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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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Isolated Progressive Congenital Left Thumb Macrodactyly : Case Report and Literature Review

Alphonsus N. Onyiriuka ; Sunday S. Anikoh ; Louis C. Onyiriuka

Pacific Journal of Medical Sciences.2019;20(1):88-94.

Isolated progressive macrodactyly belongs to a heterogeneous group of congenital overgrowth syndromes, resulting in enlargement of all tissues localized to the terminal portions (fingers or toes) of a limb. The aim of this case report is to create further awareness among physicians on this rare clinical entity and present a short review of the literature. We present the case of a 10-year-old Nigerian girl with a history of progressive overgrowth of left thumb since birth. The patient‟s facies and body habitus were normal without hemihypertrophy. Anthropometric measurements of the child‟s hands, revealed an overgrowth of the left thumb compared with the right. The child had no café-au-lait spots or any other skin lesions. The radiograph of the hands revealed increase in size of both soft tissue and phalangeal bones (enlongated and broadened) of the left thumb. A diagnosis of isolated progressive left thumb macrodactyly was made and the patient was referred to the orthopaedic surgeon for surgical intervention. The child and her parents suffered psychological distress. Isolated progressive macrodactyly is very rare but it is cosmetically displeasing to the child, resulting in psychological distress.

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Prevalence of Hepatitis C Virus infection among patients admitted in medical wards in Port Moresby General Hospital

David Linge ; David Tiwekuri ; Valerie Imanaui

Pacific Journal of Medical Sciences.2018;18(1):21-26.

The major objective of this study was to assess the prevalence of HCV infection among selected patients admitted in the medical wards in Port Moresby General Hospital (PMGH). This hospital based cross-sectional study was carried out in 2012 and 2013. Patients were selected after their routine clinical examination by the clinical consultant during ward round. About 3ml of blood was obtained from the blood already collected for routine laboratory tests. The plasma obtained from each blood sample was stored at – 20 C till required for analysis. The Enzyme-linked Immunosorbent Assay (ELISA) Commercial Kit for qualitative detection of IgM-class antibodies to HCV in human plasma was used for analysis of the plasma samples. Three recommended cut-off points and criteria (Positive, Negative and Borderline) were used for the qualitative interpretation of the results. Appropriate ethical approval and permission were obtained from the various authorities including the Medical Research Advisory Committee (MRAC), National Department of Health (NDOH) PNG. Informed consent was also obtained from the 117 patients selected for this study. The mean age of all the patients was 36.0 ± 13.9 years and their age range was 14 to 63 years. Of the 117 plasma samples 16 (13.7%) were positive for HCV IgM, 11 (9.4%) were borderline and 90 (76.9%7) were negative for HCV IgM. The clinical diagnosis for admission of the 16 patients with positive HCV IgM included 5 (31.3%) with cardiovascular disorders (CVD), 3 (18.7%) with pneumonia, 3 (18.7%) with hepatic liver disease, 2 (12.5%) with HIV and 3 (18.7%) with TB-meningitis. Of the 5 patients with CVD two of them had Rheumatic heart disease with mitral regurgitation. The data obtained in this hospital based study revealed the extent of HCV infection among patients admitted in PMGH with different medical diagnosis. It can be considered as baseline data for healthcare providers to have a first glance at the extent of HCV prevalence among the patients in Port Moresby General Hospital and to a limited extent among the general population in Port Moresby.

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Effect of ethnicity on pain perception among healthy Nigerians

Adesola A. Oniyide ; Kehinde S. Olaniyi ; Olutayo F. Olasehinde

Pacific Journal of Medical Sciences.2018;18(1):27-35.

Gender, age and ethnic differences in pain perception have been reported in clinical and experimental research. However, it is not known whether cold and ischemia-induced pain models can explain ethnic-related variability in pain perception. The current study was designed to investigate the effect of ethnicity on pain perception in healthy Nigerians and to assess whether the variability in pain perception is dependent on the circulating level of β-Endorphin. One hundred and sixty healthy volunteers were randomly selected from the four main ethnic groups (Fulani, Hausa, Igbo and Yoruba) in Nigeria. There were 40 volunteers per group. The selected individuals were informed on what they should expect during the study after which their informed consents were requested. Questionnaires were used to obtain the socio-demographic and biodata of each of the consented volunteers. Cold, ischemia and cold+ischemia- induced pains were administered, after which the pain threshold and tolerance were estimated by monitoring the time (seconds) taken for pain to occur and the point at which the subject can no longer withstand the pain. Our results show that Igbo ethnic group has significantly lower threshold in cold-induced pain and significantly higher threshold/tolerance in ischemia-induced pain. No significant difference in pain threshold of all the four ethnic groups during cold+ischemia-induced pain. However, the pain tolerance was significantly higher in Igbo ethnic group when compared with Hausa, Fulani and Yoruba ethnic groups. In addition, the pain tolerance significantly decreased in Hausa and Yoruba compared to Fulani ethnic group, while the pain tolerance was significantly higher in Yoruba ethnic group compared with Hausa ethnic group. Also, the circulating β-Endorphin decreases in all the subjects. The present study demonstrates that ethnicity causes variability in pain perception and this is accompanied with alteration in circulating level of β-Endorphin

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Diagnostic Accuracy of Xpert® Mtb / Rif Compared to Microscopy-Based Methods for Diagnosing Tuberculous Lymphadenitis from Fine Needle Aspirates at the Port Moresby General Hospital, Papua New Guinea

Rodney Itaki ; Jacklyn Joseph ; Ruth Magaye ; Jennifer Banamu ; Karen Johnson ; Francis Bannick ; Evelyn Lavu ; Henry Welch

Pacific Journal of Medical Sciences.2019;19(2):3-12.

Data on the accuracy of Xpert® MTB/RIF (Xpert) assay in detecting TB in lymph node aspirates in Papua New Guinea (PNG) is scanty. This study evaluated Xpert performance in diagnosing tuberculous lymphadenitis (TBLN) using lymph node needle aspirates at the Port Moresby General Hospital (PMGH). The objective of the study was to compare Xpert accuracy to acid fast bacilli (AFB) microscopy, cytomorphology, a composite reference test (CRS) and culture. A total of 107 eligible subjects were recruited out of 1080 clinic attendees. Results showed Xpert detected significantly more cases of TBLN than AFB microscopy (66 vs 35; p=0.001). Compared to AFB microscopy Xpert had a sensitivity of 45.4% (95% CI 33.1-58.1), specificity of 87.8% (95% CI 73.8-95.9), positive predictive value (PPV) of 85.7% (95% CI 71.6-93.4) and negative predictive value (NPV) of 50.0%% (95% CI 43.8-56.1). There was no difference between Xpert and cytomorphology (66 vs 60; p=0.5). Compared to cytomorphology Xpert had a sensitivity of 71.6% (95% CI 58.5-82.5), specificity of 51.1% (95% CI 35.7-66.3), PPV of 66.1% (95% CI 58.2-73.2) and NPV of 57.5% (95% CI 45.2-68.9). There was no difference between Xpert and CRS (66 vs 71; p=0.6). Compared to CRS Xpert had a sensitivity of 76.0% (95% CI 64.4- 85.3), specificity of 66.6% (95% CI 49.0-81.4), PPV of 81.8% (95% CI 73.5-87.9) and NPV of 58.4% (95% CI 46.7-69.4). Culture was completed on 24 subjects with positive isolates in 14 giving a culture yield of 58.3%. Of the 24 subjects, Xpert was positive in 21 subjects. There was no difference between Xpert and culture (21 vs 14; p=0.8). Compared to culture Xpert had a sensitivity of 100.0% (95% CI 76.8-100.0), specificity of 30.0% (95% CI 6.6-65.2), PPV of 66.6% (95% CI 57.1-75) and NPV of 100.0%. The results suggest Xpert is more sensitive than AFB microscopy but comparable to cytomorphology and CRS for TBLN diagnosis in the PNG context. Xpert can be used for diagnosing TBLN at PMGH

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Anti-Nociceptive effect of Glycyrrhiza Glabra root extract on Chronic Constriction Injury of Sciatic Nerve Induced Neuropathic pain and some selected inflammatory biomarkers in experimental animals

Oyesanmi Abisoye Fabunmi ; Olabode Oluwadare Akintoye ; Olutayo Folajimi Olaseinde ; Ayonbo Adeolu Aderibigbe ; Bamidele Victor Owoyele

Pacific Journal of Medical Sciences.2019;19(2):13-22.

Multiple causes of neuropathic pain have been identified and its incidence is likely to increase owing to the ageing global population. Glycyrrhiza glabra (licorice) is a medicinal plant known to be a highly efficacious medicinal herb with several pharmacological effects. Few researchers have demonstrated anti-nociceptive activity of licorice acute pain. The aim of this study was to investigate the anti-nociceptive effect of prepared aqueous extract of Glycyrrhiza glabra root administration on chronic constriction injury (CCI) of sciatic nerve induced neuropathic pain and some selected inflammatory biomarkers in adult male wistar rats. Seven groups of 5 rats per group were used. Groups 1 and 2 were controls. Administration started in groups 3, 4, and 5 three days after surgery and continued for 18 days. Group 3 received 10mg/kg of Imipramine. Groups 4 and 5 received 75mg/kg and 150mg/kg of licorice respectively. Groups 6 and 7 received 75mg/kg and 150mg/kg respectively for 10 days before surgery. Paw withdrawal thresholds were assessed using hot plate method on days 3, 7, 14, and 21. On day 21, plasma level of tumor necrotic factor (TNF-α) and C-reactive protein (CRP) were determined using appropriate ELISA kits. There was significant change in pain threshold in the extract treated ameliorative groups when compared with the control and the ameliorative reference drug. TNF- alpha and CRP concentrations were significantly reduced in groups 6 and 7, compared with groups 1, 2 and 3. In conclusion, anti-nociceptive activity of licorice and its effect on TNF-α, and CRP are dose dependent and administration before surgery was more effective.

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Exposure to Atrazine Elicits Morpho-Physiological and Testicular Dysfuntions in adult male rats

Adeoye O. Oyewopo ; Kehinde S. Olaniyi ; Oluwaseun A. Adeyanju ; Iyabo C. Oyewopo ; Oluwatobi A. Amusa ; Olabimpe C. Badejogbin ; Olusola A. Sanya ; Olugbenga O. Eweoya

Pacific Journal of Medical Sciences.2019;19(2):23-31.

Some of the environmental toxicants acting as endocrine disruptors have been associated with health hazards in human and wildlife by modulating hormonal actions. The widely used herbicide; atrazine (ATZ) is a potent endocrine and testicular disruptor. However, studies on it remain largely inconclusive especially whether the effects are reversible or permanent. We therefore designed this study to evaluate the histological and hormonal changes associated with differential ATZ exposure. Twenty (20) adult male Wistar rats were divided into 4 groups (5 rats per group) control and three experimental groups. Control received the vehicle; the 3 groups received ATZ, 38.5, 77.0 and 154.0 mg/kg bw/day for 30 days respectively. The effects of Atrazine were assessed through histopathological observation, spermatozoa quality examination and reproductive hormone levels. Results showed that irrespective of the ATZ dose, there was significant decrease in weight, severe pathological changes in testicular tissue, decrease in the quality of semen and altered luteinizing hormone (LH) of the rats. Taken together, our findings showed that ATZ exposure could lead to poor reproductive ability in male Wistar rats

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Perceived versus actual risk of Diabetes Mellitus among undergraduates in Osogbo, Nigeria

Wasiu Olalekan Adebimpe

Pacific Journal of Medical Sciences.2019;19(2):32-41.

This study determined actual and perceived risk of Diabetes Mellitus (DM) among undergraduates in Osogbo in Southwestern Nigeria. It was a descriptive cross sectional explorative study conducted among 250 newly admitted undergraduates of Osun state University selected using multi-staged sampling method. Data on perceived and actual risk to DM were collected using pre tested self- administered semi-structured questionnaire. Data was analyzed using the SPSS software. Mean age of respondents was 21.0 2.4 years. Of the 250 students 230(92.0%) have heard about DM, 37(14.8%) were overweight and 9(3.6%) were obese. Only 11(4.4%) felt they were at risk of DM, 237(94.8%) said they were not at risk, 225(90.0%) said they can never have DM. Based on the six selected risk factors, only 64(25.6%) were at no risk, 137(54.8%) had single while 49(19.6%) were at multiple risk of DM. Of the 237 who claimed or perceived they were not at risk, only 64 (27.0%) were actually at no risk. A statistically significant relationship was found between actual DM risk and having heard about DM (p<0.05). Having heard about DM was the major predictor of congruent actual and perceived risk among studied respondents. It was concluded that incongruence between perceived and actual risk to DM exists among University undergraduates studied, an indication to step up awareness programmes about DM

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