THE EFFECT OF DIET ON THE PATTERN OF GASTROOESOPHAGEAL REFLUX IN THE RURAL SETTING OF THE EASTERN CAPE

Gastro-oesophageal reflux is the return of stomach contents back up into the oesophagus. Excessive reflux of acid content into the oesophagus can cause oesophageal disorders such as heartburn, gastro-oesophageal reflux disease and oesophagitis. The prevalence of oesophageal disorders appears to be high in North America, Europe, japan and China while epidemiology data from Africa, South America and Middle East are unknown. More data is required in Africa because population diversity in reflux symptoms may exist and it is important that standard reference ranges of reflux profiles are established for African countries. The aims of this study was to establish a data base of gastro-oesophageal reflux pattern in the Eastern Cape rural area, to compare our findings with similar western studies and to establish the effect diet, H. pylori infection, gender, weight and age on the observed reflux pattern. The reflux pattern was evaluated in healthy subjects for 24h using the newer technique involving the recording of eosophageal intraluminal impedance and pH simultaneously. The technique gives quantitative data on the frequency, nature, type, and duration, and correlates them to the pH of the reflux. The diet survey was done using the usual pattern diet questionnaire, the body mass index (BMI) was calculated and the quantification of H. pylori antibodies IgG was determined in the serum of each participant using an ELISA kit. In total, 77 participants including 48 females and 29 males were included in the study. The mean age was 35 (range 18 - 60) years for females and 37 (range 18 - 54) for males. The mean BMI was 29 (range 19 - 42) for females and 23 (range 18- ii 30) for males. The total number of refluxes recorded in 24h in this population was presented as median, 25th, 75th and 95th percentile corresponding to 49, 29, 65 and 97, respectively. Of these, 37 % were acidic, 43 % were weakly acidic and 20 % were non-acidic. In term of reflux composition 12 % were liquid, 24 % were gas (belches) and 64 % were mixed (gas and liquid). The oesophageal bolus clearance time was 18 s while the acidity of the reflux was completely neutralised 30 s after a reflux. The oesophageal bolus exposure time was 14 min/day and while acid exposure time was 15 min/day. More refluxes were found in upright position compared to supine position. They were a higher number of refluxes and a predominance of non-acid reflux in the present study compared to western countries. We found that most refluxes were postprandial and some parameters of the pattern of gastro-oesophageal reflux were significantly influenced by the traditional diet. Higher carbohydrate, protein and fat in the meal were associated with a high frequency of refluxes most of which were acidic and weakly acidic while higher fruit and vegetable consumption was associated with fewer refluxes. An increased number of non-acid refluxes were observed in high carbohydrate maize based diet. Nearly all participants of the present study were positive for H. pylori and those with a higher concentration of H. pylori IgG in the serum had less oesophageal acid exposure. Females, older and overweight participants presented with an increased frequency of reflux. This study provides normal references values for the pattern of Gastrooesophageal reflux in the rural population of South Africa. The observed pattern of reflux is positively influenced by the traditional diet which is mainly carbohydrate maize based and also by BMI, weight and gende

Exploring the use of p53 protein expression as an indicator of oesophageal cancer severity from a high incidence rural area of Africa

Background: The expression of p53 has been associated with the severity of other types of cancer. There is scanty information when it comes to oesophageal cancer. Objective: This study aimed to explore the use of p53 protein expression as an indicator of oesophageal cancer severity from a high-risk incidence in the African rural population. Methods: Fifty-one patients newly diagnosed with oesophageal cancer were recruited from the endoscopic unit at Nelson Mandela Academic Hospital in Mthatha, South Africa. The serological expression of p53 was measured using the ELISA method and the severity of oesophageal cancer expressed in grade was obtained from the histopathology report from patient’s oesophageal biopsies. Results: We found that the expression of p53 was equally distributed among the histological grades of cancer with the value of 2495 pg/mL ± 1736 pg/ mL for lower grades and 2520 ± 1539 pg/mL for higher grades. Furthermore, we found that the level of p53 expression was equally distributed in patients from grade 1, 2, 3, and 4. Conclusion: The expression of p53 protein does not vary according to the histological grade of oesophageal cancer in the given population, therefore may not be helpful as a prognostic factor. Keywords: p53 protein expression; aoesophageal cancer; Africa

24-Hour Measurement of Gastric pH in Rural South Africa

Background. Previous studies have established norms of 24-hour gastric pH profiles for western countries. This study was designed to establish the pattern for a rural African population with a high incidence of oesophageal cancer. Methods. After lower oesophageal manometry a probe was placed 10 cm distal to the lower oesophageal sphincter. We carried out 24-hour ambulatory monitoring of gastric pH on 59 healthy subjects. This was satisfactorily completed on 26 female and 18 male (age 21–64, median 35) subjects in the Transkei region of South Africa. Results. The mean 24 hour gastric pH was 2.84 and the mean night-time pH was 3.7. 40 volunteers recorded a night-time pH reaching over 4. 33 volunteers recorded a night-time pH over 7. Night-time alkalinisation was present for 136.4 minutes (25th centile 22.8, 75th centile 208.1) at pH4 or over, and 79.3 (2.5, 122.7) minutes at pH7 or over. Episodes of rapid alkaline rise were 17 (10, 47). 21.1% of these occurred while supine. 35 of 36 tested subjects were positive for H. pylori IgG. Conclusion. Gastric alkalinisation is common in Transkei, at a higher pH than that reported in other studies, and is sustained longer. Nighttime alkalinisation is frequent. This suggests a high level of duodenogastric reflux

The effect of Cordia platythyrsa on various experimental models of pain and carrageenan induced inflammation

Only one study has reported on the medicinal properties of Cordia platythyrsa (C. platythyrsa) though it is used in African traditional medicine for treatment of fever and pain. The current study aimed at investigating the analgesic and anti-inflammatory properties of C. platythyrsa using various animal models: writhing test, tail flick, thermal hyperalgesia, mechanically induced-pain, formalin-induced pain and carrageenan-induced inflammation tests. Like aspirin, the two doses of plant extracts used inhibited acetic acid-induced pain though these effects were weaker than the effects of morphine. Although, the plant extract significantly (p<0.01) inhibited thermal pain, its effects were less significant compared to morphine. Celecoxib (10 mg/kg) and plant extract (100 mg/kg) significantly inhibited thermal hyperalgesia compared to indomethacin. On the other hand, both doses of plant extract significantly increased mechanical pain thresholds 30 and 90 min post treatment. The plant extract (150 mg/kg) inhibited both the neurogenic and inflammatory pain phases of formalin-induced pain as well as carrageenan-induced inflammation. This study is the first to show that C. platythyrsa has analgesic and anti-inflammatory properties.Keywords: Analgesia, pain, writhing, formalin, thermal hyperalgiaAfrican Journal of Biotechnology, Vol. 13(2), pp. 343-348, 8 January, 201

A COMPARATIVE STUDY ON THE APHRODISIAC ACTIVITY OF FOOD PLANTS MONDIA WHITEI, CHENOPODIUM ALBUM, CUCURBITA PEPO AND SCLEROCARYA BIRREA EXTRACTS IN MALE WISTAR RATS.

Background: Any substance that increases erectile function, sexual performance and enjoyment is considered an aphrodisiac. The was to compare the effects of food plants Mondia whitei, Chenopodium album, Cucurbita pepo and Sclerocarya birrea extracts 200mg/kg body weight on sexual behavior, sperm parameters and testosterone levels in adult male rats. These are food plants also aphrodisiacs in South Africa, Zimbabwe and other parts of Africa. Materials and methods: Sexual behavior parameters assessed in this study included an arousal component (mount latency and intromission sexual potency (mount frequency and intromission frequency), erection (copulatory efficiency) and ejaculations. All treatments orally daily for 28 days. Sexual behavior parameters were quantified 2 hours after a single dose, at 14 days and at 28 days of treatment. Results: The order of efficacy in stimulating sexual behavior in male rats was M. whitei >S. birrea > C. pepo ≥C. album. Although change in number of ejaculations and sperm count (P>0.05) for all treatment groups compared to controls, all treatments increased motility. M. whitei and C. pepo treatments resulted in increased (

INVESTIGATION OF ANTI-INFLAMMATORY AND ANTINOCICEPTIVE EFFECTS OF AQUEOUS EXTRACTS OF ARTEMISIA AFRA IN WISTAR RATS

Objective: The objective of the study was to evaluate the anti-inflammatory and antinociceptive effects of Artemisia afra.Methods: Animals were randomly divided into five groups of six animals each and administered with normal saline (2 ml/kg), indomethacin (10 mg/ kg), and A. afra at doses of 100, 200, and 400 mg/kg, respectively. For the anti-inflammatory activity, carrageenan-induced paw edema was used while the hot plate and acetic acid induced-writhing tests were used to assess the antinociceptive activity.Results: Pretreatment with A. afra at a dose of 100 mg/kg did not show any significant biological effects (p>0.05) for any of the three tests, when compared against saline-treated control group. At a dose of 200 mg/kg, A. afra demonstrated significant effects (p<0.01), during the 5th h reducing carrageenan-induced paw edema by 12%. The highest dose (400 mg/kg) of A. afra demonstrated more potent effects by decreasing the carrageenan-induced paw swelling (p<0.001–0.05) during the 3rd, 4th, and 5th h, by up to 38% when compared against saline-treated control group. Both the 200 and 400 mg/kg, A. afra doses achieved a significant increase (p<0.05) in reaction time in the hot plate test. In the acetic acid-induced writhing test, pretreatment with A. afra (400 mg/kg) significantly reduced pain by 39% (p<0.01) by comparison with the saline control.Conclusion: Experimental data demonstrated that aqueous extract of A. afra possesses anti-inflammatory and antinociceptive properties in experimental acute inflammation and pain. These findings support the usage of A. afra in managing inflammation and pain in traditional practice

Investigation Of The Antinociceptive And Anti-Inflammatory Properties Of Heteromorpha Arborescens (Apiaceae)

Heteromorpha arborescens belongs to the family Apiaceae. It is commonly known as the parsley tree. One of its uses in the Eastern Cape Province of South Africa is for the treatment of abdominal pains. The therapeutic effects of the methanolic and aqueous root extracts of H. arborescens were investigated at two dose levels respectively on experimental models of pain and inflammation in rodents. The antinociceptive activity was evaluated using the hot-plate, abdominal constriction and formalin tests. The anti-inflammatory properties of these extracts were assessed using albumin and carrageenan as phlogistic agents. Both extracts produced significant (P<0.05, P<0.01) inhibition of thermal nociception induced by a hot plate. On chemical nociception induced by intraperitoneal acetic acid and subplantar formalin injection, both extracts significantly (P<0.05, P<0.01) decreased the number of writhing episodes and the licking time in a dose dependent manner. Treatment with the extracts at the same doses produced a significant (P<0.05, P<0.01) pain inhibition of the carrageenan induced inflammatory pain. Similarly, both extracts produced a significant (P<0.05, P<0.01) reduction of edema induced by albumin and carrageenan. These results suggest that both extracts of H. arborescens may act by inhibition of the mediators of inflammation. These findings seem to justify the use of the plant in traditional medicine in the management of pain and inflammation related diseases

Effects of the methanol extract of Erythrina abyssinica on hot flashes in ovariectomized rats

We investigated the estrogen-like properties of the methanol extract of Erythrina abyssinica in ovariectomized rats. Climaterix was induced in female rats by surgically removing the ovaries. Data loggers implanted in the abdominal cavity during the procedure recorded core temperatures at predetermined time intervals for 72 h. 6 h after the onset of temperature recording, animals were treated with estrogen (1 mg/kg), methanol extract of Erythrina abyssinica (200 mg/kg) or an equivalent volume of 5% ethanol. Rats treated with extract had significantly fewer hot flashes (171 ± 11 vs. 264 ± 21) which were of shorter duration (683 ± 137 min vs. 1935 ± 345 min) compared to untreated animals. Treated animals had lower core temperature during periods of high activity indicating that the methanol extract of E. abyssinica reduced frequency and duration of hot flashes.Keywords: Ovariectomized, extract, Erythrina abyssinica, climaterixAfrican Journal of Biotechnology Vol. 12(6), pp. 598-60