Sub-chronic toxicity evaluation of top three commercial herbal antimalarial preparations in the Kumasi metropolis, Ghana

Purpose: Safety data on commonly used herbal medicinal (HM) products (HMPs) and marketed in Ghana are scarce. We assessed the sub-chronic toxicity of three most-patronised commercial antimalarial HMPs in Kumasi, Ghana. Method: Top three HMPs (designated as herbal products 'A' (HPA), 'B' (HPB) and 'C' (HPC)) were selected after a mini-survey and sub-chronic toxicity evaluation conducted in accordance with Organisation for Economic Co-operation and Development (OECD) 407 guidelines. Control rats received clean water while test groups received daily adult human dose (DAHD), 5x DAHD or 10x DAHD of either HPA, HPB or HPC for 30 days. Rats were killed on day 31 to obtain biochemical, haematology and histology samples for analysis. Data were analysed by one-way analysis of variance (ANOVA) and post hoc Tukey's test. Results: The three HMPs produced alterations in liver morphology predominantly characterised by prominent foci of fatty change with scattered hepatocytes containing intracytoplasmic fat globules and congested central veins and sinusoids. The lungs showed alveolar with evidence of inflammation and foci of epithelial sloughing. Alveolar spaces were also obscured by debris and inflammatory cells. HPA and HPC produced scattered intensely congested heart vessels while HPB(10) produced haemorrhage and amorphous exudates within the heart. All HMPs produced neither treatment-related deaths nor significant change in haematological and biochemical parameters, except for HPA and HPB which decreased (P Conclusion: Data from the present study suggest the potential of the herbal products (HPs), HPA, HPB and HPC, to cause major organ-system dysfunction or damage. We advise cautious use of these products and recommend further safety evaluation in chronic toxicity models.Peer reviewe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mechanical and Structural Characterization of Pineapple Leaf Fiber

Evidence-based research had shown that elevated alkali treatment of pineapple leaf fiber (PALF) compromised the mechanical properties of the fiber. In this work, PALF was subjected to differential alkali concentrations: 1, 3, 6, and 9% wt/wt to study the influence on the mechanical and crystal properties of the fiber. The crystalline and mechanical properties of untreated and alkali-treated PALF samples were investigated by X-ray diffractometry (XRD), Fourier transform infrared spectroscopy (FTIR), and tensile testing analysis. The XRD results indicated that crystal properties of the fibers were modified with 6% wt/wt alkali-treated PALF recording the highest crystallinity and crystallite size of 76% and 24 nm, respectively. The FTIR spectra suggested that all alkali-treated PALF samples underwent lignin and hemicellulose removal to varying degrees. An increase in the crystalline properties improved the mechanical properties of the PALF treated with alkali at 6% wt/wt, which has the highest tensile strength (1620 MPa). Although the elevated alkali treatment resulted in decreased mechanical properties of PALF, crystallinity generally increased. The findings revealed that the mechanical properties of PALF not only improve with increasing crystallinity and crystallite size, but are also dependent on the intermediate bond between adjacent cellulose chains.Applied Science, Faculty ofNon UBCChemical and Biological Engineering, Department ofReviewedFacult

Adverse events following immunisation (AEFI) of COVISHIELD vaccination among healthcare workers in Ghana

Objective To describe the incidence of adverse events following immunisation (AEFI) and determine the factors that affect the onset and duration of AEFI after COVISHIELD vaccination among healthcare workers.Design Prospective cohort study.Setting Tertiary healthcare, Korle-Bu, Ghana.Participant Three thousand and twenty-two healthcare workers at least 18 years of age were followed up for 2 months after receiving two doses of the COVISHIELD vaccine.Primary outcome The occurrence of the AEFI was identified by self-reporting to the AEFI team members.Results A total of 3022 healthcare workers had at least one AEFI (incidence rate of 706.0 (95% CI 676.8 to 736.1) per 1000 doses) with an incidence rate of 703.0 (95% CI 673.0 to 732.0) per 1000 doses for non-serious AEFI and an incidence rate of 3.3 (95% CI 1.6 to 6.1) per 1000 doses for serious AEFI. The most commonly reported systemic adverse events were headache (48.6%), fever (28.5%), weakness (18.4%) and body pains (17.9%). The estimated median time to onset of the AEFI following the first-dose vaccination was 19 hours and the median AEFI duration was 40 hours or 2 days. Delayed-onset AEFI occurred in 0.3% after first dose and 0.1% after second dose. Age, sex, previous SARS-CoV-2 infection, history of allergies and comorbidity were not significantly associated with the onset and duration of AEFI. However, participants who used paracetamol seemed to be significantly protected (HR 0.15; 95% CI 0.14, 0.17) from having a long duration of AEFI.Conclusion The results of our study indicate a high incidence of non-serious AEFI and the rare occurrence of serious AEFI after COVISHIELD vaccination in healthcare workers. The rate of AEFI was higher after the first dose than after the second dose. Sex, age, previous SARS-CoV-2 infection, allergies and comorbidity were not significantly associated with the onset and duration of AEFI

Electrochemical evaluation of ion substituted-hydroxyapatite on HeLa cells plasma membrane potential

This study reports the electrochemical activities of a novel ion substituted-Hydroxyapatite (HAp) material in contact with HeLa cells. The work was performed to evaluate the inhibitory effects of various concentrations of HAp on ion transfer mechanisms in HeLa cells. The materials (n = 2: HAp1 and HAp3) were prepared at different stirring times from Achatina achatina snail shells and phosphate-containing solution. The structure of the materials and the trace elements concentration were evaluated using x-ray diffractometry and infrared spectrometry as well as atomic absorption spectroscopy. Electrochemical studies conducted on the cells after 30 min of exposure to the materials demonstrated different responses as elucidated by cyclic voltammetry. The voltammograms revealed HAp1 to be non-redox whereas HAp3 was redox active. Minimal concentrations of HAp1 showed high anodic peak current when compared to the HeLa cells alone, indicating a hyperpolarization of the cells. The peak current gradually reduced as the concentration of HAp1 was increased, and then followed by a sudden rise suggesting inhibition of the cell action potential. HAp3 showed a wavy pattern of the anodic peak current when the material concentration was varied. Peak currents of $$0.92 \pm 0.03$$ nA and $$0.57 \pm 0.01$$ nA were recorded for HAp1 and HAp3, respectively at the highest concentration of 5 µL. The results suggest that different inhibitory mechanisms are at play on the voltage-gated ion channels of the cells, indicating the possibility of using the materials to achieve different cancer proliferation inhibition