Effect on blood pressure of a dietary supplement containing traditional medicinal plants of Côte d'Ivoire.

ETHNOPHARMACOLOGICAL RELEVANCE: A medicinal composition containing salt (sodium chloride) is given as a traditional dietary supplement to hypertensive patients (TDSHP) in Côte d'Ivoire. It consists of whole plant of Bidens pilosa (Asteraceae) and fresh leaves of Moringa oleifera (Moringaceae). AIM OF THE STUDY: The aim of this study was to establish the scientific basis for the use of this traditional recipe rich in sodium chloride in hypertension settings. MATERIALS AND METHODS: We used a total aqueous extract of this traditional dietary supplement containing medicinal plants (Bidens pilosa, Moringa oleifera) and salt (sodium chloride). Experiment was carried out to evaluate its effect on arterial blood pressure of rabbits. The experimental device used for recording blood pressure in rabbits is based on the principle of Ludwig mercury manometer. RESULTS: TDSHP between 5×10(-8) and 5×10(-2) mg/kg caused a dose-dependent hypotension. TDSHP elicited drops in blood pressure ranging between 7.14±4 and 100±7.5%, compared to normal blood pressure of rabbits. Fifty percent effective dose of TDSHP was 3.95×10(-4) mg/kg. Similarly as the hypotension induced by acetylcholine, the one caused by TDSHP at dose of 3.95×10(-4) mg/kg in rabbit was progressively inhibited by atropine, dosed between 5×10(-4) to 5×10(-2) mg/kg. The percentage drop of recorded blood pressure ranged from 50.3±1.87 to 3.71±1.09% compared to the normal value of blood pressure. In the presence of atropine, TDSHP effect was partially inhibited. The same increasing doses of TDSHP reduced significantly the increase of blood pressure induced by adrenaline dosed at 4.76×10(-4) mg/kg from 89.3±2.19 to 1.19±0.59%. CONCLUSION: The consumption of this traditional dietary supplement is justified in hypertensive patients according to its composition and its ability to reduce blood pressure has been demonstrated experimentally. TDSHP should not be considered as an antihypertensive drug, it remains to us a salt substitute to be taken with moderation with strict adherence to the traditional dose.

Assessment of the impact of adherence and other predictors during HAART on various CD4 cell responses in resource-limited settings.

OBJECTIVE: The aim of this study was to quantify, by modeling, the impact of significant predictors on CD4 cell response during antiretroviral therapy in a resource-limited setting. METHODS: Modeling was used to determine which antiretroviral therapy response predictors (baseline CD4 cell count, clinical state, age, and adherence) significantly influence immunological response in terms of CD4 cell gain compared to a reference value at different periods of monitoring. RESULTS: At 6 months, CD4 cell response was significantly influenced by baseline CD4 count alone. The probability of no increase in CD4 cells was 2.6 higher in patients with a baseline CD4 cell count of ≥200/mm(3). At 12 months, CD4 cell response was significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was three times higher in patients with a baseline CD4 cell count of ≥200/mm(3) and 0.15 times lower with adherent patients. At 18 months, CD4 cell response was also significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was 5.1 times higher in patients with a baseline CD4 cell count of ≥200/mm(3) and 0.28 times lower with adherent patients. At 24 months, optimal CD4 cell response was significantly influenced by adherence alone. Adherence increased the probability (by 5.8) of an optimal increase in CD4 cells. Age and baseline clinical state had no significant influence on immunological response. CONCLUSION: The relationship between adherence and CD4 cell response was the most significant compared to that of baseline CD4 cell count. Counseling before initiation of treatment and educational therapy during follow-up must always help to strengthen adherence and optimize the efficiency of antiretroviral therapy in a resource-limited setting.

Tracheal relaxation of five Ivorian anti-asthmatic plants: role of epithelium and K⁺ channels in the effect of the aqueous-alcoholic extract of Dichrostachys cinerea root bark.

ETHNOPHARMACOLOGICAL RELEVANCE: Leaves of Boerhavia diffusa (Nyctaginaceae), Baphia nitida, Cassia occidentalis, Desmodium adscendens (Fabaceae), and root bark of Dichrostachys cinerea (Fabaceae) are used in Ivory Coast for the treatment of asthma. The aim of this study was to evaluate the potential airway relaxant activity of different extracts of these plants. MATERIALS AND METHODS: Extracts of different polarities (H(2)O, EtOH/H(2)O, MeOH and CH(2)Cl(2)) were obtained from these five plants. Their ex vivo relaxant activity was tested in mice isolated trachea precontracted with carbachol (1 µM). RESULTS: Cumulative concentrations of most extracts induced moderate to strong relaxation, the methanolic extracts being the most potent and the polar extracts the most active at the concentrations used, supporting the traditional use of these five plants as anti-asthmatic remedies. We further investigated the molecular and cellular mechanisms of the mouse trachea relaxant effect of the aqueous-alcoholic extract of Dichrostachys cinerea root bark, the most potent extract. Its effect was not modified in the presence of ß-adrenoceptor antagonists (propranolol or ICI 118,551) or a PKA inhibitor (H89). By contrast, it was decreased after depolarization-induced precontraction (with 80 mM KCl), in the presence of some K(+) channels blockers [4-aminopyridine as voltage-dependent K(+) (K(v)) channel blocker and tetraethylammonium chloride as large conductance Ca(2+)-activated K(+) (BK(Ca)) channel blocker, but not with glibenclamide, an ATP-sensitive K(+) (K(ATP)) channel blocker] or after epithelium removal. CONCLUSIONS: The mouse tracheal relaxant effect of Dichrostachys cinerea EtOH/H(2)O extract was independent of ß(2)-adrenoceptors activation and cAMP/PKA pathway, but dependent on epithelium and K(+) channels, namely K(v) and BK(Ca) channels. Further investigation will be required to identify the component(s) responsible for this airways relaxant activity.

[Modeling of antiretroviral response from taxonomy of CD4 cells count trajectories in profound immunodeficiency setting]. / Modélisation de la réponse antirétrovirale en méta-trajectoires de taux de CD4 en situation d'immunodépression profonde.

Modeling of CD4 cells counts response was performed through a Non-Hierarchical-descendant process with profoundly immunocompromised symptomatic patients under nevirapine or efavirenz-based antiretroviral regimen in Abidjan. Similar CD4 cells count trajectories have been modelled in meta-trajectories linked to patients' classes. Global immunological response is similar between "nevirapine group" and "efavirenz group" but the model showed an internal variation of this response in each group. In the both groups, some variables presented a significant variation between classes: average CD4, CD4 Nadir, CD4 peak and average gain of CD4. In "nevirapine group", these following parameters vary significantly between classes: mean weight, mean haemoglobin count and mean increase in haemoglobin count and sex. It's also important to note that, all meta-trajectories began with distinctive categories of baseline CD4 cells counts. Other explanatory factors must be sought because the characteristics we have chosen to describe patients'classes, are not exhaustive.

[Place of artemisinin derivatives as anti-malarial drugs in paediatric hospitalization in Abidjan]. / Place des antipaludiques dérivés de l'artémisinine en hospitalisation pédiatrique à Abidjan.

The objective of this study is to analyze anti-malaria treatment and to appreciate the place of artemisinin and its derivatives in order to research rationality of prescriptions in paediatric hospitalization in Abidjan (Côte d'Ivoire). The investigation is based on a descriptive analysis related to 415 medical files constituting 646 prescriptions in four hospital centers. We considered therapeutic recommendations of PNLP (National Program Against Malaria) to analyse these prescriptions. The correspondence factorial analysis has been used to appreciate different correlations between anti-malaria drug use and type of malaria, patients' age, hospital... Artemisinin derivatives constitute the third of anti-malaria drugs prescribed to children. They are represented by artemether (most used), artesunate and artemether-lumefantrine combination. The treatment in emergency remains dominated by quinine. Amodiaquine and artesunate are the principal relay treatment with the detriment of chloroquine. Quinine remains the treatment of choice in paediatric hospitalization in complicated or uncomplicated malaria. The respect of national recommendations is not systematic. Some factors interfere in their non-respect: physicians' experience, existence of other hospital therapeutic protocols, pharmacoeconomic considerations, therapeutic antecedents, hospital availability of malaria drugs.