Effect of using Jojoba and Moringa protein concentrate as a fat mimetic on physical and

sensory properties of cupcake

Makpoul KR*, Ibraheem AA, Amira MS
Food Science and Technology, Agricultural Industrialization Unite, Desert Research Center, Cairo, Egypt
_________________________________________________________________________________________________

This research study was primarily conducted for the purpose to examine the Jojoba and Moringa protein concentrate as a
fat mimetic on physical and sensory properties of cupcake. Fat replacers can be used to help decrease the amount of fats
used in cooking; therefore, these health risks can be reduced. This study showed that Sensory quality was assessed by ten
experienced panelists from Desert Research center, using attributes such as bread taste, flavor, firmness, softness, crumb
and crust colors, appearance and overall acceptability. Principal components and cluster analyses confirmed two groupings
of treatments with Jojoba and Moringa protein concentrate as a fat mimetic. It is concluded that treatments with 25% and
50% fat replacement were tastier and more acceptable. Finally, Jojoba and M. olifeira protein concentrate presented good
functionality for utilization in food formulations.
_________________________________________________________________________________________________

Now-a-days people are very particular about their relation between diet and health and more over they prefer food of low
calorie which is healthy to the body. Usually for any occasion cakes are preferred first and which always been the children
favourite food. Apart from the diet foods, cakes, burgers, pizzas, etc. are playing major role in the eatables. In return they
are causing diseases such as constipation, tumours and heart attacks. In order to prevent the major health problems right
food at right time must be taken. Proteins which paly major role in the diet. Essential proteins are not synthesized from our
body they are consumed through taking vegetables, fruits, etc. whereas nonessential proteins are synthesized in body itself.
Deficiency of proteins causes the serious problems such as malnutrition (marasmus and kwashiorkor) plant proteins are
preferred first because they worth low and effective compared to animal protein.

_________________________________________________________________________________________________

Preparation of protein concentrate

A pressed cake (meal) was obtained from a press operation and extracted with hexane until the solvent was no longer
colored. The defatted meal was spread out in trays to dry overnight at 20C. The defatted meal was subsequently ground
with a hammer mill through 60 mesh screens. Protein concentrate were obtained by extracting the defatted meal with
hexane solvent (1:20, w/v) at 20C. SDI (spray-dried concentrate I) was obtained after washing the meal with methanol /
acetone (3:1) and by rewashing SDI protein concentrate with a solution of methanol and IN HC1 (98:2) (SDII).
_________________________________________________________________________________________________

Proximate composition and yield of protein concentration

The proximate composition of Jojoba and Moringa defatted seed meal is presented in
Figure 1. Protein was the major macromolecule in Jojoba defatted seed meal (35.8%)
after carbohydrates (43.2%). Higher protein content values were reported for Moringa
defatted seed meal (58.4%). Jojoba meal reported higher content of fiber, moisture and
ash (13.1%, 3.9% and 3.7% respectively) than Moringa meal (4.9%, 2.7% and 2.3%
respectively). Protein content was significantly (p<0.05) higher in M. oleifera meal
compared to Jojoba meal. Defatted seed meal was found to have fat content about (0.3
and 0.1%) for Jojoba and Moringa respectively.

_________________________________________________________________________________________________

The concentrate pressed meals were reduce weight from 50% to 55% while removing simmondsin content in Jojoba and
pressed meals and reduced content of polyphenol in all concentrate of Jojoba and Moringa. The functional properties were
investigated most thoroughly with the SDII concentrate because this concentrate had the lowest concentration of
simmondsin, a toxic compound in Jojoba, and polyphenolic compounds [7]. The concentration of simmondsin must be
reduced before Jojoba meal or protein concentrates can be used in food or feed products. Table 3 shows the protein yield
of pressed meal concentrate of Jojoba and Moringa SDI. Water extractable protein obtained after washing the meal with
methanol/acetone solution, SDII. SDI protein concentrates after washing with a methanol/HCl solution.

_________________________________________________________________________________________________

The results showed that with the increase of protein concentrate of Jojoba and Moringa contents, the general acceptance
of the cupcake final products, we introduced the sample containing 25% protein concentrate of Jojoba and Moringa as the
best sample. Then, the second level was acceptance in the study was content 50% of protein concentrates of Jojoba and
Moringa. Based on the positive results of this study, the possibility to produce low-fat cupcakes with protein concentrate of
Jojoba and Moringa with desired quantitative and qualitative properties is confirmed.

_________________________________________________________________________________________________

We acknowledge funding for this work by the Food Science and Technology, which is primarily financed Acgricultural
Industrialization Unite and was also supported by a grant from the Desert Research Center.
Compare, evaluate, and estimate chronological age with dental age and skeletal age in 614-
year-old Himachali children
Ajay K Kapoor, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam
Department of Paediatric and Preventive Dentistry, Himachal Pradesh Government Dental College and Hospital, Shimla,
Himachal Pradesh, India

Age estimation is of immense importance not only for personal identification but also for treatment planning in medicine and
dentistry. Chronologic age conveys only a rough approximation of the maturational status of a person. Hence, dental and
skeletal ages (SAs) have been explored as maturity indicators since decades. The aim of this research is to test the
applicability of Willem's dental age (DA) assessment methods as well as Mito T SA assessment method in Himachali
children. The study included 55 subjects (30 males and 25 females) ranging from 6 to 14 years age who require orthodontic
intervention. DA estimation was performed from digital orthopantomogram of mandibular teeth of left quadrant using
Willem's methods. SA estimation was done from lateral cephalogram using Mito T method. The differences between the
chronological age (CA) and the estimated dental and SAs were statistically tested using paired t-test. The correlation
between CA, dental, and SA estimation methods was confirmed statistically using Pearson's correlation. Among the age
estimation methods used in this study, the Willem's DA estimation method proved to be the most accurate and consistent.
Although various age estimation methods do exist, the results are varied in different populations due to ethnic differences.
However, till new tables are formulated using greater sample size, the Willem's method can be accurately applied to estimate
CA for the population studied.

Human growth shows considerable variation in the chronologic ages at which individual children reach similar
developmental events. Chronologic age alone is not sufficient for assessing the stage of development of a growing
child.[1],[2],[3] Dental age (DA) is of particular interest to the pedodontist and orthodontist in the management of different
types of malocclusions in relation to maxillofacial growth. It can be determined by the stage of tooth eruption or the stage of
tooth calcification.[4]

The most widely used method for DA estimation was described in 1973 by Demirjian et al.[2] but has overestimated the age
in various population studied.[4],[5],[6],[7],[8] In 2001, Willems et al., evaluated the accuracy of Demirjian method in Belgian
Caucasian population and modified the scoring system when a significant overestimation was reported.

Skeletal maturation is routinely evaluated to indicate the level of body maturation and to determine the remaining growth
potential in children. Skeletal maturation can be assessed by evaluating the degree of ossification of certain bony markers
located within the skeletal system.[9]

The study included 55 patients of age group 614 years who require preventive and interceptive orthodontic treatment
selected from routine patient OPD were included in the study. Ethical clearance was obtained from the Institutional Ethics
Committee.

CA was calculated by subtracting the date of birth from the date on which radiograph was taken. Digital panoramic
radiographs (OPGs) of all children were assessed the for maturation status on the basis of calcification of the permanent
teeth in mandibular left side, from central incisor to the second molar, using Demirjian et al., method. To avoid observer
bias, each digital OPG of an individual was coded with a numerical identity number (155) to ensure that the examiner was
blind to sex, name, and age of subjects. Two evaluators (pedontists) were supplied with all 55 OPGs each and with written
instructions for staging, including drawings and written descriptions of stages of tooth development of Demirjian et al.,
method [Table 2].[2]

[Table 1] demonstrates a total sample of 55 children were included in the study. The children were distributed among both
genders including 30 male and 25 female patients for the age group of 614 years. Correlations of dental and SAs with CAs
were done. Pearson's correlation coefficients were used to measure the association between the skeletal maturity and
dental maturity.

Determination of a child's growth and development are of great value from both the medical and odontologic points of view.
Although various methods for the age determination exists, a universal system has not yet been developed due to the
varying differences in different ethnic population groups.[11] Hence, each method requires to be tested in different
populations.

Age estimation by means of tooth development is a well-established predictor of age during childhood. Tooth development
is an accurate measure than chronologic age and is independent of extrinsic factors, for example, diseases or malnutrition,
unlike SA, body height, and weight measurement.[3] Demirjian's method of DA estimation is most widely researched and
applied technique, because of its simplicity as well as radiographic and schematic illustrations of the tooth development and
accompanying description but has shown consistent overestimation in all populations studied.[12] Hence, Willem's DA
estimation method was tested in this study which is based on the stages of the tooth development described by Demirjian
et al.[13]

It is essential for a pedodontist to study the growth of the child to compare with the normalcy and treatment planning. This
study showed a strong correlation between the developmental ages in mixed dentition population; hence, DA can be
considered a replacement in the study population. However, certain refinement would be required in Mito T. method to
assess SA in the given population. Studies with a larger sample size should be carried out for more reliable results.

The authors wish to acknowledge all people and organizations that are instrumental in collecting and processing the
datasets that make studies like this possible.
Assessment of the cardio-autonomic status by short-term heart rate variability in
young football players
Kuppusamy Maheshkumar1, Sundareswaran Loganathan2, Arbind Kumar Choudhary3

The present study was done to explain the importance of physical activity (PA) on autonomic nervous system. We have
compared the short-term heart rate variability (HRV) between football players and normal controls lacking PA, fitness, and
exercise.The sample included 40 football players and 40 controls with age group between 17 and 26 years. Individuals with
minimum 5 years of football practice were included and morphological variables (weight, height, and body mass index) were
recorded in all of them. Five minutes lead II electrocardiography recorded in supine position in the morning and R-R intervals
were analyzed in Kubios software. Time domain parameters of average mean R-R interval (1014 286.12 ms vs. 860.28
362.4 ms), standard deviation of the NN (89.81 18.14 ms vs. 63.9 31.27 ms), root mean square of successive difference
(76.95 24.20 ms vs. 43.19 29.83 ms), and pNN 50% (39.16 16.87% vs. 23.46 19.43%) were significantly higher in
the study group than the control group. Higher frequency power band (71.23 11.59 n.u vs. 54.90 17.3 n.u) showed
significant higher value while low-frequency (LF) power band (29.66 15.13 n.u vs. 47.23 13.84 n.u) and LF/high-
frequency ratio (0.964 0.286 vs. 2.04 0.459) of frequency domain parameters showed significant reduction among the
football players. The present study explains that regular PA in the form of football shifts the autonomic system toward
parasympathetic domination. The indices of HRV can be useful to monitor the effects of football training on parasympathetic
modulation and to the periods of stress and recovery.

Football players undergo a high-intensity training program to build up their speed, muscular strength, and cardiorespiratory
endurance compared to the normal.[1] Sympathetic and parasympathetic alterations in high endurance training induce rapid
physiological response such as increases in heart rate (HR) and blood pressure [2] by the involvement of the hypothalamic
pituitaryadrenal and sympathoadrenomedullary axes. The sympathetic and parasympathetic activity differs accordingly
based on the individual's physical activity (PA). Everyone perform PA to sustain their life. However, the amount varies to
personal choice from person to person. PA and exercise have an important influence on the relationship between
psychosocial stress and cardiovascular disease.[3] Reduction in the mortality rate of healthier old and young men is well
linked with the increased training and regular exercise.[4] Increased fitness level has little effect on HR variability (HRV),
which reflects the sympathetic and parasympathetic modulation of HR.[5] In general, HRV is mainly caused by autonomic
modulation on the sinoatrial node and acts as a good indicator of autonomic control related to cardiovascular health. As a
noninvasive method to assess the autonomic nervous system, HRV is a valuable tool for several physiological conditions
such as different body positions and physical training.[6] Hence, to explain the importance of PA on the autonomic nervous
system, we aimed to compare short-term HRV between football players and normal controls lacking PA and exercise in the
present modern world.

The present study was conducted on 40 male football players aged 1730 years and 40 untrained male controls aged 18
29 years from April 2015 to December 2015. Institutional ethical clearance was obtained. Players in the football group who
have been doing endurance training for more than 5 years and participated in university level football matches were included
in this study. Individuals with any form of regular PA more than 3 days, any metabolic diseases, recent surgery, acute illness,
and on any regular medication were excluded. All of them in both groups were in normal health, based on a routine clinical
examination. Informed consent was obtained from all individuals before their participation. Individuals were weighed in
minimal clothing to the nearest 0.1 kg and their height was measured to the nearest 0.1 cm. Body mass index (BMI) was
calculated using the formula weight in Kg/height in m 2 (Quetelet formula).[7]

[Table 1] shows the anthropometric and cardiovascular parameter between control and football players and there was no
significant difference was found in age, height, and weight. BMI was observed slightly higher in football players but not
significant. Resting HR found in football players was significantly (P < 0.01) lower than the control group. They also had
significantly (P < 0.01) lower systolic blood pressure and diastolic blood pressure than untrained controls. In time, domain
parameters of short-term HRV [Table 2] showed a significant (P < 0.05) higher value in mean NN, SDNN, RMSSD, and
pNN50.

In short-term HRV, LF band of frequency domain expressed in normalized unit (n.u) is mainly related to sympathetic
modulation and HF band (n.u) reflect the efferent vagal activity of the heart.[8] The LF/HF ratio is correlated with
sympathovagal balance.[9] Time domain parameter of mean NN, SDNN, RMSSD, and pNN50 represents the activity of
parasympathetic nervous system. From the present study, we identified that football players were in the state of
parasympathetic dominance. The increase in HF power and the decrease in LF power and LF/HF ratio of frequency domain
parameters in trained football players reflect the shift toward the vagal domination. Decreased resting HR in players has
been well observed in various studies, and it could be due to the long-term endurance training. This training is also
associated with the improved heart function by increasing the stroke volume and left ventricular mass. However, endurance
training also decreases the metabolic load on the heart at rest and during submaximal exercise training conditions. Normally,
long-term physical training influences the cardiac rhythm by inducing sinus bradycardia in resting condition and slow
increase in HR at various degrees of submaximal exercise is due to a shift of the sympathovagal balance [10] toward
parasympathetic dominance.[11] Studies showed that aerobically trained athletes have a higher mean NN (lower HR)
compared with the control group with the higher value of RMSSD and pNN50 in standing as well as in supine position.[12]

Apart from these various conflicting results, our findings clearly explain that high endurance training in football players may
cause the state of parasympathetic domination and this observed base line parasympathetic predominance in autonomic
nervous system was balanced with better neuromuscular contribution and their preparedness for higher performance.

The research team would like to acknowledge the football players involved in this study and Dr. R Ravindran and Dr. R
Sheela Devi for the permission and support to conduct this study.
Normative values of handgrip strength in children using a perineometer
Vaishali Pornak, Suvarna Ganvir
Department of Neurosciences, DVVPF's College of Physiotherapy, Ahmednagar, Maharashtra, India

The device used in this study is a perineometer. This study comprises 100 children (50 boys and 50 girls) in the age group
of 612 years. Children with any musculoskeletal and neurological disorder were excluded from the study. The aim of this
study is to measure hand grip strength in children. They were asked to sit on a chair with an armrest. The cuff was inflated
till 100 mmHg. They were told to press the transducer of the perineometer up to their maximum strength and release it. This
process was repeated for three times, and the maximum strength was noted for both the right and left hand. Armrest chair,
perineometer were used. Through unpaired t-test,The mean grip strength in boys is 72.6 mmHg on the right side and 67.18
mmHg on the left and 6.92 mmHg on the right and 58 mmHg on the left in girls. This study has provided the normative
values of grip strength which can be used as a reference measure for detecting the abnormality in handgrip strength.

The instrument to measure handgrip strength in children as well as in adults is a handheld dynamometer. Studies of grip
strength (all from the United States) have used a range of dynamometers-pneumatic and hydraulic manometers, spring-
loaded resistances, and cable tensiometers.[1],[2],[3],[4],[5] Majority of studies have sampled adults only and no one has
included children under 10 years of age. Nearly, all the dynamometers in clinical use have comparatively narrow ranges
and test basically isotonic contraction.

The criterion for measuring handgrip strength is to have the person press the handle of the dynamometer, which shows the
amount of pressure exerted on the device. In general, dynamometers available are designed for adults but have a few
methods for accommodating smaller hands (e.g., numerous hand-size adjustments). These procedures present challenges
when used to examine children whose hands are smaller than those of an adult.[6],[7] These devices when used in children,
they experience difficulty in holding the device which causes pain and imprecise readings. Hence, there is a need for an
instrument which the children might find it easy and will be comfortable for them to handle. Occupational therapists modify
dynamometer equipment to accommodate a child's undersized hand and other persons with hand problems. However,
these modifications are made within individual occupational therapy clinics and are not readily available to other clinicians.[8]

Written assent was obtained from the child's parent. The participants were given a demonstration before the testing. Each
participant was made to sit on an armrest chair facing the researcher. The children were told to press the transducer of the
perineometer up to their maximum strength and release it. This process was repeated for 3 times for each hand with a
pause of 10 s between two readings. The maximum strength was noted for both the right and left hand.

[Table 2] represents descriptive statistics (mean and standard deviations) in each age group. Unpaired t-test was used at
P< 0.0001 level of significance. As age increases, the grip strength also advances starting from 54.25 mmHg at 6 years of
age and advancing to 82.28 mmHg at 12 years of age. Majority of children were the right-handed dominant. Hence, the
strength of the dominant hand was greater than the nondominant hand.

The Data composed in this study give information of the expected grip strength using a perineometer typically in children.
Comparable to the results of the study conducted by Ager et al., 1984; Mathiowetz et al., 1986, our study also shows that
as we grow old, the grip strength also goes on escalating.[6],[9] There is no conformity about whether girls and boys have
the identical grip strength at every age.[9] In this study, girls recorded a smaller amount of grip strength as compared to
boys at every age.

There is a large body of research examining the influence of hand dominance on handgrip, the majority of which suggests
that the dominant hand is up to 10% stronger.[10] In this study, the right-hand side is the principal side in all ages and it
shows more grip strength as compared to the left-hand side at all ages. It has been suggested that evaluating grip strength
in the left-handed children; one should assume that both the hands are about equally strong, whereas right-handed children
are expected to be up to 10% stronger with their right hand.[11]

This study has provided the normative values of grip strength which can be used as a reference measure for detecting the
abnormality in handgrip strength.

The research team would like to acknowledge the children and experts involved in this study and the parents of the children
for the permission and support to conduct this study.
Clinical analysis of proptosis in a tertiary care hospital of South India
Soujanya Kaup1, HT Venkategowda2
1 Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India

Comprehensive data on various etiologies of proptosis is a necessity in guiding the ophthalmologists and physicians for
early diagnosis and treatment. This study aimed to describe the clinical presentation, spectrum of etiology, treatment
modality, and outcome among patients with proptosis. All the study participants who satisfied inclusion and exclusion criteria
were interviewed with a pretested and validated schedule. Detailed clinical evaluation of proptosis was done after obtaining
informed consent. Every case was followed up till the end of treatment. Data were analyzed using Statistical Package for
Social Sciences for Windows, Version 16.0. (SPSS Inc., Chicago, IL, USA). Results were expressed as frequencies and
proportions for categorical variables and mean and standard deviations for continuous variables. Fifty patients completed
the study and nearly half were in the age group of 4160 years. Axial proptosis was the most common type. Nearly one-
third required surgical treatment and was significantly high (P < 0.01) in neoplastic proptosis. More than one-third resolved
completely.Thyroid eye disease and other inflammatory disorders were the major etiology of proptosis. Extremes of age
and unilaterality and eccentricity of proptosis clearly distinguish neoplastic causes from that of inflammatory. Considering
the diverse etiology of the diseases causing proptosis, definitive management varies accordingly. The site of lesion causing
proptosis is of prognostic value during orbitotomies with higher complications occurring with intraconal lesions.

Proptosis describes an abnormal protrusion of the globe [1],[2] The anatomical position of the orbits, their relative
inaccessibility, and variety of lesions giving rise to proptosis make it a difficult yet interesting problem.[3] Orbital surgery has
become safer owing to advances in diagnostic instrumentation and surgical techniques.[4] Although over the years many
authors have assessed proptosis and its causes, there exists a disparity in the incidence of reported lesions.[5]
Comprehensive data on etiologies of proptosis is a necessity in guiding ophthalmologists toward clinical suspicion for early
diagnosis and treatment.

Statistical analysis

Data were analyzed using Statistical Package for the Social Sciences for Windows, Version 16.0. (SPSS Inc., Chicago, IL,
USA). Results were expressed as frequencies and proportions for categorical variables and mean and standard deviations
for continuous variables. Pearson's Chi-squared test was applied to capture the gender- and etiology-wise differences in
proportions of proptosis across outcome variables. Yates's Chi-squared test was considered if more than 20% of the cells
had an expected count of <5. A two-sided P< 0.05 was considered statistically significant.

A total of 56 cases satisfying study criteria were included in the study; however, 6 of them did not complete the study and
therefore, attrition rate was 10.7% and attritions were excluded from the analysis. Out of the fifty study participants, 64% (n
= 32) were males. Mean ages of males and females were 42.2 16.2 and 43.6 18.9 years, respectively (range: 977
years). Gender-wise differences in mean ages were statistically nonsignificant (P = 0.785). Majority (46%) of patients with
proptosis were in the age group of 4160 years [Table 1]. Four patients were aged <13 years.

[Table 2] shows the various etiologies of proptosis among the study participants. Thyroid eye disease (n = 21, 42%) and
orbital cellulitis (n = 10, 20%) were the most common etiologies. Nearly two-third (64%) of the patients presented with
unilateral proptosis. Axial proptosis was the most common type (76%) [Table 3]. Almost equi-proportional distribution was
seen in laterality and duration of proptosis presentation. More than half of the proptosis were mild (2123 mm). Nearly one-
third of males and one-fourth of females required surgical treatment. Gender-wise differences across various clinical
parameters of proptosis were statistically nonsignificant (P > 0.05) [Table 3].

Despite low incidence, ocular proptosis needs a special mention and detailed evaluation owing to its unfavorable outcome
including loss of vision and death. A wide range of local and systemic conditions have been enlisted as causes of proptosis.
Familiarity with common conditions in their local setting would obviously aid the ophthalmologists in clinical diagnosis. In
this regard, this longitudinal study was conducted to provide comprehensive data on proptosis in local setting.

Overall in this study, inflammatory orbital disorders (thyroid eye disease and other inflammatory diseases) were the major
etiology of proptosis. Age group of 2060 years was most commonly affected with steady decline in extreme ages. These
findings are corroborated by the studies conducted by Dallow et al.,[5] Rootman,[7] Henderson's orbital series,[8] Wilson
and Grossniklaus,[9] and Mallajosyula.[10] On the contrary, extremes of age (<20 and > 60 years) and unilaterality and
eccentricity of proptosis are more likely to have neoplastic etiology. Similar to our study, bimodal distribution and benign
nature of neoplasms were described by Dallow et al. and Rootman.[5],[7]

Relatively small study sample and only one tertiary care hospital as source of data may question the external validity of the
findings. Investigation such as thyroid auto-antibodies could not be done due to nonavailabilty in the study setting and
paucity of the funds. Nonetheless, it provides valuable information to doctors in local setting regarding proptosis to
streamline the investigations.

In the local study setting, corroborating with other studies, thyroid eye disease and other inflammatory disorders were the
major etiology of proptosis. Extremes of age and unilaterality and eccentricity of proptosis clearly distinguish neoplastic
causes from that of inflammatory. This study reaffirms that detailed history and clinical evaluation give valuable hints to the
etiology of proptosis. Considering the diverse etiology of the diseases causing proptosis, definitive management varies
accordingly. In patients requiring orbitotomy, the site of the lesion can have a prognostic significance, with intraconal lesions
having higher complication rate.

This research is funded by the Dartment of Opthalmology, Yenepoya University.

Antioxidants and Antimicrobial Activities of Methanol Extract of Newbouldia laevis and Crateva
adansonii
Tsado A. Ndarubu, Lawal Bashir, Ossai P. Chukwudi, Jagaba Aliyu, Gwadabe N. Kontagora, Jiya A. Gboke, Umar A.
Muhammad and Oladunjoye J. Olabode

Plants and plant products are continuously being explored in medicine against free radicals induced oxidative stress and
increasing No. of antibiotic resistant organisms. In the present study antioxidants and antimicrobial activity of methanol leaf
extract of N. laevis and Crateva adansonii against some pathogenic microorganism were carried out. The antioxidants
activities were conducted using DPPH radical scavenging assay. The antibacterial activity was screened against Klebsiella
pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Staphylococcus aureus and E. coli using agar well diffusion
method at various concentrations (160, 120 and 80 mg mL1). The Minimum Inhibitory Concentration (MIC) was determined
using serial dilution method, while Minimum Bacterialcidal Concentration (MBC) by plating various dilution of extract. Results
revealed the presence of alkaloid, flavonoids, saponins, terpenoids, glycoside and anthraquinone in methanol leaf extract
of N. laevis. Newbouldia laevis and Crateva adansonii extracts and the standard antioxidant (Vitamin E) promoted an
inhibition of DPPH radical with increasing concentrations. The IC50 values of C. adansonii, N. laevis and Vitamin E were
1562.52, 155.17 and 83.65 mg mL1, respectively. The zone of inhibition demonstrated by the two extracts increase with
increase concentration. The MIC of both extracts was in range of 120-160 mg mL1, while the MBC range between 120-
160 mg mL1. It is concluded that N. laevis contains some useful phytochemicals with potential antioxidants and antibiotic
reputations. Thus, it may be considered as a natural source of antimicrobials and antioxidants for therapeutic purposes.

World Health Organization (WHO) recognizes traditional based medicine particularly from plant extract as an important
alternative healthcare delivery system for most of the worlds population1. Literatures have documented the potential
beneficial effects of African medicinal plants and other African natural products in the traditional management of different
parasitic infectious, metabolic and oxidative stress induced disease2-4. They are also known for considerably huge amount
of novel bioactive compounds that could serve as a lead for the development of new and effective drugs for the treatments
of several diseases5-7. African natural products are therefore noteworthy for there remarkable healing properties as
revealed in the various citations above.

The recent growth in knowledge of free radicals and Reactive Oxygen Species (ROS) in biological systems is producing a
medical revolution that promises a new age of health. Under a situation of oxidative stress, reactive oxygen species such
as superoxide hydroxyl (OH) and peroxyl (OOH, ROO) radicals are generated. These reactive oxygen species play an
important role in degenerative or pathological processes, such as aging, cancer, coronary heart disease, alzheimers
disease, atherosclerosis, cataracts and inflammation8. The major roles of antioxidants are in preventing the oxidation of
other molecules by inhibiting the instigation or promulgation of oxidizing chain reactions by free radicals and they may
reduce oxidative damage to the human body9. Many natural antioxidants compounds are abound in plants. The increasing
prevalence of multi-drug resistant strains of bacteria and the recent appearance of strains with reduced susceptibility to
antibiotics has raises concern on untreatable bacterial infections and call for urgent search for new infection fighting
strategies and new effective antimicrobial and antioxidants agents.

Plant collection: Fresh leaf of Newbouldia laevis and Crateva adansonii were collected in the month of June, 2015 from
Chanchaga Local Govt area of Niger State Nigeria. It was identified and authenticated by a botanist in the Department of
Biological Science, Federal University of Technology, Minna, Niger State.

Sources of microorganisms: Pure isolate of Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi,
Staphylococcus aureus and Escherichia coli were obtained from Microbiology Department, Federal University of
Technology, Minna, Niger State. The identity of the organism were confirmed by standard biochemical test and proper Gram
staining test.

Phytochemical composition: The results of qualitative phytochemical composition of methanol leaf extract of N. laevis are
showed in Table 1. The results revealed the presence of alkaloid, flavonoids, saponins, terpenoids, glycoside and
anthraquinone, while steroids were absent.

Antioxidant assays
Scavenging activity on DPPH radical of N. laevis and C. adansonii: The results of DPPH radical scavenging activity of
methanol leaf extract of N. laevis, C. adansonii and the standard antioxidant (Vitamin E) are presented in Table 2 and Fig.
1. The extracts and the standard antioxidant (Vitamin E) promoted an inhibition of DPPH radical with increasing
concentrations. Although, the percentage inhibition of the DPPH radical by Vitamin E was higher than the extracts. DPPH
radical scavenging activity of methanol leaf extract of N. laevis (21.45-62.90% at 10-250 mg mL1) was higher than C.
adansonii extract which show a very low (1.22-8.68%) activity at 10-250 g mL1. The IC50 (concentration that inhibits 50%
of the DPPH radical) values of C. adansonii, N. laevis and Vitamin E were 1562.52, 155.17 and 83.65 mg mL1, respectively.

Phytochemical constituents are secondary plant metabolites that occur in various part of plants. They have played a diverse
roles in plants which include provision of vigour to plant; attraction of insect for pollination and feeding defence against
predators and provision of colour15. However, this phytochemicals elicit varied biochemical and pharmacological actions
when ingested by animals17. This study revealed the presence of various medically important phytochemicals in methanol,
leaf extract of N. laevis. Phytochemical constituents demonstrated in the plants extracts were flavonoids, phenols, glycoside
saponins, alkaloids, anthraquinone and tannins. The presence of important phytochemical is an indication that methanol
leaf extract of N. laevis if properly screened could yield a drug of clinical importance.

This study has shown that the methanol, leaf extract of N. laevis and C. adansonii contains some useful potential
antimicrobial phytochemical that are inhibitory to some pathogenic organism. Newbouldia laevis also had a good DDPH
radical scavenging activities Thus, it may be considered as a natural source of antimicrobials and antioxidants for
therapeutic purposes.

The authors wish to acknowledge all people and organizations that are instrumental in collecting and processing the
datasets that make studies like this possible.
A multi-national comparison of antipsychotic drug use in children and adolescents, 20052012
Luuk J. KalverdijkEmail author, Christian J. Bachmann, Lise Aagaard, Mehmet Burcu, Gerd Glaeske, Falk Hoffmann, Irene
Petersen, Catharina C. M. Schuiling-Veninga, Linda P. Wijlaars and Julie M. Zito

Over the last decades, an increase in antipsychotic (AP) prescribing and a shift from first-generation antipsychotics (FGA)
to second-generation antipsychotics (SGA) among youth have been reported. However, most AP prescriptions for youth
are off-label, and there are worrying long-term safety data in youth. The objective of this study was to assess multinational
trends in AP use among children and adolescents. A repeated cross-sectional design was applied to cohorts from varied
sources from Denmark, Germany, the Netherlands, the United Kingdom (UK) and the United States (US) for calendar years
2005/20062012. The annual prevalence of AP use was assessed, stratified by age group, sex and subclass (FGA/SGA).
The prevalence of AP use increased from 0.78 to 1.03% in the Netherlands data, from 0.26 to 0.48% in the Danish cohort,
from 0.23 to 0.32% in the German cohort, and from 0.1 to 0.14% in the UK cohort. In the US cohort, AP use decreased from
0.94 to 0.79%. In the US cohort, nearly all ATP dispensings were for SGA, while among the European cohorts the proportion
of SGA dispensings grew to nearly 75% of all AP dispensings. With the exception of the Netherlands, AP use prevalence
was highest in 1519 year-olds. So, from 2005/6 to 2012, AP use prevalence increased in all youth cohorts from European
countries and decreased in the US cohort. SGA were favoured in all countries cohorts.

During the past decades, antipsychotic drugs (AP) have gained popularity as a treatment for psychiatric disorders in young
people in most developed countries [1]. AP can be divided in two groups: first generation (typical) antipsychotics (FGA) and
second-generation (atypical) antipsychotics (SGA) [2, 3]. Efficacy of AP in youth has been demonstrated for psychotic
symptoms [4], bipolar disorder [5], irritability in autistic children [6], tics [7], and some forms of (severe) aggressive behaviour
[8, 9]. Ample use of AP drugs has been described in children with a mental handicap and behavioral symptoms [10]. But
only few antipsychotic drugs are licensed for those indications and for children and there is a lack of long-term efficacy and
safety data [11]. Therefore, the treatment of youth with antipsychotics is subject to debate among clinicians, scientists and
health policy makers [12].

Data sources
Denmark
We employed data from the Danish Registry of Medicinal Products Statistics (RMPS). The RMPS is a national prescription
database, which encompasses all outpatient pharmacy-dispensed prescription medications in Denmark (5.53 million
inhabitants). Each prescription record contains detailed information on the drug dispensed (incl. ATC code). Any drug
utilisation prevalence can be calculated using an estimation of the underlying population as denominator.

We observed large differences between samples from 5 countries in the prevalence of AP use, with AP use being highest
in the US cohort and lowest in the UK cohort. Since 2007, AP use in the Netherlands cohort has surpassed use in the US
cohort. Also time trends varied significantly: In the Netherlands data, AP use stabilized from 2008 to 2012. In the US cohort,
the prevalence of AP use stabilized and decreased towards 2012. All other countries showed a trend for increased use. In
most countries data, AP use was greatest in 1519 year-olds. We observed a strong and in most countries increasing
preference for SGA, relative to FGA.

There are several possible explanations for the differences in AP use in youth cohorts from different countries: The attitude
of prescribers towards psychotropic drugs and antipsychotic drugs and differences in health systems can be a factor that
influences AP prescription rates [31]. For example: the attitude of physicians that SGA should be used to treat aggressive
behavior can contribute to higher AP prescription rates [32] and the acceptance of psychiatric medication for children by the
general public may be a factor [33]. Several studies indicate a broadening of indications, for example in ADHD and other
disruptive behaviour disorders [13, 16, 34, 35].

This study is one of the first to describe use of antipsychotics in youth cohorts from different countries. The diversity of the
underlying databases is a limitation as the underlying populations differ and this will certainly influence the rates that we
found: The Danish cohort is nationwide, the US cohort comprises CHIP insured patients from one state, the Netherlands
cohort covers a region of the country, the German cohort comprises patients from one large insurance company, while the
UK cohort covers prescriptions from primary care. So, between-country comparisons should be made with caution. We
were not able to control for co-medication, prescribing physician specialty (GPs vs. specialists) or socio-economic status,
factors which influence AP use [51, 59]. Our data sources lack information that could improve the perspective on AP use,
such as underlying indication, ethnic background, foster care status, duration of pharmacotherapy, adherence, symptom
severity and symptom duration. We did not consider medication for hospitalized children. But the number of hospitalized
youth may be small, compared to outpatients [60], and usually medication is continued in the outpatient setting after
discharge from hospital.

In this vein, future studies will benefit from the use of harmonized databases, information about diagnosis (e.g. [61]) and
use of other treatments, concurrent or sequential, thus giving more insight on indications and unmet needs in care across
populations [59]. Data about incidence and duration of AP use is relevant, since longer exposure to the metabolic and
endocrinological side effects of AP poses higher risks for health.

The authors wish to acknowledge all people and organizations that are instrumental in collecting and processing the
datasets that make studies like this possible.