Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations.

Mercury is a highly toxic heavy metal that may cause neurological, respiratory, gastrointestinal and dermatological illnesses. Previously described neurological manifestations of mercury toxicity are symmetrical, and include a pancerebellar syndrome, generalised seizures and encephalopathy. Mercury is used in the gold mining process, and in artisanal or illicit gold mining, often without necessary protection. Here we describe the cases of two artisanal gold miners from western Johannesburg, South Africa, who presented with atypical neurological manifestations of mercury toxicity. Patient 1 presented with focal seizures, an asymmetrical cerebellar syndrome and an acute encephalopathy. Patient 2 had unilateral cerebellar ataxia. Both patients had toxic mercury levels, with no other cause identified for their symptoms. Patient 1 responded well to chelation therapy, but patient 2 refused admission and further medical treatment. The neurological manifestations of mercury toxicity are typically symmetrical, whereas our two patients presented with markedly asymmetrical features. It is important to maintain a high index of suspicion for mercury poisoning, even in patients with atypical and unilateral or asymmetrical presentations. A prompt diagnosis and the commencement of early chelation therapy have the potential to produce good outcomes.

Healthcare for the poor and dispossessed: from Alma-Ata to the Millennium Development Goals.

Healthcare models which recognize the equity principle have had to confront the challenge of providing healthcare for the poor and dispossessed. Healthcare premised on "human rights" strives to remove/ reduce barriers to access by a complete waiver of all fees in the public sector or various other subsidies to make healthcare more affordable. Social welfare programmes are held hostage to the vagaries of the economy and resource scarcity. The Alma-Ata's primary healthcare is inherently a health development strategy which embraces a wholistic approach to health and wellness. This strategy, by refocussing on the Millennium Development Goals, can therefore accommodate the innovations required to overcome the challenges posed by technological, financial, cultural and geographical factors to provide a better quality of life for all, but moreso for the poor and dispossessed.

Preliminary determination of median lethal dose of Azadirachta indica (A. ) Juss bark extract against Boophilus microplus

The study was carried out in order to determine the effective dose of Azadirachta indica as an acaride. From a range of effective doses, nine (9) test doses ranging from zero (0) parts per million to one hundred and fifty parts (150) per million were selected. The test species Boophilus microplus was subjected to a standard bioassay. A dose response curve was plotted of percentage mortality of B. microplus against logarithmic dosage of A indica. The lethal dose, LD50 and LD100 were also determined. The LD50 was 30.20 parts per million and LD100 was found to lie between 80 and 100 parts per million. Regression analysis was performed to verify correlation of data. The data proved to be linear with a correlation coefficient of 0.89. The results of this study indicate that when the dose required to achieve 50 percent mortality is compared to average yield of A. indica bark extract obtained in previous studies (Maharaj et al 2003), the extract appears to be feasible with respect to production for use as a prospective pesticide. This is an important point for consideration as the failure in the commercialization of many plant products is often due to the yields being too low. The bark extract of Azadirachta indica has thus far proven to be worthy of consideration for further development as a phytoacaricide

Evaluation of Trinidad and Tobago traditional medicine I: effects of traditional folk remedy on diarrhoea

Hot aqueous extract of bark of Anacardium occidentale (Cashew), commonly used in Trinidadian folk medicine for the treatment of diarrhoea was evaluated for antidiarrhoeal activity. The extract inhibited castor oil-induced diarrhoea in rats as judged by a decrease in the number of wet faeces in the extract-treated rats. The extract was also inhibited the propulsive movement of intestinal contents in mice. The extract showed no direct effect on the isolated guinea-pig ileum, however, it inhibited in a dose-related manner the contractile effects of acetylcholine, histamine, and 5-hydroxytryptamine. The inhibitary effects on these agonists were non competitive in nature. Phytochemical tests revealed the main constituents as tannin, steroids, triterpenoid and carbohydrates. The results indicates that action of A. occidentale bark extract could be through a combination of inhibition of elevated transmitter released and reduced propulsive movement of the small intestine. There is merit in the folk medicinal use of the extract (AU)

Preliminary determination of median lethal dose of Azadirachta indica (A.) Juss bark extract against Boophilus microplus

The study was carried out in order to determine the effective dose of Azadirachta indica as an acaride. From a range of effective doses, nine (9) test doses ranging from zero (0) parts per million to one hundred and fifty parts (150) per million were selected. The test species Boophilus microplus was subjected to a standard bioassay. A dose response curve was plotted of percentage mortality of B. microplus against logarithmic dosage of A indica. The lethal dose, LD50 and LD100 were also determined. The LD50 was 30.20 parts per million and LD100 was found to lie between 80 and 100 parts per million. Regression analysis was performed to verify correlation of data. The data proved to be linear with a correlation coefficient of 0.89. The results of this study indicate that when the dose required to achieve 50 percent mortality is compared to average yield of A. indica bark extract obtained in previous studies (Maharaj et al 2003), the extract appears to be feasible with respect to production for use as a prospective pesticide. This is an important point for consideration as the failure in the commercialization of many plant products is often due to the yields being too low. The bark extract of Azadirachta indica has thus far proven to be worthy of consideration for further development as a phytoacaricide (AU)