Phytochemical Analysis and Anti-diabetic Potential of Annona muricata L., Persea americana Mill. and Montrichardia arborescens L. Schott Utilized by the Residents of Pakuri (St. Cuthbert’s Mission) in Guyana

Aim: This study was designed to assess the utilization of plants with anti-diabetic properties and to conduct preliminary phytochemical analysis and moreover, to assess the anti-diabetic potential of selected plants used to treat and manage Type 2 diabetes mellitus (T2DM) among the residents of Pakuri (St. Cuthbert’s Mission) in Guyana. Methodology: The leaves of sour sop (Annona muricata L.), pear (Persea americana Mill.) and Mocou-Mocou (Montrichardia arborescens L. Schott) underwent phytochemical testing and -amylase Inhibition testing to determine their anti-diabetic properties. Results: This study showed that the leaves of pear, sour sop and mocou mocou contained different chemical constituents including alkaloids, flavonoids, saponins and tannins but the absence of amino acids (proteins), carbohydrates and glycosides. The x-amylase inhibitory studies performed demonstrated that the extracts of A. muricata in ethanol and chloroform had significant inhibitory potential. Conclusion: Considering the promising potential of phytochemicals and the anti-diabetic activity of these species of plant extracts in anti-diabetic drug development, in vivo experiments and clinical trials are required for efficacy and safety evaluation. Also, the anti-diabetic phytochemicals may be used in combination with existing orthodox drugs, thereby, reducing the dose of synthetic anti-diabetic drugs, which will help in addressing the toxicity and cost-related issues in chronic use during the management of diabetes mellitus (DM)

Comparison and Effectiveness of Complementary and Alternative Medicine as against Conventional Medicine in the Treatment and Management of Type 2 Diabetes

Aim: The main objective of the study was to compare, using laboratory data, the efficacy of herbal medicines against conventional drugs in treating and managing diabetes mellitus (DM) among type 2 diabetic (T2DM) patients. Methodology: The study recruited 80 patients from a private Herbal Clinic and the Georgetown Public Hospital Diabetic and Medical Outpatient clinic after giving their consent and satisfying the inclusion criteria. Laboratory tests and analysis were done using conventional scientific methods and data analyzed using SPSS version 20 with a p-value of 0.05 being used to determine statistical significance. Results: The results showed that age, religion, ethnicity, education, marital status and monthly income have significant associations with the use of herbs. Persons using herbal medicine alone had normal lipid profile, renal function and liver function test, in addition to hemoglobin (Hb), white blood cell count (WBC), glycosylated hemoglobin ?(HBA1C) and fasting blood glucose (FBS). The most common herbs used were Momordica charantia (local name- karela) and Azadirachta indica (local name- neem), which were used in combination or alone. Results showed a positive effect on coronary heart disease risk. Conclusion: The information generated from the study indicated that a significant number of diabetic patients using herbs alone for their treatment had normal results. However, a more controlled study is required to validate these results

Socioeconomic inequalities in reproductive, maternal, newborn and child health in Guyana: a time trends analysis

# Background Guyana is among the countries committed to achieving the sustainable development goals. This research assessed the patterns of change in reproductive, maternal, newborn, and child health (RMNCH) in Guyana. # Methods Four nationally representative surveys conducted from 2009 to 2019 were assessed. Temporal trends in RMNCH indicators were assessed at the national level, by place of residence, and by wealth index. The slope index and concentration index of inequality were calculated to assess trends in inequalities over time. The average absolute annual change (AAAC) of the indicators was calculated using a weighted variance regression. # Results From 2006 to 2019, we observed an increase in the coverage of institutional delivery (from 82.6% to 97.7%), and exclusive breastfeeding (from 21.4% to 31.0%), among others. Likewise, antenatal care with four or more visits increased from 77.4% in 2009 to 84.7% in 2019. The opposite was observed for coverage of current contraceptive use (modern methods) (from 32.7% to 28.2%), family planning needed satisfied (from 49.6% to 43.8%), tetanus toxoid in pregnancy (from 31.7% to 8.2%) and full vaccination coverage (from 82.0% to 63.4%). Under-five stunting prevalence decreased from 18.0% to 9.2% and the under-five mortality rate from 40.4 to 29.3 per 1,000 live births. The gap between the poorest and richest women tended to decrease for seven out of the 16 intervention indicators, as well as for under-five stunting prevalence and under-five mortality rate. Institutional delivery was the best performer in increasing coverage and decreasing inequality over time, while immunization with measles was the worst performer. # Conclusions Guyana has made great progress in improving its RMNCH indicators. However, the observed decline in the coverage of several RMNCH indicators can be seen as a warning sign to redouble efforts to achieve sustainable development goals, SDGs 1 and 2, by 2030 and to reduce inequalities by lagging no one behind

Trends in Transfusion-Transmissible Infections Among Blood Donors at the National Blood Transfusion Service, Guyana

Aim: The most adverse effect of blood transfusion is the acquisition of transfusion-transmissible infections (TTIs), which poses a serious threat in developing countries. This study aims to identify the trends of transfusion-transmissible infections among blood donors. Materials and Methods: This study was a laboratory-based retrospective study conducted using blood donors’ records from January 2015 to December 2018, collected at the National Blood Transfusion Service, Guyana (NBTS). Analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 22.0 software and the results were presented in tables and graphs. Chi-square and logistic regression were used to identify trends and influencing factors. Results: A total of 39,308 blood donors were included in this study, of whom 2,418 (6.2%) donors tested positive to at least one pathogen. Among those donors, 4.4% were coinfected with at least one of the sixteen dual infection combinations. The overall seroprevalence of HIV, HTLV, syphilis, HBV, HCV, Chagas, microfilaria, and malaria was 0.8%, 0.8%, 0.6%, 1.5%, 1.3%, 1.2%, 0.0%, and 0.0%, respectively. Trends of transfusion-transmissible infections showed an overall increase from the lowest prevalence, 5.1%, in 2015 to 7% in 2016, followed by decreases in 2017 (6.8%) and 2018 (5.8%). Conclusions: Even though 98.6% of the donor population are volunteers, this study has shown that a significant percentage of blood donors harbour transfusion-transmissible infections. Stringent screening and preventive measures are very important to ensure the safety of the transfusion recipient

Effectiveness of Initiatives to Minimize Blood Usage and Wastage at a Public Hospital Setting in Guyana

Objectives: This is a cross-sectional descriptive follow-up study which analysed the pattern of blood usage and wastage after initiatives were taken following the initial study done in Guyana from 2012 to 2014. This study also assessed the healthcare personnel’s knowledge regarding blood transfusion. Methods: A study was conducted concerning blood product usage and wastage using data from the laboratory blood bank information system in 2016–2018 in the public hospital. Information on knowledge, attitude, practices and administrative guidance of healthcare personnel was assessed using a self-administered questionnaire on different areas of transfusion medicine. Usage of blood products was calculated as a percentage, and wastage of blood products was calculated as the number of units wasted due to each reason divided by the total number of units wasted. The data were entered and analysed in SPSS 21.0. Results: A total of 29,577 units of blood were issued by the National Blood Transfusion Service. Each year, a blood unit collection of 9,745 (32.9%), 9,765 (33.0%), 10,067 (34.0%) units, respectively, was recorded. Data indicated that 3,851 units (13.0%) of blood were wasted at the Georgetown Public Hospital Cooperation due to various reasons. Packed red blood cells were the most commonly used blood product that was issued (52.5%) and platelets (47.8%) were the most commonly wasted product. In comparison to the previous study, blood wastage decreased from 25.4% to 13.0% after implementing simple interventions. Results of examination of knowledge, attitude, practices and administrative guidelines of health personnel were not satisfactory. Conclusion: Simple and relatively cheap interventions introduced following the previous study had a dramatic impact on reducing blood wastage in the public hospital in Guyana