Medicinal plants of the Meinit ethnic group of Ethiopia: An ethnobotanical study

Ethnopharmacological relevance

The majority of the Ethiopian people, including the Meinit ethnic group, are highly dependent on medicinal plants for their day-to-day public healthcare and veterinary needs. The existence of medicinal plants and the associated knowledge is, however, currently being threatened mainly due to deforestation, environmental degradation and acculturation. Thus, there is an urgent need to document and analyse the knowledge.

Aim of study

The aim of this study was to record and analyse local knowledge of the Meinit people of Ethiopia on the use of plants to treat or cure diseases of humans and domestic animals.

Materials and methods

Ethnobotanical data were gathered through series of individual interviews conducted with selected informants representing different social groups within the Meinit Community. Fidelity Level (FL) values were calculated to estimate the healing potentials of claimed medicinal plants.

Results

The study revealed 51 medicinal plants, most of which were herbs. Root was the most frequently used part in remedy preparation. The majority of medicinal plants were not cultivated. Significantly higher numbers of medicinal plants were cited by men than women, by older people than younger ones and by illiterate people than literate ones. Rumex nepalensis Spreng., Leucas deflexa Hook.f. and Embelia schimperi Vatke were the medicinal plants that scored the highest FL values.

Conclusions

Acculturation of the young generation has been found to be the major treat to the continuation of traditional medical knowledge and practice in the study area. Efforts should, therefore, be made to incorporate traditional medicine in school curricula so that younger people could appreciate its usefulness. Priority for further Pharmaco-chemical investigation should be given to plants that scored highest FL values, as such values could indicate better efficacy.     

Autoimmune pancreatitis: current diagnostic criteria are suboptimal

Background and Aims: The preoperative diagnosis of autoimmune pancreatitis (AIP) is difficult, given its similar clinical presentation to pancreatic cancer. The aims of the study are to describe our center's experience with AIP and apply the Japanese AIP diagnostic criteria to a cohort of patients with histologically‐proven AIP in order to assess their performance characteristics. Methods: A prospective pathology database was queried for AIP patients who were evaluated and/or treated at Johns Hopkins Hospital from 2002 to 2009. AIP histology was defined by the presence of lymphoplasmacytic infiltration, periductal inflammation, fibrosis, and periphlebitis. Imaging, clinical, and biochemical data were analyzed. Results: Thirty patients had pancreatic resection with pathological confirmation of AIP. Imaging revealed pancreatic mass (45%), focal prominence without mass lesion (24%), diffuse enlargement (17%), and normal pancreas (14%). Twenty‐four patients underwent an endoscopic retrograde cholangiopancreatography and/or magnetic resonance cholangiopancreatography, and 4/24 (17%) had pancreatic ductal narrowing or irregularity. Extrapancreaticobiliary organ involvement was found in 6% (n = 2) of patients. Biliary strictures were present in 87% of patients. Of 16 patients who underwent preoperative tissue biopsy, 10 had non‐diagnostic pathology, five had cellular atypia, and one had AIP. Serum immunoglobulin G4 (IgG4) levels were elevated in 12 of 29 (41%) patients. Three (10%) patients had evidence of extrapancreatic manifestations of AIP. When applying the Japanese criteria to the 27 patients who had serum IgG4 measurement, preoperative biopsy, and cross‐sectional abdominal imaging, only 44% of the patients would have been diagnosed accurately. Conclusions: When applied to a highly‐selected single‐center referral population in the USA, current Japanese guidelines for the diagnosis of AIP are found to have suboptimal sensitivity.     

Proximal small bowel transit pattern in patients with malabsorption induced by bovine milk protein ingestion.

Seven allergic patients with bovine milk or milk protein-inducible transient intestinal malabsorption exhibited radiologic signs of rapid transit of ingested barium through the proximal small intestine hours following oral challenge with bovine milk or milk protein solution. Control studies in the same patients without prior milk challenge revealed significantly more leisurely progress of contrast medium in the proximal small bowel. The possible pathogenetic role of such hasty transit through the functionally most effective portion of the digestive tract in patients with malabsorption points up the physiologic importance of roentgen examination of motility patterns in this particular segment of small bowel.     

HCV in sickle cell disease

The sickle cell gene is common in the U.S. In fact 8% of African Americans are healthy carriers of the sickle cell trait (HbAS). People who are homozygous (HbSS) have severe disease. They have life-long anemia, chronic hemolysis, and also have at times hematological crises, which can worsen the anemia. Many patients require chronic transfusions and as a result, substantial proportions of sickle cell patients are at high risk for infection with blood-borne diseases-such as Hepatitis C Virus infection (HCV). The HCV antibody positivity is directly related to the number of transfusions given, and on average the prevalence rate in transfused patients is more than 10%. It is known that the combination of iron overload and HCV can lead to a more rapidly progressive liver disease. The treatment of HCV in sickle cell patients poses a challenge to clinicians. A novel approach described by some is the pre-treatment of these patients with hydroxyurea to increase the fetal hemoglobin, therefore decreasing the severity of Ribavirin-related hemolysis. Treatment with Peg-interferon alone has not been used to treat HCV in sickle cell patients, but in the setting of controlled clinical trials it would be feasible. This review explores the impact of HCV in sickle cell patients and the possible therapeutic options available to them.     

Current status of natural orifice translumenal surgery

Translumenal access to the peritoneal cavity will have definite advantages in situations whereby the transcutaneous route into the peritoneal cavity is not optimal. For example, transgastric approach may decrease the risk of postoperative wound complications in patients who have marked obesity, as well as in patients who have anterior abdominal wall infection or severe scarring. Natural orifice translumenal surgery provides an exciting opportunity to improve surgical intervention using the skills, imagination, and ingenuity of endoscopists and endoscopic surgeons.