Cancer is now the second-leading cause of mortality and morbidity, behind only heart disease, necessitating urgent development of (chemo)therapeutic interventions to stem the growing burden of cancer cases and cancer death. Plants represent a credible source of promising drug leads in this regard, with a long history of proven use in the indigenous treatment of cancer. This study therefore investigated Anacardium occidentale, one of the plants in a Nigerian Traditional Medicine formulation commonly used to manage cancerous diseases, for cytotoxic activity. Bioassay-guided fractionation, spectroscopy, Alamar blue fluorescence-based viability assay in cultured HeLa cells and microscopy were used. Four compounds, zoapatanolide A (1), agathisflavone (2), 1,2-bis(2,6-dimethoxy-4-methoxycarbonylphenyl)ethane (anacardicin, 3) and methyl gallate (4), were isolated, with the most potent being zoapatanolide A with an IC value of 36.2±9.8µM in the viability assay. To gain an insight into the likely molecular basis of their observed cytotoxic effects, Autodock Vina binding free energies of each of the isolated compounds with seven molecular targets implicated in cancer development (MAPK8, MAPK10, MAP3K12, MAPK3, MAPK1, MAPK7 and VEGF), were calculated. Pearson correlation coefficients were obtained with experimentally-determined IC in the Alamar blue viability assay. While these compounds were not as potent as a standard anticancer compound, doxorubicin, the results provide reasonable evidence that the plant species contains compounds with cytotoxic activity. This study provides some evidence of why this plant is used ethnobotanically in anticancer herbal formulations and justifies investigating Nigerian medicinal plants highlighted in recent ethnobotanical surveys.

Background: Sickle cell anaemia (SCA) is the most common and burdensome inherited disease affecting children in Africa. Nonetheless, there remains a paucity of literature from Nigeria about its effects on cardiac dimensions and functioning in children.

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Patient: Female, 10Final Diagnosis: Arterial hypertension secondary to renal cell carcinomaSymptoms: Recurrent headaches • excessive sweating • anorexia • weight loss • easy fatigabilityMedication: —Clinical Procedure: NephrectomySpecialty: Pediatrics and NeonatologyObjective:Rare diseaseBackground:Blood pressure (BP) is not routinely screened in children in clinical practice. Renal cell carcinoma (RCC) is a rare cause of renal hypertension and accounts for less than 0.3% of all childhood tumors. The clinical manifestation of hypertension in children requires a high index of suspicion, as does RCC, which can have many different manifestations.Case Report:We report the case of a 10-year-old girl with 1-year history of persistent symptoms of recurrent episodes of headache and excessive sweating and a 6-months history of weight loss and loss of appetite. She was repeatedly managed as having malaria in the center where she was referred, without recovery. Persistent high BP was discovered in our center, which ranged between 180/120 and 200/120 mmHg. This was not controlled by 3 different classes of drugs. Abdominal ultrasonography showed a right kidney with a well circumscribed lower pole mass with internal echoes, compressing the pelvicalyceal system. Abdominal computed tomography revealed a huge, circumscribed, expansile, isodense mass arising from the renal cortex in the lower pole of the right kidney. Intraoperative findings included a mass seen at the lower pole of the right kidney with histology diagnosis of RCC. Other laboratory tests were normal. To date, the patient remains normotensive and symptom-free after nephrectomy.Conclusions:The nonspecific clinical manifestation found in this case show the need for hypertension screening in children. The resolution of symptoms after nephrectomy confirms RCC as the underlying cause of symptoms, making this case a unique presentation.