Virologic and immunologic outcome of treatment of HIV infection with a herbal concoction, A-Zam, among clients seeking herbal remedy in Nigeria

Abstract: This study was to determine the effectiveness (CD4 count and viral load) of a safe herbal concoction, α-Zam used by clients seeking herbal remedy for treatment of HIV infection in Nigeria. 51 patients taking α-Zam as complementary and alternative therapy through the herbal therapist were studied for a period of 16 months. Preliminary medical and laboratory examinations using WHO and CDC criteria were done after confirmation of HIV infection by Western blotting in the nearest teaching hospitals to the residence of the patients. Regular visits were paid to the patients after commencement of the α-Zam to assess the side-effects, drug interactions, toxicity and effectiveness of the herbal remedy. There was a statistical significance (P<0.05) between pre-treatment and post-treatment CD4 count. 4 (7.8%) of the patients had average increase in CD4 count of 262±16 cell/µL, 23 (45.1%) patients with average increase 310±16 cell/µL, 16 (31.4%) patients with average increase 456±25 cell/µL and 8 (15.7%) patients with average increase 510±36 cell/µL( %) were at WHO staging I , II, III and IV respectively within 4 months on herbal therapy. There was very marked reduction in viral (HIV-RNA) load with 41 (80.4%) and 10 (19.6%) HIV infected patients had undetectable viral load and <1000 copies/ml respectively after the therapy. All symptoms and signs associated with HIV infection in all patients fully subsided within 4 weeks of commencement of α-zam therapy and there was no evidence of negative drug interaction in those HIV patients using both the herbal and highly active anti-retroviral therapy (HAART). The study is in progress to determine periodic immunological outcomes of post therapy in all patients

Glycaemic Response to Different Preparations of Yam in Diabetic and Non-Diabetic Nigerians

Post-pandial glycaemic responses to food can be affected by the method involved in the preparation of the food. Dietary intervention with food modification forms the corner- stone of management of type 2 diabetes worldwide. The effect of processing on yam; a staple food in Nigeria; was studied among diabetic and non-diabetic Nigerians. Despite undergoing more processing; amala prepared from yam flour had a better post-pandial glycaemic response index (PGRI) compared to other yam preparations; and this was also significantly higher among the diabetic subjects. Yam-based products; particularly amala; should be encouraged among diabetic Nigerians

Role of hepatic enzymes in the biochemical assessment of the severity of sickle cell anemia.

BACKGROUND AND OBJECTIVES: Various clinical and hematological indices have been used to assess the severity of Sickle Cell Anemia (SCA), however biochemical indices are lacking. Hepatomegaly has been a frequent finding in SCA and its persistence has been associated with increased disease severity. The association between hepatic enzymes and disease severity in SCA is undefined. This study was therefore designed to look at the association between clinical severity and hepatic enzymes in SCA subjects with persistent hepatomegaly (that is, lasting more than six months) in order to determine a possible role for hepatic enzymes as a biochemical index of severity. MATERIALS AND METHODS: Serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (SAP) and gamma-glutamyl-transferase (GGT) were determined in two groups of SCA subjects and in hemoglobin genotype AA (HbAA) controls. SCA group comprised of 37 subjects with persistent hepatomegaly equal to or greater than 10 cm (below right coastal margin) while the second group comprised another 38 SCA subjects without palpable hepatomegaly. 40 individuals with hemoglobin genotype AA served as control for both groups. Clinical and hematological parameters of severity which included steady state haematocrit, number of transfusions per year, number of crises per year and percentage HbF level were determined and scored in a manner similar to the Glasgow coma scale. Results obtained were analyzed with the aid of statistical package on EPI-INFO version 6.02. RESULTS: There was a significant increase in serum ALT, ALP and GGT levels in SCA with persistent hepatomegaly over those without hepatomegaly (p < 0.05, p < 0.05 and p < 0.01 respectively). All the index scores and the final aggregate severity scores were also significantly higher in SCA subjects with persistent hepatomegaly. Only GGT demonstrated a fairly positive and significant correlation (r = 0.46, P < 0.05) with increased clinical severity among the hepatic enzymes. CONCLUSION: Elevated serum level of GGT in SCA during steady state is suggestive of increased disease severity.