aqueous leave extract of L. martinicensis in Wistar rats. The anticonvulsant activities of L. martinicensis (50, 100, 200 or 400 mg/kg i.p.) were evaluated using maximal electroshock seizure (MES) - and strychnine (STR) -induced seizure models while the sedative properties were evaluated using the diazepaminduced sleep model in Wistar rats. The 400 mg/kg of the extract protected rats (100%) against seizures in both models while at 200 mg/kg seizure protection (100%) was only in STR model. There was a significant (p&lt;0.05) delay in the onset and reduction in the duration of seizure in the two models in unprotected rats. L. martinicensis exerted sedative effect by significantly reducing the onset (sleep latency) and increasing the total duration of sleep induced by diazepam. These results suggest that aqueous extract of L. martinicensis may possess anticonvulsant and sedative properties that might show efficacy against primary generalised seizures and secondarily generalised tonic -clonic seizures in humans. It also lends pharmacological credence to the use of the plant in traditional medicine for the management of epilepsy and convulsions.Keywords: Leucas martinicensis; Epilepsy; Traditional medicine; Anticonvulsant; slee

Dose-Dependent Amelioration of Gentamicin-Induced Nephrotoxicity in Adult Swiss Albino Rats by Vitamin B-complex -A Preliminary Study

Purpose: To evaluate the effect of vitamin B-complex on the nephrotoxicity of gentamicin in an established rat model. Methods: Adult Swiss albino rats weighing 170±20g were divided into 4 groups of 4 rats each. Each group was given one of the following: placebo injection (Control), 80mg/kg of gentamicin sulphate alone or with 1.5ml/kg/3ml/kg body weight of vitamin B-complex (intramuscular) containing 10mg thiamine, 1.5mg riboflavin and 1.0mg pyridoxal-6-phosphate per ml. Results: In the Swiss albino rats, daily intramuscular 80mg/kg gentamicin sulphate significantly (p<0.05) and consistently produced biochemical signs of nephrotoxicity after 5 days. Also, 1.5 ml/kg of B-complex significantly (p<0.05) ameliorated the rate and extent of increase in serum urea and creatine while 3ml/kg of the same drug completely prevented the increase in serum urea and creatine in this model. Conclusion: Vitamin B-complex dose-dependently ameliorated gentamicin-induced nephrotoxicity in adult Swiss albino rats when given intramuscularly. This finding may have important clinical utility

On the safety of diagnostic ultrasound in pregnancy: Have we handled the available data correctly?

Robust evidence of the bioeffects of ultrasound is available from animal studies but human studies are less convincing. Nevertheless, it is disturbing that the only response to safety issues is a twenty-year old principle known as ALARA (As Low As Reasonably Applicable). Using experience from obstetrics and toxicology, and drawing information mainly from two recent systematic reviews and meta-analysis that extensively covered the subject of ultrasound safety, this review captures the current knowledge of ultrasound bioeffects and suggests that it may be time for an international, multidisciplinary meeting on ultrasound safety to decide how to provide the evidence (available data) to patients and sonographers in a succinct manner

On the safety of diagnostic ultrasound in pregnancy: Have we handled the available data correctly?

Robust evidence of the bioeffects of ultrasound is available from animal studies but human studies are less convincing. Nevertheless, it is disturbing that the only response to safety issues is a twenty-year old principle known as ALARA (As Low As Reasonably Applicable). Using experience from obstetrics and toxicology, and drawing information mainly from two recent systematic reviews and meta-analysis that extensively covered the subject of ultrasound safety, this review captures the current knowledge of ultrasound bioeffects and suggests that it may be time for an international, multidisciplinary meeting on ultrasound safety to decide how to provide the evidence (available data) to patients and sonographers in a succinct manner