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Curcumin and Piperine: A novel therapy in the management of osteoarthritis in Indian patients

Pacific Journal of Medical Sciences.2018;18(1):36-43.

To evaluate the efficacy and tolerability of fixed dose combination of curcumin and piperine in osteoarthritis (OA), a non-randomized, open labeled, non-comparative, single-centric, and post marketing surveillance (PMS) study was conducted in 166 osteoarthritic patients (73 men and 93 women, mean age: 54.5 ± 12.45 years). Each patient was administered a combination of curcumin 500 mg and piperine 5 mg twice daily for 12 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used as a tool to assess the efficacy of the fixe dose combination during the 12 weeks therapy. At the end of 12 weeks of therapy, WOMAC score improved significantly (p<0.0001) from 65.82 ± 18.10 to 25.12 ± 21.26. Also a significant reduction (p<0.0001) was found in scores for pain, stiffness and physical function from 15.03 ± 3.74 to 5.83 ± 4.42, 5.43 ± 1.95 to 1.52 ± 1.56 and 45.57 ± 13.72 to 17.76 ± 16.23 respectively at the end of 12 weeks. Combination of Curcumin and Piperine was effective and safe for the management of osteoarthritis in Indian patients.

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Occupational noise induced hearing loss among Dental Professionals

Ananya Madiyal

Pacific Journal of Medical Sciences.2018;18(1):44-51.

Dental professionals are subjected to noise from dental equipment and instruments throughout the day at work. Although most of the individual instruments have sound emission below the safety level stated by Occupation safety and health administration (OSHA), running of multiple instruments in close proximity for long hours and over several years causes hearing loss in dental professionals. Changes such as irritability, constriction of blood vessels, increase in heart rate and blood pressure, tinnitus and decreased hearing sensitivity is associated with exposure to high levels of noise. Cumulative effect of excess noise can lead to damage to the cochlea causing irreversible damage to hearing. Dentists begin to show reduction in hearing to high frequency sound at 4000 to 6000 Hz but remain unaware of the problem till 28% of hearing loss has occurred. Dental professionals working in a dental school set-up are at an increased risk for noise induced hearing loss due to the proximity to pre-clinical, clinical and laboratory equipment during their work day. Dental students and professionals should be educated about these hazards and advised to use preventive measures to reduce disability. Employees should be informed of the potential for hearing loss and protocols should be in place to make such working environments safer.

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Quality of Antibiotics Prescribed in Selected Outpatients Healthcare Facilities in Papua New Guinea

Isaac B Joshua ; Phillip R Passmore ; Richard Parsons ; Bruce V Sunderland

Pacific Journal of Medical Sciences.2019;20(1):3-18.

The study was conducted to evaluate compliance of antibiotics prescribing in three selected outpatients healthcare facilities in Papua New Guinea(PNG), to the country specific Standard Treatment Guidelines(STG)and to identify factors influencing prescribing pattern. The study was carried out in the Losuia Health Centre (LHC), Alotau Provincial Hospital and Port Moresby General Hospital (PMGH) outpatient departments. The study sample involved300participants at each setting. Oral amoxicillin products, chloramphenicol and co-trimoxazole made up approximately 70% of the antibiotics prescribed to 637/1090 of patients. Almost one-quarter (24.4%) of prescriptions for antibiotics were non-compliant selections. At the LHC approximately 20% of both dosage and duration errors occurred. Overall non-compliant prescribing for children was approximately 50% but significantly more compliant at PMGH (P= 0.0058) contrasting with the other settings. At the LHC only 30.6% of antibiotic prescriptions for children were compliant with STG requirements and fulfilled PNG regulatory requirements. With respect to the STGs, Community Health Workers (68.0%) and Nurse Officers made more non-compliant antibiotic selections. High levels of antibiotic prescribing combined with high levels of non-compliant antibiotic prescribing as compared to PNG-STGs, were identified in this study. This is a disturbing finding as it raises many questions related to quality assurance of health care interventions in PNG. The data also raises a clinical concern for the high level of oral chloramphenicol prescribed in out-patient settings.

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Antihyperglycemic effects of aqueous leaf extract of Senna Fistulain streptozotocin-induced diabetic rats

Maryam T Ayinla

Pacific Journal of Medical Sciences.2019;20(1):19-29.

This study investigated antihyperglycemic effects of chronic administration of aqueous leaf extract of Senna fistula in Streptozotocin-induced diabetic rat. Thirty rats were randomly assigned into six groups (A-F). Animals in group A werethe control non-diabetic,in groupB were diabetic and received distilled water, in group C werediabetic,treated with 2.5 mg/kg body weight of Glibenclamide, while animals in groups D, E and F were diabetic treated with 28.57, 57.14 and 114.28 mg/kg body weightrespectively of aqueous leaf extract of Senna fistula for 28 days. At the end of 28 days blood samples were collectedfor the assay ofInsulin, Superoxide Dismutase, Catalase,andGlutathione Peroxidasein serumand liver Glycogen.The result showed that the blood glucose levels of diabetic rats were significantly reduced in the extract and Glibenclamide treated animals when compared with diabetic rats that received distilled water. Similarly, there was a significant increase in serum Insulin level, Superoxide dismutase, Catalase and Glutathione peroxidaseactivitiesand liver glycogenin the extract and Glibenclamide treated diabetic groups when compared with diabetic untreated group. The results indicated that oral administrationof aqueous extract of Senna fistula has antihyperglycemic effect by stimulating Insulin secretion and activating antioxidant enzymes.

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Aphrodisiac Effects of Aqueous Extracts of Pausinystalia yohimbe, Cassia sieberiana and Cissus populnea Roots In Paroxetine-Induced Sexual Dysfunction Male Rats: A Comparative Study:

Musa T. Yakubu ; Adeshola I. Adebiyi ; Quadri O. Nurudeen

Pacific Journal of Medical Sciences.2019;20(1):30-42.

There is a folkloric claim that Pausinystalia yohimbe,Cassia sieberiana and Cissus populnearoots can be used to enhance sexual behaviour in male rats. However, there is still dearth of scientific evidence that substantiated the acclaimed efficacy of separate and combined use of the plant as sex enhancer. Therefore, the aims of this study were to compare the separate and combined effects of aqueous extracts of Pausinystalia yohimbe, Cassia sieberiena and Cissus populnearoots in paroxetine-induced sexually impaired male rats.Thirty five male rats were assigned into seven groups (A-G) such that rats in group A received orally 1.0 ml of distilled water for 7 days, while those in groups B -G which were induced into sexual dysfunction (administration of 10 mg/kg of paroxetine) also received equal volume of distilled water, 7.14 mg/kg body weight of PowmaxM (a reference drug), 50 mg/kg body weight of P. yohimbe, 50 mg/kg body weight of C. sieberiana, 50 mg/kg body weight of C. populneaand 50 mg/kg body weight of 1:1:1 mixture of the three extracts, once daily for seven days respectively. The sexual behavior indices of the male rats and the levels of their reproductive hormones were evaluated by standard procedures. The paroxetine-treatment related reductions (P<0.05) in the sexual behaviour indices of Mount Frequency, Intromission Frequency and Ejaculatory Frequency, levels of serum reproductive hormones of testosterone, luteinizing hormone and follicle stimulating hormone were progressively attenuated by the separate administration of the plant extracts. Furthermore, the increases in the Mount Latency, Intromission Latency, Ejaculatory Latency and Post-ejaculatory Interval were also gradually reduced, following the administration of the plant extracts. The male rat sexual behaviour indices and the levels of the male reproductive hormones following the administration of the 1:1:1 mixture of the extracts were not significantly different (P>0.05) from the effects of the separate extracts. All these changes compared favourably (P>0.05) well with those of the sexual dysfunction rats that received PowmaxM (Group G). The results obtained in the present study indicate that the extracts of these plants may have the potentialfor the management of sexual dysfunction in male rats. The combined use of the plants was not significantly better than the individual use of the plants thereby, each and any of the three plants readily available might be used for this purpose.
Aphrodisiacs ; Animals ; Phytotherapy

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Licorice Ameliorates imbalance between reactive oxygen species and antioxidant enzymes in the brain of sleep deprived rats.

Oyesanmi Abisoye Fabunmi ; Ayodeji Johnson Ajibare ; Olabode Oluwadare Akintoye ; Oluwaseun Aremu Adeyanju ; Margaret Olutayo Alese

Pacific Journal of Medical Sciences.2019;20(1):43-51.

Sleep deprivation can be described as inadequate quantity or quality of sleep characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. Sleep deprivation in animals and obstructive sleep apnea syndrome in human was reported to be associated with increased oxidative stress. Glycyrrizha glabra (licorice) is a medicinal plant known to be a highly efficacious medicinal herb with several pharmacological effects. Hence, the aim of this study was to demonstrate whether or not licorice root extract will regulate the imbalance between the reactive oxygen species and production of antioxidant enzymes in the brain of sleep deprived rats. Twenty - five 6-week-old male Wistar rats were randomly divided into five groups to undergo sleep deprivation and recovery for 5 days each. Group I (Control): Group II: sleep deprivation (SD); Group III: sleep deprivation and recovery (SD+SR) all received distill water (10ml/kg) orally; Group IV: sleep deprivation and licorice (SD+Lic), Group V: sleep deprivation, recovery with licorice (SD+SR+Lic) both received licorice (150mg/kg) orally once daily. MDA concentration among rats in Groups II (51%), III (46.7%) and IV (31.3%) were significantly higher when compared with control. Rats in Group III (20.5%), Group IV (24.6%) and Group V (30.8%) showed increased significant change in GSH concentration when compared with Group II. The concentration of CAT among rats in Group II was significantly lower than those rats in Group III (43.8%), Group IV (53.8%) and Group V (72.9%). These results clearly show that sleep deprivation significantly affects the oxidative status of rats. In conclusion, licorice root extract has ameliorative effect on the imbalance between the reactive oxygen species and production of antioxidant enzymes in the brain of sleep deprived rats.
Sleep ; Sleep Deprivation ; Oxidative Stress, Rats

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Status of Iodine nutrition among school-age children in Karimui-Nomane and Sina-Sina Yonggomugl Districts in Simbu Province Papua New Guinea

Victor J. Temple ; Guapo Kiagi ; Hethy M. Kai ; Hanifa Namusoke ; Karen Codling ; Lazarus Dawa ; Eileen Dogimab

Pacific Journal of Medical Sciences.2018;18(1):3-20.

Iodine deficiency is regarded as the single most common cause of preventable mental impairment in communities with suboptimal intake of iodine. Universal Salt Iodization is the most effective and sustainable intervention strategy for prevention, control and elimination of iodine deficiency. Urinary iodine concentration is the biochemical indicator for assessing the iodine status of a population. This study was prompted by reports showing evidence of cretinism in Karimui-Nomane district in Simbu province. The major objectives were therefore to assess the availability of adequately iodized salt in households, the per capita discretionary intake of salt per day and the iodine status of school children (age 6–12 years) in Karimui-Nomane, the district of concern, and Sina Sina Yonggomugl, a comparison district in Simbu province. Iodine level was assessed in salt samples collected from randomly selected households in both districts. The head of each household completed a questionnaire on knowledge, attitudes and practices related to salt iodization. Urinary iodine concentrations were measured in spot urine samples collected from randomly selected 6 to 12 years old children from selected primary schools in the two districts. 82.4% and 63.8% of salt samples from Karimui-Nomane and Sina Sina Yonggomugl respectively were adequately iodized above the national standard of 30ppm. The mean per capita discretionary intake of salt in households in Karimui-Nomane district was 4.62 ± 0.42 g/day, and in Sina Sina Yonggomugl district was 6.0 ± 2.61g/day. At measured levels of iodization (mean iodine content 34.7ppm and 32.7ppm respectively), this amount of salt would provide the recommended intake of iodine (150ug/day). However, for children in Karimui-Nomane the median UIC was 17.5μg/L and the interquartile range (IQR) was 15.0 – 43.0μg/L. and in Sina Sina Yonggomugl, the median UIC was 57.5μg/L and the IQR was 26.3–103.0μg/L, indicating severe and mild iodine deficiency respectively. These apparently conflicting findings may be explained by the fact that only 34% of households in Karimui-Nomane and 72% of households in Sina Sina Yonggomugl had salt on the day of the survey. The results indicate that iodine deficiency is a significant public health problem in Karimui-Nomane and Sina Sina Yonggomugl districts in Simbu province, potentially because of lack of access to salt, rather than inadequate implementation of salt iodization. Further studies are needed to quantify access to salt for communities in areas that are not easily accessible like Karimui-Nomane district in Papua New Guinea and, if inadequate salt access is confirmed, to develop alternative or complementary strategies to salt iodization

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Assessment of Secondary Metabolites and Antimicrobial activities of four solvent extracts of Vernonia amygdalina leaves on some selected Pathogenic Microorganisms

Mansurat B. Falana ; Quadri O. Nurudeen

Pacific Journal of Medical Sciences.2019;20(1):52-63.

Acetone, Hexane, Ethylacetate and Acetone / Hexane / Ethylacetate (50/30/20 v/v/v) extracts of Vernonia amygdalina leaves (Del, belonging to the family Asteraceae) were investigated for antimicrobial activities. Three different concentrations (100 mg/mL, 50 mg/mL and 25 mg/mL) of each extract were used against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25920 and Candida albicans. The disc diffusion method was used. Phytochemical screening and High Performance Liquid Chromatography (HPLC) analysis of constituents of the extracts were also carried out. Highest yield (14.25 %) after extraction was obtained for acetone extract followed by hexane extract (8.2 %), Acetone/Hexane/Ethylacetate extract (7.4 %) and ethylacetate (7.1 %) extract. Tannin, steroids, saponin, terpenoid, flavonoid, anthraquinones were present in each of the solvent extracts. Coumarin was present in both acetone and Acetone/Hexane/Ethylacetate extracts while glycosides were present only in the Acetone/Hexane/Ethylacetate extract. Protein was present in ethylacetate extract and absent in the other solvent extracts. The extracts revealed dose-dependent activities against all the test organisms. Highest range of inhibition zone (15.00 mm- 18.00 mm) was obtained for Acetone/Hexane/Ethylacetate extract at 25 mg/mL against the test organisms while lowest range of inhibition zone (7.00 mm- 10.00 mm) was obtained for acetone extract at 100 mg/mL. Various compounds (Oxalate, Phyrate, Epivernodalol, Vernodalol, Venonioside A, Vernonioside B, Vernodalin, Luteolin, Andrographolide, Andrographoside) were separated at different peak heights (mV) and at varying retention times from all the solvent extracts. The solvent extracts of Vernonia amygdalina can serve as good alternative to orthodox medicine in the treatment of infections associated with the three test organisms.

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Assessment of patients’ knowledge to their dispensed medications at Port Moresby General Hospital, Papua New Guinea

Judith Lizanne Nui ; Edwin Machine ; Jackson A.K. Lauwo

Pacific Journal of Medical Sciences.2019;20(1):64-73.

Limited information on drug use indicates that medicines are not optimally used. Inadequate knowledge of medication uses may lead to overuse of medicines or patient non-compliance with a medicine regimen, and result in serious outcomes. The aim of this study was to assess the patients’ knowledge on dispensed medications in pharmacy at Port Moresby General Hospital (PMGH). This was a descriptive cross-sectional study utilizing a self-administered questionnaire adapted from the WHO “Guide to Good Prescribing Practical Manual”. The questionnaire sought to elicit major classes of medicines prescribed, knowledge of patients on indications, how to use the medicines, precautions and possible adverse events. A total of 130 patients from PMGH participated in this study. Although majority of patients (94.6%) knew the instructions on the use of the dispensed medicines in terms of route of administration, dosage and frequency of usage; only 74.6% of them knew the duration of medicines use. Further, 19.2% of participants did not know the indications for which their medicines were prescribed. Knowledge on adverse effects was also significantly low i.e 34.7%. Lack of understanding of warnings and precautions was rated at 42.3%. These figures may contribute to poor patient compliance and cause possible harm to the patients. The results demonstrated lack of adequate information given to patients on their prescribed medicines. It is recommended that prescribers be re-trained on the importance of giving adequate information on medications given to patients, particularly to patients with low educational background.

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Providers’ perceptions of the key issues affecting the delivery of quality services at a Dental Clinic in Port Moresby, Papua New Guinea: a qualitative descriptive study

Naomi Marylyn. Asing ; Darren Lee-Ross ; Mahmood Siddiqi ; Leonard Crocombe

Pacific Journal of Medical Sciences.2019;20(1):74-87.

The aim of this study was to identify factors that affect the dental service delivery in a dental clinic from the context of Papua New Guinean dental providers and to make practical recommendations to improve dental service delivery. This qualitative descriptive study used individual interviews with seven dental providers to identify the factors that were affecting quality dental service delivery in a dental clinic in Papua New Guinea. The factors influencing the quality of dental service fell into three categories and 8 themes. The categories were environmental factors with themes of resources and facilities, leadership and management, partnership development and collaboration; provider-related factors with themes provider competence, provider motivation and satisfaction; and required measures with the themes of a new dental clinic building, renovation of the main clinic area and organizational structure. Quality dental service is achieved when there is a supportive working environment with availability of (new) physical amenities and dental resources, and proper management and organizational structures with supportive visionary leadership. This would encourage teamwork and partnership development internally within the dental team and externally with its stakeholders. Furthermore, it would increase staff motivation and satisfaction internally and partnership development internally within the dental staff and externally with its stakeholders. Consider creating a new dental clinic. Develop a contract between the University and the Hospital to resolve the property ownership issues. Create a clear organizational structure and improve management interaction with clinical staff so that management is supportive. Improve the quality of dental supplies and create an efficient material ordering system. Ensure fairness to staff and respect to procedures are compliantly maintained to encourage teamwork. Reward clinical staff for mentoring and teaching dental students. Create access to continuing professional development for the clinical staff.

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