bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herbal medicine acceptance, sources and utilization for diarrhoea management in a cosmopolitan urban area (Thika, Kenya)
Authors: Njoroge Grace Njeri , Kibunga Joan Wanjiku 
Published: February 2007

AbstractThe use of herbal remedies is usually perceived as a rural phenomenon, hence it is usually not clear whether they are an accepted mode of healthcare system in urban areas. This study aimed at investigating the role of herbal medicines in managing diarrhoea in an urban centre, document important plants utilized and their conservation status. The results indicate that diarrhoea is a serious problem in Thika urban slums. Ninety‐eight per cent in the study area had suffered had suffered diarrhoea in the recent past (during the last 1 year). In regard to the mode of treatment sought for this condition, 97.45% had used herbal preparations. The majority (52.5%) first seek treatment for diarrhoea from herbalists before going to the hospital. More people (23.7%) in the study area seek herbal preparations for diarrhoea management because they consider them more effective than biomedicines, compared with 13.2% who opt for the herbal concoctions because they are cheap. A large diversity of species (41 species in 25 families) is used in diarrhoea management. The most common plants include Senna didymobotrya (Fresen.) Irwin & Barney, Physalis Peruvian L., and Cucurbita maxima Lam. Most of these are obtained from wild habitats, hence their conservation status needs to be addressed.
Microgeographical genetic structure of forest robusta coffee (Coffea canephora, Pierre), in Kibale National Park, Uganda
Authors: Nyakaana Silvester 
Published: February 2007

AbstractGenetic variation within and between forest coffee (Coffea canephora, Pierre) populations sampled from five localities in Kibale National Park was assessed using six polymorphic microsatellite loci. In a total sample of 113 individuals, 53 alleles were observed across all loci in all populations while the total number of alleles across loci in each population ranged from fifteen to forty‐five. Significant genetic differentiation was observed between all populations in all pair‐wise population comparisons (FST = 0.041–0.284; P < 0.01). A high proportion of private alleles was observed across all loci with some of them occurring at relatively high frequencies. The implications of these findings for the future survival of the species are discussed.
Medicinal plants used by communities of Ngai Subcounty, Apac District, northern Uganda
Authors: Okello Jimmy , Ssegawa Paul 
Published: February 2007

AbstractAn ethnobotanical survey was carried out in Ngai subcounty in Apac District. Three parishes of Ajerijeri, Abok A and Omach were taken as stratified sample areas in which both male and female traditional healers of different ages were interviewed. Information about the medicinal plants and traditional healing was gathered using questionnaires, semi‐structured interviews, informal discussion and field excursion which yielded lists of local plant names, names of diseases treated, mode of administration and parts used. To enhance their effectiveness, medicinal plants are used in combinations to treat various ailments and the extent of knowledge of medicinal plant mixing determines the success of a traditional healer. Roots were the most commonly harvested part and this has greatly affected the regeneration of medicinal plants. It was believed that only plants collected from the wild were effective. Though not intentional, plant parts not used for medicinal purposes are sometimes destroyed in the process of harvesting. This practice, coupled with over harvesting, threatens the continued existence of these plants.
Establishment of plant propagules in the acid mine‐polluted soils of the pyrite trail in Queen Elizabeth National Park, Uganda
Authors: Oryem‐Origa H. , Makara A. M. , Tusiime F. M. 
Published: February 2007

AbstractThe effect of amended acidic pyrite sediments on the germination and establishment of seedlings and vegetative plant propagules of some selected plant species was investigated. The results from this study indicate that the pH values of the pyrite trail ranged from 1.6 to 3.5. Seed germination of all plant species except Bidens pilosa L. was not possible in the pyrite soils (pH 1.6–4.0) in laboratory germination trials. The germination of seeds in amended pyrite soils at pH 5.5 ± 0.2 and 7.0 ± 0.2 was possible. Seeds of Panicum maximum Jacq. and Setaria sphacelata (Schumach.) Stapf and Hubbard ex. Moss were not able to germinate in the unaltered pyrite soil under laboratory conditions. Under field conditions, seed germination was possible in all the plots with amended pyrite soils at pH 5.5 ± 0.2 and 7.0 ± 0.2. Seed germination in the uncontaminated soil was much higher than in the amended pyrite soil. Seedlings were not able to survive for long in the amended soils. Only the vegetative plant propagules of Cynodon dactylon (L) Pers. were able to secure permanent establishment in all amended plots except in plot PT3. Generally, seed germination, seedling establishment, growth and the establishment of vegetative plant propagules in unaltered soils was not possible.
East African medicinal plants as a source of lead compounds for the development of new antimalarial drugs
Authors: Waako P. J. , Katuura E. , Smith P. , Folb P. 
Published: February 2007

AbstractFour traditional medicinal plants of east and central Africa, Emilia discifolia (Oliv.) C. Jeffrey, Senecio stuhlmannii, Indigofera emarginella A. Rich. and Aspilia africana (Pers) C.D. Adams, were screened for in vitro antimalarial activity using the nitro‐tetrazolium blue‐based parasite lactate dehydrogenase assay. The plant parts were collected in two batches: one in the wet season and the other in the dry season. The ethyl acetate extract of A. africana had the highest antiplasmodial activity against both the chloroquine‐sensitive D10 [inhibitory concentration (IC)50 = 9.3; 7.7–10.9 μg ml−1] and the chloroquine‐resistant K1 (IC50 = 11.5; 8.7–14.3 μg ml−1) strains of P. falciparum. There was a positive correlation between the antiplasmodial activity of the extracts against the D10 and K1 strains of P. falciparum (Pearsons’ coefficient, r = 0.9691, P =0.05). Yields of extracts and their antiplasmodial activity varied with season in some plant species. This study shows that some East African medicinal plants can serve as a source of lead compounds for the development of new drugs against the chloroquine‐sensitive and chloroquine‐resistant strains of P. falciparum. The need for optimization of the conditions of harvest to maximize yields is also highlighted.
Rectal lactate levels in endoluminal microdialysate during routine coronary surgery*
Authors: Solligård E. , Wahba A. , Skogvoll E. , Stenseth R. , Grønbech J. E. , Aadahl P. 
Published: February 2007

SummaryThe aim of this prospective study was to determine the feasibility of intestinal endoluminal microdialysis as a new method for clinical monitoring of the adequacy of splanchnic perfusion in the large bowel. A microdialysis catheter for continuous lactate, glycerol, glucose and pyruvate measurements attached to a tonometric catheter was placed into the lumen of the recto‐sigmoid junction prior to surgery in 13 patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). Lactate was also measured in blood and muscle. CPB was associated with a 10‐fold increase in luminal lactate from 0.16 (0.01) to 1.67 (0.38) mmol.l−1 (p < 0.001). Muscular lactate increased from baseline levels 1.20 (0.21) to 1.77 (0.36) mmol.l−1 during CPB (p = 0.01), but the muscular lactate–pyruvate ratio remained unchanged. Arterial lactate increased only slightly from 0.9 (0.05) to 1.1 (0.06) mmol.l−1 (p = 0.027) during CPB. Increased lactate concentrations in the large bowel during CPB are suggestive of local lactate production consistent with impaired oxygen delivery. Intestinal endoluminal microdialysis is a potential clinically applicable method for monitoring intestinal metabolism. Combined with tonometry, microdialysis provides the opportunity to monitor both circulation and metabolism in the rectal mucosa.
Psychological assessment of ICU survivors: a comparison between the Hospital Anxiety and Depression scale and the Depression, Anxiety and Stress scale
Authors: Sukantarat K. T. , Williamson R. C. N. , Brett S. J. 
Published: February 2007

SummaryRecovery from a critical illness can be delayed by persistent anxiety and depression. To identify such patients, a new self‐report questionnaire (the Depression, Anxiety and Stress scale, DASS) was used alongside an established instrument (the Hospital Anxiety and Depression scale, HADS) in those who had spent a minimum of 3 days (median 9 days) in a general intensive care unit. Fifty‐one patients were studied 3 months later, and 45 survivors were reviewed at 9 months. High Cronbach alpha values (0.92–0.95) for each subscale of DASS confirmed its internal consistency, and likewise for HADS (0.82–0.86). HADS and DASS correlated strongly at each time point both for anxiety (r = 0.88) and depression (r = 0.93), with few discrepant values on a Bland and Altman plot. DASS performs as consistently as HADS in screening for anxiety and depression, and its psychometric properties support its use in an intensive care setting.
Retention of tracheal intubation skills by novice personnel: a comparison of the Airtraq® and Macintosh laryngoscopes*
Authors: Maharaj C. H. , Costello J. , Higgins B. D. , Harte B. H. , Laffey J. G. 
Published: February 2007

SummaryDirect laryngoscopic tracheal intubation is a potentially lifesaving manoeuvre, but it is a difficult skill to acquire and to maintain. These difficulties are exacerbated if the opportunities to utilise this skill are infrequent, and by the fact that the consequences of poorly performed intubation attempts may be severe. Novice users find the Airtraq® laryngoscope easier to use than the conventional Macintosh laryngoscope. We therefore wished to determine whether novice users would have greater retention of intubation skills with the Airtraq® rather than the Macintosh laryngoscope. Twenty medical students who had no prior airway management experience participated in this study. Following brief didactic instruction, each took turns performing laryngoscopy and intubation using the Macintosh and Airtraq® devices in easy and simulated difficult laryngoscopy scenarios. The degree of success with each device, the time taken to perform intubation and the assistance required, and the potential for complications were then assessed. Six months later, the assessment process was repeated. No didactic instruction or practice attempts were provided on this latter occasion. Tracheal intubation skills declined markedly with both devices. However, the Airtraq® continued to provide better intubating conditions, resulting in greater success of intubation, with fewer optimisation manoeuvres required, and reduced potential for dental trauma, particularly in the difficult laryngoscopy scenarios. The substantial decline in direct laryngoscopy skills over time emphasise the need for continued reinforcement of this complex skill.
The circulatory responses to tracheal intubation in children: a comparison of the oral and nasal routes
Authors: Xue F. S. , Liao X. , Liu K. P. , Liu Y. , Xu Y. C. , Yang Q. Y. , Li P. , Li C. W. , Sun H. T. 
Published: February 2007

SummaryThe circulatory responses to laryngoscopic tracheal intubation in 62 healthy children undergoing surgery requiring tracheal intubation were studied. They were randomly assigned to receive either the oral or nasal route for intubation. Baseline non‐invasive blood pressure and heart rate were recorded following induction of anaesthesia, at intubation and then every minute for 5 min. The percentage changes of systolic blood pressure and heart rate during the measurement period were calculated. The results demonstrated that intubation time was significantly longer in the nasal group. Both oral and nasal intubation caused significant increases in blood pressure and heart rate compared to baseline and postinduction values. However, there were no significant differences found between the two groups in relation to blood pressure and heart rate. The two groups were similar with respect to the percentage changes of systolic blood pressure and heart rate during the observation period. It is concluded that oral and nasal intubation using a direct laryngoscopy can result in a similar circulatory response in anaesthetised children.
The short‐term effect of hyperoncotic albumin, given alone or with furosemide, on oxygenation in sepsis‐induced Acute Respiratory Distress Syndrome
Authors: Kuper M. , Gunning M. P. , Halder S. , Soni N. 
Published: February 2007

SummaryTwo prospective non‐randomised interventional case series were conducted consecutively at a single university hospital mixed intensive care unit, in patients with severe sepsis and acute respiratory distress syndrome. The first series describes the administration of 200 ml of 20% human albumin solution over 120 s in 13 patients, examining the hypothesis that raising plasma albumin should improve oxygenation. The second series describes the effect of administering 30 mg of furosemide intravenously along with the albumin in 15 patients, exploring whether this would produce more sustained improvement in oxygenation than albumin only. Oxygenation and haemodynamic parameters were measured for 4 h, during the period of peak oncotic effect. Hyperoncotic albumin given alone or with furosemide produced only transient improvement in oxygenation and haemodynamics, which was statistically significant only in the patients given albumin alone. Although the plasma albumin remained significantly elevated at 4 h in both series, no sustained improvement in oxygenation was seen.
Temporary epicardial pacing after cardiac surgery: a practical review
Authors: Reade M. C. 
Published: February 2007

SummaryEpicardial wires allow temporary pacing after cardiac surgery. Pacing is often the best, and sometimes the only method of treating temporary rhythm disturbances in this context. Temporary epicardial pacing has evolved from simple one‐chamber systems to dual chamber, biatrial, and even biventricular systems. The first part of this two‐part review provides an overview of the management of temporary epicardial pacing systems. Factors influencing the placement of the various types of epicardial wires and the routine care of a pacemaker‐dependent patient are outlined, followed by a description of the diagnostic use of pacing wires, how to remove wires, and when to consider transition to permanent pacing. Special circumstances such as compatibility with magnetic resonance imaging and intra‐aortic balloon pumps are also discussed. The second part of this review will describe the various pacing modes, and solutions to common pacing problems using various adjustable parameters.
The use of drotrecogin alfa (activated) in a patient with recent orthotopic liver transplant*
Authors: Browne E. , Cressey D. M. , Agarwal K. , Cosgrove J. F. 
Published: February 2007

SummaryDrotrecogin alfa has been shown to reduce mortality in severe sepsis. However, it remains unlicensed for use in patients with previous liver transplantation. We report its use in such a case. Prior to administration a risk benefit analysis was performed in line with General Medical Council recommendations. This included being satisfied that no appropriately licensed alternative would better serve the patient's needs and that sufficient evidence existed to demonstrate the safety and efficacy of the drug. Responsibility was taken for prescription, monitoring and follow up. The process was carefully documented and the patient recovered fully with no adverse effects. To date the only published data on the use of drotrecogin alpha in transplant recipients is a case series of three patients. Further published data may encourage review of the licence.
Minimally invasive endoscopic port‐access™ intracardiac surgery with one lung ventilation: impact on gas exchange and anaesthesia resources
Authors: Kottenberg‐Assenmacher E. , Kamler M. , Peters J. 
Published: February 2007

SummaryMinimally invasive endoscopic intracardiac surgery including one lung ventilation has been proposed to decrease surgical trauma but its impact on oxygenation and resource consumption has not been reported. We compared effects on gas exchange, induction, total anaesthesia time, staffing costs, and complications in 42 consecutive patients to a matched group undergoing similar surgery conventionally. Use of endoscopic compared to conventional surgery evoked a decrease in the Pao2/FIo2 ratio (mean (SD) 24.1 (14.9) vs 48.9 (14) kPa, p < 0.05) following termination of bypass with one lung ventilation (10 patients showed a Pao2/Fio2 below 13.3 kPa (100 mmHg)). There was also an increase of anaesthesia induction time (47 (13) vs 31 (9) min, p < 0.05), and an increase by 156 min of total anaesthesia time (474 (89) vs 321 (69) min, p < 0.05). Anaesthetist staffing costs increased by 300%. Thus, minimally invasive endoscopic intracardiac surgery consumes many more anaesthesia resources than conventional surgery and can result in hypoxaemia, but overall can be considered feasible provided that extensive continuous monitoring is employed.
Head position for opening the upper airway
Authors: Paal P. , Goedecke A. v. , Brugger H. , Niederklapfer T. , Lindner K. H. , Wenzel V. 
Published: February 2007

SummaryInexperienced rescuers may encounter severe problems in an unconscious patient with opening and maintaining a patent upper airway. Designing a ventilating device that could indicate how to open an upper airway correctly may be beneficial. The heads of 102 volunteers were randomly placed in different head positions by one investigator. A pocket mask was then pressed gently on the volunteer's face followed by measurement of the head position angles. Mean (SD) flexion was − 4° (8°) (95% CI − 5.9 to − 2.9); the mean neutral position was 21° (6°) (95% CI, 19.9 to 22.3); extension was 42° (6°) (95% CI 40.8 to 43.0°) and differed significantly between each position (p < 0.001). The flexion and neutral position angles were significantly greater in men than in women: − 2 (7°) vs. −8 (7°) and 22 (7°) vs 20 (5°); p < 0.001 and p = 0.03, respectively. Maximum extension of the head in both supine men and women was 42°, which could be utilised to optimise assisted ventilation of an unprotected upper airway.
The effect of alcohol swabs and filter straws on reducing contamination of glass ampoules used for neuroaxial injections*
Authors: Hemingway C. J. , Malhotra S. , Almeida M. , Azadian B. , Yentis S. M. 
Published: February 2007

SummaryWe have investigated the incidence of contamination of the contents of glass ampoules used for neuraxial injections, and whether this was reduced by wiping the outsides of the ampoules with isopropyl alcohol or using a filter straw. One hundred fentanyl and diamorphine ampoules used for routine regional anaesthesia were either wiped or not wiped with alcohol before their contents were aspirated, and the residual contents were swabbed and incubated. None of the swabs from the wiped ampoules grew organisms compared with nine (18%) from non‐wiped ampoules (p = 0.004). In a second, laboratory study, 100 glass ampoules of saline were coated with Staphylococcus aureus and divided into four groups: wiped/not wiped with alcohol and with/without a filter straw. The contents of the ampoules were aspirated; the remnants and the aspirate were swabbed and incubated as before. Most contamination occurred in the unwiped groups and although numbers were small, filtering appeared to reduce contamination further. As filter straws also reduce the risk of injecting glass particles (even if not contaminated), our results suggest that wiping glass ampoules with isopropyl alcohol and using a filter straw should be part of routine practice when performing regional anaesthesia.
Influence of CYP2C9 and CYP2C19 genetic polymorphisms on pharmacokinetics of gliclazide MR in Chinese subjects
Authors: Zhang Yifan , Si Dayong , Chen Xiaoyan , Lin Nan , Guo Yingjie , Zhou Hui , Zhong Dafang 
Published: February 2007

What is already known about this subject • Gliclazide has been considered metabolized by CYP2C9.• Its modified release formulation, gliclazide MR, shows low pharmacokinetic variability in Whites but high variability in Chinese. What this study adds • The results of this study show that the pharmacokinetics of gliclazide MR are affected mainly by CYP2C19 genetic polymorphism instead of CYP2C9 genetic polymorphism.• CYP2C19 genetic polymorphism might be responsible for the high pharmacokinetic variability of gliclazide MR in Chinese.Aims To investigate the influence of CYP2C9 and CYP2C19 genetic polymorphisms on the pharmacokinetics of gliclazide modified release (MR) in healthy Chinese subjects.Methods In a single‐dose pharmacokinetic study, 24 healthy male subjects with various CYP2C9 and CYP2C19 genotypes received an oral dose of 30 mg gliclazide MR and plasma was sampled for 72 h postdose. In a multiple‐dose pharmacokinetic study, 17 other CYP2C9*1 homozygotes with various CYP2C19 genotypes received 30 mg gliclazide MR once daily for 6 days and plasma was sampled after the last dose. The plasma concentrations of gliclazide were measured using a validated LC/MS/MS method. CYP2C9 and CYP2C19 genotypes were determined by polymerase chain reaction‐restriction fragment length polymorphism analysis.Results In the single‐dose study, no significant difference in any pharmacokinetic parameters was found in CYP2C9*1/*1, *1/*3 and *1/*13 subjects. In contrast, the AUC0–∞ of gliclazide was significantly increased by 3.4‐fold [95% confidence interval (CI) 2.5, 4.7; P < 0.01] in CYP2C19 poor metabolizer (PM) subjects compared with CYP2C19*1 homozygotes. The half‐life (t1/2) was prolonged from 15.1 to 44.5 h (P < 0.01). Similar differences were found in the multiple‐dose study. The parameters of gliclazide AUCss, AUC0–∞ and Cmax were 3.4‐fold (95% CI 2.9, 4.0), 4.5‐fold (95% CI 3.8, 5.4) and 2.9‐fold (95% CI 2.4, 3.4) increased (P < 0.01) in CYP2C19 PM subjects, respectively, compared with CYP2C19*1 homozygotes, and t1/2 was increased from 13.5 to 24.6 h (P < 0.01).Conclusions The pharmacokinetics of gliclazide MR are affected mainly by CYP2C19 genetic polymorphism instead of CYP2C9 genetic polymorphism.