Vegetable production, consumption and its contribution to diets along the urban – rural continuum in Northern Ghana

Malnutrition continues to be a problem, with sub-Saharan Africa affected the worst. Women and children are at the pinnacle of this problem. The perpetual scourge of malnutrition in urban and periurban settings, coupled with levels of vegetable consumption below the recommended amounts, are a major problem in most African countries including West African cities. A household survey was conducted between November and December 2013 (dry season) in and around Tamale, Ghana as part of an urban food system analysis, to understand vegetable production and consumption and its contribution to household diets and income along the urban – rural continuum. Data collection was guided by a transect approach. A total of 240 households participated in the survey, with 62% males and 38% females. Additionally, 186 women of reproductive age (15 – 49 years) staying in the sampled households contributed to the computing of household dietary diversity through Women’s Dietary Diversity Scores (WDDS). Most vegetables produced were for subsistence use, considering that most households sold less than 50% of the crops and consumed the rest. Vegetable production varied significantly along the urban - rural continuum, with more households in rural areas producing all the requirements of their vegetables compared to urban and periurban areas. Nevertheless, the households in the rural areas (16%) had the lowest dietary diversity (≤ 3 WDDS) compared to urban areas (13%) and periurban areas (5%). The study showed low consumption of vegetables (especially the dark green vegetables) mostly in the rural area and limited diversity of vegetables, especially vitamin A rich vegetables and tubers, with only three vegetables (carrots, red pepper and sweet potato) consumed. There was evidence of more inclination toward staple crops compared to vegetables along the urban – rural continuum for both production and consumption, clearly shown in crops grown and food groups mostly consumed (cereals and tubers rather than dark green vegetables). There was overall low consumption of dark green leafy vegetables, such as amaranth, with only 26% reported to have consumed them during the reported period compared to food groups like cereals (98%). This study confirms the dual purpose of vegetables in complementing dishes (balanced diets) with much needed micronutrients and helping households along the urban – rural continuum to generate income.Keywords: Vegetables, dietary diversity, food groups, urban – rural continuum, Northern Ghan

Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic. Results from the MIMIC Study (A Multi-centre cohort study evaluating the role of Inflammatory Markers in patients presenting with acute ureteric Colic)

Objectives There is conflicting data on the role of white blood cell count (WBC) and other inflammatory markers in spontaneous stone passage in patients with acute ureteric colic. The aim of the study was to assess the relationship of WBC and other routinely collected inflammatory and clinical markers including stone size, stone position and Medically Expulsive Therapy use (MET) with spontaneous stone passage (SSP) in a large contemporary cohort of patients with acute ureteric colic. Subjects and Methods Multi‐centre retrospective cohort study coordinated by the British Urology Researchers in Surgical Training (BURST) Research Collaborative at 71 secondary care hospitals across 4 countries (United Kingdom, Republic of Ireland, Australia and New Zealand). 4170 patients presented with acute ureteric colic and a computer tomography confirmed single ureteric stone. Our primary outcome measure was SSP as defined by the absence of need for intervention to assist stone passage. Multivariable mixed effects logistic regression was used to explore the relationship between key patient factors and SSP. Results 2518 patients were discharged with conservative management and had further follow up with a SSP rate of 74% (n = 1874/2518). Sepsis after discharge with conservative management was reported in 0.6% (n = 16/2518). On multivariable analysis neither WBC, Neutrophils or CRP were seen to predict SSP, with an adjusted OR of 0.97 [95% CI 0.91 to 1.04, p = 0.38], 1.06 [95% CI 0.99 to 1.13, p = 0.1] and 1.00 [95% CI 0.99 to 1.00, p = 0.17], respectively. Medical expulsive therapy (MET) also did not predict SSP [adjusted OR 1.11 [95% CI 0.76 to 1.61]). However, stone size and stone position were significant predictors. SSP for stones 7mm. For stones in the upper ureter the SSP rate was 52% [95% CI 48 to 56], middle ureter was 70% [95% CI 64 to 76], and lower ureter was 83% [95% CI 81 to 85]. Conclusion In contrast to the previously published literature, we found that in patients with acute ureteric colic who are discharged with initial conservative management, neither WBC, Neutrophil count or CRP help determine the likelihood of spontaneous stone passage. We also found no overall benefit from the use of MET. Stone size and position are important predictors and our findings represent the most comprehensive stone passage rates for each mm increase in stone size from a large contemporary cohort adjusting for key potential confounders. We anticipate that these data will aid clinicians managing patients with acute ureteric colic and help guide management decisions and the need for intervention

A rare case of primary mucocutaneous histoplasmosis presenting as a non-healing and disfiguring upper lip ulcer

BA 27-year-old female patient presented with a non-healing disfiguring upper lip ulcer for 10 months. At the time of presentation 50% of her lip had been eroded. She had had several consultations and had been on several antibiotic courses without improvement. Histopathological evaluation of an incisional biopsy specimen revealed that she had histoplasmosis. This prompted an HIV test, as this disease is common in immunocompromised patients. Once the diagnosis was clinched she was commenced on Itraconazole with complete resolution of the ulcer. Antiretroviral therapy was also initiated.Keywords: HIV, Histoplasmosis, Histoplasma Capsulatum, mucocutaneous, ulcer, immunocompromised, Itraconazol

Price and availability survey of essential medicines in the Harare province, Zimbabwe

Background: Access to essential medicines is both a fundamental basic right and necessity for everyone, thus concerted efforts should be made to ensure universal access to safe, quality and effective medicines.Objectives: To determine prices, sources and availability of essential medicines (their innovator and/or generic equivalents) in both private retail and public pharmacies.Setting: Private and public sector retail pharmacies in Harare metropolitan province, Zimbabwe.Materials and Methods: Forty medicines were selected for the survey. A standardised methodology developed by the World Health Organization and Health Action International (WHO/HAI) was used to survey the selected medicines. The survey was conducted in 110 private pharmacies and the two central hospital pharmacies in Harare. Prices were compared with International Reference Prices (IRPs).Results: In both sectors, availability of the selected medicines (Low Priced Generics) was high (>80%). Fewer innovator brands were found for the selected medicines. Median Price Ratios (MPR) of Lowest Priced Generics (LPG) showed better access to essential medicines is hindered by the high prices obtaining in the private sector (with median MPR of 4.52). The public sector showed significant progress towards procurement efficiency (median MPR of 1.5). More than 70% of the surveyed medicines were from manufacturers outside Zimbabwe with more than 60% from Indian generic manufacturers.Conclusion: Accessibility of essential medicines from private retail pharmacies in Harare, Zimbabwe is poor due to the high prices of these medicines as compared to public pharmacies. Promoting local production of essential medicines is necessary as it may be one of the practical ways of increasing access to quality, safe and effective medicine

Genus <i>Monanthotaxis</i>: a review on distribution, ethnomedicinal uses and phytochemistry

This article reviews the geographical distribution, ethnomedicinal applications, and phytochemistry of the genus Monanthotaxis Baill, tribe Uvariae of the family Annonaceae. The reviewed works of literature were collected from various electronic databases including Google Scholar, PubMed, Science Direct, The International Plant Names Index (IPNI), and Research Gate. During this review, ninety-eight species of the genus Monanthotaxis were found to be widely distributed in tropical Africa. Some of those species are used in folkloric medicine by various communities to manage diseases and disease conditions such as fever, vomiting, headache, stomach-ache, malaria, helminthiasis, and hysteria. In the past 44 years (1979 to 2023), one hundred and nineteen secondary metabolites with different biomedical potentials have been reported from this genus. The reported compounds are categorised into flavonoids, alkaloids, terpenoids, polyoxygenated cyclohexane, and cyclohexene derivatives, benzyl derivatives, cinnamic acid derivatives, and stilbenoids. Most of the reported compounds showed an array of bioactivities corroborating the use of some members of the genus in folkloric medicine.</p