Use Of Traditional Medications Research Articles

Enhancing deficit schizophrenia treatment in college students through the integration of paliperidone and reformed civic education in higher education

BackgroundCollege students face challenges in communication, employment, learning, and emotional interaction, contributing to a range of psychological issues. Deficit schizophrenia, though uncommon among college students, can exhibit symptoms of delayed thinking and cognitive impairment. Prolonged use of traditional medications can lead to tolerance. This study investigates the synergy of reformed ideological and political education in higher education with Paliperidone to offer comprehensive intervention for college students with deficit schizophrenia.Subjects and MethodsA study was conducted on 85 college students with defective schizophrenia at a certain university. They were divided into Group C and Group D. Group C received a single treatment with Paliperidone, while Group B received combined treatment with reformed ideological and political education and teaching in universities. The treatment lasted for 3 months, and after treatment, SPSS 20.0 was used for data analysis, and the Mental Classification Cognitive Test Scale was used to quantify the mental status of college students.ResultsPost-treatment, positive symptoms in Group D reduced to 15.46 ± 1.53 points, negative symptoms dropped to 15.61 ± 3.51 points, and general psychiatric symptoms decreased to 15.12 ± 1.21 points. These values were lower than pre-treatment levels and Group C scores. The effective treatment rate for Group D reached 96.67%, surpassing Group C.ConclusionsThe intervention involving the combined use of reformed ideological and political education in universities with Paliperidone exhibited efficacy in addressing deficit schizophrenia in college students. This approach showcases the potential of interdisciplinary interventions in higher education for improving psychological well-being.

Traditional and cultural newborn care practices in the Dakace and Tsibiri communities of Nigeria: an ethnographic study

Traditional and cultural practices related to newborn care have been passed down through generations in various cultures worldwide, often with the belief that they are effective in improving the health and well-being of newborns. These practices can differ significantly between cultures. The aim of this study was to assess the traditional and cultural newborn care practices in the Dakace and Tsibiri communities of Nigeria, and to identify potential opportunities for the integration of these practices into modern healthcare approaches. An ethnographic study was conducted in the Dakace and Tsibiri communities of Nigeria, which involved observing 54 deliveries and traditional rituals surrounding newborn care through participant observation. A total of 30 participants, including traditional birth attendants, community health workers, traditional leaders, and mothers who had given birth within the past year, were included in the study, and participated in in-depth interviews and focus group discussions. The main themes that emerged from the data included the provision of warmth, nutrition, cord care, and traditional medication. In these communities, there is a strong emphasis on keeping newborns warm and providing proper nutrition, including breastfeeding and the use of traditional remedies. Cord care is also considered important, with the umbilical cord typically cut with a new razor blade and the stump treated with hot compresses and oil massages. Traditional and cultural beliefs also influence the use of traditional medication, including the use of traditional remedies to address common pregnancy-related health issues and the importance of proper nutrition during pregnancy. The study also identified the important role of fathers and other male family members in childbirth preparation. The findings of this study provide valuable insights into the traditional and cultural practices of newborn care in the Dakace and Tsibiri communities of Nigeria and identify potential opportunities for integrating these practices into modern healthcare approaches in a way that is safe and effective for the mother and child. These findings may be of interest to healthcare professionals, researchers, and policy makers working in maternal and child health, as well as to members of the Dakace and Tsibiri communities.

Household Factors of Foodborne Diarrhea in Children under Five in Two Districts of Maputo, Mozambique

Household factors involved in the disease of diarrhea are multifaceted. This study aimed to explore and describe the household factors affecting foodborne diarrhea in children younger than 5 years old using structured questionnaire data based on quantitative tools. The sample size was calculated based on a binomial distribution. A total of 300 children, together with their caregivers, participated, and the data were descriptively and mathematically analyzed using Epi Info modelling. The caregivers were mostly female and included 93.3% rural and 84% urban dwellers of ages between 18 and 38, who were single but living with someone. Of the children who were under six months of age, 23.3% in rural areas and 16.6% in urban areas had diarrhea, while of the children between 12 and 23 months of age, 36.6% in urban areas and 30% in rural areas had diarrhea. The relatives had similar symptoms before the child became ill, with 12.6% of relatives in rural areas and 13.3% in urban areas reporting this. Before receiving medical assistance, 51.3% of children in rural areas and 16% of children in urban areas were treated with traditional medication. Water was not treated before drinking in 48% of rural cases and 45.3% of urban cases. A total of 24.6% of infants in urban areas and 12.6% of infants in rural areas used a bottle for feeding. The factors affecting foodborne diarrhea were the use of traditional medication in rural areas, bottle feeding in urban areas and untreated water used for drinking in both areas.

The foliar trichomes of Combretum apiculatum subsp. apiculatum (Combretaceae): Morphoanatomy and histochemistry

Combretum apiculatum Sond. subsp. apiculatum is an important plant used in the traditional medicinal treatment of many diseases including gastrointestinal disorders, conjunctivitis, aches and leprosy. The plant's medicinal properties are putatively associated with secondary metabolites present in trichomes found on the leaf surfaces. This study aimed to investigate the distribution and morphology of the glandular trichomes of C. apiculatum at various stages of leaf development (emergent, young and mature) using stereo-, compound-light- and scanning electron microscopy, as well as to determine the leaf phytochemical constituents and to correlate the plant's medicinal properties at the cellular level by histochemical analyses. The microscopical studies revealed multicellular subsessile/sessile peltate, glandular trichomes and unicellular to multicellular non-glandular trichomes at all leaf developmental stages. Emergent leaves consisted of dense distributions of trichomes located in epidermal depressions, suggesting emergence during the early stages of leaf development. Trichome density decreased with leaf maturation, potentially attributable to the leaf expansion theory. Histochemical analyses on the leaves and trichomes detected alkaloids, phenolic compounds, lignin, terpenoids, resin acids, pectins, mucilage, carboxylated and hydroxylated polysaccharides, polyphenols, total lipids, total proteins and nucleic acids, indicating cell viability. These compounds possess medicinal properties, thereby providing supporting evidence for the plant's traditional medical use.

Lemna minor L.’ ün Sağlık ve Beslenme Alanında Kullanımına Genel Bir Bakış

Lemna minor L. is an aquatic plant that is resistant to hard conditions, is a fast growing, rapidly multiplying vascular floating macrophyte, and is widely distributed in wetlands in our country and around the world. Lemna minor L., also known as duckweed, contains essential nutrients such as proteins, carbohydrates and fats, as well as various secondary metabolites that are beneficial for humans. Therefore, it is a remarkable source of alternative food. In addition to its traditional medical use, it is thought that taking into account in the development of herbal medicines and cosmetics today in the light of scientific studies will be beneficial in terms of developing value-added products and bringing them into the economy. In this review, studies and articles on the usability of Lemna minor L. in the field of health and nutrition are reviewed and presented with an overview.

Efficacy of phyto-therapeutics in allergic rhinitis: A review

Allergic rhinitis (AR) or hay fever is the most common symptomatic allergic disorder triggered by allergen and if it remains undiagnosed, can adversely impact the general well-being. The ailment is characterized by an exaggerated immune response to environmental triggers including pollen, moulds, ragweed, dirt mites, dust, etc. within the nasal mucosa, ultimately leading to gene environment interaction which elevate the IgE level in the nasal mucosa, and ultimately infection of the nasal cavity. The major signs and symptoms of AR include rhinorrhea, sneezing, eye itching, postnasal drip, cough, nasal obstruction, and fatigue due to nasal discomfort. Various studies reported 20-30% occurrence of the disease and majority of them are inclined towards allopathic medication for instant relief. Since these drugs lead to unenviable side effects in the long term, it is of utmost importance to search for alternative mode of medication with lower side-effects. The use of traditional medication in the form of various herbal plants and their mixture have proved to be effective in the management of symptoms for asthma and AR. Their efficiencies have been restrained successfully in various reports. It has been proven that herbal medicines are safe to use and thus have rendered a vast contribution to the treatment of allergic rhinitis. Hence, the present review is aimed to discuss the efficacy and protection provided by diverse herbal drugs in the management of AR.

Common Presenting Complaints and Predisposing Factors among Adult Ophthalmic Patients with Low Vision and Blindness in Aba

Aim: To determine the common complaints and predisposing factors of low vision and blindness among adult ophthalmic patients in Abia State University Teaching Hospital, (ABSUTH), Aba, Nigeria.
 Study Design: A retrospective, descriptive study.
 Methodology: An institutional-based study involving 457 patients who attended Abia State University Teaching Hospital eye clinic between April and September 2018 was undertaken. The patients’ biodata, clinical history, ophthalmic examination findings, and results of ancillary investigations were obtained from patients’ hospital records within the period under study and analyzed using IBM SPSS version 25.0. AP-value of < 0.05 was taken to be statistical significant.
 Result: A total of 457 patients comprising of 206 males and 251 females, aged 18-85 years were seen in the study period. Based on World Health Organization (WHO)’s definition of low vision and blindness, two hundred and eighty-four (62.1%) patients had normal vision, 25(5.5%) patients had low vision while 32(7%) patients were blind. The most common complaint was blurring of vision, 136 (23.5%) followed by itching of the eye, 91 (15.7%) and tearing, 86 (14.9%). Forty percent of the respondents’ complaints had lasted for over 12 months before presentation at the clinic. Common predisposing factors for low vision and blindness observed in this study were hypertension (24.1%), previous drug use (5%), previous use of traditional medication (1.3%) and family ocular history (3.7%). No statistically significant association was found between diagnostic data and family ocular history, previous use of traditional medication and previous drug use. Statistically, significant relationship was found between diagnostic data and blood pressure (P< 0.001).
 Conclusion: There are various presentations of low vision and blindness in Aba. Routine eye check, early referral and appropriate treatment is advocated for the populace.

Corneal Healing and Recovery of Ocular Crystallinity with a Dichloromethane Extract of Sedum dendroideum D.C. in a Novel Murine Model of Ocular Pterygium.

Pterygium is a corneal alteration that can cause visual impairment, which has been traditionally treated with the sap of Sedum dendroideum D.C. The pharmacological effect of a dichloromethane extract of S. dendroideum was demonstrated and implemented in a pterygium model on the healing process of corneal damage caused by phorbol esters. In mice of the ICR strain, a corneal lesion was caused by intravitreal injection of tetradecanoylphorbol acetate (TPA). The evolution of the corneal scarring process was monitored with vehicle, dexamethasone, and dichloromethane extract of S. dendroideum treatments by daily ophthalmic administration for fifteen days. The lesions were evaluated in situ with highlighted images of fluorescence of the lesions. Following treatment levels in eyeballs of IL-1α, TNF-α, and IL-10 cytokines were measured. The effective dose of TPA to produce a pterygium-like lesion was determined. The follow-up of the evolution of the scarring process allowed us to define that the treatment with S. dendroideum improved the experimental pterygium and had an immunomodulatory effect by decreasing TNF-α, IL-1α, and maintaining the level of IL-10 expression, without difference with respect to the healthy control. Traditional medical use of S. dendroideum sap to treat pterygium is fully justified by its compound composition.

Use of traditional medication on the health of women and children of the Togutil tribe in North Moluccas Province

ObjectivesThe study aims to study 1) how to use traditional medicine in the health of women and children of the Togutil tribe, and describes 2) the local wisdom of forest conservation by the Toguti tribe. MethodsThe research used ethnography study with the design of multiple sites and a tick description approach (thick description and depth). ResultsTogutil women and children always rely on traditional medicine and they do this treatment since ancient times and have always been done from generation to generation. Traditional medicinal ingredients come from the leaves, stems, roots of trees, and fruit of the trees. If the medicine has been given and there is no change, the person who is sick will be taken to a doctor for consultation and recommend other traditional medicine to drink. The role of women and children of the Togutil tribe is more dominant in the home to maintaining the food security and the role of men of the Togutil tribe is outside the home to hunting and farming. ConclusionThe health of Togutil women and children is very important to maintain their survival. The pattern of maintaining their health by consuming traditional medicines.

A periodic review of chemical and pharmacological profiles of Tubiechong as insect Chinese medicine.

Tubiechong, in Chinese medicine, denotes the dried female insects of Eupolyphaga sinensis Walker (ESW) or Polyphaga plancyi Bolivar (PPB). As a traditional insect-type, in medicine, it has been historically utilized to treat bruises, fractures, amenorrhea, postpartum blood stasis, lumps and relieving pain. We herein have performed a systematic survey involving the chemical and biological studies in the past decades to reveal the value of such insect resources for their development and clinical utilization. Chemical studies indicated that Tubiechong generated many active compounds, including proteins, amino acids, peptides, fatty acids, alkaloids, nucleosides, polysaccharides, fat-soluble vitamins and mineral elements. Tubiechong or its extract has a wide range of activities including anticoagulation and anti-thrombosis, anti-tumor, antioxidant, immune regulation, blood lipid regulation and hepatoprotection. Finally, a periodic mini-review was conducted to summarize such chemical and pharmacological profiles of Tubiechong medicine. The active peptides in Tubiechong are majorly focused in this review and introduced as one important aspect since there is much literature and huge investigative interest in it. Traditional medical use of the insect was also stressed in this review associating with its disease-eliminating actions by promoting blood circulation or eliminating tissue-swelling pains, which might play important roles in anticancer practices or investigation. In accordance with the modern pharmacological progress, Tubiechong and its extracts indeed exerted antitumor actions through multiple pathways, such as interfering with tumor biological behaviors (growth, apoptosis, invasion, metastasis and angiogenesis), and regulating host immune function. To some extent, this knowledge would provide a basis for further research and application of Tubiechong medicine.

An Ethnobotanical Study of Medicinal Plants Used in Hizan District (Bitlis-Turkey)

Medicinal plant use culture is very rich in East Anatolia. Hizan district is one of the best examples of this. Hizan has a very hilly topography. In the past, people is living in Hizan developed alternative medicines to treat their illnesses because of geographical structure and harsh winter conditions. This study was conducted in Hizan (Bitlis) district and it was the first investigation of the knowledge of tra-ditional medicinal plants used in Bitlis Province. This research aims to scientifically identify the medicinal plants used by local people and record the culture of traditional medicinal plants use of local people living in Hizan. Face-to-face interviews were conducted with participants with ethnobotanical knowled-ge and experience in 2018 and 2019 and the collected samples were prepared according to herbarium techniques. Consequently 71 taxa belonging to 29 families used for the treatment of 35 different diseases were identified. The traditional medical use of some taxa was specific to Hizan. The results revealed that the taxonomic family with the greatest number of utilized plants was Asteraceae. These are followed by Rosaceae, Lamiaceae, Malvaceae, Polygonaceae and Apiaceae.

Use of Un-Prescribed Drugs and Traditional Medications among Pregnant Women Attending Primary Health Centres in Kano, Nigeria

The use and misuse of drugs in Sub Saharan region are of public health concern. Exposures to un-prescribed drugs and traditional medications are frequent and create a great danger in pregnant women. The use of herbal medicines has been on the increase in many developing and industrialized countries. The study examined the use of traditional medications and un-prescribed orthodox medicines for gestational mothers. A descriptive cross-sectional design & inferential statistic were employed for the study and a total sample of one hundred and ninety-six was used. A standardized data collection form was employed based on the World Health Organization criteria and the obtained data were analyzed using SPSS Version 22.The result showed that most of the respondents were between the age of 22- 27 years with the mean age of 24 years and majority of the respondents (63.3%) used both un-prescribed drugs and traditional medicines during pregnancy, while 27.0% used only un-prescribed drugs and 9.7% use only traditional medications. More so, the results revealed that pain killers’ drug were the leading cause for misused. Also, the results demonstrated a significant relationship between respondent’s awareness of harm associated with use of un-prescribed medications and educational status, (P < 0.01). The study concluded a wide spread use of un-prescribed drugs and traditional medications among pregnant women and therefore, recommend the need for health education and massive campaign with community involvement against the wrong practices by both the healthcare practioners and the government.

Gas chromatography–mass spectrometry profile and antimicrobial activities of Ballota bullata Pomel and B. nigra L. subsp. uncinata (Fiori & Bég.): A comparative analysis

This study was carried out to compare for the first time, the chemical composition and antimicrobial activities of essential oils from two Ballota species growing wild in different regions of Tunisia. The volatile oils obtained by hydro-distillation of Ballota bullata Pomel and Ballota nigra L. subsp. uncinata (Fiori & Bég.) Patzak were analyzed by gas chromatography (GC) and gas chromatography mass spectrometry (GC/MS) to investigate the variations in chemical profiles. The results showed a significant difference in terms of essential oil yields and characteristic aroma. Valerianol (18.3%), α-muurolol (7.9%) and spathulenol (7.1%) were identified as the major odorants in B. bullata, while B. nigra subsp. uncinata oil was mainly composed of hexadecanoic acid (31.8%) and linoleic acid (17.9%). In addition, oxygenated sesquiterpenes were found to be the principal constituents of B. bullata essential oil (42.1%), whereas long chain oxygenated hydrocarbons form the main class in B. nigra (49.7%). Moreover, the antimicrobial activities were tested in vitro against five bacteria: Escherichia coli, Pseudomonas aeruginosa, Salmonella enterica, Staphylococcus aureus and Bacillus subtilis and the yeast Candida albicans. B. bullata essential oil showed stronger antibacterial effects comparing to B. nigra oil. Consequently, B. bullata essential oil holds promising antimicrobial potential, confirming its traditional medical use.

Traditional uses, phytochemistry and pharmacological activity of Carpobrotus edulis: A global perspective

Carpobrotus edulis has widely been used in South Africa as a traditional medicine for a wide range of ailments and its pharmacological activities has been widely studied. The present review aims to provide a comprehensive literature overview regarding phytochemistry, traditional use, pharmacology and toxicology of different Carpobrotus edulis extracts. The review was compiled through a thorough literature search from authentic resources using data bases such as Google Scholar, PubMed, Web of Science, Scopus and Science Direct, peer reviewed articles, books and thesis. Carpobrotus edulis is an important medicinal plant used in ethno medicine for the treatment of tuberculosis and other respiratory infections, toothache and earache, facial eczema, wounds, burns, hypertension, and diabetes mellitus. Pharmacological studies performed on the fresh plant materials, crude extracts and various solvent extracts of Carpobrotus edulis validates the traditional medical use of the plant. Studies performed validate the use of Carpobrotus edulis extracts in antimicrobial, antiproliferative, and antioxidant therapy. Carpobrotus edulis also has proved to have anticholinesterase activity against acetylcholinesterase and butyrylcholinesterase. Information on therapeutic validation in wound healing, diabetes mellitus, hypertension, analgesia and gastrointestinal motility is scanty. To substantiate the traditional use of C. edulis in the aforementioned area, there is need for further experimental studies to validate its pharmacological use. The information on toxicology was also scanty however the available literature suggests that C. edulis extracts are non-toxic. The review article supports the folkloric use of the medicinal plant. However, in-depth studies evaluating the safety profile of C. edulis extracts are highly recommended.

Anti-Blastocystis Activity In Vitro of Egyptian Herbal Extracts (Family: Asteraceae) with Emphasis on Artemisia judaica.

Achillea fragrantissima (Forssk.) Sch. Bip. (known as Qaysoom), Echinops spinosus L. (known as Shoak Elgamal) and Artemisia judaica L. (known Shih Baladi) are members of the Asteraceae family known for their traditional medical use in Egypt. The ethanol extracts of these plants were evaluated for their efficacy against a protozoan parasite (Blastocystis). Two different molecular subtypes of Blastocystis were used (ST1 and ST3). Significant growth inhibition of Blastocystis was observed when exposed to both A. judaica (99.3%) and A. fragrantissima (95.6%) with minimal inhibitory concentration (MIC90) at 2000 µg/mL. Under the effect of the extracts, changes in Blastocystis morphology were noted, with the complete destruction of Blastocystis forms after 72 h with the dose of 4000 µg/mL. Different subtypes displayed different responses to the herbal extracts tested. ST1 exhibited significantly different responses to the herbal extracts compared to ST3. A. judaica was selected as the herb of choice considering all of its variables and because of its effective action against Blastocystis. It was then exposed to further fractionation and observation of its effect on ST1 and ST3. Solvent portioned fractions (dichloromethane (DCM), ethyl acetate (EtOAc) and n-hexane) in A. judaica were found to be the potent active fractions against both of the Blastocystis subtypes used.

Prevalence of chronic kidney disease in Nigeria: systematic review of population-based studies.

BackgroundThe aim of this study was to identify and discuss published population-based studies carried out in Nigeria that have information on the prevalence of chronic kidney disease (CKD) and have also used the Kidney Disease Outcomes Quality Initiative (KDOQI) practice guidelines in defining CKD, with emphasis on the performance of three estimating equations for glomerular filtration rate (GFR) – Modification of Diet in Renal Disease (MDRD), Cock-croft–Gault, and CKD epidemiology collaboration (CKD-EPI) creatinine equation.Materials and methodsA systematic literature search was carried out in Google, MEDLINE, PubMed, and AJOL database, with the aim of identifying relevant population-based studies with information on the prevalence of CKD in a location in Nigeria.ResultsSeven cross-sectional population-based studies were identified. Two of the studies used the Cockcroft–Gault and observed a prevalence of 24.4% and 26%. Four of the studies used the MDRD and the prevalences observed were 12.3%, 14.2%, 2.5%, and 13.4%. One of the studies used the CKD-EPI equation and the prevalence was 11.4%. The male to female ratios of CKD prevalence in six studies were 1:1.9, 0.8:1, 1:1.6, 1:2, 1:1.8, 1:1.4, and the observed risk factors in the studies were old age, obesity, diabetes mellitus, hypertension, family history of hypertension, family history of renal disease, low-income occupation, use of traditional medication, low hemoglobin, and abdominal obesity.ConclusionThe prevalence of CKD was high but variable in Nigeria, influenced by the equation used to estimate the GFR. MDRD and CKD-EPI results are agreeable. There is a need for more population-based studies, with emphasis on repeating the GFR estimation after 3 months in subjects with GFR <60 mL/min/1.7 m2.

Chemical diversity and antimicrobial activity of the essential oils of four Apiaceae species growing wild in Lebanon

The Apiaceae species are largely used in folk medicine to treat many diseases, including microbial infections. The essential oils (EOs) of Prangos asperula Boiss., Daucus carota L. subsp. maximus, Ferula elaeochytris Korovin and Smyrnium olusatrum L. were analysed by GC, GC-MS and NMR. The major components were as follows: sabinene (29.8%) and β-phellandrene (19.2%) were found in the P. asperula fruit oil; α-pinene (27.4%) and carotol (26.3%) were found in the D. carota flower oil; α-pinene (71.8%) was the major compound in the F. elaeochytris fruit oil; and the S. olusatrum flowerings tops EO was mainly composed of furanodiene (44.6%) and furanoeremophil-1-one (28.5%). D. carota and S. olusatrum were the most active oils especially against Staphylococcus aureus and the dermatophytes; the MIC values ranged from 8 to 64 μg/ml. Some of these EOs constituents hold promising antimicrobial potentials, confirming the traditional medical use of the plants.

Contact Dermatitis Following Use of Tropical Traditional Medicine

Traditional or herbal medications are generally perceived as safe since it is derived from natural or plant sources. A rise in number of adverse reactions are being reported with the use of traditional medications including localized cutaneous reactions. The diagnosis of contact dermatitis is often quite straight forward based on its appearance, pattern, site and distribution of the lesion which usually corresponds to the area of contact. We report the case of a 65-year-old woman who presented with redness, burning sensation and swelling of her hand after applying topical Chinese traditional medication. This report aims to outline simple measures to identify and manage contact dermatitis secondary to topical medication. The present case creates awareness that topical traditional medications are not as harmless as previously thought to be. Precautions regarding adverse reactions are required, as those with conventional medications.

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access.

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality.

Unidentified drugs in traditional medications causing toxic epidermal necrolysis: a developing country experience

Drugs are by far the most common cause of toxic epidermal necrolysis (TEN), but unidentified drugs and chemicals present in herbal and traditional medications may also be responsible for this reaction, which manifests as widespread epidermal detachment of the skin and mucous membrane. In contexts in which a subject has used an herbal or traditional medication, it is very difficult to diagnose the condition, identify the offending agent, and prevent the disease from recurring. This prospective study was conducted at a tertiary burn center between July 2004 and October 2012. All patients were referred to this unit by the local department of medicine at least one week after the eruption of vesicles. On arrival, all patients demonstrated a severe form of disease with features of sepsis and electrolyte imbalance (SCORTEN scores of ≥4). All non-fatal cases were followed to observe long-term sequelae and recurrences. About 34% of patients had developed the condition after ingesting traditional herbal medications and were unable to identify the responsible drug by name. Nineteen (66%) of the 29 patients referred to the unit with TEN died within the first week after being transferred. Nine patients achieved complete recovery, and one developed corneal haziness and alopecia. One patient experienced recurrence within three months but recovered. Illiteracy and financial vulnerability were major factors in driving patients towards the use of traditional medications, which were often prepared and preserved improperly. Mortality and other complications could be reduced by the prompt recognition of the condition, immediate withdrawal of the culprit drug, and quick referral to proper care.