Outcome of cardiovascular risk assessment among rural community dwellers in ezionum, Nigeria-implications for public health

Background: Cardiovascular disease is a major cause of mortality worldwide. Risk assessment has been shown to reduce cardiovascular morbidity and mortality. In view of their proximity and accessibility, community pharmacies could be a suitable site forcardiovascular risk assessment and other preventive health activities especially in rural underserved populations. The objective of this study was to assess outcome of cardiovascular risk assessment among rural community dwellers.Materials and methods: Five hundred and five community dwellers aged 40 to 80 years were recruited for the study. Cardiovascular risk assessment was performed using the region specific WHO/ISH risk assessment charts. Blood pressure, diabetes status, total non- fasting cholesterol, and age were used to estimate risk category. Demographic variables and clinical characteristics were expressed as frequency and percentage. Regression analysis was done to identify predictors of high risk category.Results: More than 30% of subjects were hypertensive. Nearly 30% were overweight and had abnormal cholesterol levels. The proportion of subjects in the high risk category was 8.9%. Systolic blood pressure, random blood sugar and advancing age were the highest predictors of high risk category.Conclusion: Accessibility, proximity and availability are unique characteristics of community pharmacies that could be exploited to support community based screening services.Keywords: Cardiovascular risk assessment, community pharmacy, rural community dwellers, Nigeria

Central nervous system depressant effect of the fruits of Piper guineense

The central nervous system depressant effect of the butanol extract of the fruits of Piper guineense was pharmacologically screened by measuring the prolongation of barbiturate sleeping time. Nine rats (n=9) were used and assigned into three groups, with each group comprising of three rats (n=3). Group A served as the Control, while Groups B and C served as tests. Thiopentone sodium (40 mg/kg body weight) was administered subcutaneously to the rats in Group A, 2 mg/kg of the butanolic extract of the fruits of Piper guineense was administered subcutaneously to the rats in Test Group B, 30 minutes before administering same dose of thiopentone sodium, while rats in Group C received 4 mg/kg of the butanolic extract 30 minutes before administering same dose of thiopentone sodium. The sleeping time was recorded. Student-t-test at 5% significance level was used to analyze the results obtained. The mean barbiturate sleeping time prolongation of 53.67 minutes was produced by 2 mg/kg of the extract while a dose of 4 mg/kg produced mean barbiturate sleeping time prolongation of 103.67 minutes. This study suggests that the fruits of Piper guineense have central nervous system depressant effect.Keywords: Piper guineense, fruits, glycosidic constituents, central nervous system, depressantBiokemistri 28(1): 34–3

Phytochemical screening and acute toxicity studies of crude ethanolic extract and flavonoid fraction of Carissa edulis leaves

Carissa edulis is used traditionally in Nigeria for the treatment of epilepsy, headache, syphilis, rheumatism and sickle cell anaemia. In this study, phytochemical screening was conducted to determine putative active components of Carissa edulis, as well as acute toxicity studies of the ethanolic extract and flavoniod fractions of the leaf. The phytochemical screening of the ethanolic extract of the leaves indicated the presence of carbohydrates, anthraquinones, saponins, tannins, flavonoids and alkaloids. Acute toxicity studies for the ethanolic extract and the flavonoid fraction were carried out using Lorke’s method. In the first part of the experiment (phase A), Three groups of mice (n=3 in each group) were intraperitoneally given 10 mg/kg, 100 mg/kg and 1000 mg/kg of body weight concentration of the ethanolic extract and the mice were observed for 24 hours. The same procedure was repeated for the flavonoid fraction. The results showed that administration of 1000 mg/Kg concentrations of the ethanolic extract was fatal, while no death was recorded at the same concentration of flavonoid fraction. On this basis, in the second part of the study (phase B), mice were intraperitoneally administered 600 mg/kg, 1000 mg/kg, 1600 mg/kg and 2900 mg/kg concentration of the ethanolic extract while those for the flavonoid fraction had 1200 mg/kg, 1600 mg/kg, 2900 mg/kg and 5000 mg/kg flavonoid fraction. All mice were observed for 24 hours. The LD50 of the ethanolic extract and flavonoid fraction of the Carissa edulis leaves was 2154.1 mg/kg which is said to be slightly toxic. The maximum tolerated doses for both ethanolic extract and flavonoid fraction of Carissa edulis was 646.23mg/kg. The findings revealed that the leaves of Carissa edulis contain carbohydrates, anthraquinones, saponins, tannins, flavonoids and alkaloids that may contribute to its reported medicinal value. The acute toxicity studies suggest that the extract and fraction are slightly toxic. Thus further studies are necessary for full characterization of the active components in order to develop it further for safe medicinal use.Keywords: Phytochemical Screening, Acute Toxicity, Carissa edulis, Herbal Medicine

Medicine use among HIV/Aids patients in public hospitals, Kwara State

Background: The prognosis of HIV/AIDS and HIV-related comorbidities has been revolutionized by the use of medicines. However, World Health Organization reported that 50% of patients do not use their medicines as prescribed.Objective: To assess HIV/AIDS patients’ knowledge of the use of medicines dispensed to them.Method: This study was conducted in seven public hospitals in six local government areas, Kwara State. Exit interviews of 780 eligible HIV/AIDS patients were conducted through use of structured questionnaire. Additionally, there were exit observational checks of medicines dispensed to these patients. Descriptive statistics and Fisher Exact test were used for data analyses.Results: Of the 780 study participants, 36.1% had no formal education, 99.9% knew the ‘quantity’ of medicines to be administered, while 99.2% knew the frequency of administration. All the patients knew the route of administration, 96.7% and 94.3% knew the general precautions to avoid concomitant use of dispensed medicines with alcohol or herbal products respectively, while 93.7% of those who received co-trimoxazole knew of the precaution to use “plenty of water” as the vehicle for its administration. There were no significant associations between the patients’ knowledge of these precautions and duration of antiretroviral therapy (P>0.05). However, the patients lacked knowledge of specific precautions of some dispensed medicines.Conclusion: Most of the patients knew of the administration and the general precautions of dispensed medicines. However, lack of knowledge of specific precautions of some dispensed medicines calls for intervention.Keywords: HIV/AIDS patients, Medicine use, Duration of antiretroviral therapy, Public hospitals, Kwara Stat

Outcome of cardiovascular risk assessment among rural community dwellers in ezionum, Nigeria-implications for public health

Background: Cardiovascular disease is a major cause of mortality worldwide. Risk assessment has been shown to reduce cardiovascular morbidity and mortality. In view of their proximity and accessibility, community pharmacies could be a suitable site for cardiovascular risk assessment and other preventive health activities especially in rural underserved populations. The objective of this study was to assess outcome of cardiovascular risk assessment among rural community dwellers. Materials and methods: Five hundred and five community dwellers aged 40 to 80 years were recruited for the study. Cardiovascular risk assessment was performed using the region specific WHO/ISH risk assessment charts. Blood pressure, diabetes status, total non- fasting cholesterol, and age were used to estimate risk category. Demographic variables and clinical characteristics were expressed as frequency and percentage. Regression analysis was done to identify predictors of high risk category. Results: More than 30% of subjects were hypertensive. Nearly 30% were overweight and had abnormal cholesterol levels. The proportion of subjects in the high risk category was 8.9%. Systolic blood pressure, random blood sugar and advancing age were the highest predictors of high risk category. Conclusion: Accessibility, proximity and availability are unique characteristics of community pharmacies that could be exploited to support community based screening services. DOI: https://dx.doi.org/10.4314/ahs.v19i2.35 Cite as: Adje DU, Williams FE, Oparah AC. Outcomes of cardiovascular risk assessment among rural community dwellers in Ezionum, Nigeria-implications for public health. Afri Health Sci.2019;19(2): 2112-2120. https://dx.doi.org/10.4314/ahs.v19i2.3

Outcomes in Pediatric Burn Patients With Additional Trauma-Related Injuries

The addition of trauma to burn injuries may result in higher morbidity and mortality. The purpose of this study was to evaluate the outcomes of pediatric patients with a combination of burn and trauma injuries, and included all pediatric Burn only, Trauma only, and combined Burn-Trauma patients admitted between 2011 and 2020. Mean length of stay, ICU length of stay, and ventilator days were highest for the Burn-Trauma group. The odds of mortality were almost 13 times higher for the Burn-Trauma group when compared to the Burn only group (P = .1299). After using inverse probability of treatment weighting, the odds of mortality were almost 10 times higher for the Burn-Trauma group in comparison to the Burn only group (P < .0066). Thus, the addition of trauma to burn injuries was associated with increased odds of mortality, as well as longer ICU and overall hospital length of stay in this patient population

Phytochemical screening and acute toxicity studies of crude ethanolic extract and flavonoid fraction of Carissa edulis leaves

Carissa edulis is used traditionally in Nigeria for the treatment of epilepsy, headache, syphilis, rheumatism and sickle cell anaemia. In this study, phytochemical screening was conducted to determine putative active components of Carissa edulis, as well as acute toxicity studies of the ethanolic extract and flavoniod fractions of the leaf. The phytochemical screening of the ethanolic extract of the leaves indicated the presence of carbohydrates, anthraquinones, saponins, tannins, flavonoids and alkaloids. Acute toxicity studies for the ethanolic extract and the flavonoid fraction were carried out using Lorke\u2019s method. In the first part of the experiment (phase A), Three groups of mice (n=3 in each group) were intraperitoneally given 10 mg/kg, 100 mg/kg and 1000 mg/kg of body weight concentration of the ethanolic extract and the mice were observed for 24 hours. The same procedure was repeated for the flavonoid fraction. The results showed that administration of 1000 mg/Kg concentrations of the ethanolic extract was fatal, while no death was recorded at the same concentration of flavonoid fraction. On this basis, in the second part of the study (phase B), mice were intraperitoneally administered 600 mg/kg, 1000 mg/kg, 1600 mg/kg and 2900 mg/kg concentration of the ethanolic extract while those for the flavonoid fraction had 1200 mg/kg, 1600 mg/kg, 2900 mg/kg and 5000 mg/kg flavonoid fraction. All mice were observed for 24 hours. The LD50 of the ethanolic extract and flavonoid fraction of the Carissa edulis leaves was 2154.1 mg/kg which is said to be slightly toxic. The maximum tolerated doses for both ethanolic extract and flavonoid fraction of Carissa edulis was 646.23mg/kg. The findings revealed that the leaves of Carissa edulis contain carbohydrates, anthraquinones, saponins, tannins, flavonoids and alkaloids that may contribute to its reported medicinal value. The acute toxicity studies suggest that the extract and fraction are slightly toxic. Thus further studies are necessary for full characterization of the active components in order to develop it further for safe medicinal use

Determinants and effects of sexual exploitation among female students of tertiary institutions in Rivers State

Background: Labor induction methods are continuously evolving to ensure safer and more effective outcomes for both mother and neonate. The present study aimed to assess the effectiveness and safety of combined use of misoprostol with intracervical catheter for labor induction. Methods: This single-blinded, parallel-group randomized control trial conducted at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh, included 200 women with term gestation and Bishop score ≤6. Participants were divided into two groups: the intervention group (group B) received misoprostol juice and Foley’s catheter, while the control group (group A) received misoprostol in the posterior fornix. Results: In Group A, 58% had vaginal deliveries, while in Group B, 65% had vaginal deliveries. Group B experienced a longer mean length of labor in the 1st stage (13.25±1.095) compared to Group A (12.98±1.982, p=0.008). The 3rd stage was shorter for Group B (10.00±0.000) than Group A (12.02±2.469, p&lt;0.001). The most common induction reason was labor pain with an unfavorable cervix (31 in Group A and 33 in Group B). Group B had a higher percentage of inductions at less than 12 hours and a lower percentage at more than 24 hours. Neonatal outcomes were generally better for Group B. The Cox regression hazard model showed a lower likelihood of positive outcomes in Group B (hazard ratio 0.337, 95% CI 0.243-0.469, p=0.000), indicating a statistically significant difference between the groups. Conclusions: The combined use of misoprostol with Foley’s catheter for labor induction is safe and effective, resulting in shorter labor duration and higher rates of vaginal delivery compared to misoprostol alone

Transcriptomic Response of Fusarium verticillioides to Variably Inhibitory Environmental Isolates of Streptomyces

Fusarium verticillioides is a mycotoxigenic fungus that is a threat to food and feed safety due to its common infection of maize, a global staple crop. A proposed strategy to combat this threat is the use of biological control bacteria that can inhibit the fungus and reduce mycotoxin contamination. In this study, the effect of multiple environmental isolates of Streptomyces on F. verticillioides was examined via transcriptome analysis. The Streptomyces strains ranged from inducing no visible response to dramatic growth inhibition. Transcriptionally, F. verticillioides responded proportionally to strain inhibition with either little to no transcript changes to thousands of genes being differentially expressed. Expression changes in multiple F. verticillioides putative secondary metabolite gene clusters was observed. Interestingly, genes involved in the fusaric acid gene cluster were suppressed by inhibitory strains of Streptomyces. A F. verticillioides beta-lactamase encoding gene (FVEG_13172) was found to be highly induced by specific inhibitory Streptomyces strains and its deletion increased visible response to those strains. This study demonstrates that F. verticillioides does not have an all or nothing response to bacteria it encounters but rather a measured response that is strain specific and proportional to the strength of inhibition

Antidiarrhoeal Activity of Musa paradisiaca

The folkloric claim of Musa paradisiaca sap in the management of diarrhoea is yet to be substantiated or refuted with scientific data. Therefore, the aim of the current study was to screen the sap of M. paradisiaca for both its secondary metabolites and antidiarrhoeal activity at 0.25, 0.50, and 1.00 mL in rats. Secondary metabolites were screened using standard methods while the antidiarrhoeal activity was done by adopting the castor oil-induced diarrhoeal, castor oil-induced enteropooling, and gastrointestinal motility models. The sap contained flavonoids, phenolics, saponins, alkaloids, tannins, and steroids while cardiac glycosides, anthraquinones, triterpenes, cardenolides, and dienolides were not detected. In the castor oil-induced diarrhoeal model, the sap significantly (P<0.05) prolonged the onset time of diarrhoea, decreased the number, fresh weight, and water content of feaces, and increased the inhibition of defecations. Na+-K+-ATPase activity in the small intestine increased significantly whereas nitric oxide content decreased. The decreases in the masses and volumes of intestinal fluid by the sap were accompanied by increase in inhibition of intestinal fluid content in the enteropooling model. The sap decreased the charcoal meal transit in the gastrointestinal motility model. In all the models, the 1.00 mL of the sap produced changes that compared well with the reference drugs. Overall, the antidiarrhoeal activity of Musa paradisiaca sap attributed to the presence of alkaloids, phenolics, flavonoids, and/or saponins which may involve, among others, enhancing fluid and electrolyte absorption through de novo synthesis of the sodium potassium ATPase and/or reduced nitric oxide levels