Epidemiology of colorectal cancer in Barbados: A short report

Barbados is a Caribbean island with a high incidence of colorectal cancer. This study collected epidemiologic data from Barbadian patients with colorectal cancer. There was an opportunity for targeted screening in patients actively enrolled in clinics for management of chronic diseases, accounting for 72% of cases. We also identified areas of high incidence where resources should be directed in a screening programme.

Colorectal cancer demographics in Barbados

Barbados is an island in the Eastern Caribbean that is reported to have the 8th highest incidence of colorectal cancer (CRC) worldwide. However, these figures are based only on estimates, and there is little available epidemiological data collected from Barbadians with CRC. The present study sought to collect epidemiologic data from patients in Barbados diagnosed with CRC. This information is considered important to shape national public health policies. For this purpose, hospital admission registers at all tertiary care facilities in Barbados were retrospectively audited over a four-year period from January 1, 2014 to December 31, 2018 to identify patients who underwent operative treatment for CRC. The following data were extracted: Age, sex, ethnicity, the location of the primary tumour and tumour stage. Descriptive statistical analyses were generated using SPSS version 21.0. The results revealed that there were 97 patients with CRC at a mean age of 64.9 years (SD ±12.2) and a male preponderance (1.3:1). The majority (93.8%) were from the African diaspora. Only 18.5% of diagnoses were made at (opportunistic) screening. Consequently, two thirds of the patients had advanced-stage disease at diagnosis. The disease staging of the patients was as follows: Stage 0 (1%), stage I (10.3%), stage II (23.7%), stage III (38.1%) and stage IV (26.8%). Right-sided primary tumours were most common (44.3%), followed by left-sided (41.2%) and rectal lesions (14.4%). Women were significantly more likely to have right-sided lesions (55 vs. 45%) and males were more likely to have rectal lesions (77 vs. 23%). On the whole, the present study highlights the need to implement a national screening programme in this high-risk population of African origin with a predominantly right-sided distribution of CRC primary tumours. This is reinforced by the fact that 10% of patients will be diagnosed before the age of 50 years with more aggressive disease.

One new pyrroline compound from Callistemon viminalis (Sol. Ex Gaertner) G.Don Ex Loudon

One new compound: 3,4-dihydro-2-(hydroxymethyl)-4-methyl-2H-pyrrol-2-ol (5) was isolated from the fruits and bark of Callistemon viminalis along with the known compounds lupeol (1), octacosanol (2), β-sitosterol (3), betulin (4), betulinic acid (6), ursolic acid (7), corosolic acid (8), β-sitosterol-3-O-β-D-glucoside (9), methyl gallate (10), gallic acid (11), catechin (12), ellagic acid (13) and 3-O-acetylursolic acid (14) (compound 14 was isolated from the bark and not detected in the fruits). Structures of these compounds were elucidated on the basis of their spectroscopic data (NMR, MS, IR spectra and COSY and HR-MS for 5a). The antioxidant activity of the total extracts, petroleum ether, CH2Cl2 and EtOAc fractions together with the compounds 6, 7, 9, 10, 11, 12 and 13 was comparable with that of the standard antioxidant, ascorbic acid.

Clove oil cream: a new effective treatment for chronic anal fissure

OBJECTIVE

Anal fissure is a common painful condition affecting the anal canal and causes considerable morbidity and reduction in quality of life. Surgical treatment has been associated with a degree of incontinence in up to 30% of patients. This study discussed the results of clove oil 1% cream in healing of chronic anal fissure.

METHOD

A single-blind randomized comparative trial was setup to compare traditional treatment with stool softeners and lignocaine cream 5% against clove oil 1% cream for 6 weeks.

RESULTS

55 patients were included in this study, 30 patients in clove oil group and 25 patients in control group. Healing had occurred in 60% of patients in clove oil group and in 12% of patients in the control group after 3-month follow up (P < 0.001). Patients in clove oil group showed significant reduction in resting anal pressure and almost all other anorectal manometric pressures compared with patients in control group.

CONCLUSION

Topical application of clove oil cream demonstrated a significant beneficial effect when applied to patients suffering from chronic anal fissure.

New terpenoids from Haplopappus multifolius

The chemical investigation of the aerial parts of Haplopappus multifolius afforded the new monoterpene 2,9-epoxy-p-menth-6-en-8-ol (7, haplopappol), the new monoterpenoid ester 9-cis-p-coumaroyloxy-alpha-terpineol (8, haplofolin), the new diterpene 18-hydroxylabda-7,13Z-dien-15-oic acid (6) and its known E-isomer (5). In addition, the known dihydroflavones 3',5-dihydroxy-4',7-dimethoxydihydroflavone and 3',4',5-trihydroxy-7-methoxydihydroflavone and the known dihydroflavonols 3',5-dihydroxy-4',7-dimethoxydihydroflavonol and 3',4',5-trihydroxy-3-acetyl-7-methoxydihydroflavonol were also obtained. The structural assignments of these compounds were made possible by the different spectroscopic measurements.

Two flavonoid glycosides from Chenopodium murale

Two new triglycosides, kaempferol-3-O-[(4-beta-D-apiofuranosyl)-alpha-L- rhamnopyranoside]-7-O-alpha-L-rhamnopyranoside and kaempferol-3-O-[(4-beta-D-xylopyranosyl)-alpha-L-rhamnopyranoside]-7-O- alpha-L-rhamnopyranoside were isolated from the methanol extract of Chenopodium murale, together with a known diglycoside, kaempferol-3-O-beta-D-glucopyranoside-7-O-alpha-L-rhamnopyranoside. The characterization of the three compounds was achieved by various spectroscopic methods.