Defining Sub-Saharan Africa’s Health Workforce Needs: Going Forwards Quickly Into the Past Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

Recent proposals for re-defining the roles Africa’s health workforce are a continuation of the discussions that have been held since colonial times. The proposals have centred on basing the continent’s healthcare delivery on non-physician clinicians (NPCs) who can be quickly trained and widely distributed to treat majority of the common diseases. Whilst seemingly logical, the success of these proposals will depend on the development of clearly defined professional duties for each cadre of healthcare workers (HCW) taking the peculiarities of each country into consideration. As such the continent-wide efforts aimed at health-professional curriculum reforms, more effective utilisation of task-shifting as well as the intra – and inter-disciplinary collaborations must be encouraged. Since physicians play a major role in the training mentoring and supervision of physician and nonphysician health-workers alike, the maintenance of the standards of university medical education is central to the success of all health system models. It must also be recognized that, efforts at improving Africa’s health systems can only succeed if the necessary socio-economic, educational, and technological infrastructure are in place

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 (

Impact of the problem-based learning curriculum on the learning styles and strategies of medical students at the University of Transkei

Objectives. This is a longitudinal cohort study of the learning styles and strategies  of medical students in a problem-based, community-based curriculum as they  progressed through tpe medical course. The purpose was to monitor and evaluate· whether the programme was fulfilling the objective of producing self-directed and  lifelong learners.Methods. The short version of the Lancaster Inventory of Learning Styles was  administered to the stu9-ents on admission and thereafter on a yearly basis through  the first 4 years of the medical course. Data were fed onto a database and subsequently analysed using a commercially available statistical package.Results. 140 students (falling to 106 by year 4) were interviewed and followed up through the study period. Of . the students 75% were black and 25% were of Asian descent. On admission the students had high scores for individual achievement motivation, and for meaningful learning. They had moderate scores for reproducing learning, comprehension learning, operation learning and versatile learning. They had low scores for learning pathologies, especially globetrotting and improvidence. There was no sexual difference in learning styles. Asian students had significantly higher scores for meaningful learning and for versatile learning. The effect of the problem-based curriculum was to reduce the score for individual achievement, decrease the score for fear of examinations, increase the score for operation learning, increase the score for versatile learning, increase the score for syllabus boundness, and decrease the scores for learning pathologies, especially for improvidence and globetrotting.. By year 4, there was similarity in the learning styles of black and Asian students;Conclusion. The problem-based curriculum had a positive effect on the learning styles of the students, especially the black students

Defining Sub-Saharan Africa’s Health Workforce Needs: Going Forwards Quickly Into the Past; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

Recent proposals for re-defining the roles Africa’s health workforce are a continuation of the discussions that have been held since colonial times. The proposals have centred on basing the continent’s healthcare delivery on non-physician clinicians (NPCs) who can be quickly trained and widely distributed to treat majority of the common diseases. Whilst seemingly logical, the success of these proposals will depend on the development of clearly defined professional duties for each cadre of healthcare workers (HCW) taking the peculiarities of each country into consideration. As such the continent-wide efforts aimed at health-professional curriculum reforms, more effective utilisation of task-shifting as well as the intra – and inter-disciplinary collaborations must be encouraged. Since physicians play a major role in the training mentoring and supervision of physician and nonphysician health-workers alike, the maintenance of the standards of university medical education is central to the success of all health system models. It must also be recognized that, efforts at improving Africa’s health systems can only succeed if the necessary socio-economic, educational, and technological infrastructure are in place

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