Clinical Decision Diagnosis Support System for Complementary and Alternative Medicine Practitioners in Lifestyle-related Diseases Management

Chronic diseases accounted for 60% of all deaths – corresponding to a projected 36.65 million deaths worldwide in 2007. 2.8% of the world population suffers from diabetes mellitus and it may cross 5.4% by the year 2025. Hypertension is a major burden on health care. Prevalence of lifestyle-related diseases increases. Low accessibility to and non-affordability of orthodox medicine by rural dwellers and their need to keep healthy to be economically productive have led to their dependence on medicinal plants to remedy afflictions. Complementary and Alternative Medicine (CAM) attracts patronage due to patients’ dissatisfaction with conventional health care, a desire for treatment and care that work, good relationship with practitioner, provision of information, a desire for greater control over one’s health, and a desire for cultural and philosophical congruence with personal beliefs about health and illness. Medicinal plants’ threatened sustainability makes adulteration and species’ substitutions reduce their efficacy, quality and safety. It was found that CAM practitioners who participated in this study relied heavily upon knowledge that had 'stood the test of time' (traditional theory and practice) and 'that which worked' (experientially based knowledge) as the basis for clinical decision-making. The safe, effective and efficient delivery of client care is informed primarily by sound clinical decision making. Body mass index (BMI) plays a significant role in the process. Strategies that guide practitioners through the process of decision making may not only foster professional excellence in CAM practice, but also help to improve the quality of client care. Clinical decision-making is a complex process that is reliant on accurate and timely information. Clinicians are dependent (or should be dependent) on massive amounts of information and knowledge to make decisions that are in the best interest of the patient. CAM practitioners of modern time need currency and timeliness on computations of patients’ body mass index, waist circumference and body shape combination; product/therapy data on therapeutic efficacy; product quality and safety; adverse reactions and herb-drug interactions. This paper presents a clinical decision diagnosis system supporting CAM practitioners to effectively treat emerging lifestyle-related diseases with medicinal plants. Keywords: body mass index, complementary and alternative medicine, lifestyle-related diseases, medicinal plants, clinical decision support syste

Exploring the Effect of Operational Factors and Characterization Imperative to the Synthesis of Silver Nanoparticles

The synthesis and application of silver nanoparticles are increasingly becoming attractive. Hence, a critical examination of the various factors needed for the synthesis of silver nanoparticles as well as the characterization is imperative. In light of this, we addressed in this chapter, the nitty-gritty on the operational parameters (factors) and characterization relevant to synthesis of silver nanoparticle. The following characterization protocols were discussed in the context of silver nanoparticle synthesis. These protocols include spectroscopic techniques such as ultraviolet visible spectroscopy (UV–Vis), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDX), X-ray fluorescence (XRF), X-ray diffraction (XRD), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS)

THE FLOODING EFFECT ON RESIDENTIAL PROPERTY VALUES: A CASE STUDY OF SHOGUNRO RESIDENTIAL ESTATE, AGEGE;LAGOS STATE NIGERIA

This study is aimed at evaluating the impact of flooding on residential property value using Shogunro Residential Estate, Agege, Lagos State as the case study. To achieve the aim of the study, data were collected through questionnaire instrument administered on both the residents of the estate and registered Estate Surveying and Valuation firms having their offices located within the vicinity of the estate. While sixty-one (61) questionnaires were administered on the residents out of which 58 (95%) were retrieved, a total of 45 questionnaires were given to estate surveying and valuation firms out of which 30 (67%) were returned. The retrieved data were analyzed using descriptive and inferential analytical tools. Findings from the study revealed the major cause of flooding in the estate to be due to illegal of structures across drainage channels in the area. The study further revealed that flooding does not have measurable impact on the prices of properties within the estate. The study recommends demolition of illegal structures built across the drainage channels within the vicinity of the estate and infact all over the state by the state Town and Country Planning Authority and discouragement of further act in the state

Assessment of Decentralized Electricity Production from Hybrid Renewable Energy Sources for Sustainable Energy Development in Nigeria

This paper presents technical and economic assessment of a hybrid energy system for electricity generation in rural communities in the six geopolitical zones of Nigeria. The study was based on a 500 rural household model having an electric load of 493 kWh per day. To simulate long-term continuous implementation of the hybrid system, 21 years (1992 – 2012) hourly mean global solar radiation and wind speed data for the selected sites were used. The mean annual wind speed and solar radiation for the locations ranged from 2.31 m/s for Warri to 3.52 m/ s for Maiduguri and 4.53 kWh/m2 for Warri to 5.92 kWh/m2 for Maiduguri, respectively. These weather data were used for simulation with the Micro-power Optimization Model software HOMER. From the optimum results of the hybrid system,Warri has the highest NPC and COE of $2,441,222 and$0.721/kWh, respectively while Maiduguri has the least NPC and COE of $2,225,387 and$0.658/kWh, respectively for the 21 years project lifespan. The high value of COE for Warri is due to its low renewable energy resource while low COE for Maiduguri is due to its high renewable energy resource. The Northern part of the country has ample renewable energy resource availability and with a strong political will, optimal utilization of these renewable resources (solar and wind) can be actualized. Researchers, Industrialists, Policy Makers and the Nigerian government should therefore seize this opportunity in developing a sustainable energy through utilization of abundant renewable energy resources in the country

Assessing the mycotoxicological risk from consumption of complementary foods by infants and young children in Nigeria

This study assessed, for the first time, the mycotoxicological risks from consumption of complementary foods by infants and young children in Nigeria. Molds belonging to Aspergillus aculeatinus, A. flavus, A. luchuensis, A. tubingensis, A. welwitschiae and Geotrichum candidum were recovered from the complementary foods. Twenty-eight major mycotoxins and derivatives, and another 109 microbial metabolites including chloramphenicol (a bacterial metabolite), were quantified in 137 food samples by LC-MS/MS. Aflatoxins and fumonisins co-contaminated 42% of the cereal- and nut-based food samples, at mean concentrations exceeding the EU limits of 0.1 and 200 μg/kg set for processed baby foods by 300 and six times, respectively. Milk contained mainly beauvericin, chloramphenicol and zearalenone. The trichothecenes, T-2 and HT-2 toxins, were quantified only in infant formula and at levels three times above the EU indicative level of 15 μg/kg for baby food. Chronic exposure estimate to carcinogenic aflatoxin was high causing low margin of exposure (MOE). Exposures to other mycotoxins either exceeded the established reference values by several fold or revealed low MOEs, pointing to important health risks in this highly vulnerable population. The observed mycotoxin mixtures may further increase risks of adverse health outcomes of exposure; this warrants urgent advocacy and regulatory interventions.</p

Anti-mycobacterial and GC-MS Studies of Irvingia gabonensis Baill Ex. Lanen Stem Extracts

Irvingia gabonensis baill ex. lanen (Bush mango) is an ethno-medicinal plant that has been used for traditional therapeutic purposes. With the increasing rate of drug resistance to various diseases in the society today, there is the need for alternative sources of drugs for the treatment of such disease. The Bush mango plant presents a potential candidate for such drugs discovery. Extracts from the plant stem were derived by cold maceration separately in methanol (MeOH) and Dichloromethane (DCM) for a period of 7 days. Phyto-constituents were also identified in extracts of stems by using hyphenated mass spectrometer and chromatographic technique, the Gas Chromatography - Mass Spectrometer (GC/MS) while the functional group of such phyto-constituents were identified with the aid of Nicolet 5700 Fourier Transform– Infra-Red spectrometer. Anti-tubercular screening was performed on extracts against clinically isolated drug-susceptible strains (DS-MTB-1 - DS-MTB-5), drug resistant strains (DR-MTB-1, DR-MTB-2) and a standard tubercular strain, H37Rv. This was controlled with drug standards, rifampicin and levofloxacin. Extracts revealed the presence of phyto-constituents such as saponins, tannin, alkaloids and phenol. It was observed that both extracts recorded high % alkaloid content at 10.37±0.02. Also, identified by FTIR as the principal part of the extracts are hydrocarbon groups such as carboxylic acid (1042), while the presence of the volatile components such as 9- Oxabicyclo [6.1.0] nonane (C8H14O) and 1-Chlorobutatriene (C4H3C) were reported by GC-MS. Extracts exhibited significant anti-tubercular activity against all organisms. Therefore, this study promotes the use of Irvingia gabonensis baill ex. lanen for phytotherapeutics purposes

Stroke prevalence amongst sickle cell disease patients in Nigeria: a multi-centre study

Background: Stroke is a life-changing, debilitating complication of sickle cell disease (SCD). Previous studies had recorded high stroke prevalence amongst this group of patients. Nigeria has a large population of people affected by this condition and this study aims to assess the stroke prevalence in this large population.Methodology: Stroke prevalence data from 14 physicians working in 11 tertiary health centres across the country was collated by doctors using the sickle cell registers and patient case notes. This data was then collated and used to obtain the overall stroke prevalence in adult and children.Results: The stroke prevalence in sickle cell disease patients in Nigeria was observed to be 12.4 per 1000 patients. Prevalence in the adult patients was 17.7 per 1000 patients and 7.4 per 1000 patients in children. Twenty three percent of the affected patients had more than stroke episode.Conclusion: The stroke prevalence in Nigeria is lower than previously recorded rates and further studies will be required to investigate other factors which may play a role.Keywords: sickle cell, stroke, Nigeria, prevalenc

Antimicrobial activity and time kill kinetics of Nigerian Honeys on multi-resistant Enteric Bacilli

Antimicrobial activities of some Nigeria honeys were tested on multi-antibiotic resistant enteric bacilli strains (MAREBS) that are becoming dreadful among the populace. Enteric bacilli isolated from fecal samples randomly collected from community populace were biotyped and profiled for antibiotic susceptibility by micro-broth dilution assay. Honey physico-chemical and phyto-chemical metabolites were analysed and tested for antimicrobial susceptibility to MAREBS while its time kill kinetics was evaluated. Significant rate of 31.3% Escherichia coli, Klebsiella oxytoca, (19.5%), Pseudomonas aeruginosa (15.3%) were found with only 62.6% showed significant resistance to cefotaxime (30μg) and 61.6% to ampicillin (10μg). more than 40% showed significant resistance to Cotrimoxazole, ciprofloxacin and tetracycline with MIC >16 μg/ml (p<0.05). Physico-chemical parameters vary significantly with high phenol and alkaloids contents. Few honey samples showed antimicrobial activity of more than 37% inhibition rate while 8.1% MAREBS were further inhibited at lower MIC 31.25mg/mL, 10.8% at MIC 125mg/mL and 8.1% MIC 250mg/mL, while cidal rate of 8.1% was recorded. Significant reduction in average count of different MAREBS was recorded at honey dilutions of 1:2 and 1:4 to less than 2.10Log10CFU/mL. Amidst global burden of enteric infection with persistence antibiotic resistance, Nigerian honeys showed a reliable bacteriostatic and cidal activity as prospective novel alternative therapy for MAREBS infections

Safety of Levetiracetam in paediatrics: a systematic review

Objective To identify adverse events (AEs) associated with Levetiracetam (LEV) in children. Methods Databases EMBASE (1974-February 2015) and Medline (1946-February 2015) were searched for articles in which paediatric patients (≤18 years) received LEV treatment for epilepsy. All studies with reports on safety were included. Studies involving adults, mixed age population (i.e. children and adults) in which the paediatric subpopulation was not sufficiently described, were excluded. A meta-analysis of the RCTs was carried out and association between the commonly reported AEs or treatment discontinuation and the type of regimen (polytherapy or monotherapy) was determined using Chi2 analysis. Results Sixty seven articles involving 3,174 paediatric patients were identified. A total of 1,913 AEs were reported across studies. The most common AEs were behavioural problems and somnolence, which accounted for 10.9% and 8.4% of all AEs in prospective studies. 21 prospective studies involving 1120 children stated the number of children experiencing AEs. 47% of these children experienced AEs. Significantly more children experienced AEs with polytherapy (64%) than monotherapy (22%) (p<0.001). Levetiracetam was discontinued in 4.5% of all children on polytherapy and 0.9% on monotherapy (p<0.001), the majority were due to behavioural problems. Conclusion Behavioural problems and somnolence were the most prevalent adverse events to LEV and the most common causes of treatment discontinuation. Children on polytherapy have a greater risk of adverse events than those receiving monotherapy