Asian Pacific Journal of Tropical Biomedicine

Issue 6,2014 Table of Contents

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  • 1  Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England
    Erhabor Osaro Njemanze Chima
    2014(6):421-429. DOI: 10.12980/APJTB.4.2014C1199
    [Abstract](6) [HTML](0) [PDF 280.84 K](127)
    The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5’s, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.
    2  A recent review on phytochemical constituents and medicinal properties of kesum (Polygonum minus Huds.)
    Paritala Vikram Kishore Kumar Chiruvella Ilfah Husna Abdullah Ripain Mohammed Arifullah
    2014(6):430-435. DOI: 10.12980/APJTB.4.2014C1255
    [Abstract](5) [HTML](0) [PDF 822.67 K](153)
    Medicinal plants and herbal preparations are gaining renowned interest in scientific communities nowadays due to their reliable pharmacological actions and affordability to common people which makes them effective in control of various diseases. Polygonum minus (Polygonaceae) locally known as kesum is an aromatic plant commonly used in Malay delicacies. The plant is having potential applications due to its high volatile oil constituents in perfumes and powerful antioxidant activity. It has been used traditionally to treat various ailments including dandruff. The research has been carried out by various researchers using different in vitro and in vivo models for biological evaluations to support these claims. This review paper may help upcoming research activities on Polygonum minus by giving up to date information on the phytochemical constituents and medicinal properties of kesum to a possible extent with relevant data.
    3  Macrosomia in non-gestational diabetes pregnancy: glucose tolerance test characteristics and feto-maternal complications in tropical Asia Pacific Australia
    Algenes Aranha Usman H Malabu Venkat Vangaveti Elham Saleh Reda Yong Mong Tan Kunwarjit Singh Sangla
    2014(6):436-440. DOI: 10.12980/APJTB.4.2014APJTB-2013-0027
    [Abstract](10) [HTML](0) [PDF 294.87 K](147)
    Objective: To look into the glucose tolerance test characteristics and determine complications in non-gestational diabetes pregnant subjects. Methods: From 2006 to 2009 all non-gestational diabetes mellitus (non-GDM) pregnant women who delivered macrosomia at the North Australia’s Townsville Hospital were retrospectively reviewed by extracting data from clinical record. Glucose tolerance tests results were analysed in the light of an earlier diagnosis of non-GDM. Results: Ninety-one non-GDM mothers with macrosomia were studied and compared with 41 normoglycemic subjects without macrosomia. Of the subjects with non-GDM macrosomia, 45 (49.4%) had normal 50 g glucose challenge test (GCT) without further testing, another 8 (8.8%) had abnormal GCT but normal 75 g oral glucose tolerance test (OGTT). A total of 4 (4.4%) subjects had normal GCT and OGTT. Interestingly, 14 out of 16 (87.5%) subjects who were tested with OGTT owing to past history of macrosomia had normal results but delivered macrosomic babies. Only 12 subjects had both GCT and OGTT, the rest of the cohort had either of the two tests. Subjects with non-GDM macrosomia had higher frequency of neonatal hypoglycaemia 34% as compared to 10% in non-macrosomic babies (P=0.003). Other feto-maternal complications were similar in both groups. Conclusions: No significant pattern of glucose tolerance characteristics was identified in non-GDM mothers with macrosomic babies. In spite of being normoglycemic significant neonatal hypoglycaemia was recorded in non-GDM macrosomic babies. Further prospective studies on a larger population are needed to verify our findings.
    4  Evaluation of leptin, interleukin-1 beta and tumor necrosis factor alpha in serum of malaria patients as prognostic markers of treatment outcome
    Mariam Abdulrhman Al-Fadhli Mohammad Ahmed Saraya Jafar Abdulrida Qasem
    2014(6):441-445. DOI: 10.12980/APJTB.4.201414B11
    [Abstract](7) [HTML](0) [PDF 279.85 K](132)
    Objective: To analyze serum leptin levels in patients with malaria falciparum and compare them with healthy controls and correlate with development and outcome of malaria infection. Methods: Sixty cases of malaria falciparum were included in this study as patients. Thirty healthy individuals of comparable age, racial and body mass index were taken as controls. All patients were diagnosed by clinical picture and the presence of malaria parasites in blood film. Estimation of liver function test, kidney function test, complete blood count, fasting blood sugar, fasting serum insulin, pro-inflammatory cytokine tumor necrosis factor alpha (TNFα) and interleukin 1 (IL1), estimation of morning serum leptin and calculation of body mass index (kg/m2) were done in both groups on the day of admission, on discharge and 7 d after discharge. Results: At admission, leptin levels were significantly higher in patients group than in control while fasting serum insulin levels were not significantly different between the two groups. There were significant increases as regard to TNFα and IL1 in malaria patients. Significant differences were observed between the control and the patient group for leptin, TNFα and IL1 at the time of admission and discharge. After discharge for 7 d, a significant decline in serum leptin levels, TNFα and IL1 in the patients group was observed as compared with time of admission and time of discharge, a positive correlation between serum leptin levels and TNFα and IL1. Conclusions: Leptin hormone level might play an important role in development and outcome of malaria infection.
    5  Entamoeba histolytica acetyl-CoA synthetase: biomarker of acute amoebic liver abscess
    Lim Boon Huat Alfonso Olivos Garcia Tan Zi Ning Wong Weng Kin Rahmah Noordin Siti Shafiqah Anaqi Azham Lee Zhi Jie Guee Cher Ching Foo Phiaw Chong Pim Chau Dam
    2014(6):446-450. DOI: 10.12980/APJTB.4.2014C1169
    [Abstract](23) [HTML](0) [PDF 875.24 K](123)
    Objective: To characterize the Entamoeba histolytica (E. histolytica) antigen(s) recognized by moribound amoebic liver abscess hamsters. Methods: Crude soluble antigen of E. histolytica was probed with sera of moribund hamsters in 1D- and 2D-Western blot analyses. The antigenic protein was then sent for tandem mass spectrometry analysis. The corresponding gene was cloned and expressed in Escherichia coli BL21-AI to produce the recombinant E. histolytica ADP-forming acetyl-CoA synthetase (EhACS) protein. A customised ELISA was developed to evaluate the sensitivity and specificity of the recombinant protein. Results: A ~75 kDa protein band with a pI value of 5.91-6.5 was found to be antigenic; and not detected by sera of hamsters in the control group. Tandem mass spectrometry analysis revealed the protein to be the 77 kDa E. histolytica ADP-forming acetyl-CoA synthetase (EhACS). The customised ELISA results revealed 100% sensitivity and 100% specificity when tested against infected (n=31) and control group hamsters (n=5) serum samples, respectively. Conclusions: This finding suggested the significant role of EhACS as a biomarker for moribund hamsters with acute amoebic liver abscess (ALA) infection. It is deemed pertinent that future studies explore the potential roles of EhACS in better understanding the pathogenesis of ALA; and in the development of vaccine and diagnostic tests to control ALA in human populations.
    6  Traumatic myiasis agents in Iran with introducing of new dominant species, Wohlfahrtia magnifica (Diptera: Sarcophagidae)
    Javad Rafinejad Kamran Akbarzadeh Yavar Rassi Jamasp Nozari Mohammad Mehdi Sedaghat Mostafa Hosseini Hamzeh Alipour Abdolmajid Ranjbar Danial Zeinali
    2014(6):451-455. DOI: 10.12980/APJTB.4.2014C1029
    [Abstract](32) [HTML](0) [PDF 550.74 K](134)
    Objective: To study agents of animal wound myiasis in various geographical districts of Fars province. Methods: This study has been done in Fars province, located in the southern part of Iran. Sums of 10 358 domestic animals have been visited from April 2011 to March 2012. The infected wounds in any parts of animal body were sampled by means of forceps. Results: About 61% of all animal wound myiasis were caused by larvae of Wohlfahrtia magnifica. The most wound myiasis cases due to this species occurred in central part of Fars province. There wasn’t any significant difference between sheep and goat in infestation with myiasis (P>0.05). The infestation rate of myiasis in cattle community was 0.86%. Conclusions: The infestation rate of livestock was lower than other works in Iran and some other countries like Saudi Arabia. Chrysomya bezziana has been mentioned as main myiasis agent in Iran. But in this study it cleared that similarly to some European countries, the common animal myiasis agent in Iran is Wohlfahrtia magnifica. Introducing new species as principal agent for myiasis can help public health and animal husbandry policy makers to prepare sufficient and effective control and/or preventive measures for this disease.
    7  Phytochemical and biological studies of Butia capitata Becc. leaves cultivated in Egypt
    Nagwa Mohamed Ammar Mohammed Said Hefnawy Sahar Youssef Al-Okbi Doha Abdou Mohamed Nabil Khamis El-Sayed Amira Ahmed El -Anssary Tom Mabry
    2014(6):456-462. DOI: 10.12980/APJTB.4.2014C1192
    [Abstract](6) [HTML](0) [PDF 302.49 K](122)
    Objective: To study the antioxidant and anti-inflammatory activity of Butia capitata (B. capitata) leaf extracts along with phytochemical analysis of the proposed bioactive constituents. Methods: Different successive extracts of B. capitata Becc. leaves were prepared with selective organic solvents and screened for their anti-inflammatory activities in tested animals and in vitro antioxidant effect. An extensive phytochemical investigation of the bioactive extracts through paper chromatography, thin layer chromatography, column chromatography, gasliquid chromatography (GLC), high pressure liquid chromatography and spectral analysis. GC- Mass, ultraviolet, hydrogen and carbon nuclear magnetic resonance, electron ionization-mass spectrometry, heteronuclear multiple bond correlation and heteronuclear multiple quantum correlation were carried out. Results: Results showed that different extracts possess promising antioxidant effect and significant anti-inflammatory activity with variable degrees. The results of the phytochemical investigation of the bioactive extracts revealed the presence of volatile substances, lipoidal matter, α-tocopherol, free sugars, polysaccharides and flavonoidal compounds. Conclusions: B. capitata leaf extracts were shown to possess variable antioxidant effect, the most promising was methanol extract. Both polar and non polar extracts were proved to have anti-inflammatory activity, the non polar extract was superior in this respect. The bioactivity of the extracts was ascribed to the presence of flavonoids, sterols and α-tocopherol.
    8  Antimicrobial activity of some essential oils against oral multidrug-resistant Enterococcus faecalis in both planktonic and biofilm state
    Fethi Benbela?d Abdelmouna?m Khadir Mohamed Amine Abdoune Mourad Bendahou Alain Muselli Jean Costa
    2014(6):463-472. DOI: 10.12980/APJTB.4.2014C1203
    [Abstract](18) [HTML](0) [PDF 339.48 K](139)
    Objective: To evaluate some essential oils in treatment of intractable oral infections, principally caused by biofilm of multidrug-resistant Enterococcus faecalis (E. faecalis), such as persistent endodontic infections in which their treatment exhibits a real challenge for dentists. Methods: Ten chemically analyzed essential oils by gas chromatography-mass spectrometry were evaluated for antimicrobial activity against sensitive and resistant clinical strains of E. faecalis in both planktonic and biofilm state using two methods, disk diffusion and broth micro-dilution. Results: Studied essential oils showed a good antimicrobial activity and high ability in E. faecalis biofilm eradication, whether for sensitive or multidrug-resistant strains, especially those of Origanum glandulosum and Thymbra capitata with interesting minimum inhibitory concentration, biofilm inhibitory concentration, and biofilm eradication concentration values which doesn’t exceed 0.063%, 0.75%, and 1.5%, respectively. Conclusions: Findings of this study indicate that essential oils extracted from aromatic plants can be used in treatment of intractable oral infections, especially caused by biofilm of multidrug-resistant E. faecalis.
    9  In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of methanol extract of Citrus macroptera Montr. Fruit
    Nizam Uddin Md. Rakib Hasan Md. Monir Hossain Arjyabrata Sarker A.H.M. Nazmul Hasan A.F.M. Mahmudul Islam Mohd. Motaher H. Chowdhury Md. Sohel Rana
    2014(6):473-479. DOI: 10.12980/APJTB.4.2014C1173
    [Abstract](21) [HTML](0) [PDF 328.17 K](142)
    Objective: To investigate the therapeutic effects of methanol extract of Citrus macroptera Montr. fruit in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo). Methods: Fruits of Citrus macroptera without rind was extracted with pure methanol following cold extraction and tested for presence of phytochemical constituents, α-amylase inhibitory activity, and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats. Results: Presence of saponin, steroid and terpenoid were identified in the extract. The results showed that fruit extract had moderate α-amylase inhibitory activity [IC50 value=(3.638±0.190) mg/mL] as compared to acarbose. Moreover at 500 mg/kg and 1 000 mg/kg doses fruit extract significantly (P<0.05 and P<0.01 respectively) reduced fasting blood glucose level in normal rats as compared to glibenclamide (5 mg/kg). In oral glucose tolerance test, 500 mg/kg dose significantly reduced blood glucose level (P<0.05) at 2 h but 1 000 mg/kg dose significantly reduced blood glucose level at 2 h and 3 h (P<0.05 and P<0.01 respectively) whereas glibenclamide (5 mg/ kg) significantly reduced glucose level at every hour after administration. Overall time effect is also considered extremely significant with F value=23.83 and P value=0.0001 in oral glucose tolerance test. Conclusion: These findings suggest that the plant may be a potential source for the development of new oral hypoglycemic agent.
    10  Hepatocurative potential of Vitex doniana root bark, stem bark and leaves extracts against cc14-induced liver damage in rats
    James Dorcas Bolanle Kadejo Olubukola Adetoro Sallau Abdullahi Balarabe Owolabi Olwnuyiwa Adeyemi
    2014(6):480-485. DOI: 10.12980/APJTB.4.2014C207
    [Abstract](19) [HTML](0) [PDF 5.15 M](118)
    Objective: To evaluate the hepatocurative effects of aqueous root bark, stem bark and leaves of Vitex doniana in carbon tetrachloride (CCl4,) induced liver damage and non induced liver damage albino rats. Methods: A total of 60 albino rats (36 induced liver damage and 24 non induced liver damage) were assigned into liver damage and non liver damage groups of 6 rats in a group. The animals in the CCI4. induced liver damage groups, were induced by intraperitoneal injection with a single dose of CCI4. (1 mUkg body weight) as a l:l(v/v) solution in olive oil and were fasted for 36 h before the subsequent treatment with aqueous root bark, stem bark and leaves extracts of Vitex doniana and vitamin E as standard drug (100 mglkg body weight per day) for 21 d, while the animals in the non induced groups were only treated with the daily oral administration of these extracts at the same dose. The administration of CCI4. was done once a week for a period of 3 weeks. Results: There was significant (P<0.05) increase in concentration of all liver marker enzymes, alanine aminotransferase, aspartate aminotransferase and alkaline aminotransferase (ALT, AST and ALP) and significant (P<0.05) decrease in albumin in the CCI4. induced liver damage control when compared to the normal control. The extracts caused a significant (P<0.05) reduction in the serum activities of liver marker enzymes (ALT, AST and ALP) and a significant (P<0.05) increase in albumin of all the induced treated groups. Only stem bark extract and vitamin E significantly (P<0.05) increased total protein. All the extracts significantly (P<0.05) lowered serum creatinine whereas only root bark extract significantly (P<0.05) lowered serum level of urea in the rats with CCl4 induced liver damage. Conclusion: Hepatocurative study shows that all the plant parts (root bark, stem bark and leaves) possess significant hepatocurative properties among other therapeutic values justifying their use in folklore medicine.
    11  Pharmacognostical study and establishment of quality parameters of aerial parts of Costus speciosus-a well known tropical folklore medicine
    Pradeep Singh Ratan Lal Khosa Shruti Srivastava Garima Mishra Keshri Kishor Jha Sourabh Srivastava Sangeeta Ramesh Kumar Verma Mohd Adil Tahseen
    2014(6):486-491. DOI: 10.12980/APJTB.4.2014C1103
    [Abstract](30) [HTML](0) [PDF 1.32 M](123)
    Objective: To evaluate the diagnostic pharmacognostical characters of Costus speciosus (aerial parts) along with their physico-chemical parameters and fluorosence analysis. Method: The pharmacognostical characters were determined in terms of macroscopy, microscopy, powder microscopy, leaf constant, fluorescence analysis and preliminary phytochemical investigation. Results: The findings of macroscopy revealed that leaves elliptic to oblong or oblong-lancoelate, thick, spirally arranged, with stem clasping sheaths up to 4 cm, flowers large, white, cone-like terminal spikes, with bright red bracts. Transverse section of leaflet showed the presence of cuticularised epidermis with polygonal cells on adaxial surface and bluntly angled cells on abaxial surface of lamina, mesophyll cells differentiated in to single layered palisade cells on each surface and 2-3 layered spongy parenchyma, unicellular and uniseriate multicellular covering trichomes, paracytic stomata and vascular bundles surrounded by sclerenchymatous multicellular sheath. Preliminary phytochemical screening exhibited the presence of various phytochemical groups like alkaloids, glycosides, steroids, phenolic constituents. Further, the leaf constants, powder microscopy and fluorescence characteristics indicated outstanding results from this investigation Conclusions: Various pharmacognostical and physico-chemical parameters have pivotal roles in identification, authentication and establishment of quality parameters of the species.
    12  Study of the efficacy of a Wheaton coated bottle with permethrin and deltamethrin in laboratory conditions and a WHO impregnated paper with bendiocarb in field conditions
    Nazaire A?zoun Roseric Azondekon Rock A?kpon Virgile Gnanguenon Razaki Osse Alex Asidi Martin Akogbéto
    2014(6):492-497. DOI: 10.12980/APJTB.4.2014C1111
    [Abstract](16) [HTML](0) [PDF 366.42 K](131)
    Objective: To determine the efficacy of WHO impregnated paper and CDC coated bottle based on number of storage days and number of times of consecutive use, in the assessment of insecticide vector susceptibility tests in laboratory and field conditions. Methods: Larvae and pupae of Anopheles gambiae s.l. mosquitoes were collected from the breeding sites in Seme-Kpodji and Cotonou districts in Southern Benin in April 2013 during the first rainy season. Anopheles gambiae s.l. mosquitoes were also collected from the breeding sites in Parakou district in Northern Benin in May 2013 at the beginning of the rainy season. Susceptibility tests were done using impregnated paper with bendiocarb (0.1%) following WHO protocol and stock solutions of permethrin (21.5 µg per bottle) and deltamethrin (12.5 µg per bottle) following CDC protocol on unfed female mosquitoes aged 2-5 days old. These bioassays were repeated a certain number of times. The temperature and relative humidity were monitored and recorded during the susceptibility tests. Results: This study showed that a WHO impregnated paper with bendiocarb could be used four times during four consecutive days in field conditions. Regarding a Wheaton coated bottle with permethrin or deltamethrin, they could be used at least three times during four consecutive days in laboratory conditions. Conclusions: The day storage and the number of times that a WHO impregnated paper and a CDC coated bottle maintained their efficacy are useful in the assessment of insecticide vectors susceptibility tests.
    13  A retrospective evaluation of the quality of malaria case management at twelve health facilities in four districts in Zambia
    Pascalina Chanda-Kapata Emmanuel Chanda Freddie Masaninga Annette Habluetzel Felix Masiye Ibrahima Soce Fall
    2014(6):498-504. DOI: 10.12980/APJTB.4.2014C153
    [Abstract](19) [HTML](0) [PDF 332.82 K](135)
    Objective: To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods: This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management. Results: Out of 4891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9- 9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria, years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices. Conclusions: Malaria case management was characterised by poor adherence to treatment guidelines. The non-adherence was mainly in terms of: inconsistent use of confirmatory tests (rapid diagnostic test or microscopy) for malaria; prescribing anti-malarials which are not recommended (e.g. sulphadoxine-pyrimethamine) and prescribing anti-malarials to cases testing negative. Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.

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