Perception and Use of Herbal Medicine in General Practice Patients: A Cross-Sectional Study in Saudi Arabia.

BACKGROUND: In Saudi Arabia, herbal medicine is an essential component of traditional health practices, reflecting a deep cultural appreciation for natural remedies. Despite widespread use, comprehensive data on perceptions and utilization among general practice patients are scarce. This study aims to elucidate the patterns of herbal medicine use, associated beliefs, and communication with healthcare professionals in this context. METHODS: A cross-sectional survey was conducted using an online questionnaire distributed through social media and professional networks, targeting adult residents of Saudi Arabia. The survey encompassed questions on demographic characteristics, use of herbal medicine, reasons for use, sources of herbal products, perceptions of efficacy and safety, and discussions with healthcare professionals about herbal medicine usage. RESULTS: The survey was completed by 1,184 participants, with 736 (62%) reporting the use of herbal medicines in the past 12 months. Among these users, the age group 30-39 was most represented (328/1,184, 27.8%), while participants over 60 were the least (66/1,184, 5.6%). Herbal medicines were primarily used for general wellness (332/736, 45%) and treatment of specific ailments (221/736, 30%). The majority obtained their herbal medicines from pharmacies (427/736, 58%), and 294 (40% of users) used them as alternatives to prescribed medications. Only 259 (35% of herbal medicine users) had discussed their usage with healthcare professionals. Most users believed in the safety (515/736, 70%) and effectiveness (478/736, 65%) of herbal remedies, with a significant portion (626/736, 85%) advocating for more scientific research. CONCLUSION: This study reveals a significant engagement with and positive perception of herbal medicine among general practice patients in Saudi Arabia, alongside a notable gap in communication between patients and healthcare providers. The findings highlight the need for integrating discussions on herbal medicine into patient care, encouraging evidence-based, safe use through better-informed healthcare practices.

Lack of Association of C677T Methylenetetrahydrofolate Reductase Polymorphism with Breast Cancer Risk in Mali.

Methylenetetrahydrofolate reductase (MTHFR) plays a major role in the metabolism of folates and homocysteine, which in turn can affect gene expression and ultimately promote the development of breast cancer. Thus, mutations in the MTHFR gene could influence homocysteine, methionine, and S-adenosylmethionine levels and, indirectly, nucleotide levels. Imbalance in methionine and S-adenosylmethionine synthesis affects protein synthesis and methylation. These changes, which affect gene expression, may ultimately promote the development of breast cancer. We therefore hypothesized that such mutations could also play an important role in the occurrence and pathogenesis of breast cancer in a Malian population. In this study, we used the PCR-RFLP technique to identify the different genotypic profiles of the C677T MTHFR polymorphism in 127 breast cancer women and 160 healthy controls. The genotypic distribution of the C677T polymorphism in breast cancer cases was 88.2% for CC, 11.0% for CT, and 0.8% for TT. Healthy controls showed a similar distribution with 90.6% for CC, 8.8% for CT, and 0.6% for TT. We found no statistical association between the C677T polymorphism and breast cancer risk for the codominant models CT and TT (p > 0.05). The same trend was observed when the analysis was extended to other genetic models, including dominant (p = 0.50), recessive (p = 0.87), and additive (p = 0.50) models. The C677T polymorphism of MTHFR gene did not influence the risk of breast cancer in the Malian samples.

An unusual case of Dyke-Davidoff-Masson syndrome revealed by status epilepticus in a Malian patient.

The Duke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown prevalence, globally. To date, <100 cases have been reported worldwide. We report the case of an 18-year-old patient admitted for status epilepticus seizure, and who presented a right hemiparesis, body asymmetry, joints ankylosis, and mental retardation. Brain CT-scan revealed left hemisphere atrophy, skull bone thickening, and hyperpneumatization of the frontal sinuses; all consistent with DDMS. Seizures improved remarkably on Levetiracetam and Valproate. This is the first report of an unusual DDMS in Mali, and the diagnosis delay highlights the challenges for the management of these diseases in resource-limited settings.

Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa.

INTRODUCTION: Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. METHODS: This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. RESULTS: We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. CONCLUSION: The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.

Prevalence and determinants of current asthma in Cameroon.

INTRODUCTION: The prevalence of asthma varies from one country to another due to differences in ethnicity, socio-economics status, environmental and climatic risk factors. The aim of this study was to determine the prevalence and determinants of current asthma in Cameroonian adults. MATERIAL AND METHODS: Data from 4 cross-sectional community-based studies from 2014 to 2018 were analyzed. Participants aged 19 years and above were selected through multilevel stratified random sampling methods across 2 urban areas, 2 semi-urban areas and 1 rural area. Current asthma was defined as "wheezing in the last 12 months in a subject with self-reported asthma or having used drugs for asthma treatment". Logistic regression was used to investigate the determinants of current asthma. RESULTS: A total of 10,707 adults [median age (interquartile range)=36 (26-52) years, 44.5% of men] were definitively enrolled in the study. The overall prevalence [95% confidence interval (CI)] of current asthma was 3.9% (3.5-4.3)%. Determinants [odd's ratio (OR), (95%CI)] of current asthma were: Sudanese ethnicity [1.9(1.4-2.7)], rural area [1.5(1.1-2.1)], urban area [1.6(1.2-2.2)], past history of pneumonia [1.9(1.1-3.4)], allergic rhino-conjunctivitis [6.5(4.7-8.9)], atopic eczema [2.3(1.5-3.6)], body mass index (BMI)≥40kg/m2 [1.9(1.0-3.4)] and BMI<18kg/m2 [1.8(1.2-2.9)]. CONCLUSION: The prevalence of current asthma is close to the low value of the Sub-Saharan African range. Sudanese ethnicity, rural area, urban area, history of pneumonia, allergic disease, severe obesity and underweight were determinants of current asthma in Cameroon. More research is surely warranted to understand the mechanisms underlying the association of asthma with Sudanese ethnicity.

[Epidemiological and cultural aspect of gingival tattooin the dental department of the Infirmérie Hôpital of Bamako (IHB) in Mali]. / Aspects epidemiologique et culturel du tatouage gingival dans le service d'odontologie de l'Infirmerie Hopital de Bamako (IHB) au Mali.

INTRODUCTION: Gingival tattooing is a traditional practice consisting of artificial pigmentation of the pink gum in black-gray. The objective of this study was to determine the prevalence and level of perception of gingival tattooing in women who came for consultation in the dentistry department of the Infirmary Hospital of Bamako (Mali). METHODOLOGY: This was a cross-sectional, descriptive study lasting 3 months from January 01 to March 31, 2018. Data collection was done on the basis of a survey form developed for this purpose depending on the objectives of the study. The variables studied are epidemiological and cultural data. The data has been processed by Epi-info software version 3.5.3. RESULTS: In this study, the prevalence of gingival tattooing was 69.43%. The most represented age group was 26 - 35, followed by 46 - 55. Maxillary localization alone represented 90.16% followed by maxillary and mandibular localization in 06.33%. The Fulani represented 39.58% followed by the Sarakolés in 32.55%. According to this study, 65, 11% thought that the gum tattoo was pretty (good). CONCLUSION: In addition to the aesthetic side created by the contrast of the effects of the gray-black color of the gum with the milky white of the teeth, gingival tattooing is often used in the traditional treatment of periodontopathies.

INTRODUCTION: Le tatouage gingival est une pratique traditionnelle consistant à une pigmentation artificielle de la gencive rose en noire-grise. L'objectif de cette étude était de déterminer la prévalence et le niveau de perception du tatouage gingival chez les femmes venues en consultation dans le service d'odontologie de l'Infirmerie Hôpital de Bamako (Mali). MÉTHODOLOGIE: Il s'agissait d'une étude transversale, descriptive d'une durée de 3 mois allant du 01 janvier au 31 mars 2018. La collecte des données a été faite sur la base d'une fiche d'enquête élaborée à cet effet en fonction des objectifs de l'étude. Les variables étudiées sont les données épidémiologiques et culturelles. Les données ont été traitées par le logiciel épi- info version 3.5.3. RÉSULTATS: Dans cette étude, la prévalence du tatouage gingival était de 69,43%. La tranche d'âge la plus représentée était celle de 26 ­ 35 ans, suivie de celle de 46 ­ 55 ans. La localisation au maxillaire seul représentait 90,16% suivi de la localisation maxillaire et mandibulaire dans 06,33%. Les peulhs représentaient 39,58% suivie des Sarakolés dans 32,55%. Selon cette étude, 65, 11% pensaient que le tatouage gingival est jolie (bon). CONCLUSION: En plus du côté esthétique créé par le contraste des effets de la couleur grise-noire de la gencive avec le blanc-laiteux des dents, le tatouage gingival est souvent utilisé dans le traitement traditionnel des parodontopathies.

Évaluation de l'hygiène buccodentaire des patients consultant le service d'odontostomatologie du centre de santé de référence de Ouelessebougou au Mali / Assessment of the oral hygiene of the patients consulting the odonto-stomatology service of the reference health center of 0uelessebougou in Mali

INTRODUCTION: La santé bucco-dentaire fait partie intégrante de la santé générale et du bien-être de tous les individus selon l'OMS. L'objectif de cette étude était d'évaluer l'état buccodentaire des patients vus en consultation dans le service d'Odontostomatologie du Centre de Santé de Référence de Ouelessebougou au MALI. MÉTHODOLOGIE: Il s'agissait d'une étude prospective, transversale de type descriptif d' une période de 3 mois allant du 01 Août au 30 octobre 2018.L'étude portait sur tous les patients venus en première consultation dans le service. RÉSULTATS: Dans cette étude, le sexe masculin représentait 52% des cas avec un sex ratio de 1,08 %. La tranche d'âge la plus représentée était celle de 16 à 30 ans avec 53,25 %. La moyenne d'âge était de 30 ans. Parmi les pathologies bucco-dentaires, la carie dentaire était la plus représentée avec 94,14 % suivie des affections parodontales avec 71,82%. Cette étude a montré que 79 % des patients se brossaient les dents. Parmi les 122 patients qui se brossaient, 41,80% se brossaient 1 fois par jour, et 45,80% se brossaient 2 fois par jour. La méthode horizontale traumatisante était la plus présentée avec 78,68 %. Selon cette étude, 91% des patients avaient besoin d'enseignement de l'Hygiène Bucco-dentaire. CONCLUSION: Devant cette situation, une nouvelle orientation de la politique de santé bucco-dentaire basée sur l'odontologie préventive s'impose afin d'améliorer la santé et la qualité de vie des populations

INTRODUCTION: Oral health is an integral part of the overall health and well-being of all people according to the WHO. The objective of this study was to evaluate the oral status of patients seen in consultation in the Odonto-stomatology Department of the Ouelessebougou Reference Health Center in MALI. METHODOLOGY: This was a prospective, cross-sectional descriptive study of a 3-month period from August 1st to October 30th, 2018. The study included all the patients who had come for first consultation in the department. RESULTS: In this study, males accounted for 52% of cases with a sex ratio of 1.08%. The most represented age group was 16 to 30 years old with 53.25%. The average age was 30 years old. Among dental pathologies, tooth decay was the most represented with 94.14% followed by periodontal disease with 71.82%. This study showed that 79% of patients brushed their teeth. Of the 122 patients who brushed, 41.80% brushed once a day, and 45.80% brushed twice a day. The traumatic horizontal method was the most presented with 78.68%. According to this study, 91% of patients needed oral hygiene education. CONCLUSION: Given this situation, a new orientation of oral health policy based on preventive dentistry is needed to improve the health and quality of life of populations

Impact of Epilepsy on Adolescents in a Rural Nigerian Community: A Case-Control Study.

BACKGROUND: Epilepsy is associated with impaired physical, psychological and social functioning. Assessing its impact on these parameters is important to improving the wellbeing of those with the disorder. OBJECTIVE: To assess the impact of epilepsy on the physical, psychological and social status of adolescents in a rural community. METHODS: Adolescents with epilepsy (Subjects) were identified in a community house to house survey. Controls (adolescents without epilepsy) matched for age and sex were randomly selected from the community. Information obtained from the subjects, controls and their care givers using a structured questionnaire included: Age, Sex, Social Class, Knowledge of epilepsy, Characteristics of epilepsy, Treatment options utilized, Health-Related Quality of Life (HRQOL), Body Mass Index (BMI), Academic performance and Epilepsy related problems. RESULTS: Eighteen subjects, 10.5/1000 of the adolescent (10-19 years) population, had epilepsy. The mean age was 16.7± 2.6 years and 16.3± 2.6 years for the subjects and controls respectively. Most of the subjects were males (83.3%). All the subjects had generalized epilepsy, were on traditional medication and none was on orthodox medical therapy. Occurrence of seizures, cost of accessing orthodox medical treatment and stigma were the major problems identified. Ingestion of traditional medication was the commonest modality for overcoming the major problems identified. Seven (38.8%) were underweight but it was not significant (p>0.05). Epilepsy was significantly associated with impaired HRQOL, academic performance and social relationships (p>0.05). CONCLUSION: Epilepsy had a negative impact on the psychosocial and academic status of adolescents. It highlights the need to provide comprehensive adolescent health and social services in epilepsy management.

Socio-cultural adaptation and standardization of Dubois' five words testing in a population of normal subject in Mali, West Africa.

INTRODUCTION: Dubois' five words testing (5WT) is a verbal memory test that depends on many parameters. The aim of this study is to adapt Dubois' 5WT to the Malian socio-cultural conditions to (i) determine performances of normal subjects to the 5WT and (ii) provide reference scores of the 5WT. METHODS: A sample of 276 normal subjects aged ≥ 50 years (154 males and 122 females; 144 literates and 132 illiterates) were enrolled from February 2008 to January 2009. Subjects with a history of symptoms likely to modify cognitive functions and those who were found disabled under Lawton's four simplified item test were excluded. RESULTS: The learning score in illiterates was 1.51 in Dubois' 5WT and 4.90 in the modified 5WT. The mean value of the modified 5WT total score was 9.71. Majority (90.22%) of the subjects scored the maximum (10). The modified 5WT reduced with both the age (p < 0.006) and education level (p < 0.04). CONCLUSION: Our results show that Dubois' 5WT is influenced by culture and the socio-educative level in French. Its adaptation to the socio-cultural context could prove useful and efficient in countries with a low literacy rate and a diverse cultural background.

Natal tooth and cultural impact on its management in a tropical neonatal unit: a case report.

The incidence of natal tooth is uncommon and its management could be fraught with challenges. A 3 day old female presented with features of sepsis and a natal tooth. Treatment for sepsis was permitted and successfully instituted but definitive management of the natal tooth was deferred, for cultural reasons, by the parents. The case documents the occurrence of natal tooth and highlights the impact of cultural beliefs on management of some medical conditions. It underscores the need to develop the relationship between orthodox medical care and cultural beliefs, in susceptible communities, with a view to achieving optimal health care delivery.

Febrile seizures in Kaduna, north western Nigeria.

BACKGROUND: Febrile seizure is the most common seizure of childhood and has a good prognosis. However its presentation is fraught with poor management, with grave consequences, in our environment. Thus a review of its current status is important. OBJECTIVE: To review the status of febrile seizures in Kaduna metropolis. MATERIALS AND METHODS: A review of cases seen in the Department of Paediatrics, 44 Nigeria Army Reference Hospital, Kaduna between June 2008 and June 2010. RESULTS: Out of the 635 cases admitted in the department 17 (2.7%) fulfilled the criteria for febrile seizures. There were 11 Males and 6 Females (M: F, 1.8:1). Age range was from 9 months to 5 years with a mean of 2.2 years ± 1.1 and peak age of 3 years. Twelve (70.6%) were in the upper social classes (I-III). Fever, convulsion, catarrh and cough were major presenting symptoms. Incidence of convulsion was least on the 1st day of complaint. Fourteen (82.4%) of the cases were simple febrile seizures while 3 were complex. There was a positive family history in 5 (29.4%) of the cases. Eleven (64.7%) had orthodox medication at home, before presentation, 5 (29.4%) consulted patient medicine sellers and 7 (41.7%) received traditional medication as part of home management. Malaria and acute respiratory infections were the identifiable causes. Standard anti-malaria and anti-biotic therapy were instituted, where indicated. All recovered and were discharged. CONCLUSION: There was a low prevalence of febrile seizures among the hospitalized children and a poor pre-hospitalization management of cases. It highlighted the need for improved community awareness on the prevention and management of febrile seizures.

Predisposing factors to neonatal septicaemia at ahmadu bello university teaching hospital, zaria Nigeria.

OBJECTIVES: The study aimed at identifying the risk factors for neonatal septicaemia in Zaria. PATIENTS AND METHODS: Consecutive newborns admitted into the Special Care Baby Unit of Ahmadu Bello University Teaching Hospital, Zaria with the presumptive test diagnosis of neonatal septicaemia between 25 May, 2004 and 31 May, 2005 were studied. History of events in the antenatal and neonatal periods was obtained and physical examination was done. Blood, urine, cerebrospinal fluid and swabs of body discharges were taken for culture and sensitivity studies. The data were analysed using Epi Info version 6 software. Associations were tested using Chi square, with Yates correction, or Fisher's exact tests where appropriate, while statistical significance was set at p < 0.05. RESULTS: A total of 211 neonates, consisting of 69 in-born and 142 out-born infants were studied. There were 122 (57.8%) males and 89 (42.2%) females; giving a male: female ratio of 1.4:1. Seventy-five (35.5%) of the newborns had bacteriologically proven septicaemia consisting of 54 (38.0%) of the outborn and 21 (30.4%) of the inborn babies (p = 0.3535); 42 males and 33 females (p = 0.8011). The male: female ratio of newborns with culture-proven septicaemia was 1.2:1. The predisposing factors that were associated with culture-proven septicaemia were lack of antenatal care (p = 0.0234), prolonged rupture of membranes (p = 0.0085), prolonged labour (p = 0.0032), preterm delivery (p = 0.0125) and perinatal asphyxia (p = 0.0078). CONCLUSION: The risk factors in neonates with septicaemia in this study emphasise the need for timely improvement in the implementation of existing public health strategies.

Pattern of neurological disorder presenting at a paediatric neurology clinic in Nigeria.

BACKGROUND: Neurological diseases account for more than 20% of the world's disease burden with majority of affected people living in Africa. However there is a paucity of literature on neurological disease in Africa. METHODS: A retrospective review of 114 children with neurological problem seen at a paediatric neurological clinic in a 2-year. RESULTS: Delayed developmental milestone, convulsion and inability to walk were the 3 most common reasons for referral to our Paediatric neurology clinic. Cerebral palsy (55.3%), Seizure disorder (26.3%) and postmeningitic complications (6.2%) were the common neurological disorder seen at our neurology clinic. The Paediatric outpatient department (POPD) of our hospital was the main source of referral for most cases (83.2%) and 71.1% of all patients resides within Zaria metropolis. The default rate from follow-up was higher among children with cerebral palsy compared to children with seizure disorder (58.7% vs. 13.3%, P < 0.001). CONCLUSION: Lack of adequate facilities for proper rehabilitation of children with cerebral palsy could have been the main reason for the high default rate from follow-up.

Burkitt's lymphoma presenting as obstructive jaundice.

A 12-year-old boy presented with a 5-month history of yellowness of the eyes, progressive painless abdominal swelling and weight loss. Physical examination revealed a grossly wasted child with marked jaundice and non-tender hepatomegaly. Liver function tests and abdominal ultrasound suggested obstructive liver disease. Tissue biopsy at laparotomy showed histological findings consistent with Burkitt's lymphoma. He was commenced on cytotoxic chemotherapy and, after two courses, the jaundice disappeared and he remained well. Although ante-mortem presentation of Burkitt's lymphoma as hepatic disease is rare, this condition should be included in the differential diagnosis of a child with obstructive jaundice.