Search

Background The longevity of people living with HIV has been enhanced by the introduction of antiretroviral (ARV) drugs in the mid-90s. Antiretroviral therapy (ART) is now mandatory for all persons who test HIV positive in South Africa and the government policy is to start treatment upon diagnosis. The ART is based on protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs) and both groups of drugs have been reported to have deleterious side effects manifesting as HIV-associated lipodystrophy syndrome, metabolic syndrome and cardiovascular diseases. HIV infection also causes dislocation of the gut microbiota which also contribute towards the observed systemic inflammation even before patients are on ART. The aim of this study is find the relationship between HIV infection, ART, endothelial function, and gut microbial dynamics and how they influence development of cardiovascular disease (CVD) and metabolic syndrome. Presented here is the detailed study protocol. Methods This is a longitudinal study to be conducted over a period of two years. Newly diagnosed patients of both genders enrolled for the ART programme will be recruited and blood, stool and anthropometric measurements will be collected every 6 months. Endothelial function, measured by non-invasive methods i.e. flow-mediated dilation and retinal microvasculature assessment. Lipid profile, viral load and other relevant blood parameters will be measured using routine methods employed by the National Health Laboratory Services in Mthatha, South Africa. Stool samples will be used for metagenomic analysis to characterise changes in the gut microbial richness and abundance. The 16S rRNA gene will be PCR amplified and amplicons will be sequenced using a next-generation sequencing platform. Multivariate analysis will be used to determine the nature of the relationship between blood chemistry parameters, gut microbial profile, endothelial function and anthropometric data. Impact of project : The study aims to determine changes in vascular function and gut flora in the in persons living with HIV on the ART programme, subsequently providing a platform for development of corrective and therapeutic nutraceuticals and probiotics for the same population.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP and acting as a temporary solution to the lack of screening programmes worldwide. As part of MMM, screening in South Africa in 2017 revealed that 24.5% of adults (mean age = 31 years) have hypertension and only half of those with hypertension had controlled BP. These data highlight the need for continued screening and awareness campaigns. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurements, the definition of hypertension and statistical analyses followed the MMM protocol. The sites screened were general populations and university campuses in preference to hospitals and clinics, aiming to raise awareness and allow access to screening to those less likely to be aware of their BP. In total, 2965 individuals (age 40.5 ± 18.2 years) were screened. After multiple imputation for missing BP readings, 34.6% had hypertension, only 56.7% of those with hypertension were aware, 21.2% of those not receiving treatment for hypertension were hypertensive, and a large proportion (42.5%) of individuals receiving antihypertensive medication had uncontrolled BP. These results suggest that opportunistic screening campaigns can identify significant numbers with undiagnosed and uncontrolled hypertension. The high proportions of individuals with undiagnosed and treated uncontrolled hypertension highlight the need for hypertension awareness campaigns and more rigorous management of hypertension.

Objective Recent findings have associated insulin resistance and obesity with increased gut permeability. However, it still remains unclear whether obesity may be the underlining factor for the association between gut permeability and insulin resistance. This study investigated the relationship between gut permeability, measures of obesity, and markers of insulin resistance in young adults. Materials and Methods A cross-sectional quantitative study which enrolled 151 young South African adults was conducted. Anthropometric measurements were performed to assess obesity. Adiponectin, leptin, and zonulin, a marker for gut permeability, were assayed. Insulin and fasting glucose were assayed and used to determine insulin resistance (HOMA-IR), insulin sensitivity (%S) and beta cell function (%B). Results Decreased adiponectin and increased leptin were associated (p 0.05) with obesity. Overweight/obese (O/O) females had a significantly (p

Purpose: To synthesize some pyrimidine derivatives and investigate their radical scavenging activities. Methods: A series of newly pyranopyrimidines derivatives and dithiopyridopyrimidinediones were synthesized by condensation of barbituric acid, malononitrile and different substituted benzaldehydes reacted with 1,4-Diazabicyclo[2.2.2] octane (DABCO) as a base. Compounds P1-7 (series 1), S1-11 (series 2) Scheme 1 and 6-amino-2-thiouracil with aromatic aldehydes in glacial acetic acid under reflux J1-13 (series 3) Scheme 2. 1H & 13C NMR, CHN, GC-MS and IR were used to characterize the compounds and were also screened for radical scavenging activity using 2,2-diphenyl- 1-picrylhydrazyl (DPPH) radical scavenging activity (IC50 = 50 μg/ml). Results: The potency of radical scavenging activity was ranked as series 1 > series 3 > series 2. Compounds P3, J4, S10, P5, P7 with inhibitory concentration at 50 % level (IC50) of 12, 40, 48, 50, and 54 μg/ml, respectively, showed radical scavenging activity equal or more potent than the standard antioxidant, ascorbic acid (IC50 = 50 μg/ml). Conclusion: Series of newly pyranopyrimidines and dithiopyridopyrimidinediones derivatives have been successfully synthesized, and they demonstrate good radical scavenging activity. Keywords: Pyranopyrimidine, Dipyrimidines, Anti-oxidant, DPPH, Ascorbic acid, Radical scavenging

Background: Though gut permeability has shown to be associated with measures of obesity and hypertension, its relation- ship with endothelial dysfunction, an early predictor for cardiovascular diseases remains unknown. Objective: This study assessed the relationship between hypertension, measures of obesity, gut permeability and endothelial dysfunction. Methods: A cross-sectional quantitative study which enrolled 151 South African youths was conducted. Anthropometric and blood pressure measurements were performed. Zonulin, a marker for gut permeability; adiponectin, an anti-inflamma- tory molecule, as well as asymmetric dimethylarginine (ADMA) and Nitric oxide (NO) which are markers for endothelial- function were assayed. Results: Approximately eighteen percent (17.88%) of the participants were hypertensive while 40.4% were pre-hyperten- sive. Adiponectin significantly increased in hypertensive subjects and negatively correlated (p

Background Central obesity and insulin resistance are associated with metabolic syndrome (MetS) which is aggravated by diet and sedentary lifestyle. Athrixia phylicoides (AP) is reported by rural communities to have medicinal benefits associated with MetS such as obesity and type 2 diabetes. This study was aimed to investigate the effects of AP on diet-induced MetS in Wistar rats to validate its ethnopharmacological use. Methods AP was profiled for phytochemicals by LC-MS. After induction of MetS with high energy diet (HED), 30 male rats were divided into five treatment groups (n = 6): normal diet control, HED control, HED + AP 50 mg/Kg BW, HED + AP 100 mg/Kg BW and HED + 50 mg/Kg BW metformin. The rats were treated daily for 8 weeks orally after which weight gain, visceral fat, total cholesterol, free fatty acids (FFAs) and adipokine regulation; leptin: adiponectin ratio (LAR) were assessed. Also, glucose homeostatic parameters including fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glucose transporter 4 (GLUT 4), insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. Results Findings showed that AP was rich in polyphenols. The HED control group showed derangements of the selected blood parameters of MetS. AP reversed diet-induced weight gain by reducing visceral fat, total blood cholesterol and circulating FFAs (p ≤ 0.05). Treatment with AP improved adipokine regulation depicted by reduced LAR (pp ≤ 0.05) and increased GLUT 4 (p Conclusion Athrixia phylicoides tea infusion was shown to possess anti-obesity and anti-inflammatory properties, improved glucose uptake and reduce insulin resistance in diet-induced MetS in rats which could be attributed to its richness in polyphenols. Therefore, AP could have potential benefits against type 2 diabetes and obesity which are components of MetS validating its ethnopharmacological use.

Medicinal and food plants contain phytoconstiuents that can provide protection against oxidative damage. The aim of this study was to determine the hepatoprotective effects of Fadogia ancyl...

Taraxacum officinale (T. officinale) is a leafy vegetable that is commonly used traditionally as a diuretic agent. In the current study, we aimed at exploring the potential antihypertensive effect ...

Simple Summary The diagnosis of obesity in sub-Saharan African children relies on cut-off values for body mass index percentile (pBMI) and waist-to-height ratio (WtHR) established in western populations. Hence, this study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. Findings from this study showed that the cut-off value for pBMI was p85.2th, which improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile of p95.0th. Moreover, the optimal cut-off for WHtR was 0.481, which was close to the recommended cut-off value of 0.5. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population and suggests that the optimal pBMI cut-off for obesity screening may be ethnic-specific. Abstract The assessment of obesity in sub-Saharan Africa relies on cut-offs established from western populations. This study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. A cross-sectional study involving 1144 (796 females and 348 males) adolescents aged 11–17 years from the Eastern Cape Province of South African was conducted. Anthropometric parameters were measured. Receiver operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of obesity screening tools and establish cut-offs. The optimal cut-offs for obesity in the cohort using waist-to-height ratio (WHtR) as reference were: neck circumference (NC) = 30.6 cm, mid-upper arm circumference (MUAC) = 25.9 cm, waist circumference (WC) = 75.1 cm, hip circumference (HC) = 92.15 cm and body mass index percentile (pBMI) = p85.2th. The new pBMI cut-off value at p85.2th improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile (pBMIr) of p95.0th. When pBMI was used as reference, the optimal cut-offs in the cohort were: WHtR = 0.481, NC = 30.95 cm, MUAC = 27.95 cm, WC = 76.1 cm and HC = 95.75 cm. The WHtR optimal cut-off of 0.481 was close to the recommended cut-off value of 0.5. The predicted prevalence of obesity obtained using cut-offs from ROC analysis was higher than those from recommended references. All cut-off values for the various anthropometric measures generally increased with age for all percentile ranges. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population. The study has established that the optimal pBMI cut-off for obesity screening may be ethnic-specific.

Background. Particulate matter (PM) air pollution is an important environmental health risk factor. Although some studies have shown PM to be associated with obesity and hypertension, very few studies have assessed the association of indoor PM specifically with obesity and blood pressure measures in children with respect to seasonal variation. Objectives. The present study investigated the relationship of PM with obesity and blood pressure variables in children across the winter and summer seasons. Methods. A comparative descriptive approach was adopted and school children from 10–14 years of age from selected rural and urban localities of the Eastern Cape Province of South Africa were assessed in winter and summer. Anthropometric measurements were taken, including height, weight, waist circumference, body mass index (BMI), and total fat mass (TFM), while blood pressure variables including systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured. Indoor air PM concentrations were measured in the classrooms in the presence of children. Results. The prevalence of obesity and hypertension in children were 13.4% and 5.1% in winter and 12.9% and 1.0% in summer, respectively. High blood pressure was more prevalent in children in rural areas, while the prevalence of obesity in children was higher in urban areas. Particulate matter was significantly (p Conclusions. High concentrations of indoor PM were positively associated with obesity in children in summer, particularly among rural children. This association could be accounted for by location and seasonal differences. Participant Consent. Obtained Ethics Approval. Ethics approval was obtained from the Health Sciences Ethics Committee of Walter Sisulu University, South Africa (Ref No: CHI011SCHU01). Competing Interests. The authors declare no competing financial interests.

ObjectivesPrevalence of child and adolescents’ overweight and obesity in low- and middle-income countries has increased dramatically. Simultaneously, the incidence of pre-hypertension/hypertension is also increasing in children, which, in turn, predisposes these children to the risk of cardiovascular disease (CVD) in later life. The present study assessed cardiometabolic risk factors and early indicators of vascular dysfunction in adolescents from a low socio-economic rural area in South Africa.DesignCross-sectional cohort study.SettingThe study was conducted in public schools in Mthatha, OR Tambo district municipality, Eastern Cape Province, South Africa.ParticipantsA total of 244 adolescents (188 females) of African ancestry aged 13–16 years were enrolled.Primary and secondary outcome measuresAnthropometric and haemodynamic measures and pulse wave velocity (PWV) were related to overweight/obesity and hypertension. Blood markers of cardiometabolic syndrome were assessed as well as vascular function (via PWV).ResultsOne-third (33.0%) of the adolescents exceeded the age and sex-specific body mass index percentiles for overweight (≥85th) or obesity (>95th) with a prevalence of 61.1% pre-hypertensives in this group. Overweight/obesity and hypertension were associated with higher triglycerides (lean:overweight: 0.794.69 mmol/L, pConclusionOverweight/obesity and hypertension show a high prevalence in rural South African youth. Almost half of the studied adolescents are at risk for developing CVD. The high association between cardiometabolic risk factors and PWV further suggests that hypertension in adolescents may promote the progression of CVD in adulthood. Early detection of those at risk and the implementation of preventive strategies in underprivileged young people is urgently needed to stop the progression of vascular damage and manifestation of CVD in rural African children.

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV+ART+), 163 HIV-positive individuals not on ART (HIV+ART&minus, ) and 171 individuals without HIV (HIV&minus, ) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV+ART+ participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV+ART+ participants compared with the controls (HIV+ART&minus, and HIV&minus, participants). FMD was not different between HIV+ART+ participants and the controls. Moreover, HIV+ART+ participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV&minus, and HIV+ART&minus, participants. A positive relationship between FMD and CD4 count was observed in HIV+ART+ participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.

Though the association between high blood pressure and microalbuminuria is well established in adults, there is a paucity of information on microalbuminuria in children. This study investigated the relationship between high blood pressure and microalbuminuria in 6&ndash, 9-year-old children. A cross-sectional study, which included 306 primary school children of age 6&ndash, 9 years old from urban areas (n = 154) and rural areas (n = 152) of the Eastern Cape Province of South Africa, was conducted. Participants&rsquo, anthropometric data were determined and systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured and converted to BP percentiles for age, sex and height. Creatinine and albumin concentrations were assayed in early morning midstream urine and the albumin to creatinine ratio (ACR) was calculated. There was a 42.8% prevalence of elevated blood pressure/high blood pressure (E-BP/H-BP) and a 10.1% prevalence of microalbuminuria. Among the 131 children with E-BP/H-BP, 17 had elevated ACR with a prevalence of 13.95%. SBP and HR increased with increasing range of ACR and, furthermore, SBP was significantly (p &lt, 0.05) higher in children with moderately and severely increased ACR. SBP was associated with ACR and increased SBP predicted microalbuminuria (R2 = 0.42, adj R2 = 0.039, B: 0.120, p = &lt, 0.05). In conclusion, microalbuminuria was present in 6&ndash, 9-year-old South African children of African Ancestry and a weak association was observed with SBP in children.

Background Senecio serratuloides DC is used in folk medicine for treating hypertension, skin disorders, internal and external sores, rashes, burns and wounds. This study aimed at investigating the antihypertensive effects of the hydroethanol extract of S. serratuloides (HESS) in N-Nitro-L-arginine methyl ester (L-NAME) induced hypertension in rats. Methods: Acute toxicity of HESS was first determined to provide guidance on doses to be used in this study. Lorke’s method was used to determine safety of the extract in mice. Female Wistar rats were treated orally once daily with L-NAME (40 mg/kg) for 4 weeks and then concomitantly with L-NAME (20 mg/kg) and plant extract (150 and 300 mg/kg), captopril (20 mg/kg) or saline as per assigned group for 2 weeks followed by a 2-week period of assigned treatments only. Blood pressure was monitored weekly. Lipid profile, nitric oxide, renin and angiotensin II concentrations were determined in serum while mineralocorticoid receptor concentration was quantified in the kidney homogenate. Nitric oxide (NO) concentration was determined in serum and cardiac histology performed. Results HESS was found to be non-toxic, having a LD50 greater than 5000 mg/kg. Blood pressure increased progressively in all animals from the second week of L-NAME treatment. HESS treatment significantly and dose-dependently lowered systolic blood pressure (p

Cardiovascular disease (CVD) risk factors are known to begin early in life, but limited data on the relationship of obesity and hypertension with other known CVD risk factors, such as endothelial dysfunction, oxidative stress, and chronic low-grade inflammation is available on children. In this cross-sectional study involving 6&ndash, 9 years old school children aged from the Eastern Cape Province of South Africa the relationship between obesity/hypertension and other risk factors for CVDs was investigated. General anthropometric parameters were measured, followed by blood pressure (BP) measurements and pulse wave velocity (PWV). Urine samples were collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG), and thiobarbituric acid-reactive substance (TBARS). Overweight/obesity (19.28%) and pre-hypertension/hypertension (42.16%) were prevalent in children. Mid-upper arm circumference (MUAC), a marker of obesity, was positively correlated with ADMA, while ADMA and PWV were significantly different (p &lt, 0.05) between hypertensive and normotensive children. Also, TBARS and 8-OHdG were significantly (p &lt, 0.05) increased in hypertensive subjects. Creatinine was significantly (p &lt, 0.05) increased in obese, as well as in hypertensive children, and positively associated with waist circumference (WC) and neck circumference (NC). In conclusion, obesity and hypertension were associated with renal-cardiovascular disease risk, while oxidative stress showed a possible association with obesity in 6 to 9 year old South African children of African descent. This suggests that South African children of African descent may be becoming more prone to developing CVDs, and therefore may require early intervention for the prevention of CVDs in the near future.

Ledebouria ovatifolia (Baker) Jessop is a wild plant widely used for medicinal purposes including diarrhoea, stomach ache and gastric ulcer in African rural settings. This study aims to evaluate th...

BackgroundHypertension is a silent killer with no obvious signs and symptoms; thus, it is crucial to prevent its development. Oxidative stress and hyperlipidemia are associated risk factors for developing hypertension. This study aimed at investigating the role of a crude extract of Senecio serratuloidesin preventing the development of hypertension, oxidative stress and hyperlipidemia in a rat model of nitric oxide deficiency.MethodsFemale Wistar rats were co-treated with Nω-Nitro L-arginine methyl ester (L-NAME) (40 mg/kg) and the hydroethanolic extract ofS. Serratuloides(HESS150 or HESS300 mg/kg) for 4 weeks. Twenty-hour urine samples were collected weekly during the study. At the end of the study serum, heart and kidneys were harvested for biochemical and histopathological analysis.ResultsThe higher dose (300 mg/kg) of the extract was more effective in preventing increase in systolic (pConclusionThese findings demonstrate the potential ofS. Serratuloidesin protecting rats from developing hypertension, hyperlipidemia and oxidative stress.

Senecio serratuloides commonly referred to as “two day cure” is used in folk medicine for treating hypertension and wounds in South Africa. This study was aimed at isolating and testing the antihypertensive effects of bioactive compounds from S. serratuloides. Senecio serratuloides was serially extracted using solvents of increasing polarity. Phytochemical analysis, antioxidant capacity and antihypertensive properties of fractions were investigated. Bioactive compounds were isolated from ethyl acetate and methanol fractions, their antihypertensive effects and effect on urine norepinephrine concentration were determined. Ethyl acetate and methanol fractions had all eight phytochemicals tested, better antioxidant capacity and significantly (p < 0.001) prevented the increase in blood pressure induced by Nω-Nitro-l-arginine methyl ester hydrochloride. The isolated bioactive compounds were phytosteroids and Estran-3-one, 17-(acetyloxy)-2-methyl-, (2à,5à,17á) – which was isolated from methanol fraction had significantly (p < 0.001) better antihypertensive effects through the 4-h period of the study. Senecio serratuloides may be a potential source of antihypertensive lead compounds.

Oxidative stress has gained attention as one of the fundamental mechanisms responsible for the development of hypertension. The present study investigated in vitro and in vivo antioxidant effects of 70% ethanol-water (v/v) leaf and root extracts of T. officinale (TOL and TOR, respectively). Total phenolic and flavonoid content of plant extracts were assessed using Folin Ciocalteau and aluminium chloride colorimetric methods, while, 2,2-diphenyl-1-picrlhydrazyl (DPPH), 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and ferric reducing antioxidant power (FRAP) protocols were used to determine the free radical scavenging and total antioxidant capacities (TAC), respectively. The in vivo total antioxidant capacity and malondialdehyde acid (MDA) levels for lipid peroxidation tests were performed on organ homogenate samples from N&omega, nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats treated with leaf extract, TOL (500 mg/kg/day) and TOR (500 mg/kg/day) for 21 days. Results showed that compared to TOR, TOL possessed significantly higher (p &lt, 0.01) polyphenol (4.35 &plusmn, 0.15 compared to 1.14 &plusmn, 0.01) and flavonoid (23.17 &plusmn, 0.14 compared to 3 &plusmn, 0.05) content, free radical scavenging activity (EC50 0.37 compared to 1.34 mg/mL) and total antioxidant capacities (82.56% compared to 61.54% ABTS, and 156 &plusmn, 5.28 compared to 40 &plusmn, 0.31 FRAP) and both extracts showed no toxicity (LD50 &gt, 5000 mg/kg). TOL and TOR significantly (p &lt, 0.01) elevated TAC and reduced MDA levels in targets organs. In conclusion, T. officinale leaf extract possesses significant anti-oxidant effects which conferred significant in vivo antioxidant protection against free radical-mediated oxidative stress in L-NAME-induced hypertensive rats.

Morongwe Annah Sekokotla,1 Nandu Goswami,2 Constance Rufaro Sewani-Rusike,1 Jehu Erapu Iputo,3 Benedicta Ngwenchi Nkeh-Chungag4 1Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; 2Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria; 3Department of Medical Education, Faculty of Health Sciences, Walter Sisulu University, 4Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa Objective: Metabolic syndrome (MetS), defined as the clustering of three of five risk factors (hypertension, obesity, triglyceridemia, dyslipidemia and hyperglycemia), is being increasingly mentioned among children and adolescents despite there being no consensus on how it should be defined in this set of population. Furthermore, very few studies have focused on MetS in children and adolescents in sub-Saharan populations. This study, therefore, aimed at determining the prevalence of the MetS and contributing risk in adolescents living in Mthatha, South Africa.Research design and methods: Four hundred and ten adolescents (age range: 13–18 years, both sexes) were recruited into this cross-sectional study. In addition to a lifestyle questionnaire being administered, anthropometric measurements (weight, height and waist circumferences) were carried out for each participant. Fasting venous blood was collected for lipid profile and blood glucose assessments. Blood pressure was also measured. MetS was assessed using appropriate diagnostic criteria for children and adolescents.Results: Complete data sets were collected from 371 participants. Females showed an elevation in the risk factors for MetS. Of the 371 participants, 40.2% were overweight/obese (47.5% females; 22.5% males). MetS was diagnosed in 3.1% female participants compared with 6.0% in male participants.Conclusions: More risk factors for the MetS are seen among the overweight/obese as compared to lean adolescents. Given the fact that childhood overweight/obesity often continues into adulthood, it is important to address the causes of increased risk for MetS earlier in life to prevent the development of disease in adult life. Keywords: metabolic syndrome, adolescent health, overweight, obesity

OBJECTIVES: Previous studies suggest a strong relationship between obesity and hypertension. This study aimed at evaluating the prevalence of hypertension and pre-hypertension in 10- to 14-year-old boys and girls in the Eastern Cape Province of South Africa and to determine the association between blood pressure parameters and selected measures of adiposity. METHODS: A cross-sectional, school-based study of 540 10- to14-year-old children from seven schools in the Eastern Cape Province was carried out. Anthropometry and blood pressure parameters were determined. RESULTS: All measures of adiposity and blood pressure were significantly higher in the girls (p < 0.05). The prevalence of hypertension and pre-hypertension was over 20 and 12%, respectively. Systolic blood pressure and pulse pressure were associated (r > 0.27; p < 0.05) with increasing levels of adiposity. CONCLUSION: This study highlights the importance of weightcontrol strategies for the prevention of hypertension in these adolescents and later on in life.

Background Typha capensis is one of the medicinal plants commonly used to manage male fertility problems. The objective of the present study was to assess its fertility-promoting effects in a rat model of cadmium-induced infertility. Methods A total of 30 male Wister rats were randomly divided into five groups of six animals each. Animals of group I, which served as control, were administered with cadmium chloride (CdCl2; 2.5 mg/kg) and normal saline (2 mL/kg). Group II was served with 0.5 mL normal saline only. Animals of groups III–V were treated with CdCl2 (2.5 mg/kg) plus T. capensis extract at doses of 100, 200, and 400 mg/kg, respectively. Animals were sacrificed under sedation. Testes and epididymal weights and sperm count were determined. Histological assessment of the testes was conducted. Results T. capensis at any dose did not improve (p > 0.05) testicular and epididymal weights compared with those of the CdCl2-exposed control group. Histology revealed moderate necrosis in the same group. T. capensis modestly increased the sperm count by 14%, 31%, and 35%, for groups treated with the extract at doses 100, 200, and 400 mg/kg, respectively, when compared with the CdCl2 control group, although the differences were not significant statistically (p > 0.05). Conclusions Results of our study demonstrated that T. capensis can neither offer protective effects against oxidative stress nor promote fertility in an animal model of cadmium-induced infertility.

Arterial stiffness is an independent predictor of cardiovascular disease. Although mostly detected in adults evidence in children is conflicting. Many more children are being diagnosed with hypertension indicating that these children might have some level of endothelial dysfunction. The current study set out to investigate the relationship between endothelial function as measured by the Vicorder and anthropometric measurements as well as blood pressure in 6-8 year old children. A total of 202 children were recruited from a rural and an urban community were recruited into a cross sectional study between March and November 2017. Anthropometry was performed followed by measurement of blood pressure parameters and flow mediated slowing (FMS) using the Vicorder. Urine samples were collected for creatinine/albumin ratio. Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP) were converted to percentiles for age, height and sex. Stata ® was used for all data analysis. Mean PWV and FMS% were 5.0 m/s and 25.7% respectively. PWV and heart rate (HR) were different by sex and location (p

Hypertension is becoming a major health problem in children worldwide. There is evidence suggesting a complex association between hypertension, endothelial function and other cardiovascular disease risk factors in the adult population. Very few studies have investigated the relationship between hypertension and endothelial function in sub-Saharan children. The aim of this study was to explore the relationship between blood pressure parameters and pulse wave velocity (PWV) in 6-8 years old children in the Eastern Cape of South Africa. A cross-sectional study of 202 children (103 girls and 99 boys) aged 6-8 years old was conducted between March and November 2017. General anthropometric measurements were measured and blood pressure measurements were recorded. Blood pressure measurements were converted to blood pressure percentiles for height, age and sex. Flow mediated slowing was used to measure endothelial function. The prevalence of hypertension and prehypertension was higher in girls compared to boys (7.9% and 28.7% vs 7.1% and 20.2% respectively). Systolic and diastolic pressure (SBP, DBP) and pulse pressures were similar in boys and girls. No sex related difference in PWV was noted thought the strength of correlation was different. PWV correlated modestly with age, SBP, DBP and mean arterial BP in females (r= 0.24, 0.30, 0.40, 0.49 p

Several studies have shown a relationship between indoor particulate matter and cardiovascular diseases in adults though this relationship is yet to be clarified in children and adolescents. This study purposed to investigate the relationship between indoor air particulate matter and blood pressure in 10-14 year old rural and urban children in Eastern Cape, South Africa. A cross sectional study of 10-14 year old children was carried out in selected rural and urban schools of the Eastern Cape. Anthropometry was performed and blood pressure measured. Indoor air particle counts were determine. Blood pressure parameters and body mass index (BMI) were converted to percentiles for height, sex and age. Prevalence of overweight/obesity were 10.9%/14.0% and hypertension/prehypertension were 12%/20%. Hypertension/prehypertension were more prevalent in rural compared to urban adolescents. All blood parameters were higher in rural adolescents and higher in rural girls compared to boys. In hypertensive/prehypertensive adolescents, systolic blood pressure (SBP) showed a strong correlation with BMI, waist, hip and mid upper arm circumferences (0.50, 0.51, 0.52, 0.53, 0.49; p

The purpose of this study was to determine the chemical composition of essential oils from Tagetes minuta from the Eastern Cape of South Africa and evaluate their antioxidant potential for medicinal end use. The essential oils were extracted by hydrodistillation method from fresh and dry parts (stem, leaves and flowers) of Tagetes minuta collected from Komga, Eastern Cape Province, South Africa and analyzed by gas chromatography coupled with mass spectrometry (GC-MS) and gas chromatography (GC). This analysis has led to the identification of 12, 31, 10, 37, 4 and 39 compounds representing 99.16, 98.07, 98.86, 98.30, 100 and 97.66% of fresh stem (TMFS), dry stem (TMDS), fresh leaves (TMFL), dry leaves (TMDL), fresh flower (TMFF) and dry flower (TMDF) essential oil respectively. The major components were identified to be cis-β-ocimene (38.03%) for TMFS; caryophyllene oxide (18.04%) for TMDS; trans, cis-alloocimene (25.35%) for TMFL; isopropyl tetradecanoate (17.02%) for TMDL; cis-β-ocimene (38.14%), for TMFF and trans-β-ocimene (37.03%), for TMDF. The dry parts (TMDS, TMDL and TMDF) essential oil were evaluated for antioxidant activity using DPPH and FRAP bioassays. Standard equivalent values from DPPH assay were between 6.74 ± 0.27 and 18.7 ± 0.35 μg/mL AAE with scavenging ability in descending order: TMDF > TMDL > TMDS. Standard equivalent values from FRAP assay were between 26.30 ± 0.41 and 113.0 ± 1.2 μg/mL AAE with antioxidant activity in descending order: TMDF > TMDL > TMDS. These results suggest that T. minuta may be used as a potential natural source of antioxidant.

OBJECTIVETraumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Clinical outcomes in TBI are determined by the severity of injury, which is dependent on the primary and secondary brain injury processes. Whereas primary brain injury lesions are related to the site of impact, secondary brain injury results from physiological changes caused by oxidative stress and inflammatory responses that occur after the primary insult. The aim of this study was to identify important clinical and biomarker profiles that were predictive of recovery after moderate to severe TBI. A good functional outcome was defined as a Glasgow Outcome Scale (GOS) score of ≥ 4.METHODSThis was a prospective study of patients with moderate to severe TBI managed at the Nelson Mandela Academic Hospital during the period between March 2014 and March 2016. Following admission and initial management, the patient demographic data (sex, age) and admission Glasgow Coma Scale score were recorded. Oxidative stress and inflammatory biomarkers in blood and CSF were sampled on days 1–7. On day 14, only blood was sampled for the same biomarkers. The primary outcome was the GOS score—due to its simplicity, the GOS was used to assess clinical outcomes at day 90. Because of difficulty in performing regular follow-up due to the vastness of the region, difficult terrain, and long travel distances, a 3-month follow-up period was used to avoid default.RESULTSSixty-four patients with Glasgow Coma Scale scores of ≤ 12 were seen and managed. Among the 56 patients who survived, 42 showed significant recovery (GOS score ≥ 4) at 3 months. Important predictors of recovery included antioxidant activity in the CSF (superoxide dismutase and total antioxidant capacity).CONCLUSIONSRecovery after TBI was dependent on the resolution of oxidative stress imbalance.

Background: Oxidative stress is implicated in the pathogenesis of many diseases. Proper management of oxidative stress requires antioxidants from external sources to supplement that of the body. Plants are considered as a major source of antioxidants because of their natural origin and therapeutic benefits. Objectives: This study was aimed at investigating the renoprotective and antioxidant capacity of hydroethanolic extract of Senecio serratuloides (HESS). Materials and Methods: In vitro and ex vivo antioxidant capacity of the extract was investigated. Female Wistar rats were treated with Nw-nitro L-arginine methyl ester (L-NAME) (40 mg/kg) for 4 weeks and then cotreating with L-NAME (20 mg/kg) and extract (HESS150 or HESS300 mg/kg) for 2 weeks and finally with plant extract or normal saline only for 2 weeks making a total of 8 weeks. Twenty-four-hour urine samples were collected during the study, and at the end of the study; blood and kidneys were harvested for biochemical and histological assays. Results: HESS exhibited high antiradical activity against 1,1-diphenyl-2-picrylhydrazyl and 2,2'-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) radicals with IC50values of 0.1 and 0.4 mg/ml, respectively. HESS significantly (P

Purpose: To investigate the in vivo analgesic and anti-inflammatory activities of essential oil of dried flowers of Chamaemelum nobile (Asteraceae L. All) in Swiss mice and Wistar rats, respectively.Methods: The volatile oil of the dried flowers of C. nobile obtained by hydrodistillation was analyzed by gas chromatography-mass spectrometry (GC-MS). Animals were assigned to the following experimental groups: C. nobile (180 mg/kg), ibuprofen (100 mg/kg) and vehicle-treated groups. Chemical and thermal pain models were used for the antinociceptive study in mice while fresh egg albumin-induced acute inflammation model in rats was used for anti-inflammatory study of the essential oil.Results: The most abundant components of the oil were α-bisabolol (50 %) and farnesene (5.35 %). Oral administration of essential oil (180 mg/kg, po) significantly (p < 0.05) reduced pain and prevented inflammation in the different test models used in this study.Conclusion: The essential oil of the dried flowers of C. nobile shows in vivo analgesic and antiinflammatory activities in rodents, and therefore, possesses potentials for development into effective analgesic and anti-inflammatory agent.Keywords: Chamaemelum nobile, Asteracea, essential oil, anti-inflammatory, antinociceptive

Objective: The study was carried out to investigate the antidiarrheal activity of ethanolic leaf extract of Eriobotrya japonica (EEJ) using various models of experimental diarrhea.Methods: Antidiarrheal property of EEJ at 100, 200, and 400 mg/kg/bwt was evaluated using castor oil-induced diarrhea, castor oil-induced enteropooling, and gastrointestinal propulsive models of experimental diarrhea in Sprague Dawley rats of both sexes, weighing 200–250 g. Cytotoxicity test of EEJ was performed using brine shrimp bioassay.Results: Toxicity assay of EEJ showed a lethal concentration value of 1225 μg/ml suggesting non-toxicity. EEJ significantly (p

Purpose: To determine the phytochemical content, toxicity and hypertension prevention effects of Osteospermum imbricatum leaf and root extracts.Methods: Phytochemical screening of leaf and root extracts of O. imbricatum was performed by colorimetric procedure. Acute toxicity of leaf and root extracts was conducted in two phases; phase I consisted of three groups of mice (n = 3) for each dose level of 10, 100 and 1000 mg/kg while phase II had three mice that received 1600, 2900 or 5000 mg/kg. Wistar rats were grouped into 7 groups that were co-treated with L-NAME and normal saline or L-NAME and hydroethanolic leaf extract (150 and 300 mg/kg) or L-NAME and hydroethanolic root extract (150 and 300 mg/kg) or L-NAME and amlodipine (5 mg/kg) or normal saline only for 4 weeks. Treatment was carried out via the oral route while blood pressure was measured weekly for 4 weeks by non-invasive tail cuff method.Results: The phytochemical profile of the leaf and root extracts revealed the presence of phenols, terpenoids, flavonoids, glycosides, tannins, steroids and saponins. Both the leaf and root extracts were toxic at 5000 mg/kg with an LD50 of 3807.89 mg/kg. In the fourth week of the study, only the leaf extract significantly (p < 0.01) prevented the progression of L-NAME induced hypertension; systolic and diastolic blood pressure of the group treated with L-NAME and leaf extract (300 mg/kg) were 183 ± 1 and 140 ± 1 mmHg, respectively, compared to the group that was treated with L-NAME and normal saline which produced systolic and diastolic BP values of 213 ± 3 and 172 ± 4 mmHg, respectively. The extracts, especially OIR300, exhibited diuretic effects in the second and third week of study by promoting excretion of 16 and 19 ml urine, respectively, compared to 11 and 14 ml for LN group.Conclusion: The results suggest that O. imbricatum is moderately toxic at a high dose and contains a wide range of phytochemicals which offer partial protection against the development of nitric oxide deficiency hypertension.Keywords: Hypertension, Phytochemicals, Acute toxicity, Nω-Nitro-L-arginine methyl ester (L-NAME), Osteospermum imbricatum

Background: Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements. Methods: A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated. Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females. Conclusion: Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.

Background: There is a hierarchical organisation of knowledge in the use of medicinal plants in communities. Medicinal use knowledge starts in thehome and is passed on to family members. Next in the hierarchy are neighbours, village elders and finally, traditional healers being the mostknowledgeable. For primary health care this hierarchy is actively followed in seeking remedies for ailments.Materials and Methods: This study was a survey of medicinal plant knowledge from family members of 1st year medical students registered atWalter Sisulu University. A total of 206 first year medical students participated in this study in 2010 and 2011.Results: Results revealed 47 species used as home remedies, 32% of which are food plants. Leaves and roots were reported as most commonly used. The top five ailments managed at home were gastrointestinal problems (25 plants), wounds (19 plants), respiratory tract problems (19 plants), infections, including sexually transmitted diseases (19 plants) and pain including headaches (19 plants). Chronic diseases such as hypertension, diabetes, cancer and reproductive ailments also formed a large group of diseases self-managed at home (29 plants).Conclusion: Family members hold knowledge of medicinal plant use. From this study, first year medical students were made aware of the relationship between common ailments and associated home remedies. This study forms a basis for further study of medicinal plants to validate theiruse as medicinal remedies.Key words: medicinal plants, home remedies, medical students, South Africa

The continued use of plants by women to prevent pregnancy suggests there are plants out there with potential use as contraceptives. In Zimbabwe, Pouzolzia mixta is used as a “morning after” contraceptive, thus it may possess postcoital antifertility activity. To test contraceptive activity, animals (n=8/group) were orally pretreated with aqueous (EqPM) or ethanolic (AtPM) extract of P. mixta at 300mg/kg b.wt for 7 days followed by mating with continued treatment for 10 days post-conception. To test for postcoital activity, treatment was initiated on day-1 of pregnancy and continued for 10 days. Laparotomy was performed and implantations counted. For estrogenic activity, immature ovariectomised rats were treated for 7 days after which vaginal opening and uterine weights were determined. In vitro oxytocic effects were performed using uterine tissue in organ bath with De Jalon’s solution. Acetylcholine (Ach) was the positive control. Results showed modest contraceptive activity with EtPM more effective in inhibiting fertility compared to AqPM (25% vs 37.5%) with a similar trend for antiimplantation effects (31% vs 19%). There was potent postcoital antifertility effects with AqPM more effective in inhibiting implantation (94.6% vs 86%) and fertility (87.5% vs 75%) compared to EtPM. Immature rat bioassay for estrogenic activity demonstrated pronounced estrogenic activity by both extracts. Oxytocic effects at 400ng/ml were more pronounced for the AqPM (92% of 100ng/ml Ach) than EtPM (25% of 100ng/ml Ach). Findings demonstrate the antifertility effects of aqueous and ethanolic extracts of P. mixta. The antifertility effects may be attributed to antiimplantation, estrogenic and oxytocic effects of the plant extracts.

Summary Hypoxis hemerocallidea is used in traditional medicine in South Africa, for the treatment of male reproductive ailments and various chronic illnesses. Despite chronic use, its effects on male reproductive system are unknown. Male Wistar rats were treated orally daily for 28 (n = 18) and 56 days (n = 18). Treatment groups (n = 6/group) per treatment period were as follows: untreated control, 150 mg/kg and 300 mg/kg 70% ethanolic extract of H. hemerocallidea. Sexual behaviour observations were performed on days 17 and 42 of the study. Sperm, biochemical and testicular histopathological studies were carried out. Arousal and libido and serum testosterone increased after 56 days of treatment. There was an increase in epididymal sperm count at both treatment doses, with the 300 mg/kg dose showing a higher sperm count (p

Heteromorpha arborescens belongs to the family Apiaceae. It is commonly known as the parsley tree. One of its uses in the Eastern Cape Province of South Africa is for the treatment of abdominal pains. The therapeutic effects of the methanolic and aqueous root extracts of H. arborescens were investigated at two dose levels respectively on experimental models of pain and inflammation in rodents. The antinociceptive activity was evaluated using the hot-plate, abdominal constriction and formalin tests. The anti-inflammatory properties of these extracts were assessed using albumin and carrageenan as phlogistic agents. Both extracts produced significant (P

Antifertility effects of an aqueous leaf extract of Oldenlandia affinis on male rats were investigated. The extract was administered intraperitoneally in sexually mature male rats at a dose of 24 mg/rat (n=8) for a total of eight injections over a 4 week period. There was a decrease in testis weights but all other accessory sex organs and vital organ weights were not affected by treatment with O. affinis extract. Testis histology revealed fewer spermatozoa or azoospermic seminiferous tubules in treated animals compared to controls with no change in neither tubule thickness nor Sertoli cell structure. O. affinis treatment caused a 17% decrease in sperm motility but there was no change in cauda epididymal sperm counts. However, serum testosterone levels decreased significantly (P

Ethnomedicine has gained a lot of recognition in post-independence Zimbabwe and yet little research on anti-fertility medicines has been done. Information on plants used as anti-fertility medicines was obtained by interviewing women, men, traditional healers and traditional midwives in urban Harare and surrounding rural areas of Mvurwi, Seke and Chiweshe. The use of 31 species belonging to 17 families for antifertility purposes is described. This survey forms a basis to initiate a study into the efficacy and toxicology of plants used by Zimbabwean women as traditional anti-fertility medicines.Key words: antifertility; Zimbabwe; postcoital anticonceptive; abortifacient; contraceptive.