Physician-brief advice for promoting smoking cessation among cancer patients on treatment in low and middle-income countries: a scoping review.

INTRODUCTION: Physician-brief advice has been utilized in high-income countries to promote smoking cessation among cancer patients. Empirical evidence on its effectiveness among cancer patients in low and middle-income countries (LMICs) is lacking. The gap could be due to inadequate training, and competing healthcare priorities, leading to insufficient implementation of targeted smoking cessation interventions in oncology settings. We undertook this scoping review to determine if physician-brief advice is effective in promoting smoking cessation among cancer patients in LMICs. METHODS: We conducted a literature search of all relevant articles across five databases: Cochrane Central Register of Controlled Trials, Cochrane Library (Tobacco Addiction Group trials), World Conference on Lung Cancer proceedings, PubMed, and Google Scholar up to November 2023, using pre-defined inclusion criteria and keywords. The study population was cancer survivors in LMICs, the intervention was smoking cessation advice by a physician in a clinic or oncology center during a consultation, and the outcome was the effect of smoking cessation programs in discontinuing smoking among cancer survivors in LMICs. RESULTS: Overall, out of every 10 cancer patients in LMICs, about seven were smokers, and one-half had received physician-brief advice for smoking cessation. Physician-brief advice was more likely to be delivered to patients with smoking-related cancer (Cohen's d = 0.396). This means that there is a noticeable difference between patients with smoking-related cancer compared to those with cancer unrelated to smoking. Smoking cessation failure was due to the inability to cope with the symptoms of withdrawal, missed smoking cessation clinic visits, mental health disorders, limited time and resources, and minimal patient-physician contact. CONCLUSION: There is very little literature on the frequency of use or the efficacy of physician-brief advice on smoking cessation in LMICs. The literature suggests that cancer patients in LMICs have low self-efficacy to quit smoking, and smoking cessation is rarely part of cancer care in LMICs. Physicians in LMICs should be trained to use motivational messages and good counseling techniques to improve smoking cessation among cancer patients. Policymakers should allocate the resources to implement physician-brief advice and design training programs for physicians focusing on physician-brief advice tailored to cancer patients.

Knowledge and risk perception of e-cigarettes and hookah amongst youths in Lagos State, Nigeria: An exploratory study.

INTRODUCTION: Limited research exists describing young people's knowledge and risk perception of e-cigarettes and hookah in Nigeria. This qualitative study explored the knowledge and risk perception of e-cigarettes and hookah amongst young people in Lagos, Nigeria. METHODS: Participants (n = 20), aged 15-24 years who had used e-cigarettes or hookah at least once in the past 12 months, participated in three focus group (FG) discussions in January 2020. Each FG session consisted of 6-7 participants, was facilitated by a trained moderator and lasted approximately 60 min. Sessions were recorded, and notes were taken after informed consent. Recordings were transcribed verbatim and analysed using NVIVO 10 software. RESULTS: An essential element of our findings was that the majority of the participants seemed to be more aware of hookah and used hookah compared to e-cigarettes. The participants mentioned they used these tobacco products mainly to reduce stress, for pleasure and for social acceptance. Most of the study participants reported that they were aware of some adverse health effects associated with e-cigarette or hookah use. Although some participants felt that the use of e-cigarettes or hookah could transform to cigarette smoking, many felt that e-cigarette was a harm reduction tool. CONCLUSION: Young users of e-cigarettes and hookah continue to use these products though they are aware of some associated adverse health effects. These products are used primarily for relieving stress and for social reasons. Raising awareness of the risks associated with the use of these tobacco products may help to reduce the acceptability of these products amongst youths.

Protein Tyrosine Phosphatase 1B Inhibitory Iridoids from Psydrax subcordata.

Phytochemical investigation of the leaves and bark of Psydrax subcordata has led to the isolation of six new iridoids, subcordatanols I-V (1-4 and 6) and 1-O-methylcrescentin I (5), along with two known analogues (7 and 8). Among them, subcordatanol I (1) is the first example of a 3,8-monoepoxy-iridoid featuring a caged 2-oxa-bicyclo[3.2.1]octane core. The absolute stereochemistry at C-4 of 3, 4, and 6 was established through their acid-catalyzed reaction products subcordatalactones A (3a), B (4a), and C (6a), respectively. Subcordatanols I (1) and II (2), as well as subcordatalactones A (3a) and B (4a), displayed inhibitory activity against protein tyrosine phosphatase 1B (PTP1B). Enzyme kinetic studies indicated that 3a and 4a are competitive inhibitors. A molecular docking study is also reported.

Antifungal and antiproliferative activities of endophytic fungi isolated from the leaves of Markhamia tomentosa.

CONTEXT: Plants harbor endophytes with potential bioactivity. Markhamia tomentosa (Benth) K. Schum ex. Engl. (Bignoniaceae) is reported to possess antioxidant, anti-inflammatory and anticancer activities. OBJECTIVE: The antifungal and antiproliferative properties of endophytic fungi extracts and fractions from M. tomentosa were evaluated. MATERIAL AND METHODS: Endophytic fungi were isolated from the leaves of M. tomentosa and identified by ITS-rDNA sequence analysis. The antagonistic effect of the fungal strains was investigated against pathogenic fungi viz, Fusarium oxysporum, Sclerotinia sclerotiorium, Rhizoctonia solani, and Botrytis cinerea using the dual culture assay for 5-7 days. Antiproliferative effect of the fungal extracts and fractions (3.91-250 µg/mL) on HeLa cancer cell line was tested and IC50 was calculated. Poisoning food assay and antifeedant activity against the pathogenic fungi and Spodoptera litura larvae, for 7 days and 2 h, respectively, was also tested at concentrations of 250, 500 and 1000 µg/mL. RESULTS: Fungal endophytes Trichoderma longibrachiatum and Syncephalastrum racemosum were isolated from the leaves of M. tomentosa. Isolated endophytic fungal strains and solvent extracts showed MIC value of 1000 µg/mL against tested pathogenic fungi in the dual culture and poisoning food assays. Methanol fraction of S. racemosum isolate showed the most effective antiproliferative activity with IC50 of 43.56 µg/mL. Minimal feeding deterrent activity against S. litura larvae was also observed. DISCUSSION AND CONCLUSION: These findings showed that the leaves of Markhamia tomentosa harbor strains of endophytic fungi with promising health benefits, and suggest their antifungal and antiproliferative effects against pathogenic fungi and HeLa cancer cell line.

A novel nor-megastigmane from the leaves of Rhaphiostylis beninensis.

A novel nor-megastigmane, normegastigmane-5α,9-epoxy-3ß,8-diol (1), together with 10 known compounds of diverse classes including megastigmanes, sesquiterpenoids, and triterpenoids were isolated from the leaves of Rhaphiostylis beninensis. The structure of 1 was established by 1D and 2D NMR and HRESIMS data analysis. The known compounds were identified as 5,11-epoxy-3,9-megastigmanediol (2), 7-megastigmene-3,6,9-triol (3), 1,3-dihydroxypropan-2-yl stearate (4), (1E,5E)-1,5-dimethyl-8-(propan-2-ylidene)cyclodeca-1,5-diene germacrene (5) 3,5-dihyroxy-6,7-megastigmadien-9-one (6), squalene (7), ß-amyrin (8), ß-amyrone (9), ß-amyrin eicosanoate (10), and ß-sitosterol (11). Compounds 2, 3, and 6 displayed inhibitory effects on acetylcholinesterase enzyme. This is the first report of these compounds from the plant and their anticholinesterase activity.

A new source of elemol rich essential oil and existence of multicellular oil glands in leaves of the Dioscorea species.

Dioscorea species is a very important food and drug plant. The tubers of the plant are extensively used in food and drug purposes owing to the presence of steroidal constituent's diosgenin in the tubers. In the present study, we report for the first time that the leaves of Dioscorea composita and Dioscorea floribunda grown under the field conditions exhibited the presence of multicellular oil glands on the epidermal layers of the plants using stereomicroscopy (SM) and scanning electron microscopy (SEM). Essential oil was also isolated from the otherwise not useful herbage of the plant, and gas chromatographic-mass spectroscopy analysis revealed confirmation of the essential oil constituents. Out of the 76 compounds detected in D. floribunda and 37 from D. composita essential oil, major terpenoids which are detected and reported for Dioscorea leaf essential oil are α -terpinene, nerolidol, citronellyl acetate, farnesol, elemol, α -farnesene, valerenyl acetate, and so forth. Elemol was detected as the major constituent of both the Dioscorea species occupying 41% and 22% of D. Floribunda and D. composita essential oils, respectively. In this paper, we report for the first time Dioscorea as a possible novel bioresource for the essential oil besides its well-known importance for yielding diosgenin.

Prevalence of haemoglobin A1c based dysglycaemia among adult community dwellers in selected states in Nigeria: a descriptive cross-sectional study.

Background: Type 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c. Methodology: A cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16. Results: The mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p< 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p< 0.001), tribe (p = 0.004), marital status (p< 0.001), blood pressure (p< 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45-54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes. Conclusion: Over half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia.

Epidemiology and Survival outcomes of HIV-associated cervical cancer in Nigeria.

Introduction: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America's National Institutes of Health/National Cancer Institute funded project titled 'Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria'. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan-Meier and compared between groups using the log-rank test. Results: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV-/ICC+), and 47 (19.7%) were HIV-positive (HIV+/ICC+). The HIV+/ICC) patients were younger with median age 46 (IQR: 40-51) years compared to 57 (IQR: 45-66) among HIV-/ICC+) (P<0.001. Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV+/ICC+ diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV-/ICC+. The HIV-/ICC+ women had better OS compared to HIV+/ICC+ participants (p=0.018), with 12-month OS 84.1% (95%CI: 75% - 90%) and 67.6% (95%CI: 42%-84%) respectively. Conclusion: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria.

INTRODUCTION: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. METHODS: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America's National Institutes of Health/National Cancer Institute funded project titled 'Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria'. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan-Meier and compared between groups using the log-rank test. RESULTS: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV-/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40-51) years compared to 57 (IQR: 45-66) among HIV-/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV-/ICC +. The HIV-/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75-90%) and 67.6% (95%CI 42-84%) respectively. CONCLUSION: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

COVID-19 Pandemic: A Case for Phytomedicines.

Coronavirus disease 2019 (COVID-19) is an infection caused by a newly discovered coronavirus which was identified in Wuhan, China. The race is on globally to repurpose drugs for COVID-19 and develop a safe and effective vaccine against the disease. There is an urgent need to search for effective remedies against COVID-19 from the rich and extensive flora of Africa and the world. A literature search was conducted to obtain information on drugs with the potential for effectiveness in the treatment of COVID-19 based mostly on outcomes of preclinical studies and a few clinical investigations. This was considered important to this perspective as some of the identified mechanisms of action may be related to potential anti-COVID-19 actions of phytomedicines. The findings from the literature search were also used to establish the need for exploration of phytomedicines in the fight against COVID-19. This perspective identifies the need to preserve the rich tradition of herbal medicine in Africa, repositioning it by inculcating all aspects of discovery, development, and chemical evaluation of pharmaceuticals from medicinal plants for effective management of prevalent diseases. The identified mechanisms of action of current drugs under consideration for the treatment of COVID-19 include preventing fusion of SARS-CoV-2 with human cells; decrease acidity in endosomes, cell membrane-derived vesicles for transportation of the virus within the host cell and within which the virus can replicate; and blockade of the production of proinflammatory cytokines. Phytomedicines may possibly elicit either one or a combination of these effects. The case for the exploration of phytomedicines against COVID-19 is strengthened by the emergence of a number of conventional drugs from medicinal plants and the emergence of botanicals with proven efficacy for some medical conditions. Caution against indiscriminate use of medicinal plants in the guise of treating COVID-19 has been highlighted and the need for reliable preclinical and clinical studies.

Review of the Phytochemical and Pharmacological Studies of the Genus Markhamia.

Natural product compounds obtained from medicinal plants have been great contributions in the discovery of numerous clinically useful drugs. Markhamia species have been reportedly used by many cultures in human and veterinary traditional medicines. The five identified species of Markhamia, that is, Markhamia lutea, Markhamia obtusifolia, Markhamia stipulata, Markhamia tomentosa, and Markhamia zanzibarica have been the subject of chemical investigations that have led to the characterization of their secondary metabolites. Plants of the genus with the identified phytoconstituents, including phenylpropanoid glycosides (PhGs), terpenoids, phytosterols, lignans, quinones, and flavonoids, have been claimed to possess antiviral, antifungal, antiprotozoal, analgesic, antiinflammatory, and cytotoxic activities. In vitro and in vivo pharmacological research studies have reported the validation of the medicinal properties of plants of this genus. The present review analyzes published data from the ethnomedicinal, phytochemical, and pharmacological studies of plants of the genus Markhamia.

Results From Nigeria's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: The Nigerian Report card on Physical Activity (PA) in Children and Youth was first developed in 2013 to inform practice and policy on healthy living and prevention of noncommunicable diseases among Nigerian children and youth. This article summarizes the results of the 2016 report card and provides updated evidence on the current situation in Nigeria. METHODS: A comprehensive review of literature was undertaken by the Report Card Working Group. Grades were assigned to 10 PA indicators based on the criteria used for the 2013 edition. RESULTS: Grades assigned to the indicators were Overall PA, D; Active Play and Leisure, C; Active Transportation, B; Sedentary Behaviors (screen-based, F and nonscreen-based, D); Overweight and Obesity, A; PA in Schools, C-; Government/Nongovernment Organizations/Private Sector/Policy, B. The following indicators were graded as Incomplete: Organized Sport and PA, Community and Built Environment, and Family and Peers. CONCLUSIONS: The overall PA levels of Nigerian children and youth seemed to be declining compared with the 2013 Report card but with slight improvement in active play and leisure, and PA in school settings. A substantial number of Nigerian children and youth still have high sedentary behaviors, overweight and obesity. Efforts are needed to promote PA among them.

Sub-acute and chronic toxicity profiles of Markhamia tomentosa ethanolic leaf extract in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Markhamia tomentosa (Benth.) K. Schum Ex Engl. (Bignoniaceae) is used in traditional African medicine for the treatment of diarrhoea, oedema, pain and malaria. The leaf extract was reported to show no visible sign of toxicity on acute exposure. This present study investigates the sub-acute and chronic toxicity effects of Markhamia tomentosa in rats. MATERIALS AND METHODS: The animals (n=6/group) were treated daily with the extract at doses of 40, 200 and 1000mg/kg orally for 28 and 90 days. Control rats received distilled water and all animals were weighed at 7 days interval. The haematological, biochemical and histological parameters were determined. RESULTS: The extract showed non-significant changes in body weight gain of treated compared to control rats in both studies. Extract significantly decreased red blood cell (RBC), mean cell haemoglobin concentration and increased mean corpuscular volume (MCV) parameters after the 28 day study. In the 90 day study, a significant increase in white blood cell, RBC, platelets and decrease in MCV and mean cell haemoglobin (MCH) parameters were observed. Biochemical parameters were significantly changed in both studies; triglycerides, total protein, alanine transaminase, aspartate transaminase and albumin showed significant increase while creatinine, blood urea nitrogen and uric acid levels showed significant decrease. Significant increase in liver weight with no treatment-related histological changes was observed in all harvested vital organs. CONCLUSION: Markhamia tomentosa extract elicited non-toxic effect in the liver and kidney function parameters in rats. Thus, the extract is safe when administered orally.

Antiproliferative and apoptosis inducing activity of Markhamia tomentosa leaf extract on HeLa cells.

ETHNOPHARMACOLOGICAL RELEVANCE: Markhamia tomentosa (Benth) K. Schum ex. Engl. (Bignoniaceae), a tree widely dispersed in West Tropical Africa, is used traditionally to treat various diseases as it possesses antimicrobial, antioxidant, analgesic, anticancer and anti-inflammatory activities. MATERIALS AND METHODS: This study evaluates the cytotoxic effect and underlying mechanisms of the ethanolic extract of Markhamia tomentosa on HeLa and MCF-7 cancer cell lines and non-cancerous Vero cell line. Brine shrimp lethality test was used for preliminary screening. Cytotoxicity was determined using the MTT assay and IC50 was calculated. Effect of Markhamia tomentosa on the cell cycle was monitored by flow cytometry and the apoptosis-induction capability confirmed by exposure of phosphatidylserine to the outer leaflet of the plasma membrane. Loss of mitochondrial membrane potential was analysed by flow cytometry using JC-1. RESULTS: Markhamia tomentosa was toxic to brine shrimps with LD50 of 31.62µg/ml. Cell viability and growth of HeLa cells was inhibited by the extract with an IC50 of 189.1±1.76µg/ml at 24h post treatment. However, no cytotoxic effect was observed in MCF-7 and Vero cell lines. The extract induced cell cycle arrest in HeLa cells in the G0/G1 phase resulting in cell death after 24h exposure. Induction of apoptosis in HeLa cells was substantiated by Annexin V-FITC/PI double staining showing phosphatidylserine translocation and depolarisation of the mitochondrial membrane potential by flow cytometry of JC-1 stained cells. CONCLUSION: The ethanolic extract of Markhamia tomentosa induces G0/G1 in HeLa cells followed by induction of the intrinsic pathway of apoptosis.

Phenolic contents, antioxidant and antibacterial activities of Hymenocardia acida.

This study investigates the antioxidant and antibacterial activities of aqueous and methanolic extracts from Hymenocardia acida Tul. (Hymenocardiaceae). The inhibition values of the extracts and quercetin were found to be very close, with no significant differences at a concentration of 0.05 mg mL(-1) in their ability to inhibit 1,1-diphenyl-2-picrylhydrazyl (DPPH). Total proanthocyanidins for both water and methanol extracts were 20.2 +/- 0.01 and 30.6 +/- 0.51 mg g(-1) (catechin equivalent) while the total phenol contents were 20.0 +/- 0.52 and 35.6 +/- 1.42 mg mL(-1) (tannic acid equivalent), respectively. Positive correlations R(2) = 0.85, R(2) = 0.94, R(2) = 0.97 for DPPH, reducing power and 2'-azino-bis(3-ethylbenzo thiazoline)6-sulphonic acid (ABTS). Linear regression analysis also produced a high correlation coefficient with total proanthocyanidins (DPPH, R(2) = 0.69; ABTS, R(2) = 0.94). H. acida extracts showed low antibacterial activity (minimum inhibitory concentration (MIC) value >or=5.0 mg mL(-1)) against gram negative bacteria but significantly (MIC value