Exploring the inhibitory potential of phytochemicals from Vernonia glaberrima leaves against snake venom toxins through computational simulation and experimental validation.

Phospholipase A2 (PLA2) is an enzyme present in appreciable quantity in snake venoms which catalyze the hydrolysis of glycerophospholipids at sn-2 position and promote the release of lysophospholipids and fatty acids. 5-methylcoumarin-4-ß-glucoside (5MC4BG) and lupeol were previously isolated from the leaves of V. glaberrima. The aim of this research was to evaluate effect of these compounds as potential inhibitors of snake venom toxins of Naja nigricollis using an in vitro and in silico studies. Antisnake venom studies was conducted using acidimetry while the molecular docking analysis against PLA2 enzyme from N. nigricollis was performed using Auto Dock Vina and ADME-Tox analysis was evaluated using swissADME and ProTox-II online servers. The two compounds (5MC4BG and Lupeol) were able to inhibit the hydrolytic actions of PLA2 enzyme with percentage inhibition ranging from 23.99 to 72.36 % and 21.97-24.82 % at 0.0625-1.00 mg/mL respectively while the standard ASV had 82.63 % at 1.00 mg/mL after 10 min incubation at 37 °C. Similar effects were observed after 30 min incubation, although there was significant increase in percentage inhibition of 5MC4BG and lupeol ranging from 66.51 to 83.73 % and 54.87-59.60 % at similar concentrations. Furthermore, the compounds were able to bind to the active site of PLA2 enzyme with high affinity (-7.7 to -6.3 kcal/mol); the standard ligand, Varespladib had a docking score of -6.9 kcal/mol and they exhibited favorable drug-likeness and pharmacokinetic properties and according to toxicity predictions, the two compounds are toxic. In conclusion, the leaf of V. glaberrima contains phytoconstituents with antisnake activity and thus, validates the hypothesis that, the phytoconstituents of V. glaberrima leaves has antisnake venom activity against N. nigricollis venom and thus, should be studied further for the development as antisnake venom agents.

Mental Health Burden and Facilitators Among Frontline Healthcare Professionals in Nigeria Amid COVID-19 Pandemic: A Cross-sectional Study.

BACKGROUND: During the COVID-19 pandemic, the frontline healthcare providers faced significant mental health stressors. Previous pandemics have revealed the need for psychosocial support and healthy coping mechanisms to mitigate mental health risks. AIM: The study aimed to assess psychological impact and supportive mechanisms experienced by frontline healthcare workers treating COVID-19 patients in Kaduna State. METHODS: This study involved 38 frontline healthcare providers mainly from Kaduna State Infectious Disease Treatment Center. Participants' mental health burden was captured through Hospital Anxiety and Depression Scale. Mental health facilitators were assessed through six tools: Ten-Item Values Inventory, healthy defense section of the Defense Style Questionnaire, Existential Anxiety Questionnaire, Brief Resilience Scale, Oslo Social Support Scale, and the Insomnia Severity Index. RESULTS: The mean age of the study participants was 35.5 ± 6.6 years, with the majority being males (68.4%) and doctors (39.5%). More than a quarter of the participants showed appreciable symptoms of depression and anxiety. Psychosocial facilitators such as moral values, openness to change, self-transcendence, sublimation, anticipation, and humor scored above average for more than half of the participants. Most participants demonstrated moderate resilience and social support, with few experiencing sleep challenges. Comparisons of variables indicated "openness to change" was significantly higher among males, whereas symptoms of depression and anxiety were associated with higher levels of existential concerns and sleep challenges. CONCLUSION: Our study finds that Nigerian frontline health workers experienced significant mental health challenges during the COVID-19 pandemic. It identified specific facilitators linked to gender and psychological burdens, informing the need for tailored support interventions.

Deciphering the interactions of scopoletin and scopolin from Catunaregam nilotica roots against Naja nigricollis phospholipase A2 enzyme.

Catuneragam nilotica has been used in ethnomedicine to treat snakebite, inflammation, and diarrhea among others. The aim of this research is to isolate, and characterize potential potential phospholipase A2 (PLA2) inhibitors from the roots of C. nilotica. The plant material was collected, authenticated, and sequentially extracted using solvents of increasing polarity starting from n-hexane, ethyl acetate, and methanol. The extracts as reported in our previous work, were screened in vitro for their inhibitory activity against PLA2 enzyme from N. nigricollis venom using acidimetric assay. In line with the bio-activity guided isolation, methanol extract (being the most active) was subjected to chromatographic separation using silica gel and sephadex LH-20 which resulted in the isolation and characterization of scopoletin, and scopolin; the compounds were able to inhibit the hydrolytic actions of PLA2 enzyme with percentage inhibition ranging from 67.82 to 100.00 % and 65.76-93.15 %, respectively while the standard Antisnake Venom (ASV) had 74.96-85.04 % after 10 min incubation at 37 °C. The molecular docking of the compounds against PLA2 enzyme was performed using Auto Dock Vina while ADME-Tox analysis was evaluated using swissADME and ProTox-II online servers; The findings indicated that both compounds were able to bind to the active site of PLA2 enzyme with high affinity (-6.5 to -6.2 kcal/mol) and they exhibited favorable drug-likeness and pharmacokinetic properties, and according to toxicity predictions, scopolin was found to be non-toxic (LD50 of 5000 mg/kg) while scopoletin has a slight chance of being toxic (LD50 of 3800 mg/kg). In conclusion, the findings of the research revealed that the roots of C. nilotica contains phytoconstituents with anti-PLA2 enzyme activity and thus, validates the ethnomedicinal claim of the use of the plant as herbal therapy against N. nigricollis envenomation.

The phytochemical and pharmacological actions of Entada africana Guill. & Perr.

Entada africana (Ea, Asteraceae) has been widely used traditionally to treat different ailments, as food, insecticides, source of gums, in some small carpentry works. Studies on the pharmacognostic characterization, nutritional, elemental and physicochemical contents has been reported. In vivo and in vitro studies on the plant validated some ethnomedicinal claims of the use of the plant as an anti-inflammatory, analgesic, antibacterial, antioxidant, antiviral, anti-angiogenic, cytotoxic agents among others. Triterpenes, saponins, flavonoids and sugars were reported as bioactive constituents which might be responsible for the aforementioned pharmacological actions of the plant. However, more researches are required in order to isolate bioactive compounds from the different parts of Ea and evaluate their effects on different ailments.

Late life depression among elderly hypertensive patients.

AIMS AND OBJECTIVES: To determine the correlates of late life depression among elderly hypertensive patients as seen in Zaria Northern Nigeria. SUBJECTS AND METHODS: Elderly hypertensive patients attending the cardiac clinic of Ahmadu Bello University Teaching Hospital Zaria were recruited for the study. They were interviewed using socio-demographic Questionnaire, Consortium to Establish Registry for Alzheimer's Disease (CERAD), Geriatric Depression Scale-30 and Stick Design Test. Patients that had a score of 11 and above in the GDS-30 were further interviewed using the Geriatric Mental State Schedule (GMSS) AGECAT. Data obtained from the study was analyzed using Statistical Package for Social Sciences windows version 15. All tests of significance were carried out at 5% level of probability. RESULTS: A total of 179 patients participated in the study out of which 110 (65.1%) were females. The mean age of the subject was 68.23±5.72 years. The rate of late life depression based on International Classification of Diseases (ICD), 10th edition and Geriatric Mental State Schedule AGECAT (GMSS-AGECAT) diagnoses were 17. 88% (32) and 20.11 % (36) respectively. There was very good agreement between diagnoses based on ICD-10 criteria and GMSS-AGECAT (kappa=0.82, p<.001). Late life depression was significantly associated with recent bereavement (OR=11.04, p=.001), poverty (OR=4.39, p=.036) and lower diastolic blood pressure (7.04, p=.008). CONCLUSION: The rate of late life depression in this study is comparable to that of other studies reported in the literature. Poverty and bereavement but not high blood pressure, are important factors associated with depression in the elderly.

Recurrent depressive illness or craniopharyngioma: a diagnostic dilemma.

BACKGROUND: Brain tumors have been associated with various psychiatric and neurological manifestations. However in some patients with brain tumors psychiatric symptom might be the only clinical presentation for various lengths of time. As such they would be treated as straight forward psychiatric disorders. OBJECTIVE: To report a case of craniopharyngioma presenting as recurrent depressive illness in a 42 years old man. METHODS: Clinical follow up of a patient presenting with recurrent depressive illness till death RESULTS: recurrent severe depressive illness in the absence of focal neurological deficit that is unresponsive to anti-depressant might be due to intracranial neoplasm. CONCLUSION: Brain tumors can sometime present as psychiatric disorders and be difficult to detect in the absences of focal neurological deficit and Neuro-imaging studies.

Emotional distress among caregivers of patients with epilepsy in Katsina State, Northern Nigeria.

OBJECTIVE: Caregivers of patients with epilepsy experience onsiderable emotional distress. The study aimed to assess the magnitude of the problem in a developing country. METHOD: A total 166 patients-caregivers were enrolled for the study. They were interviewed using a socio-demographic data collecting sheet and the Hospital Anxiety-Depression Scale (HADS). Data obtained were analysed using Statistical Package for Social Sciences Windows version 13. All statistical tests were carried out at a 5% level of probability. RESULTS: The mean age of the caregivers was 45.44 ± 6.67 years. Emotional distress was found among 109(65.7%) of the caregivers. This is was significantly associated with male gender of both care giver and patient as well as residing in a rural area. CONCLUSION: The study demonstrated a high level of emotional distress associated with caring for patients with epilepsy, which is comparable to other studies carried out in other parts of the world.

Male urinary incontinence and dementia in Zaria, Nigeria.

BACKGROUND: Ageing population in all parts of the world has make dementia in the elderly an important public health issue. Behavioural and Psychological symptom of dementia like urinary incontinence seldom attract the attention of clinicians providing care for the elderly. OBJECTIVE: To determine the prevalence of dementia among elderly male patients presenting with urinary incontinence to a urology clinic. SUBJECTS AND METHOD: We recruited consecutive elderly patients and their caregivers presenting to the urology clinic of Ahmadu Bello University Teaching Hospital for the treatment of urinary incontinence. The patients were assessed using Socio-demographic data collecting sheet, Consortium to Establish Registry for Alzheimer's Disease (CERAD), Stick Design Test and physical examination. While the caregivers were interviewed using the Blessed Dementia Scale. A consensus diagnosis was made for each of the patients based on criteria for dementia in both Diagnostic and Statistical Manual 4th edition (DSM-IV) and International Classification for Diseases 10 edition( ICD-10). All test of statistics were carried out at 5%level of probability. RESULTS: A total of 121 patients participated in the study. The mean age of the patients was 70.58 ± 5.47 years (95% CI=69.10-71.55). A total of 11 patients (9.10%, 95% CI=3.98-14.22) have dementia based on the consensus diagnosis. Dementia among this cohort is significantly associated with advancing age and enuresis. CONCLUSION: Dementia is common among elderly patients with urinary incontinence in Africa but remains large undetected and unrecognised.

Psychiatric sequelae of traumatic brain injury: retrospective analysis of 75 subjects from Kaduna, Nigeria.

OBJECTIVE: Traumatic brain injury (TBI) is a public health problem and is associated with many complications. However little is known about the psychiatric sequelae of TBI in Nigeria. This study described the pattern and determinants of psychiatric sequelae among subjects with TBI. MATERIALS AND METHODS: The study is a retrospective review of cases of subjects referred to Federal Neuropsychiatric Hospital, Kaduna on account of TBI or its complications from 2001 to 2008. Information obtained included the socio-demographic characteristics, type of injury, durations of unconsciousness (LOC) and posttraumatic amnesia (PTA), psychiatric and psychoactive substance use history. Psychiatric diagnosis was based on the criteria of the 10th edition of the International Classification of Diseases (ICD-10) RESULTS: Mean age of the subjects was 32.2 ± 35.8 years, mean duration of unconsciousness was 6.88 ± 9.40 days, mean duration of PTA was 5.45 ± 8.78 days, 90.7% were males, 69.3% had road traffic accident (RTA), 28.0% had psychosis, 25.3% had cognitive impairment while 17.3%, 8.0%, and 6.7% had epilepsy, personality change and depression respectively. About 15% had no complications yet. Only 30.7% did cranial CT scan. Long duration of LOC and PTA were significantly associated with psychiatric complications (P value <0.05). CONCLUSIONS: Psychiatric sequelae are common after TBI. Long periods of LOC and PTA are predictive of such sequelae. Efforts should be made to prevent RTA, communal clashes and other activities that can lead to TBI.

Beliefs and attitudes towards dementia among community leaders in northern Nigeria.

BACKGROUND: Dementia is an important devastating disease in old age. The number of dementia cases is in increasing worldwide with majority of them living in developing countries; however awareness about this important disease is poor especially in these developing countries. OBJECTIVES: This study aimed at determining the beliefs and attitude of community leaders on dementia in Northern Nigeria. METHODS: A cross sectional descriptive study was done using a structured questionnaire answered in Yes or No pattern. The questions were derived from the informant section of Community Screening Interview for Dementia and Blessed Dementia Scale. Fifty seven traditional rulers and fourty three Islamic clerics were interviewed. Data obtained was analysed using SPSS for windows version 11.0. RESULTS: The mean age of the participants was 57.76 ± 11. 10 years and 28% were over the age off 65 years. The result showed that 77 (77%) of the subject believed that dementia is a normal process of aging. This was significantly associated with educational status but not age of the participants. The most recognisable symptoms are psychotic features of dementia (82%), while difficulty in dressing (56%) is the least recognisable symptom. Most of the participants would refer a person with features suggestive of dementia to see a physician. CONCLUSION: The study demonstrated that the belief dementia is a normal process ageing is common among these community leader. Therefore there is need to carry out awareness campaign to educate them.

Psychological and physical effects of pain on cancer patients in Ibadan, Nigeria.

OBJECTIVE: To determine the prevalence of pain and its psychological and physical effects on cancer patients. METHOD: We interviewed 210 consecutively admitted cancer patients in the University College Hospital, Ibadan between May 2006 and November, 2006 using the socio-demographic / clinical questionnaire with a section designed to measure psychological and physical symptoms. The screening modules of the depression and anxiety sections of the Structured Clinical Interview for DSM-IV diagnosis was used to screen for depression and anxiety. RESULTS: There were 63 (30%) males and 147 (70%) females. Sixty-eight (32.4%) subjects had breast cancer, 59 (28.1%) had cervical cancer, 40 (19.0%) had colon / rectal cancer while the remaining 43 (20.5%) had prostate cancer. The prevalence of pain was found to be 73.8%. Presence of pain was significantly associated with depressive and anxiety symptoms, suicidal ideation, poor sleep, impaired concentration, lack of opportunity for leisure, dissatisfaction with health, poor overall quality of life, poor ability to get around and the need for extreme amount of medical treatment to function in the daily life. CONCLUSION: Pain is common among cancer patients and is associated with significant psychological and physical impairment. Therefore pain should be adequately assessed and managed.

Severe depression following á-interferon usage in a patient with chronic myeloid leukemia.

BACKGROUND: Chronic myeloid leukaemia (CML), with a median age of 40 years, is one of the commonest haematological malignancies in Nigeria. Cytoreductive agents, which were hitherto the mainstay of treatment, neither induce cytogenetic nor haematologic remission. Alphainterferon (á-IFN), an endogenous glycoprotein with cytotoxic and natural killer cell enhancer effects has been found to induce haematologic and cytogenetic remission in patients with CML, but neuro-psychiatric complications of á -interferon (á-IFN) usage were not reported in Nigeria. OBJECTIVE: To report a case of deliberate self-harm in University Lecturer as a side effect of á-IFN in the treatment of CML METHOD: Clinical and laboratory follow up of a patient receiving á-IFN in the management of CML from the time of diagnosis of CML to the point of loss of contact. RESULT: Severe depression is a complication that may adversely influence the clinical outcome of á-IFN usage CONCLUSIONS/RECOMMENDATIONS: Although interferon related depression is uncommon, it is suggested that pre-therapy interferon assays and neuro-psychiatric assessment are carried out in prospective users of á-IFN.

Severe Depression Following a-interferon Usage in a Patient with Chronic Myeloid Leukemia

Background: Chronic myeloid leukaemia (CML); with a median age of 40 years; is one of the commonest haematological malignancies in Nigeria. Cytoreductive agents; which were hitherto the mainstay of treatment; neither induce cytogenetic nor haematologic remission. Alpha-interferon (a-IFN); an endogenous glycoprotein with cytotoxic and natural killer cell enhancer effects has been found to induce haematologic and cytogenetic remission in patients with CML; but neuro- psychiatric complications of a -interferon (a-IFN) usage were not reported in Nigeria. Objective: To report a case of deliberate self-harm in University Lecturer as a side effect of a-IFN in the treatment of CML. Method: Clinical and laboratory follow up of a patient receiving a-IFN in the management of CML from the time of diagnosis of CML to the point of loss of contact. Result: Severe depression is a complication that may adversely influence the clinical outcome of a-IFN usage Conclusions/Recommendations: Although interferon related depression is uncommon; it is suggested that pre-therapy interferon assays and neuro-psychiatric assessment are carried out in prospective users of a-IFN