Analgesic activity of ethanolic leaf extract of Solanum anomalum

Background: Solanum anomalum Thonn. ex Schumach. (family Solanaceae) is a shrub with edible fruit consumed locally for nutritional and medicinal purposes. Objective: To evaluate the leaf extract of Solanum anomalum for analgesic properties in mice. Method: The ethanol leaf extract of Solanum anomalum (70-210 mg/kg) was evaluated for analgesic activity against nociception in mice using acetic acid-induced writhing, formalin-induced hind paw licking and thermally-induced pain models. Results: The leaf extract significantly inhibited nociception in all the models tested in a dose-dependent fashion. Conclusion: The leaf extract possesses analgesic activity which confirms its use in traditional medicine in the treatment of pains. Keywords: Solanum anomalum, analgesic, medicinal plant Published: May, 202

INHIBITION OF GASTRIC DEGRADATION OF OMEPRAZOLE USING A pH-SENSITIVE POLYMER AS A BINDER IN TABLET FORMULATION

Objective: This work was aimed at formulating omeprazole tablets using afzelia gum as a binder that is capable of inhibiting the gastric degradation of the drug. Methods: Afzelia gum at different concentrations of 0, 5, 10, 15, 20 and 30% was used as a binder to formulate omeprazole tablets. The tablets were formulated by direct compression and the batches labelled F1 to F6 respectively. A batch containing 15% hydroxypropyl methylcellulose (F7) was also formulated. The tablets were characterized; and dissolution in a pH 1.2 dissolution medium over 120 min period was studied. Aliquots taken every 20 min were analyzed by ultraviolet spectrophotometry to determine the amount of drug released and not degraded. Results: Amounts of drug released and not degraded at time 120 min were 53.1%, 57.3%, 57.8%, 58.8%, 62.1%, 83.4% and 90.0% for F1 to F7 respectively. Conclusion: Afzelia gum at a concentration of 30% is suitable for use as a binder in tablet formulation of omeprazole to ensure substantial inhibition of gastric degradation of the drug

ANTIOXIDANT AND ANTIULCER ACTIVITIES OF ETHANOL LEAF EXTRACT AND FRACTIONS OF SOLANUM ANOMALUM

Solanum anomalum leaf is used in Ibibio traditional medicine for the treatment of various ailments including diabetes mellitus, malaria and ulcer. The ethanol leaf extract and fractions of Solanum anomalum were investigated for in vitro antioxidant activity using various models; 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, Ferric Reducing Power assay (FRAP) and Nitric oxide (NO) scavenging assay and antiulcer activity using indomethacin, ethanol and histamine-induced ulcer models in rats. The leaf extract and fractions exhibited significant antioxidant activity with the hexane and dichloromethane fractions demonstrating higher antioxidant potentials. The leaf extract (70-210 mg/kg) was found to significantly (p<0.05 -0.001) inhibit ulcers induced by indomethacin, ethanol and histamine in a dose-dependent fashion. These results suggest that the leaf extract of Solanum anomalum possess  antioxidant and antiulcerogenic potentials which are due to the activities of the phytochemical constituents

Biochemical parameters in alloxan induced diabetic rats treated with glibenclamide, metformin and two polyherbal bitters

Background: Manufacturers and promoters of various polyherbal bitters claim that, being of natural origin, they could be co-administered with therapeutic drugs with no adverse effects, and that it could be used to treat a wide array of ailments including diabetics. Most Nigerians use the bitters and their conventional drugs concurrently. Objectives: To assess the effects(s) or otherwise of the co-administration of two popular bitters in Nigeria market S-bitter and Y-bitter with two therapeutic antidiabetic drugs glibenclamide and metformin on some liver and kidney  biochemicals and lipid profile. Methodology: Therapeutic doses of glibenclamide, metformin and the bitters alone and a combination of the drugs and the bitters corresponding to the body weight of the rats were administered orally to different groups daily for fourteen days.  On the 15th day, the rats were sacrificed and plasma collected was analyzed for the hepatic biochemicals (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, albumin, total and direct bilirubin), lipid biochemical (high density lipid cholesterol, low density lipid cholesterol, total cholesterol and triglycerides) and renal biochemicals (creatinine and urea). Results: When metformin, glibenclamide and the bitters were administered alone, there was a marginal decrees in the levels of alanine aminotransferase, and a significant increase (p<0.05) in the plasma levels of creatinine and blood urea nitrogen.  A combination of the bitters with metformin and glibenclamide caused a significant decrease (P<0.05) in the levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and bilirubin, but there was an increase in the levels of total cholesterol, high density lipid cholesterol, low density lipid cholesterol, triglycerides and albumin. Conclusion: From the results, we conclude that the co-administration of the bitters with therapeutic drugs is hepatoprotective by reducing the levels of liver enzymes and bilirubin, and by increasing levels of lipid biochemicals, it could lead to the development of   heart disease. We therefore advise users of the bitters to do so separately and not in combination with conventional drugs. Key words: Polyherbal bitters, biochemicals, glibenclamide, metformin

Implementing health worker training on sepsis in South Eastern Nigeria using innovative digital strategies: an interventional study

Background: Sepsis is a leading cause of morbidity and mortality especially in low- and middle-income countries such as Nigeria. Training of health workers using digital platforms may improve knowledge and lead to better patient outcomes. Objectives: To assess the effectiveness of a digital health educational module on sepsis in improving the knowledge of medical doctors in Cross River State Nigeria on the diagnosis and management of patients presenting with sepsis. Design: Quasi-experimental analytical study. Methods:: We developed and deployed a sepsis module through an innovative application (Sepsis tutorial app) to doctors in Calabar, Nigeria. We assessed quantitative pre- and post-intervention knowledge scores for those completing the tutorial on sepsis between both assessments. A user satisfaction survey evaluated the content of the tutorial and the usability of the app. Results:: One hundred and two doctors completed the course. There were more males than females (58.8% versus 41.2%). Over half (52%) were junior doctors, a minority were general practitioners and house officers (3% and 5%, respectively), and 72.6% had practiced for periods ranging from 1 to 15 years post-qualification. Gender and age appeared to have no significant association with pre- and post-test scores. The oldest age group (61–70) had the lowest mean pre- and post-test scores, while general practitioners had higher mean pre- and post-test scores than other cadres. The majority (95%) of participants recorded higher post-test than pre-test scores with a significant overall increase in mean scores (25.5 ± 14.7%, p < 0.0001). Participants were satisfied with the content and multimodal delivery of the material and found the app usable. Conclusion:: Digital training using context-responsive platforms is feasible and may be used to close the critical knowledge gap required to respond effectively to medical emergencies such as sepsis in low- to middle-income settings

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Appropriating the Ethos of Confucius for the Rebuilding of the Nigerian Commonwealth

The Nigerian commonwealth has been bastardized by our national political and economic managers. This has given rise to the current cry in search of unity, peace and patriotism of Nigerians. It can be said again that things have fallen apart and the centre seems not to hold any longer. The current wave of corruption, bloodshed, ethnic militia and communal and political subdivisions and carpet crossing at our political arena are clear signs of the deteriorating state of our Nigerian commonwealth. Good Nigerians desire to see Nigeria return back to her former glory of oneness, prosperity and pride. That is why this research explored the ethos of Confucius for the rebuilding of the Nigerian commonwealth. This work which is anchored on the sociological theory of “Structural Functionalism” propounded by Emile Durkheim (1850-1917) and adopted the qualitative or exploratory research method in gathering information. It employed the content analysis approach in examining available printed materials on the subject matter. The findings from the research showed that Nigerians have deviated from the ethical values that had initially been the source of strength and toe the path of selfishness, ethnicity and division. This new path became a path to corruption and disintegration. The research recommends an inclusiveness of human responsibility for improving life; adoption of an ideal political system founded on “ideals of personal conduct” rather than on formerly enacted laws; and adoption of a viable religious ethos that will revitalize the ailing economic, social and political status of the Nigerian commonwealth

Modern Religious Slavery in Nigeria: the Christian Perspective

Gandhi's concept of nonviolence has a humanistic approach. He tried to change the very character of every Indian in the society where he lived. He said that man is basically a violent being, but gradually he can become non-violent if he desires. He recognizes that man is a conditional being and as such subject to the determination of the physical world. The ultimate end in man's life for Gandhi is realizing the Absolute. Pertinent to note that, Gandhi had spent quite some time in his tutelage in Southern Africa where his experiences impelled him to adopt non-violence as the only paradigm to overcome oppression and domination in his country India. British oppression and inhumanity were so severe and intensive that Gandhi was cautious about the use of violence, alternatively, he adopted non-violence to be the only imperative paradigm to dislodge the domination and inhumane treatment of the British against the Indians in South Africa. In this respect, I recommend Gandhi's non-violence principles as a fundamental paradigm towards peace in Africa. Peace in Africa is imperative for human and societal development especially as one sees Africa grappling with instabilities, insurgencies, terrorism, xenophobia, political upheavals, nepotism and gender agitations. In this article, I recognize Gandhi's postulations on non-violence as an initiative which if adopted and its dictates are adhered to, could enhance peace in Africa

Effect of some Artemisinin and Combination Therapy Regimens with and without Concomitant Administration of Phospholipids on the Levels of Plasma Aminotransferases and Bilirubin in Nigerian Male Subjects

Background: Previous studies in animal have shown that high doses of artemisinin caused injury to liver cells. Presently artemisinin and its derivatives such as artesunate (ART), and it’s combination therapy (ACT) has been adopted as the frontline drug for treatment of uncomplicated malaria in Nigeria without considering the effect it has on some major organs of the body. Objective: The objective of this study was to evaluate the effect of ART when administered as a monotherapeutic agent and in combination as ACT on the plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin (BIL) and the effect of concomitant administration of a hepatotonic phospholipid (PL) on such effects. Methodology: The prepared plasma samples were analyzed using the end point calorimetric method for each parameter as explained in the Randox kits manual. Results: Co-administration of ART with amodiaquine (AMQ), mefloquine (MFQ) and sulphadoxine/pyremethamine (SP) respectively, on the 4th day of the studies increased the mean plasma concentration of AST to 80.70%, 108.0% and 75.0% against 59% for ART alone; ALT increased to 104%, 33.0% and 43.30% against 25.05% for ART alone; total bilirubin (TBIL) increased to 80.0%, 78.88% and 98.91% against 17.6% for ART alone. The co-administration and post-administration of ART and the ACTs with 900mg and 1800mg daily dose of PL respectively reduced the levels of the AST, ALT and BIL by 65.0% and 97.0% of the increased values respectively on 4th day. Discussion: The results suggest that ART as a monotherapeutic agent has injurious effect on the liver, and this effect is aggravated when ART is used in ACTs, however, the co-administration with phospholipids cushions the adverse effects. Key words: Artesunate; Artemisinin Combination Therapy (ACT); Aminotransferases; Bilirubin; Phospholipid

Biopharmaceutics and clinical outcomes of emerging dosage forms of insulin: A systematic review

Background: Many works are ongoing with the aim of obtaining a more convenient way than the parenteral injection for administering insulin. Purpose: To review the biopharmaceutics and clinical outcomes of the various emerging dosage forms of insulin so as to identify the promising formulations. Method: A systematic literature search with analysis was carried out to obtain information on the biopharmaceutics and clinical outcomes of the emerging dosage forms. Results: Intraperitoneal insulin was found to be characterized by direct drug delivery through the portal vein to the liver having bioavailability of 60%, but its clinical application is limited by the high risk of infection. The bioavailability of transdermal insulin has been enhanced using electrical, mechanical and physical techniques; and such formulations could achieve up to 39.5% blood glucose reduction. Oral insulin, known to be the most convenient, has its bioavailability limited to 1% by enzymatic degradation and poor absorption. Its challenges however, have been addressed by various interventions to achieve different levels of bioavailability up to 73.1%. Buccal insulin has shown potentials in managing postprandial hyperglycaemia without posing hypoglycaemic risk but its clinical applicability has not been established; whereas the long transit time, lower levels of peptidases and incorporation of permeation-enhancers have been shown to be responsible for the good treatment outcome of colon-targeted insulin. Rectal insulin with bioavailability of 11% has been shown to be considerably safe but not cost-effective while the ocular insulin is limited by poor absorption. Nasal tolerance and high rate of treatment failures were shown to be limiting intranasal insulin while the pulmonary insulin is being limited by peripheral drug retention and insulin resistance. Conclusion: The biopharmaceutical profiles and clinical outcomes of transdermal, oral and colon-targeted insulin are superior to those of the other dosage forms. Further research works could be done towards the full development of these promising formulations