Wound healing activity of Carica papaya L. in experimentally induced diabetic rats.

The aqueous extract of C. papaya fruit (100 mg kg(-1) day(-1) for 10 days) was evaluated for its wound healing activity in streptozotocin-induced diabetic rats using excision and dead space wound models. Extract-treated animals exhibited 77% reduction in the wound area when compared to controls which was 59%. The extract treated wounds were found to epithelize faster as compared to controls. The wet and dry granulation tissue weight and hydroxyproline content increased significantly when compared to controls. The extract exhibited antimicrobial activity against the five organisms tested. Carica papaya promotes significant wound healing in diabetic rats and further evaluation of this activity in humans is suggested.

The general public's perceptions and use of antimicrobials in Trinidad and Tobago / Las percepciones del público general y el uso de antimicrobianos en Trinidad y Tabago

Objective. To determine the general public's perceptions and use of antibiotics in Trinidad and Tobago, a two-island republic in the Caribbean. Methods. This prospective study surveyed 824 randomly selected households listed in the telephone directory, from November 1998 to January 1999. Through telephone interviews we determined knowledge about antibiotics and beliefs concerning their safety and efficacy. We studied the influence of age, gender, education, and having private health insurance on knowledge, self-medication, storing medication at home for emergency use ("hoarding"), and asking a private doctor to prescribe antibiotics ("demand prescribing"). Results. For the 824 telephone calls that the interviewers completed, 753 of the households agreed to participate (91.4% response rate). Of those 753 participants, 699 of them (93%) knew the term "antibiotic," 29% (206/699) said it was a drug for bacterial infections, and 25% (170/690) had asked a doctor for an antibiotic prescription. Penicillin was correctly identified as an antibiotic across age, gender, and education categories, but 36% of respondents incorrectly said Benadryl (diphenhydramine), a common over-the-counter cough and cold formulation, was an antibiotic. Gender was not significantly associated with knowledge of antibiotic safety, with self-medication, or with hoarding antibiotics. On the other hand, completion of tertiary (university) education was significantly associated with correct knowledge of the safety of antibiotics and whether or not they could cure all infections. Of the various antimicrobials, beta-lactams were the ones that survey respondents had used most frequently in the preceding year, and 20% of antibiotics users had used multiple antibiotics in that period. In comparison to persons with private health insurance, more individuals without private health insurance said that antibiotics are safe and do not have side effects, and more of them also incorrectly called aspirin and Benadryl antibiotics. Conclusions. In Trinidad and Tobago, inappropriate use of antimicrobials results from self-medication, over-the-counter availability at the community pharmacy, prescribing on demand, and lack of regulatory control. In order to contain antibiotic abuse, both the Drug Inspectorate of the Ministry of Health and the Pharmacy Board should exert stricter control on the dispensing of antibiotics at private pharmacies. Further, education of the general public and of health care professionals on antibiotic misuse and appropriate use must be instituted, along with community-based surveillance of antimicrobial resistance trends

Objetivo. Investigar las percepciones del público general y el uso de antimicrobianos en Trinidad y Tabago, una república caribeña formada por dos islas. Métodos. En este estudio prospectivo se encuestaron, entre noviembre de 1998 y enero de 1999, 824 domicilios seleccionados aleatoriamente que figuraban en la lista telefónica. En las entrevistas, realizadas por teléfono, se investigaron los conocimientos sobre los antimicrobianos y las creencias de los entrevistados acerca de su eficacia y seguridad. Se estudió la influencia de la edad, del sexo, de la educación y del hecho de disponer de seguro de salud privado sobre los conocimientos, la automedicación, el almacenamiento de medicamentos en casa para utilizarlos en caso de urgencia ("acumulación") y la petición de prescripción de antimicrobianos a médicos privados ("demanda de prescripción"). Resultados. De los 824 contactos telefónicos realizados por los entrevistadores, en 753 (91,4%) se obtuvo una respuesta favorable a la participación en la encuesta. De estos 753 participantes, 699 (93%) conocían el término "antibióticos", 29% (206/699) dijeron que se trataba de fármacos para las infecciones bacterianas, y 25% (170/690) le habían pedido al médico prescripciones de antibióticos. La penicilina fue identificada correctamente como un antibiótico por personas de diferentes edades, sexos y niveles educacionales, pero el 36% de los entrevistados dijeron que el Benadryl (difenhidramina), un fármaco muy utilizado en el resfriado y que no necesita receta médica, era un antibiótico. El sexo no se asoció de forma significativa a los conocimientos sobre la seguridad de los antibióticos, a la automedicación ni a la "acumulación" de antibióticos. Por otra parte, el haber completado estudios universitarios se asoció de forma significativa a un buen conocimiento de la seguridad de los antibióticos y del hecho de que no curan todas las infecciones. Los beta-lactámicos fueron los antimicrobianos que los encuestados habían usado con mayor frecuencia el año anterior, período durante el cual el 20% de ellos habían usado múltiples antibióticos. En comparación con las personas que disponían de seguro de salud privado, las que no lo tenían afirmaron con más frecuencia que los antibióticos son seguros y no tienen efectos colaterales y que la aspirina y el Benadryl son antibióticos. Conclusiones. En Trinidad y Tobago, el uso inapropiado de los antimicrobianos se debe a la automedicación, a la posibilidad de adquirirlos en las farmacias sin necesidad de receta médica, a la "demanda de prescripción" y a la ausencia de normas de control. Con el fin de reducir el abuso de antibióticos, la Inspección de Medicamentos del Ministerio de Salud y el Consejo de Farmacéuticos deben ejercer un control más estricto sobre la dispensación de antibióticos en las farmacias privadas. Además, se debe informar mejor al público en general y a los profesionales sanitarios acerca del uso de los antibióticos e instaurar un sistema basado en la comunidad para vigilar las tendencias de la resistencia a los antimicrobianos

Existence of a silent gene for pseudocholinesterase in a Trinidad population

Although the values reported were higher than those reported for Caucasians, differences in dibucaine number for pseudocholinesterase values among the three ethnic groups in Trinidad and Tobago, were not significant. Eight individuals had intermediate dibucaine numbers values between 40 and 70; one of them was African, 3 were East Indians, and 4 Mixed. Two of the mixed group were of Portuguese lineage and had significantly lower dibucaine numbers and enzyme concentration. Two sisters of East Indian origin had an inestimable dibucaine number and their pseudocholinesterase values were just detectable, suggesting the presence of a 'silent gene' for pseudocholinesterase. These studies, which are being extended, suggest that the dibucaine number should be estimated prior to succinylcholine administration in patients in Trinidad and Tobago who are at risk of apnoea

A fixed drug eruption to baralgin (dipyrone) tablets

Dipyrone-induce adverse skin reactions appear within the first seven days of drug administration, and the aetiology is often missed. A patient who regularly consumed dipyrone for dysmenorrhoea is presented. The adverse cutaneous manifestations may be predictive of the occurrence of severe haematological adverse reactions. Adverse drug reactions (ADR) should be documented, and initiation of ADR monitoring units in the Caribbean will be a step in establishing a data base of these events in Caribbean populations

Trinidad and Tobago Ministry of Health drug formulary: a guide to rational drug prescribing

A document listing drugs, which may be purchased by the Ministry of Health, and containing information on the indications, contraindications, side effects, dosage, and any other special information related to the drug.