Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.

Level of Adherence to Cytotoxic Drugs by Breast Cancer Patients’ in Lagos State University Teaching Hospital

Background: Breast cancer is one of the most common malignant diseases in women and adjuvant combination chemotherapy has been shown to reduce mortality from this disease. Adherence to medical treatment is a multifaceted issue that can substantially alter the outcomes of therapy. Patient non-adherence to chemotherapy is the ultimate barrier to the treatment effectiveness. Objective: This study was carried out to determine the relationship between cancer chemotherapy adherence and breast cancer staging, patient’s perception of cancer care and patient’s socio-demographic characteristics. Material and method: This was a cross sectional study selection of respondents and was based on simple random sampling technique, 184 patients were interviewed and data was collected using a semi-structured questionnaire to obtain socio-demographic data, adherence data, and facility-related information. Results: There was a significant association between marital status and non-adherence (P?= 0.013). Both separated and single subjects had higher proportion of non-adherence compared with married subjects. Analysis of perception of chemotherapy care revealed a significant association between the satisfaction score and non-adherence, with non-adherent patients showing higher scores or being less satisfied. The quality of service (P?= 0.0052);rating of needs been met (P?= 0.0079);rating on whether the services helped the subject (P?= 0.0405);rating on the general satisfaction of the services provided (P?= 0.0115);and rating on whether subject would seek help again (P?= 0.0320) all had a significant association with non-adherence. Conclusion: The awareness of oncologist and patient of the problem of non-adherence and communication regarding the importance of adherence to therapy may improve health outcomes.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

The Association between <i>Chlamydia Trachomatis</i>and Ectopic Pregnancy in Lagos, Nigeria—A Case Control Study

Objectives: To determine the seropositivity of Chlamydia antibody in patients with ruptured ectopic pregnancy compared to normal pregnant women and the risk factors for ectopic pregnancy. Study Design: This was a prospective case-control study of 85 cases of ruptured ectopic pregnancy and 100 cases of second trimester on-going intrauterine pregnant controls presenting in Lagos State University Teaching Hospital (LASUTH) between September 2009 and March 2010. Study Site: This was at the gynaecological emergency room and antenatal clinic in the Department of Obstetrics and Gynaecology. Ethical approval was sought and granted by the ethics review committee of LASUTH. Study Participants: Patients presenting with ruptured ectopic pregnancy were recruited as cases while the controls were made up of those with uncomplicated second trimester intrauterine pregnancy. A semi-structured questionnaire containing socio-demographic and clinical characteristics was administered following informed consent. Five milliliters of venous blood was taken from each participant and tested for?Lymphogranuloma Venerum?(LGV) type 2 broadly reacting antigen of?Chlamydia trachomatis.?Data Analysis: Data gathered from the case notes and laboratories were imputed into the computer and analyzed using the statistical package?Epi-Info 3.51, Atlanta, USA. Frequency tables were generated for continuous variables and?chi-square analysis used to determine association between variables, with p values <0.05 considered statistically significant. Results: There were 91 cases of ectopic pregnancy among a total of 2468 deliveries giving an incidence of 3.68% or 1 in 27 deliveries. Factors which significantly contributed to increased incidence of ectopic pregnancy in this study were: level of education (p = 0.001), socio-economic status (p = 0.001), parity (p = 0.005), early age of sexual debut (p = 0.001), multiple sexual partners (p = 0.001), previous pelvic inflammatory disease (p = 0.003), previous induced abortion (p = 0.013) and previous?postabortal/puerperal sepsis (p = 0.013). The seropositivity of?Chlamydia IgG (62.4%) in the cases was significantly higher than that of 29% in the control (p < 0.0001). Conclusion: There was a high incidence of ectopic during the period of study and the seropositivity of Chlamydia IgG antibody was significantly higher amongst the cases. Risk factors identified were low level of education, low socio-economic status, low parity, early age of sexual debut, multiple sexual partners, previous history of pelvic inflammatory disease, previous induced abortion and previous postabortal/puerperal sepsis.

Weight losing, antihyperlipidemic and cardioprotective effects of the alkaloid fraction of Hunteria umbellata seed extract on normal and triton-induced hyperlipidemic rats

Objective: To investigate the weight losing, antihyperlipidemic and cardioprotective effects of the alkaloid fraction of Hunteria umbellata(H. umbellata) seed.Methods: Adult female Wistar rats(weight range: 120-150 g) were randomly divided into 4 and 5 treatment groups in the normal and triton-induced hyperlipidemic models, respectively. and were daily treated for 14 d before they were humanely sacrificed under inhaled diethyl ether anesthesia. About 5 mL of whole blood was obtained by cardiac puncture from each treated rat, from which serum for lipids assay was subsequently separated. Tissue samples of livers of treated rats were harvested and processed for histopathological analysis.Results: Repeated daily oral treatments of normal rats with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata resulted in significant(P<0.05 and P<0.001) and dose-dependent weight loss, and decreases in the serum triglyceride, total cholesterol and low density lipoprotein cholesterol, while significantly(P<0.001) increased the serum levels of high density lipoprotein cholesterol fraction. Similarly, oral pre-treatments with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata for 14 d before induction of hyperlipidemia with triton WR-1339 significantly(P<0.01, P<0.001) and dose-dependently attenuated increases in the average body weights, serum levels of triglyceride, total cholesterol and low density lipoprotein cholesterol while also significantly(P<0.01, P<0.001) and dose-dependently attenuated significant(P<0.001) decrease in the serum high-density lipoproteincholesterol levels when compared to the untreated control values. However, the results obtained for 50 mg/kg of alkaloid fraction of H. umbellata in both normal and triton WR-1339-induced hyperlipidemic rats were comparable to that recorded for 20 mg/kg of simvastatin. Similarly, oral pretreatments with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata significantly improved the histological lesions of fatty hepatic degeneration induced by triton WR-1339 treatment.Conclusions: Overall, results of this study showed that repeated oral treatments with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata elicited weight losing, antihyperlipidemic and cardioprotective effects in triton WR-1339 induced hyperlipidemic rats that were mediated via de novo cholesterol biosynthesis inhibition.

Children with transposition of the great arteries: Should they actually be born in Nigeria?

AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.

Ponseti method treatment of neglected idiopathic clubfoot:Preliminary results of a multi-center study in Nigeria

AIM To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.METHODS Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet(225 patients) met inclusion criteria. All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.RESULTS A painless plantigrade foot was obtained in 255 feet(78%) without the need for extensive soft tissue release and/or bony procedures.CONCLUSION We conclude that the Ponseti method is a safe, effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age. Longterm follow-up will be required to assess outcomes.

Assessment of Mothers’ Oral Health Knowledge: Towards Oral Health Promotion for Infants and Children

Aim: To assess the knowledge and oral health practices of a selected population of mothers in order to develop appropriate oral health promotion program for children in the area. Method: A cross sectional study was carried out among a convenient sample of mothers who attended two well-baby clinics—a tertiary and a primary health care centre in Lagos, Nigeria. A questionnaire requesting personal information, previous exposure to and source of oral health education (OHE), knowledge of oral health, diet and oral hygiene practices was administered. Results: There were 104 participants, aged 21 - 46 years (mean 32.01 ± 4.85 years);58.7% had received OHE, 23.1% from electronic media, 22.1% dentist and 9.6%, doctor or nurse. Only 44 (42.3%) had attended the dentist, 5 (4.8%) in <1 year and 10 (9.6%) within 1 - 2 years. Most younger mothers, compared with older mothers had knowledge of fluoride (x2 = 8.51, p = 0.014). Only 44 (42.3%) and 20 (19.2%) respectively believed the type of baby food and supplement affect the child’s teeth. Conclusion: Participants in this study showed inadequate knowledge of preventive oral health care. Regular OHE is recommended for mothers at the well baby and immunization clinics where they can be easily reached by health professionals.

Effect of Behavioural Therapy on Depression in Adolescents with Sickle Cell Disease

Background: Depression, one of the commonest mental health problems in SCD, has high prevalence rates. While psychological therapies have been found to be beneficial in mild to moderate depression, their use as non-pharmacological methods amongst adolescents in sub-Saharan Africa, particularly Nigeria, is still at its infancy. Objective: To determine the effect of behavioural activation therapy on depression in adolescents living with Sickle Cell Disease attending out-patient clinic at the Lagos State University Teaching Hospital, Lagos, Nigeria. Method: The study was conducted in Lagos State University Teaching Hospital, Lagos, Nigeria, between November 2017 to February 2018 (4 months) among adolescents living with SCD and depression attending out-patient clinic. A randomized control trial (RCT) was conducted among participants assigned to treatment (30) versus control (30) group. A manualized behavioral therapy programme developed was delivered to the treatment group. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 23. Pair T-test was used to compare the two groups across continuous variables, pre- and post intervention. Analysis of Covariance (ANCOVA) was used to determine treatment effects controlling for baseline scores. Result: After the intervention, the mean depression score reduced from 22.13 ± 3.08 to 13.02 ± 4.56 while Paediatric quality of life score increase from 62.57 ± 17.85 to 67.90 ± 7.99 in the treatment group (BDI, p < 0.001;PedsQL, p = 0.045). However, the pre- and post-intervention mean depression scores in the control group showed insignificant reduction from 22.23 ± 3.24 to 21.60 ± 2.75 and mean PedsQL from pre-intervention scores of 59.67 ± 12.60 to 56.73 ± 8.94 post intervention (BDI, p = 0.388;PedsQL, p = 0.242). From multivariate analysis (ANCOVA), only the Quality of Life scores ceased to show any significant effect of the intervention. Conclusion: This study further strengthens and supports the extant literature that behavioral therapy alone is efficacious for depressive.

Diabetes mellitus in Nigeria: The past, present and future

Diabetes mellitus(DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to "curses" or "hexes" and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is "out of pocket"-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program.

Prevalence, Pattern and Factors Associated with Psychiatric Disorders among Persons Arrested for Violent Crimes in Ife/Modakeke Area, Southwestern Nigeria

Background: Association between violence and mental disorders has contributed immensely to the stigma associated with mental illness in the society;because people erroneously see mentally ill individuals as dangerous, they will not want to associate with them. Aims: To assess the prevalence and pattern of psychiatric disorders among a sample of the violent offenders and to examine any relationship between psychiatric disorders and crimes. Method: This was a two-phase cross-sectional study in three police stations in Ile-Ife/Modakeke area of Nigeria. In the first phase, we screened 400 consecutive adults arrested for violent crimes using the General Health Questionnaire—30. In the second phase, all 36 persons with probable psychopathology were then interviewed with the Present State Examination to make a definitive diagnosis. Results: The mean age of all the subjects was 29.9 years (SD ± 7.3). The male to female ratio was 11:1. Respondents were mostly single (54%);most had secondary education or less (82%) and about 60% were currently using psychoactive substances (drugs). About 8.5% of all the subjects had a diagnosable psychiatric disorder;paranoid schizophrenia was the commonest psychiatric disorder (41.2%). Mentally ill subjects were three times more likely to commit homicidal offence than non-mentally ill subjects. Conclusion: There exists a significant but weak relationship between mental illness and violent crimes.

Adansonia digitata aqueous leaf extract ameliorates dexamethasone-induced testicular injury in male Wistar rats

Objective:To evaluate the effects of aqueous leaf extract of Adansonia(A.)digitata L on dexamethasone-induced testicular damage in male Wistar rats.Methods:Twenty adult male Wistar rats weighing 170-190 g were divided into four groups.GroupⅠreceived 0.5 mL of phosphate buffer orally for 28 days and served as the normal control group;groupⅡreceived 10 mg/kg of dexamethasone(a synthetic glucocorticoid)intraperitoneally for 7 days and 0.5 mL of phosphate buffer orally for 21 days,groupⅢreceived 10 mg/kg of dexamethasone for 7 days and 800 mg/kg of A.digitata extract orally for 21 days;groupⅣreceived 10 mg/kg of dexamethasone for 7 days and 300 mg/kg of vitamin-E orally for 21 days.Dexamethasone was administered intra-peritoneally for 7 days and all administration lasted for 28 days.The rats were sacrificed by anesthesia with diethyl ether and the testes of each animal were harvested.The testis was homogenized in 0.25 M sucrose at 4℃for biochemical and histological analyses.Results:Administration of dexamethasone significantly decreased body weight,glucose-6-phosphate dehydrogenase(G6PDH),lactate dehydrogenase(LDH),superoxide dismutase(SOD),and glutathione peroxidase(GPx)(P<0.05),and significantly increased malondialdehyde(MDA)activities(P<0.05).The degeneration in the population of spermatogonia and vacuolation and abnormal widening of the interstitial spaces were observed in the rats treated with dexamethasone.However,administration of A.digitata significantly increased SOD,GPx,G6PDH,and LDH levels,significantly decreased MDA activities and improved the histoarchitecture of the testis(P<0.05).Conclusions:A.digitata may have an ameliorative effect on dexamethasone-induced testicular damage in Wistar rats because of its anti-inflammatory and antioxidant properties.

New-Onset Seizures in HIV Patients on Antiretroviral Therapy at a Tertiary Centre in South-West, Nigeria

Background: Seizures are associated with neurological manifestations of HIV. They may be the presenting symptom and can occur at any disease stage. Aim: To determine the frequency and clinical aspects of new-onset seizures in patients with human immunodeficiency virus (HIV) infection. Methods: A study of an HIV-infected patient cohort on highly active anti-retroviral therapy (HAART) in the out-patients clinic of the Lagos state university teaching hospital, Nigeria. In a cross-sectional design, 308 HIV infected patients were recruited over a period of 1 year. Cases with a first seizure during this period were further examined. Details of demographic data, the first seizure date, seizure characteristics, neurologic complications and CD4 count at the time of the seizure were documented. Results: A total of 20 (6.5%) had new-onset seizures during the study period. 6/20 (30%) were males and 14/20 (70%), females. Their ages ranged between 22 - 51 years with a mean of 34.2 ± 8.7 years. The seizure was focal in 2/20 (10%) of cases and generalised in 90% (18/20) of cases. A total of 13/20 (65%) had recurrence of their seizures. None of the cases had focal neurological deficit at the time of the first seizure. The mean CD4 count was 165.3 ± 145.7. The mean duration on HAART was 19.5 ± 12.7 months. Cases with CD4 counts ≤200 cells/mm3 constituted 70% (14/20) whilst those with CD4 counts >200 made up 30% (6/20) [p = 0.666]. Conclusions: Seizures remain a significant neurological manifestation of HIV infection and has a high recurrence rate. It occurs more commonly in the advanced stage with severe immune suppression and may be attributable to HIV encephalopathy. Early treatment would reduce the burden and improve patient’s quality of life.

Upper arm composition and nutritional status of school children and adolescents in Abeokuta,Southwest Nigeria

Background:Upper arm composition is a reflection of body protein and calorie reserves.However,there is a paucity of data on upper arm composition of children from African countries,including Nigeria.This study aimed to determine the composition of upper arm and nutritional status of school children in Abeokuta,Nigeria and to compare with international reference standards.The sensitivity and specifi city of upper arm muscle area by height(UAMAH)as a nutritional assessment tool was also determined.Methods:Five hundred and seventy children aged 5 to 19 years were selected from seven schools using multistage random sampling.Weight,height,mid-upper arm circumference(MUAC)and triceps skin fold thickness(TSF)were measured.Body mass index,upper arm muscle area(UAMA),upper arm fat area(UAFA),fat percentage and UAMAH were derived.Results:The TSF,UAFA and fat percentage were significantly higher in females than males at each age group.MUAC and UAMA were significantly higher in female children aged 10-14 years,whereas UAMA was significantly higher in male children aged 15-19 years.UAMA and UAFA of the children were lower than those of Americans but similar to those of Zimbabweans,and higher than those of Indians.The sensitivity and specifi city of UAMAH for detecting wasting were 80.8%and 63.9%,respectively,whereas the corresponding values for stunting were 32.2%and 58.2%,respectively.Conclusions:The school children studied have a combination of poor calorie and protein reserve.UAMAH may be a valuable tool for complete evaluation of the nutritional status of school children.

Effects of aqueous leaf extract of Tridax procumbens on contractile activity of corpus cavernosum in N-nitro-L-arginine methyl ester-induced hypertensive male rats

Objective： This study investigated the effects of aqueous leaf extract of Tridax procumbens （ALETP） on con- tractile activity of corpus cavernosum in N-nitro-L-arginine methyl ester （L-NAME）-induced hypertensive male rats. Methods： Twenty normal, adult male rats （130-150 g） were divided into four groups of five rats each. Group I （control） was given normal saline （0.6 mL/kg） and group II was given L-NAME （40 mg/kg） for 6 weeks. Groups Ill and IV also received L-NAME （40 mg/kg） for 6 weeks but were further co-treated with 100 and 200 mg/kg of ALETP, respectively, from week 4 to week 6. All treatments were given orally. Strips of corpus cavernosum from each of the four groups were exposed to increasing concentrations of acetyl~ choline （ACh） and sodium nitroprusside （SNP） （10^-9-10^-5 tool/L） after contraction with phenylephrine （10^-7 mol/L） to test for a dose-response effect, Response to potassium and calcium was also measured after cumulatively adding potassium and calcium （10-50 mmol/L） to potassium- and calcium-free organ chamber. Isometric contractions were recorded through an Ugo Basile data capsule acquisition system. Results： Mean arterial blood pressure was significantly reduced in the ALETP co-treated group compared to the control and L-NAME-only groups （P 〈 0.05）. Cavernosa strips from ALETP co-treated rats exhibited significant inhibition of contraction in response to phenylephrine, potassium chloride, and calcium chlo- ride （P 〈 0.05）. Relaxation in response to Ach and SNP was also significantly impaired in cavernosa strips from the L-NAME-only treated group （P 〈 0.05）, while ALETP co-treated groups showed enhanced per- centage relaxation. Conclusion： ALETP treatment of L-NAME-induced hypertensive rats promotes a relaxant effect on isolated cavernosa strips. ALETP shows potential in correcting erectile dysfunction in hypertension.

Dracaena arborea leaf extract:A phytotherapeutic option for ameliorating oxidative stress-mediated endocrine and testicular disorders in alloxan-induced diabetic rats

Objective:To explore and exploit these anti-diabetic properties of the leaf extracts of Dracaena arborea by investigating its therapeutic effects on blood glucose regulation,testicular and endocrine disorders in alloxan(ALX)-induced type-1 diabetic rats.Methods:Rats were divided into four groups of five animals each in a completely randomized trial and treated.ALX and then Dracaena arborea extracts(DAE)at 100 mg/kg and 300 mg/kg/day were administered to both normal(Group A)and diabetic rats(Groups C and D)and none to the diabetic control group(Group B)for a period of 8 weeks.The serum level of glucose,follicle stimulating hormone,luteinizing hormone and free testosterone were estimated for all treated and control groups.Oxidative stress parameters such as superoxide dismutase,glutathione peroxidase,glutathione reductase,catalase,and malondialdehyde were also estimated from testicular cells of control,untreated diabetic and DAE-treated diabetic rats.Results:We observed a significant(P<0.05)decrease in the serum glucose level as well as a drug-induced dose-dependent reduction in testosterone,follicle stimulating hormone and luteinizing hormone in the rats following type-1 diabetic conditions induction by ALX.There was a significant dose dependent response(P<0.05)to treatment between the DAE-treated diabetic groups.Furthermore,a significant decrease(P<0.05)in oxidative stress parameters was observed in testicular cells of diabetic rats post-treatment.Conclusions:These findings suggest that DAE is a potential beneficial phytotherapeutic agent that may be used in ameliorating hyperglycemic,endocrine and reproductive disorders in type-1 diabetic men.