Missed opportunities for HIV counselling and testing service delivery among pregnant women in Nigeria: Evidence from the 2018 National nutrition and health survey.

According to UNAIDS, the 90-90-90 strategy calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression. HIV counselling and testing (HCT) is an important entry point for effective prevention of mother-to-child transmission of HIV. However, evidence abounds that HCT is often missed by pregnant women during antenatal care in Nigeria. We used secondary data from the 2018 Nigerian National Nutrition and Health Survey (NNHS) to determine the pattern of missed opportunities within the HCT algorithm and the factors associated with the missed opportunities. Of the 8,329 eligible women, 2,327 (27.9%) missed HCT because of lack of antenatal care; 1,493 (24.9%) missed HIV pre-test counselling; 180 (4.0%) missed HIV testing after participating in pre-test counselling, while 793 (18.2%) missed collection of HIV result and post-test counselling. Generally, most of the women that missed HCT were from the North West (43.3%) and had their antenatal care with traditional birth attendants. The odds of missing ANC were higher in women in the Northern and Southern regions. Concerning pre-test HIV counselling, the odds of missing it were higher among women in the Northwest and Southeast while the odds of missing post-test counselling of HIV test were higher among women in the Northeast and Southeast relative to other regions. Using TBA as a care provider was associated with higher odds of women missing pre-test and post-test counselling of HIV during ANC compared to those that used doctors or midwives or CHEWs. Missed opportunities are common in different stages of HIV counselling and testing pathway in Nigeria, particularly in the Northern regions. Future studies would need to identify the specific reasons for these missed opportunities, enabling the targeting of more specific policy reform and interventions.

Individual and ecological analyses of antenatal care: Prospects for delivery assistance and use of modern family planning in Nigeria.

Despite the availability of healthcare centres for the provision of antenatal care (ANC) services in Nigeria, the services are still underutilized by pregnant women. ANC services not only reduce maternal mortality and birth defects, but also have a strong link to many causes of maternal deaths. This study explored the individual and ecological relationships between antenatal care, skilled birth assistance during delivery, and family planning use across states in Nigeria. This study was a secondary analysis of data from the 2018 National Nutrition and Health Survey (NNHS) carried out among 24,985 women aged 15-49 years in the 36 states and the Federal Capital Territory (FCT) in Nigeria. Analysis was carried out at the level of individual women and at the ecological level. Only 68.3% visited a health professional (doctors, nurses, midwives, community health extension workers, and community health officers) for ANC in the most recent pregnancy before the survey. At delivery, 44.9% were assisted by delivery attendants with about half (50.1%) assisted by non-professional (traditional birth attendants, relatives and friends) during delivery. There was a significant variation in use of modern family planning (FP) across types of ANC provider. There was a strong positive correlation between ANC utilisation and skilled birth attendance (SBA) (r=0.706, p <0.001), and between SBA and FP (r=0.730, p <0.001). These results have implications for the design of appropriate interventions for strengthening the role of healthcare providers to enhance ANC patronage, utilization of safe delivery services and sustained use of reproductive health services.

Effects of Telfairia Occidentalis Leaf Extract on Plasma Lactate and Liver Glycogen in Rats.

Telfairia occidentalis is a green vegetable popularly consumed among the native of Africa and it is generallybelieved to be of medicinal and nutritional value. Studies have reported its hypoglycaemic and hyperglycaemic effects inrats. In addition to these conflicting reports, the mechanisms for its effects on blood glucose remain inconclusive. Theobjective of this study was to investigate the mechanism involved in the increased blood glucose following treatment withT. occidentalis. Twenty five (25) male albino rats (200-250g) were randomly divided into 5 groups (n=5/group). Rats in thecontrol group received normal saline while rats in other groups were orally treated with 100 or 200 mg/kg body weight ofthe extract for either 1 or 2 weeks. At the end of the treatment, the rats were anaesthetized and blood samples were collectedfor the estimation of some biochemical parameters. The results showed significant decreases in plasma glucose after 1 weekof treatment with 100 mg/kg and 200 mg/kg. However, after 2 weeks of treatment with both doses, plasma glucose levelsincreased significantly and were higher than those of the control and the rats treated for 1 week with both doses. There werealso dose- and duration-dependent decreases in glycogen concentration in the treated rats, especially those treated for twoweeks. Glucose-6-phosphatase activity and liver glycogen concentration were lower in rats treated for 2 weeks whencompared with those treated for 1 week with both doses. Moreover, plasma lactate concentration was lower in the treatedgroups when compared with control. The results suggest that Telfairia occidentalis-induced lowering of plasma glucose afterone week of treatment probably favoured lactate oxidation/gluconeogenesis and elicited breakdown of liver glycogen whichresulted in increased plasma glucose after two weeks of treatment.

Effects of Petrol Exposure on Glucose, Liver and Muscle glycogen levels in the Common African toad Bufo regularis.

This study investigated the effects of exposure to petrol on blood glucose, liver and muscle glycogen levels in the common African toad Bufo regularis. A total of 126 adult toads of either sex weighing between 70-100g were used for this study. The experiment was divided into three phases. The phase 1 experiment the acute toxicity test consisted of animals divided into six groups of 10 toads per group and were exposed to water (H2O), H2O + Tween 80, 2ml/l, 3ml/l, 5ml/l, and 10ml/l of petrol respectively for 96 hours using the static renewal bioassay system. In the Phase 2 experiment, the animals were exposed to H2O, H2O + Tween 80, 0.14ml/l, 0.3ml/l, 0.6ml/l, and 1.13ml/l of petrol respectively for 3 days; while in phase 3 experiment they were exposed to petrol solutions for 14 days. After the various exposures, the blood glucose, liver and muscle glycogen contents were determined using standard methods. The results of the study showed that the median lethal concentration of petrol (96 hours LC50) was 4.5ml/l and sub-lethal concentration of petrol caused mortality of animals. Exposure to petrol solutions for 3 days had no significant effect on blood glucose level of the animals but caused significant decrease in the liver and muscle glycogen levels at high concentrations. In the animals exposed to petrol solutions for 14 days, there was a significant increase in glucose levels and significant reduction in liver and muscle glycogen levels at high concentrations when compared with the control. The results show that sub-lethal concentrations of petrol can cause mortality of animals, hyperglycemia and reduction in liver and muscle glycogen levels. The effects of petrol exposure on carbohydrate metabolism depend on the concentration and duration of exposure.

Potassium channels and prostacyclin contribute to vasorelaxant activities of Tridax procumbens crude aqueous leaf extract in rat superior mesenteric arteries.

BACKGROUND: Previous studies have shown that aqueous extract of the leaf of Tridax procuinbens is capable of lowering blood pressure through its vasodilatory effects. In the present study attempt was made to examine the biological active components of T procuinbens leaf using GC-MS methods. We further investigated the role of K+ channels in the vasorelaxation effects of Tridax procumbens using rat isolated mesenteric artery. METHODS: The superior mesenteric artery isolated from healthy, young adult Wistar rats (250-300 g) were precontracted with phenylephrine (PE) (10(-7) M) and potassium chloride (KCl) (60 mM) and were treated with Various concentrations of aqueous extract ofT procumbens (0.9.0 mg/ml). The changes in arterial tension were recorded using a force-displacement transducer (Model 7004; Ugo Basil Varese, Italy) coupled to data capsule acquisition system. RESULTS: The results of GG-MS revealed the presence of linoleic acid. The T. procumbens extract (TPE) ranging from 0.5-9.0 mg/mI significantly (p<0.05) reduced the, contraction induced by (PE) and (KCl) in a concentration-dependent manner. The extract also antagonised the calcium-induced vasoconstriction (1(-9) - 10(-5)) in calcium-free with high concentration of potassium as well as. in calcium- and potassium free physiological solutions. The vasorelaxing effect caused by TPE was significantly (p<0.05) attenuated with preincubation of potassium channels blockers (Barium chloride and apamin), NO synthaseinhibitor (L-NAME), prostacyclin inhibitor (indomethacin), atropine; propranolol, and methylene blue while it was not affected by preincubation with glibenclamide and tetra ethyl ammonium, 4-aminopyridine (4-AP) and oxadiazolo quinoxalin (ODQ). CONCLUSION: The results of this study demonstrate that T procumbens extract causes vasodilatory effects by blocking calcium channels and the vasodilatory effect of the extract may also be due to stimulation of prostacyclin production and opening of small-conductance Ga2+ activated potassium channels. The observed effect of this extract may be probably due to the presence of linoleic acid in this extract.

Effects of chronic administration of ethanolic extract of kolanut (Cola nitida) and caffeine on vascular function.

BACKGROUND: Kolanut (Cola nitida) is consumed in virtually every part of the world. The caffeine content of kolanut is scarce and the number of investigations studying the health benefits of kolanut is negligible compared to coffee. OBJECTIVE: The present study was designed to identify the caffeine content of kolanut and evaluate the effect of its chronic consumption on cardiovascular functions in rats. METHODS: The caffeine content of kolanut was determined by Gas chromatography-mass spectrometry (GC-MS). Wistar albino rats were divided into four groups (10 Rats/group). Kolanut extract (11.9 mg/kg), caffeine extracted from kolanut (7.5 mg/kg), decaffeinated of kolanut extract (6 mg/kg) and distilled water (control) was administered orally to each group for six-weeks. Effect of treatment on body weight, blood pressure and relaxation response to acetylcholine (ACh) and sodium nitroprusside (SNP) of the aortic rings was assessed. RESULTS: The total caffeine content of kolanut extract was found to be 51% and it was 96% pure from GC-MS analysis. Chronic consumption of kolanut and caffeine significantly (p < 0.05) decreased body weight. Similarly, kolanut extract decaffeinated kolanut and caffeine significantly (p < 0.05) reduced the contractile response to noradrenaline and higher potassium solution. Kolanut extract and caffeine also significantly (p < 0.05) increased the mean arterial blood pressure. Caffeine and kolanut consumption reduced the relaxation response to both acetylcholine and sodium nitroprusside. Atropine and L-NAME considerably inhibit the ACh-induced relaxation of the rat aortic ring suggesting the involvement of cholinergic mechanism. However, indomethacin (10(-4)M) also attenuated the ACh response indicating involvement of protanoids. CONCLUSION: The results suggest that treatment with both kolanut extract and caffeine had similar characteristics between the two groups with no significant differences in the ACh-induced relaxation of thering suggesting that the action of kolanut extract is due to its caffeine content.

The Aqueous Calyx Extract of Hibiscus sabdariffa Lowers Blood Pressure and Heart Rate via Sympathetic Nervous System Dependent Mechanisms.

The antihypertensive effect of Hibiscus sabdariffa (HS) has been validated in animals and man. This study tested the hypothesis that its hypotensive effect may be sympathetically mediated. The cold pressor test (CPT) and handgrip exercise (HGE) were performed in 20 healthy subjects before and after the oral administration of 15mg/Kg HS. The blood pressure (BP) and heart rate (HR) responses were measured digitally. Mean arterial pressure (MAP; taken as representative BP) was calculated. Results are expressed as mean ±SEM. P<0.05 was considered significant. CPT without HS resulted in a significant rise in MAP and HR (111.1±2.1mmHg and 100.8±2.0/min) from the basal values (97.9±1.9mmHg and 87.8±2.1/min; P<0.0001 respectively). In the presence of HS, CPT-induced changes (ΔMAP=10.1±1.7mmHg; ΔHR= 8.4±1.0/min) were significantly reduced compared to its absence (ΔMAP= 13.2±1.2mmHg; ΔHR= 13.8±1.6/min; P<0.0001 respectively). The HGE done without HS also resulted in an increase in MAP and HR (116.3±2.1mmHg and 78.4±1.2/min) from the basal values (94.8±1.6mmHg and 76.1±1.0/min; p<0.0001 respectively). In the presence of HS the HGE-induced changes (ΔMAP= 11.5±1.0mmHg; ΔHR= 3.3±1.0/min) were significantly decreased compared to its absence (ΔMAP=21.4±1.2mmHg; ΔHR= 12.8±2.0/min; P<0.0001 respectively). The CPT and HGE -induced increases in BP and HR suggest Sympathetic nervous system activation. These increases were significantly dampened by HS suggesting, indirectly, that its hypotensive effect may be due to an attenuation of the discharge of the sympathetic nervous system.

Effect of aqueous extract of Phyllantus amarus leaves on implantation and pregnancy in rats.

Phyllanthus amarus is a medicinal plant used widely in the treatment of many diseases. It has a long tradition of use in the Hindu Ayurvedic system of medicine and it has long been used as a medicinal agent in cultures around the world. Traditionally, in the Yoruba speaking part of western Nigeria it is used in treating sterility and difficult childbirth. This experiment was therefore designed to scientifically test the effect of aqueous extract of Phyllanthus amarus (AEPA) leaves on implantation and pregnancy. Animals were divided into two groups of 18 rats each after pregnancy has been established. Group I received 0.2mg/100g body weight of AEPA from day 1 of pregnancy. Group II received equal volume of distilled water serving as the control. Six rats from each group were sacrificed on days 6, 8 and 19 respectively. Implantation and pregnancy were assessed. AEPA reduced the time frame for implantation in the treated rats and caused abortion of pregnant rats. Although the aqueous extract of Phyllanthus amarus reduces the time frame for implantation, its abortificent effect does not support the traditional claim that it can treat sterility.

Effect of caffeine and ethanolic extract of kolanut on glucose uptake in the canine hindlimb at rest and during contraction.

The study investigated the effects of caffeine and ethanolic extract of kolanut (EEK) on glucose uptake in the canine hindlimb at rest and during contraction. Thirty male anaesthetized mongrel dogs [11-13 kg] were divided into six groups [5 dogs/group] Caffeine [6 mg/kg], EEK [5 mg/kg], or normal saline [control] was administered intravenously to each group at rest. Arterial and venous blood samples were collected at 0, 5, 10, 15, 20, 25, 30, 45, 60, 75 and 90 minutes after drug administration. Blood glucose was measured by glucose oxidase method. Arteriovenous [A-V] glucose difference was calculated and venous blood flow [VBF] was measured during the sampling period. Hindlimb glucose uptake [HGU] was calculated as the product of [A-V] glucose and blood flow. After sampling at rest, the experiments were repeated with the right femoral nerve stimulated using electrical stimulator at 5 Hz. At rest, A-V glucose increased significantly [P<0.05] from 4.2+/-0.2 mg/dl to 29.8+/-8.6, and 24.4+/-2.6 for caffeine and EEK respectively. VBF decreased to 2.0+/-0.9 and 6.0+/-0.6 ml/min for caffeine and EEK respectively. However, HGU significantly increased from 34.8+/-0.1 mg/min to 74.5+/-3.2 mg/min and 175.8+/-3.4 mg/min for caffeine and EEK, respectively. Contraction of the hindlimb muscle alone significantly increased the [A-V] glucose [68%], VBF [26%] and HGU [120%] when compared with the control. During contraction, [A-V] glucose increased from 4.3 +/-1.5 mg/dl to 35.6+/-3.0 mg/dl, and 27.0+/-2.2 mg/dl for caffeine and EEK respectively. VBF also increased from 8.4+/-0.3 ml/min to 12.8+/-0.3 ml/min for EEK. Although, contraction improves VBF [7.3+/-0.5 ml/min] to the hindlimb in response to caffeine, the value was significantly [P<0.05] lower than that of control [8.4+/-0.5 ml/min]. Contraction also significantly increased HGU from 35.8+/-3.6 mg/min to 249.0+/-3.3 and 286.72+/-2.0 mg/min for caffeine and EEK, respectively. The results showed that caffeine and EEK significantly increased HGU and that these effects are due to the increases in glucose extraction [A-V glucose] caused by caffeine and EEK.

Studies on the anti-inflammatory properties of Entada abyssinica.

The defatted methanolic extract of Entada abyssinica was evaluated for anti-inflammatory activity in acute and chronic models of inflammation. The extract (50--200 mg/kg, p.o.) exhibited dose-dependent and significant inhibition of both the carrageenan-induced rat paw oedema and granuloma tissue formation in rats. The extract (50--200 mg/kg, p.o.) was also found to inhibit the acetic acid-induced vascular permeability in a dose-dependent fashion in mice. This study demonstrated the anti-inflammatory activity of Entada abyssinica.

Effects of calcium channel blockers on nicotine-induced hyperglycemia in the rat.

Effects of nifedipine and verapamil on nicotine-induced hyperglycemia were studied in fasted, anesthetized male rats. Blood glucose was measured using the glucose oxidase method. Nifedipine (0.05-0.20 mg/kg i.p.) significantly reduced nicotine-induced hyperglycemia in a dose-dependent manner. While lower doses (0.1.0-1.0 mg/kg i.p) of verapamil did not effect nicotine-induced hyperglycemia, higher doses 95.0-10 mg/kg i.p) of verapamil caused significant reduction but did not abolish it. Both nifedipine and verapamil had no significant effect on the basal blood glucose levels at any dose used. These results seem to suggest that the reduction in nicotine-induced hyperglycemia is related to inhibition of some of the processes by which nicotine induced hyperglycemia.

Biological effects of Myristica fragrans (nutmeg) extract.

The chloroform extract of nutmeg has been evaluated for antiinflammatory, analgesic and antithrombotic activities in rodents. The extract inhibited the carrageenan-induced rat paw oedema, produced a reduction in writhings induced by acetic acid in mice and offered protection against thrombosis induced by ADP/adrenaline mixture in mice.

Effects of glucagon, glucose, adrenaline and insulin infusion on blood glucose level in the common African toad (bufo regularis).

Male toads, weighing 70-123 g, were divided into 13 groups with 8 toad in each group. Animals in each group were fasted overnight before the experiments. Toads in groups 1 to 4 were infused for 30 minutes with adrenaline, 5 ugkg-1 min-1, glucose, 5.5 mg kg-1 min-1; glucagon 2 ugkg-1 min-1; and insulin 2000 uU kg-1 min-1, respectively. Blood samples for blood glucose measurement were taken before, during and after each infusion. The experiment was repeated in groups 5 and 6 using 3.5 mg kg-1 min-1 and 7.5 mg kg-1 min-1 of glucose respectively. Toads in groups 7 to 9 were pretreated with prazosin, 0.2 mg/kg and those in groups 10 to 12 were pretreated with propranolol, 0.5 mg/kg. After pretreatment, glucose, glucagon and insulin infusions were repeated in the alpha-blocked and beta-blocked toads, respectively. Group 13 was infused with 0.7% saline and served as the control. The results showed that infusions of adrenaline, glucose and glucagon resulted in significant hyperglycaemia while insulin caused hypoglycaemia. The hyperglycaemic response to glucose was dose-dependent. The experiments using blockers showed that the glycaemic effects of glucagon and insulin are mediated via beta adrenoceptors, that for glucose is via alpha adrenoceptors and from an earlier study, the glycaemic response of adrenaline is through both alpha and beta adrenoceptors.