Asian Pacific Journal of Tropical Medicine

1-7

Authors: Adenike Okunlola, Oluwatoyin A. Odeku

Objective:The quantitative effects of formulation and processing variables affecting the binding properties of Chinese yam starch (Dioscorea oppositifolia) in chloroquine phosphate tablet formulations have been investigated in comparison with corn starch using a 23 factorial experimental design.Methods:Chinese yam starch, representing the "low" level, and corn starch, representing the "high" level were used as binders at concentrations of 2.5 ％w/w and 10 ％ w/w in chloroquine phosphate tablet formulations. The mechanical properties of the tablets, measured by the tensile strength (T) and brittle fracture index (BFI) as well as the release properties measured by the disintegration time (DT) and dissolution time (t80 time for 80 ％ drug release), were used as assessment parameters.Results:The ranking of the individual coefficient values for the formulations on T was D ＞N -C, on BFI was N ＞D -C, on DT was D ＞N ＞C and on t80 was C＞N＞D while the ranking of the interaction coefficient on T was N-D＞ C-D – N-C, on BFI was N-D ＞ N-C = C-D, on DT and t80 was N-C＞ N-D＞ C-D. Changing the binding agent from Chinese to corn starch, led to a decrease in T, DT and t80 but increase in BFI of the tablets. There were significant (P<0.001) interactions between the nature of binder, N and the other two variables, C and D.Conclusion:The result showed that Chinese yam possessed stronger binding capacity than corn starch and could be useful as an alternative binder when tablets with high mechanical strength with minimal problems of lamination, and slow release are required.

11-15

Authors: Obianime AW , Uche FI

Objective:To investigation the comparative effects of the aqueous extracts of the seeds of Tetracarpidium conophorum (T. conophorum) and Proviron on the sperm parameters of male guinea pigs, and screen phytochemical constituents of the seeds of T. conophorum. Methods: The sperm count, motility and morphology of the male guinea pigs were done using Neubauer chamber (Haemocytometer), light microscope and dilute carbol Fuchsin (1∶20) method, respectively. Phytochemical screening was done by standard procedures. Results: The aqueous extract of the T. conophorum seeds (100-400 mg/kg) caused statistically significant increase (P< 0.05, ANOVA) in the sperm count and motility, from 67.7± 2.10 and 56.5 ± 2.40 to 78.0± 3.5 and 75.0± 2.8, respectively. The highest effect was obtained at 300 mg/kg of T. conophoru. At this dose, the sperm count and motility of the male guinea pigs administered with T. conophorum were the same with the group administered 12.5 mg/kg Proviron. The values were 78.0 ± 3.50 and 75.0 ± 2.80, respectively for sperm count and motility (P <0.001, ANOVA). At 400 mg/kg, T. conophorum caused a slight decline in sperm count and motility. These effects were dosedependent and comparable to the observed effects of Proviron (12.5 mg/kg) on sperm parameters of male guinea pigs. In timedependent study, the observed effect of T. conophorum (300 mg/kg) and Proviron on the values of sperm count and motility at 14th day were almost the same. These values are 58.0± 1.80 and 70.0 ± 2.60, respectively for sperm motility and count. However, on the 7th day of treatment, T. conophorum exhibited highest effect which was higher than that of Proviron. These effects decreased progressively from the 14th to the 28th day. But Proviron showed the highest effect on the 28th day. These effects were all timedependent and statistically significant at P < 0.05 (ANOVA). Finally, the phytochemical screening of the seeds of T. conophorum revealed the presence of flavonoids, tannins, alkaloids, terpenoids, carbohydrates, volatile oils, steroids, saponins and cardiac glycosides. Conclusion:This study shows that the seeds of T. conophorum possess some active principles that can contribute positively on male fertility. This therefore, supports the claims on the use of the seeds of this plant by traditional medicine practitioners to increase/improve libido in men. However, further studies need to be done to investigate the mechanism of this action and also to isolate and characterize the active principles responsible for this effect in the extracts of this plant.

18-21

Authors: Siddiqui R, Siti Asma' H,Tang L, Jie CC, Rosliza AR, Roziawati Y

Objective: To analyze the effect of selected plant product against several bacterial which commonly causes oral infection. It was hope that in future, this product will become the remedy for treatment of oral infection and with the hope that it can substitute antibiotics. Methods: A total of 5 species of oral bacteria from American Type Culture Collection (ATCC) were employed in this study(S.mutans, S.aureus, P.aeruginosa, S.sobrinus and L.salivarius). Three types of natural plants crude extracts were used(garlic, curry leaves and cloves). Bactericidal and bacteriostatic effects of these herbs were tested.Results: It was shown garlic had antibacterial effects on all bacteria. The Minimal Inhibitory Concentration (MIC in g/mL) of garlic towards S.aureus, P.aeruginosa, S.mutans, S.sobrinus and L.salivarius were 0.3,1.8,1.2,0.5 and 1.8, respectively. There was significant difference among the MIC of garlic on tested bacteria. It was more potent toward S. aureus. The curry leaf solution on the other hand, did not show any zone of inhibition in all bacteria plates but adversely showed enhanced growth of those bacteria. Clove had shown its antibacterial effects on S. aureus and P. aeruginosa. The clove was more potent toward S. aureus with the MIC of 0.45 g/mL. P. aeruginosa was more sensitive to clove compared to garlic. For S.aureus, it was more sensitive to garlic compared to clove.Conclusion:The antibacterial activity of garlic and clove crude extracts shown in our study further confirm these natural plants' potential usage in therapeutic use for oral diseases or infections. This could be the platform for the interested party to do research and development on it and to produce oral health products which are more affordable for lower economic income groups and with fewer side effects as seen in synthetic drug.

28-32

Authors: Saraswathy TS , Az-Ulhusna A, Nor Zahrin H, Nurhasmimi Hassan , Zainah S, Rohani J

Objective:To analyse the laboratory surveillance data from 2004 till 2008 to examine the changing trend of rubella cases in Malaysia.Methods:Samples for this study were either received through the measles case based surveillance program or were hospital cases received for serodiagnosis of congenital rubella syndrome (CRS). Specific rubella IgM antibody test was carried out on all samples that were negative for measles IgM antibody and for serodiagnosis of CRS.Results:Through the surveillance program for measles, the samples received for rubella had increased five fold from 365 in 2004 to 1 522 in 2007. Positive rubella cases detected had also increased from 4.1 % in 2004 to 33.2 % in 2007. The age group 11 to 20 years accounted for 73.6 % of rubella cases confirmed in 2008, with a higher incidence among males than females. Positive rubella IgM was detected in 25 CRS cases during the 6 year period between January 2003 and December 2008.Conclusion:The measles elimination program had contributed to significant progress in the control of rubella, with the majority of rubella cases detected through this strategy. Since rubella is not notifiable in Malaysia, this integrated measles and rubella surveillance should be continued. However, to enhance the progress, specific targets should also be established in the national program to eliminate rubella and CRS.

37-39

Authors: Malison Marilyn T, Sia Su Glenn L

Objective:This study aims to determine the prevalence of intestinal parasites infesting the vegetable foodstuffs and determine the parasitological profile of the vegetable foodstuffs examined. Methods:About 200 randomly sampled vegetable foodstuffs obtained from the vendors of the Balintawak and Divisoria public markets were examined for the occurrence of intestinal parasites. Results:A total of 119 (59.5 %) vegetable foodstuffs examined were tested positive. The most common parasite found was the Ascaris lumbricoides. No significant differences between the prevalence of intestinal parasites at the two public markets were found (P > 0.05).Conclusion:The vegetables can be a potential source of parasitic infection.

43-47

Authors: Lawrence O

Objective: To investigate the incidence of human cytomegalo virus (HCMV) in pregnant women. Methods: One hundred and twenty two (122) blood samples and 80 umbilical cord fluids were tested for IgG and IgM respectively using the enzyme linked immunosorbent assay (ELISA). Results: Of the 122 samples screened for IgG and IgM only 56 (47.1 %) tested positive for IgG while 63 (52.9 %) were positive for IgM with 3 samples nonspecific. Pregnant women with signs of normal pregnancy made up 60% of the positive results while 20 % had a history of ectopic pregnancy and 20 % with a history of miscarriages. Of the total of 80 umbilical cord fluids tested, only 59 (73.8) tested positive. Eleven of the selected 40 umblical cord fluid was positive to IgG to human cytomegalovirus along with mother and child. Antibody titration result gave diagnostic titre for both IgG and IgM from the 40 umbilical cord fluids. There was a significant relationship between mother, child and umbilical cord fluids ( χ2=1.360, CI=99 %, P=0.568). Conclusion: There could be a possible neonatal infection, and the infection is common among toddlers and children of preschool age.

52-58

Authors: Mahmoud M Al-Bendary, Mahmoud Abdel-Aziz, Waleed A Al-Sherbeeny, Raghda El-Sayed Farag, Abdel-Hady El-Gilany, Mohammad Hosam Eldeen Zaghloul

Objective:To determine the prevalent pathogens responsible for spontaneous bacterial peritonitis (SBP) and their sensitivity pattern, to test the efficiency of different culture techniques in microbial isolation, and to study the diagnostic predictors of such cases.Methods:One hundred eight SBP episodes from 92 adult patients were compared to 88 cirrhotic ascites patients cross-matched with age and sex without SBP. Ascitic fluid was subjected to cytological, biochemical examination and culture on both conventional and blood culture bottles at the bedside for bacterial identification and antimicrobial susceptibility testing.Results:The prevalence of SBP was 25.02 %. Logistic regression analysis revealed that; previous SBP episode, low ascitic fluid protein levels, high serum creatinine and low serum albumin levels were the independent significant predictors of SBP. About forty-five per cent of SBP episodes were detected by conventional culture compared to 73.15 % by modified technique with a significant difference. Gram-negative bacteria were the cause of SBP in 46 (58.23 %) culture positive episodes. Escherichia coli and Staphylococcus aureus were the most commonly detected organisms. Resistance to different antibiotics was high.Conclusion:Culture of ascitic fluid in blood culture bottles at bedside increases the sensitivity of SBP detection. There is a recent increase in Gram-positive pathogen with emergence of multidrug resistance. These recent changes may have an impact on guidelines for management and treatment of SBP in our locality.

63-70

Authors: Sayasone S, Erlanger TE, Kaul S, Sananikhom P, Tanner M, Utzinger J, Odermatt P

Objective:To compare perceived illhealth and health seeking behavior between two communities affected by the large Nam Theun 2 hydroelectric project in central Lao People's Democratic Republic (PDR). Methods:Two different affected areas: Nakai plateaubeing remote, sparcely populated and mountainous, and Xe Bang Fai lowland plains, more densely populated and comparatively affluent were included. Data were obtained from two crosssectional householdbased health and socioeconomic surveys. Results:We found pronounced differences in the frequency of selfreported fever, cough, headache and myalgia according to location. On the Nakai plateau, 45.1 % of the individuals with illhealth report (recall period: 2 weeks) went to a local health volunteer compared to only 7.2 % in the Xe Bang Fai area (P<0.001). In Nakai, there were disproportionately more illiterates seeking help from local health volunteers when compared to those who attended at least primary schooling (49.2 % versus 17.5 %, P<0.01). Selfmedication with antimalarials was more common in Xe Bang Fai than on Nakai (32.3 % versus 7.0 %, P<0.001). The mean amount of money spent per health consultation was US$ 1.7 in Nakai and US$ 7.2 in Xe Bang Fai. Conclusion:The observed differences in selfreported illhealth and health seeking behavior among these two Lao communities need to be considered when implementing settingspecific mitigation measures as part of the public health action plan of the Nam Theun 2 hydroelectric project.

78-80

Authors: Col Prasan Kumar Hota

Splenic abscess is an uncommon clinical presentation in surgical practice, associated with high morbidity and mortality. Mortality may be 100 % if left untreated. Splenic abscess is also rarely encountered as a complication of typhoid fever. We present here a case of multiple splenic abscesses with neuropsychiatric complications due to typhoid fever, which was managed successfully with splenectomy and other supportive therapies. Another case of single splenic abscess due to enteric fever was treated successfully with CTguided aspiration and appropriate antibiotics.Being a rare entity in clinical practice, splenic abscess has been poorly studied. Haematogenous seeding of the spleen due to typhoid is a common cause of splenic abscess in the tropical countries. In multiple or multiloculated abscesses aspiration usually does not succeed, which happened in our case. Splenectomy remains the definitive choice of treatment. However, Ultra sonography (USG) or CTguided aspiration may be tried in selective cases.