Page|3CHAPTERONE1.1INTRODUCTION.Haemostasisisthatbodilymechanismthatpreventsexcessivebloodlossfromthebodyduringdamagetotissues.Thehaemostaticsystemrepresentsadelicatebalancebetweenpro-coagulantandanti-coagulantmechanismslinkedtoaprocessoffibrinolysis(Sandhyarani&Kumar2014).Therearefivemajorcomponentsinvolvedinthehaemostaticsystemandtheseincludes;platelets,coagulationfactors,coagulationinhibitors,fibrinolysisandbloodvessels(Guyton&Hall2006).Haemostasisisalifesavingprocessandso,thestudyofsubstancesthatfacilitateitsprocessisofmedicinalimportance(Sandhyarani&Kumar2014).Thehealingpowersembeddedinplantshavebeenstudiedforcenturies,withmostpharmaceuticaldrugsderivedfromthem.Medicinalplantsaremostlyusedinruralareasaroundtheworldespeciallyinthetropics,wherethereisabundanceofflora.PlantsarerelieduponinalmosteverypartofAfricaforthetreatmentofailmentsanddiseases.OthersliketheAnarcardiumoccidentale(Arokoyoetal.2015)andGongronemalatifolium(Oguwikeetal.2013)arenotablelocallyfortheirabilitytoarrestbleeding.Unfortunately,onlyfewofthesemedicinalplantshavebeenscientificallyvalidated(Tanko,etal.,2007).AmongstthevarietiesofplantsusedfortheirmedicinalpurposesistheSpondiasmombin.SpondiasmombinisafructiferoustreehavinghabitatinNigeria,Brazilandseveralothertropicalforestsintheworld.ThisplantisreadilycommonintheSouth-WestofNigeria(Yorubalands)andiscommonlyusedinfolkmedicine.Spondiasmombin,commonlyknowninEnglishasHogplumbelongstothefamilyAnacardiacae.Itgrowsintherainforestandinthecoastalareas,reachingaheightof15–22mandhasshowntobeveryrichinvitaminsB1andC.Itsfruitmostlyexistsinanovalform(Ayokaetal.2008).Intoughclimates,whenfreshwaterisunavailable,waterfromtherootsofS.mombin(Spondiasmombin)canbedrunk.Itsshoottasteslikecassavaandcanbeeatenraworboiled.Theseedsarealsoedible(Orwaetal.2009).S.mombinistraditionallyusedasapurgative,anthelmintic,analgesic,haemostaticandremedyforcoughandgonorrhoea(Burkill,1985).Theplantisalsoincludedinantidiabetic/antihyperglycaemicherbalremediesinarecentethnobotanicalsurveyofSouthWesternNigeria(Gboladeetal.2011).Diabetesmellitusisametabolicdisorderthatiscausedbyoxidativestresswhichinducesinsulinresistanceintheperipheraltissuesandimpairsinsulinsecretionfrompancreaticβ- Page|4cells.Itischaracterisedbychronichighbloodglucose(Hyperglycaemia)thatcouldleadtomorbidityandmortality.Itisalsooneofthemostprevalentdiseasesintheworldaffectingnearly25%ofthepopulation(Alberti,1998;Wang,etal.,2006).Diabeticshaveskinulcers,impairedhaemostaticactivitiesandslowwoundhealingasaresultofpoorbloodflowlinkedtoinsufficientabnormalangiogenesis(Kotaetal.2012).Thishealinginpatientswithdiabetesmellitusischaracterisedbyreducedtensilestrengthofwoundswhencomparedwithhealthyindividuals,suggestingeitherdefectivematrixproductionordeposition(Fergusson,etal.,1996).Alsothereistheproblemoffragilityoftheepithelialwallofbloodvesselsduetopoorcapillarybedformationbyendothelialcellandweakreticularnetworkslaidbythefibroblastcoupledwiththeslowwoundhealingandthispredisposesthepatientinthelongruntohaemorrhagicconditionscharacterisedbyfrequentblood loss.For example: Diabetic vitreous haemorrhage whichoccurs whenthe retinabecauseofthefragilityofbloodvesselssupplyingitandpoorbloodflowandoxygensupply,beginstoundergoabnormalangiogenesisorproductionoffragilebloodvessels(whichtendstoruptureeasily)fromtheretina.Thisbloodvesselsdonotsupplytheretinawithoxygeninstead,theyenterthevitreoushumouroftheeyeandcausebloodtoleakintoit,resultingtosuddenlossofvision.Itistheleadingcauseofblindnessindiabeticpatientsbetweentheagesof20-60years(SouthDevonHealthcareNHS2014;Limetal.2015).Coupledwiththisdeficiency,thereisalsotheproblemofreducedbloodlevelandseverederangementinvarioushaematologicalparameters.Thisresultsinthehighprevalenceofanaemiaidentifiedindiabeticpatients(Al-Khoury,etal.,2006;Ezenwaka,etal.,2008).About27%ofpatientswithdiabetesareanaemicandthisshowsthehighprecedenceofhaematologicalderangementindiabeticpatients(Dipta,etal.,2009).
