Nutrient and Bioactive Components of Annona muricata and Fagara zanthoxyloide of South-Southern Nigeria

Introduction:Prediabetes is associated with dysglycemia, endothelial dysfunction,obesity and inflammation, placing them at an increased risk of cardiovascular events.Aims: The present study aimed to investigate the risk of cardiovascular disease associated with prediabetes by estimation of serum interleukin-6, myeloperoxidase and urine microalbumin and their correlation with fasting plasma glucose and anthropometric measurements.Study Design:Cross sectional study.Place and Duration of Study: Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru between 2014 and 2015.Methodology:Eighty subjects were categorised into prediabetes and healthy controls based on their fasting plasma glucose values. Anthropometric data (weight, body mass index, waist circumference, hip circumference and waist-to-hip ratio from all subjects were recorded. Interleukin-6 & myeloperoxidase were estimated in serum sample whereas microalbumin was estimated in random urine sample Results:The mean anthropometric measurements and cardiovascular disease risk markers (interleukin-6, myeloperoxidase and urine microalbumin) were found to be significantly higher (p < 0.05) in prediabetes group. Myeloperoxidase had significant correlation with fasting plasma glucose (r-0.388) in the prediabetes group. Interleukin-6 and myeloperoxidase also showed a positive correlation with body mass index (r -0.339, r -0.327), waist circumference (r -484, r -0.493) and waist-to-hip ratio (r -0.430, r -0.493) while urine microalbumin did not correlate with fasting plasma glucose and anthropometric measurements in prediabetes group.Conclusion:This study suggests that prediabetes is associated with central adiposity and have an increased risk for cardiovascular disease.

Antimicrobial and Antioxidant Studies of the Leaf Extract and Fractions of Sabicea brevipes Wernham (Rubiaceae)

Phytochemical analysis, antimicrobial and antioxidant properties of the leaf extract and fractions of Sabicea brevipes were studied. Theleaveswere defatted and the marc extracted with methanol. The extractwas further purified by solvent-solvent partitioning using n-hexane, ethyl acetate and n-butanol to obtain the three solvent fractions. They were screened for phenolics, flavonoids, tannins, saponins, terpenoids, glycosides, and steroids. Total phenolics, flavonoids and tannins were determined quantitatively. The antimicrobial test was screened in vitroby agar diffusion method. Analysis of variance (ANOVA) was used to test for significant difference at p ≤ 0.05 in all study groups. The methanol extract exhibited the most significant amount of phenolics (110.78 ± 1.06 mg GAE/g) while ethyl acetate fraction had the least total phenolics content (50.55 ± 2.91 mg GAE/g). The same trend was observed for the total flavonoids content whereas the methanol extractmeasured (418.40 ± 14.03 mg QE/g) while ethyl acetate fraction had 192.40 ± 3.06 mg QE/g. Total tannins contents were: methanol extract (102.22 ± 7.58 mg GAE/g) and ethyl acetate (27.33 ± 0.77 mg GAE/g). The antioxidant results showed that the methanol extract had the highest DPPH free radical scavenging ability (93.69%) with half maximal inhibitory concentration (IC50) of 0.601± 0.02 and also highest ferric ion reducing power (50.381 ± 1.56 μmol Fe2+/g). Also, the methanol extract showed high total antioxidant capacity (96.79 ± 0.31 mg AAE) and IC50of 0.798± 0.01. The antimicrobial results revealed that the methanol extract showed better activity against Escherichia coli, Bacillus subtilis, Pseudomonas aeruginosa, Staphylococcus aureus, andCandida albicans than the solvent fractions at concentrations of 200, 100, 50, 25, 12.5, mg/mL having various inhibition zone diameters (IZDs). The methanol extract and fractions of S. brevipescompared favourably in terms of zone of inhibition and minimum inhibition concentration (MIC) with the standard drug disc (Gentamycin and Ketoconazole) against the tested microorganisms. The MIC of the extract and solvent fractions ranged from 6.31 mg/mL to 50.12 mg/mL. The continual use of the extract of Sabicea brevipesin preventing oxidative stress and in the treatment of common infection is justified by these results.

Body Weight and Platelet Count Changes in Zidovudine Administered Wistar Albino Rats Treated with Ethanolic Extracts of Annona muricata and Fagara zanthoxyloide

Zidovudine administration either in single or fixed-dose combination usually results in a decrease in body weight and in some cases thrombocytopenia. The present study investigated the body weight and platelet count changes observed in zidovudine pre-administered Wistar albino rats on treatment with ethanolic extracts of the leaves Annona muricata (AM) and roots of Fagara zanthoxyloide (FZ). Plants samples were collected from Alakahia community, Rivers state and Opoo community, Ogun state; while Wistar albino rats were grouped into normal control, negative control (receiving zidovudine at 100 g/ml/Kg bw), AM and FZ extract treatment (at 4.5 and 3.8 g/ml/Kg B.W respectively) groups with analysis performed bi-weekly. All tests were performed using standard procedures with all reagents of analytic grade. Phytochemical screening of the extracts showed significantly high amounts of alkaloids (10.47- 21.15 mg / 100 g), phenols (10.60-15.22 mg / 100 g) and tannins (14.23 - 50.19 mg / 100 g). The investigation into their proximate compositions also showed high fat (5.78 ± 0.02) in FZ, moisture (10.47 ± 0.05) in AM and fibre (7.37 ± 0.03) in FZ. The amino acid phenylalanine (5.10-6.01 g / 100 g), isoleucine (4.44-5.20 g / 100 g), lysine (4.03 -5.31 g / 100 g) was observed to be available in the extracts. In the normal control group body weight increased by 20.75 g at week 6 while administration of Zidovudine, resulted in a decreased in bodyweight by 1.14 g in week 2 and 3.32 g in week 6. Extract treatment caused a significant increase (p?0.05) in body weight by 17.95g (AM) and 18.23g (FZ) at week 6. Platelet count was also observed to significantly decrease (p?0.05) by 33.42% in the negative control group when compared to the normal control. This was observed to significant increases in extract treatment by 49.56% (AM) and 51.32% (FZ). The results thus suggest a possible beneficial effect of the extracts of AM and FZ in checkmating the weight and platelet loss observed as a side effect of zidovudine therapy as well as the possible use in haemorrhagic conditions to reduce bleeding without thromboembolism.

Paediatric Morbidity and Mortality in a Suburban Hospital in Jos, North -Central Nigeria.

Background: Even though there has been some decline in childhood mortality, figures still remain high in sub- Saharan Africa. The pattern of morbidity and mortality in health care institutions may be a reflection of the disease burden of the community which it serves and will facilitate prevention/ control strategies. This study was conducted to determine the pattern of paediatric morbidity and mortality in a secondary level hospital in a sub – urban area in Jos, North – central Nigeria. Materials and Methods: This retrospective study is a review of paediatric admissions into the Vom Christian Hospital. Relevant data on all children who were admitted into the Vom Christian Hospital between May 2012 and April 2013 with medical conditions were retrieved from the admissions records. Data were entered into excel spread sheet and analyzed using Epi info 7. A p< 0.05 was considered statistically significant. Results: A total of 334 children aged between one day and 15 years were admitted during the period, out of which 235 (70.4%) were children less than 5 years old. Infections (221, 66.2%) were the major causes of morbidity. Out of all the 334 admissions, 304(91%) were discharged, 7 (2.1%) left against medical advice, 6(1.8%) were referred, while 17 (5.1%) died. Malaria was the commonest cause of morbidity (102, 30.5%) and mortality (6, 35.3%). Severe protein energy malnutrition had the highest case fatality rate (25%). Conclusion: The burden of paediatric morbidity and mortality is in children under 5 years and are mainly preventable. An emphasis on malaria eradication and child survival strategies will help to reduce childhood morbidity and mortality.

Assessment of the Knowledge and Utilization of the Partograph among Non-physician Obstetric Care Givers in the University of Calabar Teaching Hospital, Calabar, Nigeria.

Background: Obstructed labour and ruptured uterus contribute a significant proportion to the alarming maternal mortality ratio in sub-Saharan Africa. Proper management of labour by using the partograph, a simple tool that is designed to detect early signs of abnormal progress, can significantly reduce incidence and complications of prolonged labour. Objective: The objective of this study was to assess the knowledge and utilization of the partograph among non-physician obstetric health care providers in University of Calabar Teaching Hospital (UCTH). Methods: This was a descriptive cross-sectional survey which employed the use of a semi-structured self-administered questionnaire with purposive sampling conducted among 132 consenting non-physician obstetric health care providers in UCTH. Results: The mean age of the respondents was 37.84±9.38 years. About 66% of them used partograph but only 13.6% of those who had used partograph were very confident with the tool in monitoring labour. Fifty-six percent of them had received formal training on partograph. Only 34 percent of those surveyed could correctly interpret various sections of the partograph, like the cervicogram. The main reasons for non-utilization of the partograph were inadequate knowledge (73.5%), non-availability (46.2%) and shortage of manpower (34.8%). Knowledge of the partograph (X2=38.1, P=.00) and partograph availability (X2=52.5, P=.00) significantly affected its utilization. Years of experience did not significantly influence partograph use. Conclusion: The knowledge and utilization of the partograph in our hospital can be enhanced by periodic training and retraining of obstetric care givers, developing protocols, ensuring its availability, as well as increasing the staff strength in the delivery units.

Poliomyelitis: Pattern and Treatment Outcome in Niger Delta; Nigeria

Background: Poliovirus is an enterovirus in the family of Picornaviridae and consists of three antigenic types; 1; 2; and 3. All three types cause paralysis. It is a major cause of musculoskeletal deformity in many African communities including Nigeria. The deformities include muscle weakness; contractures; grotesque foot deformities and angular deformities around the knee; amongst others. Aim: To highlight 20 children with musculoskeletal deformities due to poliomyelitis treated in a private hospital in Port Harcourt. Methods: Twenty children with musculoskeletal deformities due to poliomyelitis were retrospectively studied. Results: The patients' ages ranged from1 to 16 years; with 95of them under 15 years of age. More than 50of the study group had poor immunisation status as 6 of them were unimmunised (30) and 5 (25) of them were incompletely immunised. Even though all school strata were represented; most of them were not schooling. The commonest deformity was contracture of the knees (100) and muscle wasting in the affected limbs. All of them had loss of muscle power in the lower limbs. Surgical correction was achieved by soft tissue release in 95of them and osteotomy in 5. The outcome was good; as acceptable extension of the knee was achieved post operatively. Conclusion: The musculoskeletal abnormalities of poliomyelitis contribute highly to physical disability. All patients affected by paralytic poliomyelitis become disabled to some extent and this increases the disease burden in Nigeria

Epidemiologic and behavioral characterization of knowledge of condom use and modeling among military personnel

How accurately condoms are being used vary across populations and knowledge of the factors determining its proper use remains unclear. Knowledge of such differentials and determinants would aid in evaluating the contributions of condom use to HIV epidemic reduction. Baseline data from the Situationally Focused Individual HIV/AIDS intervention to promote HIV protective behavior among 2,213 Nigerian Military Personnel were analyzed. Educational status as a predictor variable was assessed using univariable and multivariable logistic regression model. Compared to those with less than high school education, those with high school and some college education were two times more likely to demonstrate knowledge of condom use and modeling, prevalence odds ratio (POR), 2.32, 95% Confidence Interval (CI)=1.60-3.37. After adjustment for the relevant covariates, higher education attainment was associated with nonsignificant 62% increase in knowledge and modeling, POR, 1.62, 95% CI=0.78-3.38. This study is indicative of low knowledge of condom use and modeling among the Nigerian military personnel; as well as a direct correlation between education attainment and knowledge of condom use and modeling

Epidemiology of open Tibial Fractures in a Teaching Hospital

) were males and the majority had at least a secondary education (86.7) and were single (95.1). Most of them (82.2) were aware of sexually transmitted infections; and 77.9were aware that condoms prevent transmission of HIV. Seventy-one percent of the young persons were sexually experienced (i.e. previously had sex); 12.9admitted they had previously had sex in exchange for money; and 63.4reported ever using a condom. Median age of sexual debut (sexarche) was 15.7 years. Most (82.1) of the sexually experienced were currently sexually active reporting sexual intercourse within the 6 months preceding survey. Nearly half (47.1) of these had sex with a casual and/or commercial sex worker without a condom.Conclusion: Young people are adopting sexual practices that are essentially high-risk; with severe implications for regional and national socio- economic development. This underscores the fact that they know only little and lack skills to protect themselves from being infected with HIV infections; even when they are sexually active. There is therefore need to advocate for and support initiatives that address reproductive health needs of young people in the Niger Delta region

Gunshot injuries in the Niger Delta region of Nigeria

Background: Violent trauma especially by gunshot injuries appears to be on the increase worldwide. There is inadequate data from many centres in Nigeria to support this observation. Aim: To determine the pattern of gunshot injuries in the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective study covering a period of three years (January 2002-December 2004). A standard proforma was used to record all cases of gunshot injuries reporting to the UPTH. Details sought were age, gender, occupation, gun type, anatomic region of the body involved and treatment given. Other information recorded were time of injury, duration of hospital stay, injury time before presentation, assailant and outcome. Information was obtained directly from victims, relations, the police or those accompanying the victim. Where surgical operations were done or patients were admitted to the wards, relevant information or findings were then retrieved from theatre and ward records. Results: There were 135 patients (120 males and 15 females) between the ages of 1½ -67 years. Students and civil servants constituted the largest number. Seventy-one injuries were due to high velocity missiles while 64 were low velocity. Armed robbery and attacks by "unknown assailants" were the commonest modes of attack with 47 and 41 victims respectively. The lower limbs, abdomen and chest were the most frequent anatomic regions involved recording 38, 28 and 27 cases respectively. There were 9 cases in which multiple anatomic sites were affected. The majority of patients (56) presented within 12-18 hours after injury; only 9 cases presented within 6 hours. Twenty-nine patients underwent laparotomy while 14 had thoracostomies. Forty-nine patients were treated and discharged. Minor surgery (like wound debridement) was the commonest treatment in 43 patients. All cases of fracture among these were subsequently referred to the trauma unit for appropriate treatment. Thirty patients died giving a mortality rate of 22.2%. Conclusion: Gunshot injuries constitute a major cause of violent trauma in the Niger Delta Region of Nigeria with a high and disturbing level of morbidity and mortality