Ethnomedicinal Survey of Plants Used for the Management of Hypertension Sold in the Makola Market, Accra, Ghana

Hypertension is a highly prevalent public health problem among Africans, including Ghanaians, and it is a major risk factor for cardiovascular diseases such as congestive heart failure, kidney disease, and coronary artery disease. Hypertension occurs at a rate of 19% to 48% across Ghana; and because about 70% of the patients are believed to be using herbs to manage this condition, it is important to know the kind of plants that are used in the management of this condition. The aim of this study was therefore to conduct an ethnomedicinal survey to document medicinal plant species which are sold on the open Ghanaian market; and are traditionally used in the treatment of hypertension. Validated questionnaires were administered to sellers of dried or semi-processed herbs at the Makola market, in the Accra Metropolitan Area. The survey identified the plant materials and the way and manner; by which these plant materials are prepared and administered. A total of 13 plant species belonging to 13 plant families were identified. The following medicinal plants were found to be commonly sold for the treatment of hypertension: Bambusa vulgaris (Graminaeae), Bridellia ferruginea (Euphorbiaceae), Carica papaya (Caricaceae), Mangifera indica (Anacardiaceae), Moringa oleifera (Moringaceae), Nauclea latifolia (Rubiaceae), Ocimum gratissimum (Lamiaceae), Parkia biglobosa (Leguminosae), Persea americana (Lauraceae), Proporis africana (Leguminosae – Mimosoideae), Pseudocedrela kotschyii (Maliaceae), Theobroma cacao (Sterculiaceae) and Vitellaria paradoxa (Sapotaceae). Leaves and roots of these plants predominated other plant parts. Most of these herbs were prepared as aqueous decoctions before administration. In conclusion, there are many medicinal plant species used to treat several conditions, including hypertension, within the Ghanaian community. This study therefore underscores the need to preserve, document and scientifically investigate traditional herbs used for the treatment of various diseases of public health importance, and to optimize their use since they serve as alternative treatment

The Association between Health Conditions in World Trade Center Responders and Sleep-Related Quality of Life and Sleep Complaints

Background: World Trade Center (WTC) dust-exposed subjects have multiple comorbidities that affect sleep. These include obstructive sleep apnea (OSA), chronic rhinosinusitis (CRS), gastroesophageal-reflux disorder (GERD) and post-traumatic stress disorder (PTSD). We examined the impact of these conditions to sleep-related outcomes. Methods: Demographics, co-morbidities and symptoms were obtained from 626 WTC (109F/517M), 33–87years, BMI = 29.96 ± 5.53 kg/m2) subjects. OSA diagnosis was from a 2-night home sleep test (ARESTM). Subjective sleep quality, sleep-related quality of life (QOL, Functional Outcomes of Sleep Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep duration and sleep onset and maintenance complaints were assessed. Results: Poor sleep quality and complaints were reported by 19–70% of subjects and average sleep duration was 6.4 h. 74.8% of subjects had OSA. OSA diagnosis/severity was not associated with any sleep-related outcomes. Sleep duration was lower in subjects with all conditions (p < 0.05) except OSA. CRS was a significant risk factor for poor sleep-related QOL, sleepiness, sleep quality and insomnia; PTSD for poor sleep-related QOL and insomnia; GERD for poor sleep quality. These associations remained significant after adjustment for, age, BMI, gender, sleep duration and other comorbidities. Conclusions: Sleep complaints are common and related to several health conditions seen in WTC responders. Initial interventions in symptomatic patients with both OSA and comorbid conditions may need to be directed at sleep duration, insomnia or the comorbid condition itself, in combination with intervention for OSA

Severe obstructive sleep apnea is associated with alterations in the nasal microbiome and an increase in inflammation

Rationale: Obstructive sleep apnea (OSA) is associated with recurrent obstruction, subepithelial edema, and airway inflammation. The resultant inflammation may influence or be influenced by the nasal microbiome. Objectives: To evaluate whether the composition of the nasal microbiota is associated with obstructive sleep apnea and inflammatory biomarkers. Methods: Two large cohorts were used: 1) a discovery cohort of 472 subjects from the WTCSNORE (Seated, Supine and Post-Decongestion Nasal Resistance in World Trade Center Rescue and Recovery Workers) cohort, and 2) a validation cohort of 93 subjects rom the Zaragoza Sleep cohort. Sleep apnea was diagnosed using home sleep tests. Nasal lavages were obtained from cohort subjects to measure: 1) microbiome composition (based on 16S rRNA gene sequencing), and 2) biomarkers for inflammation (inflammatory cells, IL-8, and IL-6). Longitudinal 3-month samples were obtained in the validation cohort, including after continuous positive airway pressure treatment when indicated. Measurements and Main Results: In both cohorts, we identified that: 1) severity of OSA correlated with differences in microbiome diversity and composition; 2) the nasal microbiome of subjects with severe OSA were enriched with Streptococcus, Prevotella, and Veillonella; and 3) the nasal microbiome differences were associated with inflammatory biomarkers. Network analysis identified clusters of cooccurring microbes that defined communities. Several common oral commensals (e.g., Streptococcus, Rothia, Veillonella, and Fusobacterium) correlated with apnea–hypopnea index. Three months of treatment with continuous positive airway pressure did not change the composition of the nasal microbiota. Conclusions: We demonstrate that the presence of an altered microbiome in severe OSA is associated with inflammatory markers. Further experimental approaches to explore causal links are needed