Dyslipidaemia in hypertension - are we treating enough?

Introduction: The coexistence of dyslipidaemia and hypertension results in enhanced atherosclerosis. Adequate treatment of dyslipidaemia in hypertensive patients is thus essential for reducing the burden of cardiovascular diseases.Objective: To determine the prevalence of dyslipidaemia among hypertensives and evaluate lipid treatment status of patients with dyslipidaemia in a tertiary hospital in Nigeria.Methods: This cross-sectional comparative study was done between May, 2015 and June, 2016 in a tertiary hospital in Nigeria. The serum lipid levels of adult patients with hypertension and controls without hypertension were determined. Lipid treatment status of patients with dyslipidaemia were also reviewed. Serum lipid levels were analyzed using spectrophotometric methods.Results: The study included 200 adult hypertensive patients and 100 control participants. The mean age (SD) was 56.3 (6.9) years and 54.9 (8.3) years with range 41-68 and 44-69 years for patients and controls respectively. Eighty-eight (44.0%) hypertensive patients and 23(23.5%) of the control group were found to have dyslipidaemia. Out of the 60(68.2%) patients with elevated LDL-C, 32(53.3%) had LDL-C >4.1mmol/L, out of which only 8(25%) were on antilipid medication.Conclusion: Over one-third of studied hypertensive patients had dyslipidaemia and only a quarter of those who needed antilipids were on the medication. Greater awareness is needed both in the medical and patient communities in order to effectively manage dyslipidaemic hypertension, and hence aid in ameliorating the burden of cardiovascular diseases

Evaluation of gut modulatory and bronchodilator activities of Amaranthus spinosus Linn.

Background The aqueous-methanolic extract of Amaranthus spinosus (A. spinosus Linn.,) whole plant, was studied for its laxative, spasmolytic and bronchodilator activities to validate some of its medicinal uses. Methods The crude extract of A. spinosus was studied in-vivo for bronchodilator and laxative activities and in-vitro using isolated tissue preparations which were mounted in tissue baths assembly containing physiological salt solutions, maintained at 37°C and aerated with carbogen, to assess the spasmolytic effect and to find out the possible underlying mechanisms. Results In the in-vivo experiments in mice, the administration of A. spinosus increased fecal output at doses of 100 and 300 mg/kg showing laxative activity. It also inhibited carbachol-induced bronchospasm in anesthetized rats at 1, 3, 10 and 30 mg/kg indicative of bronchodilator activity. When tested on isolated gut preparations, the plant extract showed a concentration-dependent (0.01-10.0 mg/ml) spasmogenic effect in spontaneously contracting rabbit jejunum and guinea-pig ileum. The spasmogenic effect was partially blocked in tissues pretreated with atropine (0.1 μM). When tested on K+ (80 mM)-induced sustained contractions in isolated rabbit jejunum, the plant extract caused complete relaxation and also produced a shift in the Ca++ concentration-response curves (CRCs) towards right, similar to diltiazem. In rabbit trachea, the plant extract completely inhibited K+ (80 mM) and carbachol (CCh, 1 μM)-induced contractions at 1 mg/ml but pretreatment of tissue with propranolol (1 μM), caused around 10 fold shift in the inhibitory CRCs of the plant extract constructed against CCh-induced contraction. The plant extract (up to 0.3 mg/ml) also increased both force and rate of spontaneous contractions of isolated guinea-pig atria, followed by relaxation at higher concentration (1.0-5.0 mg/ml). The cardio-stimulant effect was abolished in the presence of propranolol, similar to that of isoprenaline. Activity-directed fractionation revealed that the spasmolytic component(s) was separated in the organic fraction, whereas the spasmogenic component was concentrated in the aqueous fraction. Conclusion These results indicate that A. spinosus possesses laxative activity partially mediated through cholinergic action. The spasmolytic effect was mediated through calcium channel blocking (CCB), while bronchodilator activity through a combination of β-adrenergic and CCB pathways, which may explain the traditional uses of A. spinosus in gut and airways disorders

The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

Implications of health literacy attributes: the provider’s and health professional’s perspective

Post-Affordable Care Act (ACA), consumers are empowered to have more control over their healthcare than ever before, giving patients more voice and choice with their plans for healthcare. Health literacy becomes increasingly important because navigating through the health care system is already difficult. With an improvement in health literacy levels, we can see an improvement in patient health outcomes, patient satisfaction, and a decrease in hospital readmissions and costs. This has public health relevance because it contributes to the efforts of disease prevention, health promotion, and prolonging life among the population as a whole. For the aforementioned reasons, an increase in health literacy can improve health outcomes and improve quality of life. A survey was conducted to understand the provider’s perspective of the current climate and effectiveness of the 10 Attributes of a Health Care Organization developed by the Institute of Medicine (IOM). This survey was administered through a Health Literacy email listserv that includes over 1500 providers and health professionals, of which 48 responded. Results show that 83% of respondents perceive that less than 25% of their employees are aware of the IOM 10 Attributes. Additionally, 56% perceive their leadership prioritizes health literacy at a rating of 6-10 (scale from 1(lowest) – 10 (highest)), with a mean score of 6. When asked, “How strongly do you feel you understand the attributes and their aims?” 77% reported comprehension levels ranging from 6 to10 with a mean score of 7. Results suggests that providers understand the attributes but portrays not many of their employees do so. The survey results also suggest that providers and their organizations are not utilizing all 10 Attributes to their fullest potential to create a health literate organization. I have proposed that the federal government incentivize healthcare leaders to appoint a Health Literacy Champion within their organizations. For example, if hospitals want to continue benefiting from Medicare programs, then they should be required add the 10 Attributes to their quality metrics. It should be the hospital’s responsibility to either adopt the teach-back method or create its own intervention to help patients understand and communicate better with providers

African Women and Religious Change: A study of the Western Igbo of Nigeria with a special focus on Asaba town

This study focuses on a small ethnic group in the western part of Igboland called Asaba. It describes how the religious and socio-political role of women has changed, due to colonialism, modernisation, Western education and Christianity, which were brought by the groups of Europeans and Americans, who penetrated Africa in the nineteenth century. One of the major points of the thesis is that the freeborn women in the traditional “dual-sex”society of the Igbo lost their previous power to speak for themselves when the Igbo were Christianised. However, the women of slave origin happily adopted the new, more egalitarian faith. The dissertation is divided into three parts. The first part is the traditional aspect, which highlights the role of women in Igbo traditional society. The second is a theoretical and historical part. This part deals with the socio-economic and political changes, which took place between 1830 to 1910 in Asaba society, due to colonialism, modernization, Western education and Christianity, and the impact of these forces of change on Asaba women. The third part deals with the role of women in the Catholic Church in Asaba. It analyses the various women's organisations in the Catholic Church in Asaba and the roles, which they play in the church. The major conclusion arising from the present analysis is that with the coming of forces of change, such as colonialism, modernization, Western education and Christianity, the religious and socio-political roles of women changed in Asaba society

ANTI-INFLAMMATORY ACTIVITY OF SELECTED NIGERIAN MEDICINAL PLANTS

Extracts of nineteen plant species from an inventory of Nigerian medicinal plants were screened for activity in two in vitro anti-inflammatory model test systems, inhibition of prostaglandin biosynthesis and PAF-induced elastase release from neutrophilis. Anacardium occidentale and Acalipha hispida were active in both test systems. Amatranthus spinosus had high specific prostaglandin synthesis inhibitory activity, while Bryophyllum pinnatum and Combretodendron macrocarpum had specific activity in the PAF elastase release test. The results obtained were related to the traditional uses of the plants and chemical constituents where known. Key Words: Nigerian medicinal plants; anti-inflammatory activity, prostaglandin biosynthesis; PAF-induced elastase release Nig. J. Nat. Prod. And Med. Vol.1 1997: 10-1