Potential deleterious effects of paracetamol dose regime used in Nigeria versus that of the United States of America.

Paracetamol, also known as acetaminophen (N-acetyl-para-aminophenol, APAP) is the world's most used over-the-counter analgesic-antipyretic drug. Despite its good safety profile, acetaminophen can cause severe hepatotoxicity in overdose, and poisoning from paracetamol has become a major public health concern. Paracetamol is now the major cause of acute liver failure in the United States and Europe. This systematic review aims at examining the likelihood of paracetamol use in Nigeria causing more liver toxicity vis-à-vis the reduced maximum recommended daily adult dose of 3 g for the 500 mg tablet. Online searches were conducted in the databases of PubMed, Google Scholar and MEDLINE for publications using terms like "paracetamol toxicity," "acetaminophen and liver toxicity," "paracetamol and liver diseases in Nigeria," and other variants. Further search of related references in PubMed was carried out, and synthesis of all studies included in this review finalized. There were 94 studies that met the inclusion criteria. Evaluation of hepatic disorder was predicated mostly on a constellation of clinical features and limited clinical laboratory investigations. Determination of blood paracetamol concentration was rarely reported, thus excluding paracetamol poisoning as one of the likely causes of liver disorders in Nigeria. In Nigeria and elsewhere, several factors are known to increase paracetamol's predisposition to liver injury. They include: the over-the-counter status of paracetamol, use of fixed-dose combinations of paracetamol with other drugs, malnutrition, dose miscalculations, and chronic alcohol consumption. The tendency to exceed the new paracetamol maximum daily dose of 3 g in Nigeria may increase its risk for hepatotoxicity than observed in the United States of America known for emphasizing lower dose of the drug. In addition to recommending the new maximal daily paracetamol dose allowance, the historical maximum daily adult dose of 4 g should be de-emphasized in Nigeria.

Natural antidotes and management of metal toxicity.

The global burden of heavy metal especially mercury, arsenic, lead, and cadmium toxicities remains a significant public health challenge. Developing nations are particularly at high risk and carry the highest burden of this hazard. Chelation therapy has been the mainstay for treatment of heavy metal poisoning where the chelating agent binds metal ions to form complex ring-like structures called "chelates" to enhance their elimination from the body. Metal chelators have some drawbacks such as redistribution of some heavy metals from other tissues to the brain thereby increasing its neurotoxicity, causing loss of essential metals such as copper and zinc as well as some serious adverse effects, e.g., hepatotoxicity. The use of natural antidotes, which are easily available, affordable, and with little or no side effects compared to the classic metal chelators, is the focus of this review and suggested as cheaper options for developing nations in the treatment of heavy metal poisoning.

Improvement of Lead Acetate-Induced Testicular Injury and Sperm Quality Deterioration by Solanum Anomalum Thonn. Ex. Schumach Fruit Extracts in Albino Rats.

Objective: This study has investigated the protective role of a natural alternative, Solanum anomalum fruit extract in lead induced testicular toxicity in male albino rats. Materials and methods: Twenty-four mature male albino rats were used, divided into four groups of six rats per group. Group 1 (control rats) were given distilled water (10ml/kg), group 2 received lead acetate solution 60mg/kg, group 3 received lead acetate (60mg/kg) followed by Solanum anomalum (452mg/kg) and group 4 rats were given lead acetate (60mg/kg) followed by Solanum anomalum (678mg/kg) by oral gavage daily for 28 days. Results: Lead treated group showed significant increase in Malondialdehyde MDA (1.58 ± 0.09 to 1.90 ± 0.17 µmol/L of plasma) and decreases in Superoxide dismutase SOD, glutathione peroxidase (482.85 ± 53.43 to 247.18 ± 70.40 U/L of blood), total glutathione (1.11 ± 0.03 to 0.56 ± 0.31 ng/µL) (144.80 ± 7.00 and 122.39 ± 4.63 U/ml of blood), epididymal sperm reserve, testicular sperm count, % sperm motility and % sperm viability. Conclusion: Co-administration of Solanum anomalum significantly reversed the effect of lead with restoration of histoarchitecture of the testes. Solanum anomalum may be a protective modulator of lead -induced testicular injury.

Levels of some heavy metals in vegetables from artisanal mining sites of Dilimi River, Bukuru and Barkin Ladi North Central Nigeria: any public health concern?

Background: North Central Nigeria is the food basket of Nigeria but is also known for its artisanal mining with attendant public health consequences which is hitherto unquantified. Vegetables grown close to these mining sites may be contaminated with heavy metals. Objective: This study has estimated health risk associated with heavy metals HM (Cd, Cr, Cu, Zn, Se and Ni) in vegetables harvested inform the mining areas of Dilimi, Bukuru and Barkin Ladi by calculating the Daily intake, Target Hazard Quotient (THQ), Hazard Index (HI) and the Cancer risk (CR) for adults and children in the local population. Material and methods: Vegetable, soil, irrigation water and sediments samples were collected, digested, ashed and analyzed for HM using an Atomic Absorption Spectrometer (AAS). Results: The concentration of heavy metals in vegetables were in the order Cd < Se < Cr < Cu < Ni < Zn. There were higher HM levels in soil than vegetables samples. The daily intake of HM from vegetable consumption decreased in the following order Cd < Se < Cr < Cu < Ni < Zn. At least 62.5% of vegetable samples had THQ values > 1 in Dilimi, Bukuru and Barkin ladi (Adults) while 13% of vegetable samples had THQ values > 1 in children. The THQ of nickel ranged from 0.38-2.73 and 0.21-1.53 in adults and children respectively. The bio-concentration factor ranged from 0.026-7.52, 0.01-0.36 and 0.0011-1.23 in Dilimi, Bukuru and Barkin Ladi respectively for all the studied heavy metals. The cancer risk values ranged from 0.011-0.04 and 0.00066-0.02 across all the studied areas for adults and children respectively. HI values for adults were all >1 and also the total cancer risk was above the acceptable range of 10-4. Conclusion: Since THQ is > 1 in most of the samples, HI values > 1 for adults in all the vegetable and cancer risk above the acceptable limit consumption of vegetables from the study areas is not free of risk.

Heavy metals hazards from Nigerian spices.

BACKGROUND: Natural spices are commonly used by the people in Nigeria. They may be easily contaminated with heavy metals when they are dried and then pose a health risk for the consumers. OBJECTIVE: The aim of this study was to determine the levels of heavy metals in some commonly consumed natural spices namely Prosopis Africana, Xylopia aethiopica, Piper gineense, Monodora myristica, Monodora tenuifolia and Capsicum frutescens sold in the local markets of Awka, Anambra state, South East Nigeria to estimate the potential health risk. RESULTS: The range of heavy metal concentration was in the order: Zn (14.09 - 161.04) > Fe (28.15 - 134.59) > Pb (2.61 - 8.97) > Cr (0.001 - 3.81) > Co (0.28 - 3.07) > Ni (0.34 - 2.89). Pb, Fe and Zn exceeded the maximum allowable concentrations for spices. The Target Hazard Quotient (THQ) of the spices varied from 0.06-0.5. Estimated daily intakes (EDI) were all below the tolerable daily intake (TDI). The lead levels in Prosopis africana, Xylopia aethiopica, Piper gineense, Monodora myristica and Capsicum frutescens which are 8-30 times higher than the WHO/FAO permissible limit of 0.3 mg/kg. CONCLUSIONS: Lead contamination of spices sold in Awka (south east Nigeria) may add to the body burden of lead. A good quality control for herbal food is important in order to protect consumers from contamination. KEY WORDS: food products, spices, potential toxic metals, risk assessment, public health.