P Singh

Association between exposure/non-exposure to the mandatory seat belt law with regards to compliance in vehicle accident victims: a hospital review

OBJECTIVEnInjuries sustained in motor vehicle accidents (MVAs) are a major challenge to the Jamaican healthcare system. In November 1999, Jamaica enacted legislation to make seat belt usage in motor vehicles compulsory. The effect of this policy change on seat belt usage is unclear. This study therefore sought to determine the prevalence of seat belt usage and to determine the association between exposure/non-exposure to the mandatory seat belt law and seat belt use in subjects who presented to the Accident and Emergency Department (A&E) of the University Hospital of the West Indies (UHWI) as a result of motor vehicle accidents.nnnMETHODSnSubjects were recruited from June to November 2003, post-seat belt law (POBL) period, and May to October 1999, pre-seat belt law (PRBL) period. Data collected included demographic variables, seat belt use and position of the occupants in the vehicle.nnnRESULTSnOf the 277 patients who were eligible for inclusion, data were complete in 258 subjects, 87 in the PRBL period and 171 in the POBL period. The prevalence of seat belt use was 47% (PRBL) and 63% (POBL) respectively. There was no significant gender difference at each period. The odds of wearing seat belt in the rear of a motor vehicle were significantly lower than that of a driver (Table 3, OR 0.19, 95% CI 0.07, 0.48). Adjusting for age, gender and position in vehicle exposure, there was about 100% increase in the odds of seat belt use during the post seat belt law era (OR = 2.09, 95% CI 1.21, 3.61).nnnCONCLUSIONnIt is concluded from this hospital-based study that the mandatory seat belt law legislature was associated with increased seat belt use in motor vehicle accident victims. However, current data from the Road Traffic Agency indicate that there is still an alarming number of fatalities. This clearly suggests that additional public health measures are needed to address the epidemic of motor vehicle trauma in Jamaica.

Mode of action studies of the acaricidal agent, epingaione

Summary Activity directed isolation studies of the ethanol extract of Bontia daphnoides L (Myoporaceae) leaves and stems led to the isolation of epingaione, a sesquiterpene furan. This compound was previously described by Chinnock et al. (1987) from the same plant. The compound showed growth regulatory activities on gravid adult female Boophilus microplus Canestrini (the southern cattle tick). The dose required for inhibiting the hatching of B. microplus eggs by 50% (Fid50)was 0.4±0.06 mg/g of the tick body weight. The Fid50 dose inhibited the sequestration of protein into eggs oviposited by 80%. These eggs were non-agglutinated and wrinkled. Histological examination of ovarian sections from the treated ticks revealed significant degeneration of funicle cells and reduction in yolk content.

Extracts from Blighia sapida (Koenig) produce neutropenia and thrombocytopenia in mice

Neutrophil and platelet counts were significantly lowered (p<0.05) in mice treated with aqueous and lipid extracts of the unripe fruit of Blighia sapida. The percentage reduction in neutrophil and platelet counts relative to the controls for the aqueous and lipid (data in parentheses) extracts were 63.4% (59.3%) and 37.46% (32.44%) respectively after 6 weeks of treatment.

The effect of hurricane Ivan on emergency department operations at the University Hospital of the West Indies

The objective of this study was to determine the impact of Hurricane Ivan on the operations of the Emergency Department (ED) at the University Hospital of the West Indies (UHWI). Hurricane Ivan,--a category four Hurricane--traversed the south coast of the island of Jamaica on September 10, 2004, causing damage to several parishes. The study design is a descriptive retrospective record-based incidence study of all admissions to the ED commencing at 8:00 am September 10, 2004 and ending at 12 midnight September 11, 2004, covering the period of the entire duration of the hurricane as well as immediately after. Injuries that took place during the hurricane, inclusive of gun-shot wounds (GSWs) represented 40% of the total patients seen. The types of admission are listed categorically as well as specific items to be considered in planning for potential disasters of higher magnitude. Overall, the coping mechanism of the ED at UHWI was adequate for this magnitude of disaster.

Oesophageal foreign bodies at the University Hospital of the West Indies

A retrospective study was conducted of 97 patients with oesophageal foreign bodies (EFB). The patients were admitted to assess characteristics of EFB, modes of presentation and radiological and endoscopic findings. The patients were from the University Hospital of the West Indies and most (42%) were over the fourth decade of life. The commonest EFB were bones. A negative radiological finding was not a reliable means to select patients for endoscopy. Oesophagoscopy is a reliable method in the treatment of EFB impaction. There were no major complications or deaths.

The Protective Effect of Epigallocatechin-3-gallate on Paraquat-induced Haemolysis.

Epigallocatechin-3-gallate (EGCG) is a major ingredient present in green tea, which has a high antioxidant activity. In this study, the effect of EGCG was investigated on paraquat-induced haemolysis of erythrocyte membrane. Erythrocytes were incubated in 0.03, 0.3, 3.0 and 30 mg/mL EGCG, respectively and exposed to 30 mg/mL of paraquat for 10 minutes. The effect of paraquat was determined by an analysis of the osmotic fragility of the erythrocytes. The results showed that EGCG (30 mg/mL) significantly (p < 0.05) reduced the haemolysis of erythrocytes exposed to paraquat (5.0 mg/mL). This suggests that EGCG may have a protective effect on paraquat-induced erythrocyte membrane haemolysis and that consumption of green tea, with high EGCG concentration, could ameliorate the deleterious effect of paraquat toxicity on the haemolysis of erythrocyte membrane.

Demonstration of antihistamine properties with AST-1: a bioactive extract from garden slugs (Diplosolenodes occidentalis)

Parched and ground whole garden slugs are claimed in rural Jamaican folklore practices to have useful effects in the treatment of bronchial asthma. Since this claim may be associated with respiratory dysfunction due to histamine from allergic sensitization, the authors investigated the effects of a semi-pure alcoholic extract (AST-1) on histamine-induced contraction of the guinea pig in vitro tracheal muscle preparation and cutaneous allergic responses in ovalbumin sensitized guinea pigs. Chemical analysis of AST-1 by column chromatography and thin layer chromatography indicated two compounds in the composition, but the molecular structures were not determined Pharmacological evaluation of AST-1 produced a concentration-dependent inhibition of histamine-induced contraction of the guinea pig tracheal muscle preparation. AST-1 also inhibited contraction of the tracheal muscle produced by selective H1 receptor stimulation with HTMT dimaleate. H2 receptors were not involved, as indicated by the absence of contraction with dimaprit hydrochloride, a selective H2 agonist. Also, in ovalbumin sensitized guinea pigs, AST-1 and diphenhydramine, a selective H1 antagonist, inhibited the cutaneous responses due to intradermal injection of histamine and ovalbumin. These results suggest that AST-1 has H1 anti-histamine properties which can inhibit histamine-induced tracheobronchial muscle contraction and cutaneous responses due to allergy.

Acute toxicity of seeds of the sapodilla (Achras sapota L.)

An aqueous extract of the sapodilla seed (Achras sapota L.) was acutely toxic to mice and rats (i.p. LD50 = 190 and 250 mg/kg, respectively) with symptoms of dyspnoea, apnoea and convulsions. Soxhlet extraction and chromatographic separation of the seed constituents yielded a brown amorphous solid containing saponin. This was heat-stable and toxic by the i.p. route (LD50 = 30-50 mg/kg) but non-toxic by the oral route in mice and rats. It is proposed that the toxicity of the sapodilla seed is due mainly to the saponin content.

Knowledge and Attitudes towards Fluid Hydration of Athletes by Jamaican Track and Field High School Coaches

Objective: To determine whether or not Jamaican coaches’ knowledge and practices of fluid replacement is on par with that of the National Athletic Association’s and the American College of Sports Medicine Standards. Methods: A descriptive survey of 90 high school track and field coaches in Jamaica was conducted. Coaches were given a 29 item survey questionnaire which adapted the content from previous surveys and also based on the National Athletic Training Associations’ guidelines for fluid replacement and information sources of fluid replacement. A pass score of 80% was employed. Results: 26.6% of participants passed the knowledge based assessment with the minimum requirement of 80%. Approximately 73.4% of participants had an unacceptable level of knowledge about fluid replacement and hydration. Only 26 (28.9%) received training in fluid replacement therapy. Most therefore relied on reading material ranging from magazines to journals, or learnt it on the job from other coaches. Conclusion: Findings suggest that the level of knowledge in Jamaican track and field high school coaches about fluid replacement and hydration is very poor. However their attitudes towards fluid replacement and hydration are very good and this will facilitate their acceptance and adoption of correct fluid replacement guidelines. Tapping into this positive attitude and implementing workshops, seminars and on-site promotion should improve the coaches’ knowledge significantly.

Investigation of the Blood Glucose Lowering Potential of the Jamaican Momordica charantia (Cerasee) Fruit in Sprague-Dawley Rats.

The Momordica charantia (MC) fruit has been documented to possess antidiabetic properties. However, these studies were not without controversy surrounding the blood glucose-lowering ability and the mechanism of action in diabetes therapy. In an effort to evaluate such claims in the Jamaican MC species known as cerasee, aqueous extracts of the unripe fruit were studied in normal and diabetic rats. Normal male Sprague-Dawley rats were divided into groups (n = 6) orally administered distilled water, 10% dimethyl sulfoxide (DMSO) solution, the aqueous extract (400 mg/kg body weight) and glibenclamide (15 mg/kg body weight), respectively prior to assessment of fasting blood glucose (FBG) concentration. The oral glucose tolerance test (OGTT) was conducted in normoglycaemic rats orally administered distilled water, 10% DMSO solution, glibenclamide (15 mg/kg body weight) or aqueous extracts of the fruit (200 and 400 mg/kg body weight). Blood glucose concentration was also monitored in streptozotocin-induced diabetic rats administered the aqueous extract (250 mg/kg body weight) or water vehicle after an overnight fast. The aqueous extracts showed no hypoglycaemic or antidiabetic activity. However, the administration of the aqueous extracts (200 and 400 mg/kg body weight) resulted in significant improvement in glucose tolerance of glucose-primed normoglycaemic rats during the OGTT. These data suggest that the glucose-lowering mechanism of the Jamaican MC fruit species likely involves altered glucose absorption across the gastrointestinal tract.