Open Access Original Research Article

Short Term Effects of Performance-Based Financing on Maternal and Child Health Services in the MIFI Health District

Djam Chefor Alain, Earnest Njih Tabah, Bekolo Calvin Epie, Lenwo Njonwo Leslie, Augustine Eyong Bate

Journal of Complementary and Alternative Medical Research, Page 1-11
DOI: 10.9734/jocamr/2021/v14i430249

Background: Improving maternal, neonatal and child health are two of the most critical Sustainable Development Goals (MDGs). The Cameroon health system has consistently faced huge challenges to meet these objectives. As upshot; decision-makers identified the lack of a suitable health financing policy as an important issue that needed to be addressed. In response; the performance- based financing (PBF) scheme was implemented.

Objective of Study: Assess the short term effects of PBF on both maternal and child health services.

Methods: An analytical cross-sectional study was carried out in the Mifi Health District to compare the trend in some key child health indicators before and after PBF’s implementation across 41 randomly selected health facilities. A linear regression model and a paired sample T-test were used in the analysis, considering a p-value of <0.05 as significant and a confidence interval at 95%.

Results: There was a significant decrease in the mean Pentavalent dropout rate (p-value=0.02) as well as in the mean number of child deaths (p-value=0.019), per facilities per year from 26.61 and 0.46 before, to -104.07 and 0.15. There was also a significant increase in the proportion of women per facility per year who came for first antenatal care visit (ANC) p=0.001 from 94.55 before to 229.71 during PBF. The mean number per facility per year of pregnant women who attended at least 4 ANCs (p=0.034) also increased significantly from 44.65 before to 119.05 during PBF. Equally, the mean number of women per facility per year attending post natal visits significantly increased (p=0.010) from 23.23 before to 75.29 during PBF.

Conclusion: The findings of the assessment of the effect of PBF scheme on maternal and child health services in the Mifi Health District, demonstrates a significant improvement in key indicators of maternal and child health, following PBF implementation. This study highlights the essential need for policymakers to carefully examine the effect of the PBF strategy on maternal and child health with the perspective of further scaling up this reform to other regions. Therefore, PBF can be an effective strategy for improving maternal and child health by increasing the utilisation of MCH services.

Open Access Original Research Article

Evaluation of Antacid Potential of Ayurvedic Poly-Herbal Formulation for Functional Dyspepsia

Alpana Kulkarni, Dinesh Pandit, Sanket Walke, Ajit Kolatkar

Journal of Complementary and Alternative Medical Research, Page 12-21
DOI: 10.9734/jocamr/2021/v14i430250

Aim: Ayurveda describes herbal or polyherbal or herbo-mineral medicines such as Avipattikar churna for treatment of Amlapitta, ajirna for centuries. Ayurvedic medicines are associated with limitations namely, palatability, stability and accuracy of dose. Ayurvedic medicines lack in adequate safety and efficacy evidence data. The aim of the study was to develop a stable and palatable Avipattikar suspension using recent formulation and analytical techniques. The study was also aimed at determination of acid neutralizing capacity of Avipattikar suspension and predicting its efficacy for treatment of Functional Dyspepsia and Gastroesophageal Reflux Disorder. Methods: Flocculated Avipattikar suspension was prepared using sodium carboxymethylcellulose (CMC) as the suspending agent, sodium citrate as the flocculating agent, mannitol as a taste masking agent. Sodium carboxymethylcellulose, sodium citrate, Tween 80®, glycerin and mannitol were not used in Deflocculated Avipattikar suspension. The sedimentation volume, degree of flocculation, redispersibility and pH of the suspension was evaluated. The acid neutralization capacity of Avipattikar suspension was determined by Unite States Pharmacopoeia method.

Results: The present study successfully demonstrated formulation of stable Avipattikar suspension from Avipattikar churna.  The suspendability of sediment was retained for 15 days in presence of CMC. The results indicated that the acid neutralizing capacity of Avipattikar suspension (2.80 mMol of H+/ gm) was similar to that of the marketed antacid suspension (2.756 mMol of H+/ gm). The unpleasant taste of herbal drugs was masked satisfactorily.

Conclusion: Avipattikar suspension may be a cheaper, safer and effective alternative for current antacids for the treatment of functional dyspepsia.

Open Access Original Research Article

Antioxidant Potentials of Blue Whiting Fish (Micromesistus poutassous) Oil Extracts in Streptozotocin Induced Diabetic Rats

U. J. O. Orji, H. Brown, E. O. Nwachuku, N. Boisa

Journal of Complementary and Alternative Medical Research, Page 22-29
DOI: 10.9734/jocamr/2021/v14i430251

Aim: The aim of this study was to assess the antioxidant potentials of Blue Whiting Fish (Micromesistus poutassous) oil extracts in streptozotocin induced diabetic rats.

Study Design:  An experimental study.

Place and Duration of Study:  Animal House, Department of Applied and Environmental Biology, Rivers State University, Port Harcourt and University of Port Harcourt Rivers State, Nigeria, between February 2020 and August 2020.

Methodology: Thirty Six (36) albino rats were purchased and allowed to acclimatize for two (2) weeks in the laboratory at the animal farm house of the Department of Animal and Environmental Biology, Rivers State University. They were fed the normal rat feed (Chow feed) and water was allowed ad libitum.  The rats were weighed and randomly grouped into six (6) groups with six rats in each group. Group 1 (Negative control) was placed on normal diet while groups 2 to 6 were placed on a high fat diet (HFD) prior to the induction with Streptozotocin to achieve diabetes and the animals were treated according to their groupings for four weeks by means of oral gavage. The dose of Blue Whiting Fish (Micromesistus poutassous) oil extracts administered to the rats was extrapolated from human doses. The high fat diet was prepared by mixing the animal feed (Chow diet) with margarine in a ratio of 3:1. After each period of treatments, blood samples were collected from the rats at the end of the treatments via cardiac puncture by anaesthetizing the rats with chloroform after a six (6) hour fast. Fasting blood glucose was determined using the Glucose Oxidase method, total antioxidant capacity, malondialdehyde, superoxide dismutase and glutathione were analysed quantitatively and measured spectrophotometrically and the GC–MS analysis of bioactive compounds from Blue Whiting Fish (Micromesistus poutassous) oil was done using Agilent Technologies GC systems with GC-7890A/MS-5975C model. Data generated were analysed using SPSS version 22.0 of windows statistical package. Results were considered statistically significant at 95% confidence interval (p < 0.05).

Results: After week 1 - 4 of exposure, the mean SOD (Superoxide dismutase) value of the Negative control group (NC), Positive control (PC) group, diabetic groups exposed for weeks 1, 2, 3 and 4 expressed in U/ml were 299.41 ± 5.49, 217.38 ± 5.33, 220.56 ± 4.14, 240.45 ± 1.21, 258.19 ± 1.73 and 278.03 ± 1.98  respectively. The mean TAC (Total antioxidant capacity) value expressed in U/ml were 2.97 ± 0.10, 1.84 ± 0.04, 1.97 ± 0.04, 2.16 ± 0.02, 2.26 ± 0.02 and 2.46 ± 0.02 respectively. The mean GSH (Glutathione) expressed in µg/ml were 56.05 ± 0.60, 47.37 ±1.04, 47.94 ± 0.87, 50.80 ± 0.35, 53.07 ± 0.36 and 55.38 ± 0.33 respectively. The mean MDA (Malondialdehyde) expressed in nmol/l were 2.40 ± 0.13, 4.56 ± 0.28, 4.66 ± 0.06, 4.39 ± 0.01, 4.16 ± 0.03 and 3.70 ± 0.06 respectively. Comparison of different groups showed varying significant differences across groups.

Conclusion: Hyperglycaemia induced in rats studied led to an increase in oxidative stress, depletion of antioxidant parameters was observed. However, after treatment with Blue Whiting Fish (Micromesistus poutassous) Oil extracts, it was observed that there was improvement in the overall antioxidant status of the rats.

Open Access Original Research Article

Specific Naturopathic Modalities Ameliorate Glucose Homeostasis and Other Physiological Parameters in Human Diabetics

P. G. Ahalya, K. J. Sujatha, Prasanth Shetty, Ganesh Prasad

Journal of Complementary and Alternative Medical Research, Page 47-55
DOI: 10.9734/jocamr/2021/v14i430252

Background: Diabetes Mellitus is now becoming a serious medical and socio-economic issue all over the world. Early initiation of combination therapy has been suggested as a way to achieve glycemic control, postpone the complications and possibly restore β-cell function. Naturopathy and yoga is one of the upcoming medical systems which had showed a promising result for many lifestyle disorders and hence, this study was aimed to evaluate the effect of 10 days Integrated Naturopathy and Yoga (INY) treatment especially Abdomen Massage and Neutral Hip Bath on glycemic control and anthropometric measures.

Methods: 100 subjects with diabetes were selected and randomly allocated into Case group (naturopathy & yoga intervention with Abdomen Massage and Neutral Hip Bath) and Control group (naturopathy & yoga intervention). The subjects were assessed for blood glucose levels and anthropometric measures at baseline and after the intervention of 10 days.

Results: The result of this study showed a significant reduction in Fasting Glucose (FG) and Post Prandial Glucose (PPG) after 10 days of intervention where Body Mass Index (BMI) and Waist Hip Ratio (WHR) have not shown significant changes in the groups. The case group has a larger mean difference between pre and post values of FG, PPG, BMI, and WHR as compared to the control group.

Conclusion: Abdomen massage with neutral hip bath is relatively better for lowering the FG, PPG along with BMI and WHR, by the activation of adiponectin, Brown Adipose Tissue, Atrial natriuretic peptide and counter-regulatory stress hormones, which control hormonal activity, glucose absorption, metabolism and excretion.

Open Access Original Research Article

Antiproliferative Activity, c-Myc and FGFR1 Gene Expression Profiles and Safety of Annona muricata Fruit Extract on Rhabdomyosarcoma and BALB/c Mice

Naomi Chikwana, Esther N. Maina, Yahaya Gavamukulya, Wallace Bulimo, Fred Wamunyokoli

Journal of Complementary and Alternative Medical Research, Page 30-46
DOI: 10.9734/jocamr/2021/v14i430253

Introduction: Rhabdomyosarcoma is an aggressive solid tumour of skeletal muscles origin whose current treatment is associated with high expenses, severe side effects, drug resistance and tumour regrowth. There is a need to develop safer and more effective chemotherapeutic agents. Annona muricata is one of the widely used plants in treating various diseases due to its reported effectiveness. However, there is a dearth of scientific information regarding the efficacy of Annona muricata on rhabdomyosarcoma and its safety. This study aimed to evaluate the effects of Annona muricata ethanolic fruit extract on the antiproliferative activity and gene expression in RD cell line, including its biosafety in BALB/c mice.

Materials and Methods: The resazurin metabolic assay was used to assess the antiproliferative and cytotoxic activities of Annona muricata ethanolic fruit extract on RD and Vero cells. Quantitative real-time polymerase chain reaction was used to assess the gene expression profiles on c-Myc and FGFR1 genes. To evaluate the safety of the Annona muricata ethanolic fruit extract, an acute oral toxicity study was conducted on BALB/c mice.

Results: Annona muricata ethanolic fruit extract significantly inhibited the growth of RD cells in a concentration and time-dependent manner while being highly selective on the Vero cells (selectivity index of 6.10 at 72h) compared to a reference cancer drug, doxorubicin (Selectivity index of 1.38 at 72hr). The c-Myc and FGFR1 genes were under expressed in RD cells treated with Annona muricata ethanolic fruit extract with (3.4 and 6.1 fold), respectively, compared to untreated cells. Acute oral toxicity studies revealed no significant difference (p ≥ 0.05) between the treated mice and the control group, indicating the safety of the fruit extract.

Conclusion: Annona muricata ethanolic fruit extract can serve as effective and safe anticancer agents against rhabdomyosarcoma and further develop into standard drugs. Non-human primate studies need to be undertaken to step towards the clinical utilization of the Annona muricata ethanolic fruit extract in the management of rhabdomyosarcoma.