Prevalence of meropenem-resistant Pseudomonas Aeruginosa in Ethiopia: a systematic review and meta­analysis.

INTRODUCTION: Antimicrobial resistance (AMR) is a pressing global health concern, particularly pronounced in low-resource settings. In Ethiopia, the escalating prevalence of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) poses a substantial threat to public health. METHODS: A comprehensive search of databases, including PubMed, Scopus, Embase, Hinari, and Google Scholar, identified relevant studies. Inclusion criteria encompassed observational studies reporting the prevalence of meropenem-resistant P. aeruginosa in Ethiopia. Quality assessment utilized JBI checklists. A random-effects meta-analysis pooled data on study characteristics and prevalence estimates, with subsequent subgroup and sensitivity analyses. Publication bias was assessed graphically and statistically. RESULTS: Out of 433 studies, nineteen, comprising a total sample of 11,131, met inclusion criteria. The pooled prevalence of meropenem-resistant P. aeruginosa was 15% (95% CI: 10-21%). Significant heterogeneity (I2 = 83.6%) was observed, with the number of P. aeruginosa isolates identified as the primary source of heterogeneity (p = 0.127). Subgroup analysis by infection source revealed a higher prevalence in hospital-acquired infections (28%, 95% CI: 10, 46) compared to community settings (6%, 95% CI: 2, 11). Geographic based subgroup analysis indicated the highest prevalence in the Amhara region (23%, 95% CI: 8, 38), followed by Addis Ababa (21%, 95% CI: 11, 32), and lower prevalence in the Oromia region (7%, 95% CI: 4, 19). Wound samples exhibited the highest resistance (25%, 95% CI: 25, 78), while sputum samples showed the lowest prevalence. Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (3.7%, 95% CI: 2.3, 9.6). CONCLUSION: The noteworthy prevalence of meropenem resistance among P. aeruginosa isolates in Ethiopia, particularly in healthcare settings, underscores the urgency of implementing strict infection control practices and antibiotic stewardship. Further research is imperative to address and mitigate the challenges posed by antimicrobial resistance in the country.

Evaluation of hepatoprotective and antidiarrheal activities of the hydromethanol crude extract and solvent fractions of Schinus molle L. (Anacardiaceae) leaf and fruit in mice.

Background: Liver disease is any disease that negatively affects the normal function of the liver, and it is a major health problem that challenges not only healthcare professionals, but also the pharmaceutical industry and drug regulatory agencies. Similarly, diarrhea is the second leading cause of death among children under five globally next to pneumonia. The available synthetic drugs for the treatment of liver disorders and diarrhoea have limited safety and efficacy. Objective: To evaluate the in vivo hepatoprotective and antidiarrheal activities of hydroalcoholic leaf and fruit extracts of Schinus molle L. (Anacardiaceae) in mice. Methods: Hepatoprotective activity of the extracts was evaluated by using CCl4 induced hepatotoxicity in mice model. In this model, mice were divided into groups and treated as follows. The normal control and toxicant control groups were treated with the vehicle used for reconstitution, the positive control was treated with the standard drug (silymarin), and the test groups were treated with different doses of plant extracts daily in the morning for seven days. Additionally, all groups except the normal control were treated with CCl4 (2 mg/kg, IP) on the 4th day of treatment, 30 min post-dose. On the 7th day, blood was collected from each mouse via a cardiac puncture. The collected blood was centrifuged, and serum levels of ALT, AST, and ALP were determined using an automated chemistry analyser. Data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test.The antidiarrheal activity of the extract was investigated using castor oil-induced diarrhoea, enteropooling, and small intestine transit. The test groups received various doses (100, 200, and 400 mg/kg) of the extract, whereas the positive control received loperamide (3 mg/kg), and the negative control received the vehicle (distilled water, 10 ml/kg). Result: Hepatoprotective activity: The leaf and fruit crude extracts showed significant improvement in the body weight and liver weight of mice compared to the untreated toxicant control. Additionally, treatment with hydromethanol leaf and fruit extracts caused a significant (P < 0.05) improvement in liver biomarkers compared to the toxicant control. Similarly, the n-butanol and chloroform fractions of the fruit extract caused a significant reduction (P < 0.01) in serum AST, ALT, ALP and Bilirubin levels and a significant (P < 0.001) increase in total protein compared to the toxicant control. However, none of the three solvent fractions (n-butanol, chloroform, and aqueous) of the fruit extract significantly affected (P > 0.05) the level of albumin compared with the toxicant control.Antidiarrheal activity: In the castor oil-induced diarrheal model, the 80 % methanol extract delayed the onset of defaecation and significantly reduced the number and weight of faeces at all tested doses compared to the negative control. In the enteropooling test, 80 ME significantly (P < 0.001) reduced the weight and volume of intestinal fluid at all tested doses compared with the negative control. Results from the charcoal meal test revealed that the extracts produced a significant anti-motility effect at all tested doses compared with the negative control. Conclusion: This study confirmed the hepatoprotective and antidiarrheal activities of hydroalcoholic extracts. The highest test dose produced the maximum hepatoprotective and antidiarrheal activities in all models.

Wound Healing Activity of 80% Methanolic Crude Extract and Solvent Fractions of the Leaves of Justicia schimperiana (Hochst. ex Nees) T. Anderson (Acanthaceae) in Mice.

Introduction: Justicia schimperiana has been used traditionally for the treatment of wound and skin burn, but there is no scientific evidence that supports the traditional claim. Objective: To evaluate the wound healing activity of 80% methanol crude extract and solvent fractions of the leaves of Justicia schimperiana in mice. Methods: Mice were used for wound healing study, while rats were used for acute dermal toxicity test. The 80% methanol crude extract and chloroform, ethyl acetate and aqueous fractions were formulated in ointments with 5% and 10% strength. Burn, excision and incision wound models were used to evaluate the effect of the crude extract, whereas the activity of the solvent fractions was evaluated using excision wound model. Parameters such as wound contraction, and period of epithelialization were studied in the excision and burn wound models, while tensile strength was measured in incision wound model. Results: Treatment of wound with 80% methanol extract of Justicia schimperiana leaves using 5% (w/w) and 10% (w/w) ointment formulation induced significant (P<0.05) improvement in wound contraction rate, epithelialization time and skin breaking strength in excision, incision and burn wound model, respectively as compared to negative control. The chloroform, ethyl acetate and aqueous fractions with 5% (w/w) and 10% (w/w) ointment formulation showed significant (p<0.001) improvement in wound contraction and epithelialization time in excision wound model as compared to the negative control group. Conclusion: This study has demonstrated that the 80% methanol crude extract and solvent fractions of Justicia schimperiana leaves possess wound healing activity.

A cross-sectional study of herbal medicine use and contributing factors among pregnant women on antenatal care follow-up at Dessie Referral Hospital, Northeast Ethiopia.

BACKGROUND: Herbal medicines are widely used in the world especially in developing countries. Pregnant women use herbal products to treat pregnancy related illnesses due to prior experience of herbal medicine use and easy accessibility of the products with less cost. However, herbal products could affect fetal growth and contribute to maternal and fetal morbidity and mortality. Herbal drug use during pregnancy is not well studied in Ethiopia specifically in northeast Ethiopia. METHODS: A cross-sectional survey was conducted among 254 pregnant women on antenatal care follow-up at Dessie referral hospital. Semi-structured questionnaires were used for data collection. After collection, data were coded, entered and analyzed by SPSS version 20. Chi squared test and Logistic regression were used to evaluate the association between dependent and independent variables. RESULT: Among the total of 254 respondents, 130 (51.2%) used herbal drugs during current pregnancy. The most commonly mentioned reason for herbal drug use was "herbal medicines are accessible without prescription" (43.1%). The herbal medicines used were Ginger (Zingiber officinale Roscoe) (43.8%), followed by Garlic (Allium sativum L.) (23.8%), Damakese (Ocimum lamiifolium Hochst. ex Benth.) (21.5%) and Tena-adam (Ruta chalepensis L.) (10.8%). The indications for herbal drug use were nausea/vomiting (43.8%), headache (30.8%) and common cold (25.4%). The most commonly mentioned sources of information on herbal medicine were families and friends (80.0%) followed by neighbors (12.3%), and the most commonly cited sources of herbal products were market (67.7%) and self-preparation (20.0%). Being illiterate or having only primary school education (Adjusted Odds Ratio [AOR]: 3.717, 95% CI: 0.992-13.928), having secondary school education background (AOR: 3.645, 95% CI: 1.394-9.534), and poor monthly income (AOR: 7.234, 95% CI: 2.192-23.877) were the variables that showed significant association with herbal drug use during current pregnancy. CONCLUSION: This study showed that half of the sampled pregnant women used herbal medicine during current pregnancy, and education status and monthly income level of the women were associated with herbal drug use.

In vivo hypoglycemic, antihyperglycemic and antidyslipidemic effects of the solvent fractions of Hagenia abyssinica leaves in mice.

BACKGROUND: Hagenia abyssinica leaves have been used traditionally for the management of different diseases including diabetes mellitus (DM) although the antidiabetic effect of different solvent fractions of hydromethanol H. abyssinica leaf extract has not been scientifically studied. Thus, this study was conducted to investigate the in vivo hypoglycemic, antihyperglycemic and antidyslipidemic effects of the solvent fractions of Hagenia abyssinica leaf extract. METHODS: The antidiabetic effect of the solvent fractions was evaluated in normal, oral glucose loaded and streptozotocin-induced diabetic mice. Hypoglycemic, antihyperglycemic, antidyslipidemic activities and effect on body weight change were evaluated after administration of three different doses of the solvent fractions (100, 200, and 400 mg/kg). One-way ANOVA followed by Tukey's post hoc test was used for data analysis, and p<0.05 was considered as statistically significant. RESULTS: The crude hydromethanol extract of H. abyssinica leaves did not show any sign of toxicity at the dose of 2000 mg/kg in mice. In normoglycemic mice, both aqueous and ethyl acetate fractions of H. abyssinica leaves showed significant (P<0.05) hypoglycemic activity. In oral glucose loaded mice, the two doses of the aqueous fraction, 200 mg/kg (p<0.05) and 400 mg/kg (p<0.001), showed a significant antihyperglycemic effect at 60 and 120 minute post-oral glucose loading while the ethyl acetate fraction showed significant antihyperglycemic effect at 60 (P<0.05 for 200 mg/kg and P<0.001 for 400 mg/kg) and 120 min (P<0.01 for 400 mg/kg) post-oral glucose loading. In single dose-treated diabetic mice, all doses of the solvent fractions caused a significant (P<0.05) reduction in blood glucose level except 100 mg/kg of the aqueous and chloroform fractions. Additionally, repeated daily treatment with the aqueous fraction significantly reduced hyperglycemia, body weight loss, and improved dyslipidemia of diabetic mice. CONCLUSION: This study has revealed that the solvent fractions of H. abyssinica leaves possess in vivo blood-glucose-lowering activities on normal, oral glucose loaded, and streptozotocin-induced diabetic mice. Additionally, the aqueous fraction prevented diabetic body weight loss and dyslipidemia in mice after repeated daily dose administration.

Evaluation of the antiulcerogenic activity of hydromethanol extracts of Solanum incanum L. (Solanaceae) leaves and roots in mice; single and repeated dose study.

OBJECTIVE: The aim of this study was to evaluate the antiulcer activity of hydromethanol extracts of Solanum incanum L. (Solanaceae) leaves and roots in mice. METHODS: The antiulcerogenic activity of the plant extracts were evaluated using Pylorus ligation and ethanol induced gastric ulcers in fasted mice. Data were analyzed using one way ANOVA, and P-values <0.05 were considered statistically significant. RESULTPYLORUS LIGATION-INDUCED ULCER: Single dose and repeated daily dose administration of the leaf and root extracts for 10 days didn't significantly (P > 0.05) affect pH, total acidity and volume of gastric secretion. Single dose of both extracts significantly reduced ulcer score (P = 0.036) and ulcer index (leaf, P = 0.037; root, P = 0.041) at the dose of 400 mg/kg. Similarly, significant reduction in ulcer score was observed after repeated daily treatment with 200 mg/kg (P = 0.030) and 400 mg/kg (P = 0.005) of the leaf extract and 400 mg/kg (P = 0.005) of the root extract. In addition, repeated administration of 400 mg/kg of the leaf (P = 0.004) and root (P = 0.005) extracts significantly reduced ulcer index. ETHANOL-INDUCED ULCER: Single dose of both extracts significantly reduced ulcer score at the dose of 200 mg/kg (leaf, P = 0.017; root, P = 0.036) and 400 mg/kg (leaf, P = 0.001; root, P = 0.001). Similarly, 200 mg/kg (leaf, P = 0.002; root, P = 0.018) and 400 mg/kg (leaf, P = 0.001; root, P = 0.001) of the extracts significantly reduced ulcer index after single dose treatment. Repeated daily treatment with leaf and root extracts for ten days caused a significant (P = 0.037, 0.001 and 0.001 for 100, 200 and 400 mg/kg leaf extract; P = 0.026, 0.018 and 0.001 for 100, 200 and 400 mg/kg root extract, respectively) reduction in ulcer score. In addition, both extracts significantly (P = 0.041, 0.004 and 0.000 for 100, 200 and 400 mg/kg leaf extract; P = 0.038, 0.008 and 0.000 for 100, 200 and 400 mg/kg root extract, respectively) reduced ulcer index after 10 days of treatment. CONCLUSION: This study has revealed hydromethanol extracts of Solanum incanum leaves and roots have antiulcerogenic activity using in vivo models. The antiulcer activity of the plant is not related to acid anti-secretory action, suggesting the plant may have cytoprotective effect on the gastric mucosa.

A retrospective study of drug related problems and contributing factors among type 2 diabetes mellitus patients on follow up at public health institutions of kemisse town, north east Ethiopia.

BACKGROUND: Drug related problems interfere with the desired treatment outcomes of type 2 Diabetes mellitus. This study was conducted to determine prevalence of drug related problems and associated factors among patients with type 2 Diabetes Mellitus in public health institutions of Kemisse town, northeast Ethiopia from May 01 to 30, 2019. METHODS: Institution based retrospective cross sectional study was conducted among type 2 Diabetes Mellitus patents on follow up at public health institutions of Kemisse town, northeast Ethiopia. RESULT: From the total of 156 patients included in the study, 126 (80.8%) patients have at least one drug related problem with a total of 149 drug related problems. The most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Identified causes of need for additional drug therapy were the need for prophylactic drug therapy (statins and antiplatelet), 83.3%; presence of untreated medical condition (Hypertension, diabetic nephropathy and diabetic foot ulcer), 11.7%; and the need for combination therapy for better efficacy, 5%. This study revealed that age ≥45 years (AOR = 5.59, 95% CI = 1.38-20.64, P = 0.016), presence of comorbid condition (AOR = 3.22, 95% CI = 1.75-13.47, P = 0.014 and emergency visit in the last one year (AOR = 5.08, 95% CI = 1.14-18.71, P = 0.033) were significantly associated with the occurrence of drug related problems. CONCLUSION: A total of 149 drug related problems were identified in 80.8% of type 2 diabetes mellitus patients. The three most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Additionally, age ≥45 years (AOR = 5.59, P = 0.016), presence of comorbidity (AOR = 3.22, P = 0.014) and emergency visit in the last one year (AOR = 5.08, P = 0.033) were significantly associated with the occurrence of drug related problem.

In Vitro α-Amylase and α-Glucosidase Inhibitory and Antioxidant Activities of the Crude Extract and Solvent Fractions of Hagenia abyssinica Leaves.

BACKGROUND: The leaves of Hagenia abyssinica have been used in the management of diabetes mellitus in Ethiopian folk medicine. Thus, this study is aimed at investigating the in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities of the crude extract and solvent fractions of H. abyssinica leaves. METHODS: The in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities of the plant extract were assessed using 3,5-dinitrosalicylic acid (DNSA), p-nitro-phenyl-a-D glucopyranoside (p-NPG), and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays, respectively. Each value of percent inhibition of α-amylase, α-glucosidase, and DPPH scavenging effect was presented as means ± SEM (n = 3). RESULTS: The α-amylase inhibitory activity of the crude extract and solvent fractions was found to be concentration-dependent. The strongest activity was exhibited by the crude extract at the highest concentration with a percentage inhibition of 74.52% (IC50, 14.52 µg/ml) followed by water fraction 68.24% (IC50, 16.31 µg/ml), ethyl acetate fraction 61.57% (IC50, 18.73 µg/ml), and chloroform fraction 56.87% (IC50, 21.57 µg/ml) of H. abyssinica leaves. In the α-glucosidase inhibition assay, the maximum activity was exhibited by the aqueous fraction 62.54% (IC50, 11.67 µg/ml) followed by ethyl acetate fraction 54.97% (IC50, 15.89 µg/ml), crude extract 46.79% (IC50, >16.5 µg/ml), and chloroform fraction 36.44% (IC50, >16.5 µg/ml). In the antioxidant assay, the crude extract exhibited the highest antioxidant activity 86.36% (IC50, 10.25 µg/ml) followed by water fraction 78.59% (IC50, 13.86 µg/ml), ethyl acetate fraction 71.58% (IC50, 16.34 µg/ml), and chloroform fraction 63.65% (IC50, 18.83 µg/ml). CONCLUSION: This study has revealed that H. abyssinica leaves possess noticeable in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities.

Updates on the molecular mechanisms of aspirin in the prevention of colorectal cancer: Review.

Colorectal cancer is one of the commonest malignancies worldwide. The estimated lifetime risk of the disease is about 5% with an incidence of one million new cases and 600,000 deaths worldwide every year. It is estimated that in 2019, approximately 134,490 new cases of colorectal cancer will be diagnosed with 49,190 mortalities. Though the disease is regarded as a disorder of the more developed world, the occurrence is steadily increasing in many developing countries. Since chronic inflammation is a known aggravating risk factor for colorectal cancer, anti-inflammatory agents such as aspirin have been used to prevent the development of colorectal cancer and related mortality. The potential mechanisms for the effect of aspirin in the prevention of colorectal cancer have been proposed and broadly classified as cyclooxygenase (COX) dependent and COX-independent. Some of the primary effectors of COX-dependent mechanisms in carcinogenesis are likely to be prostaglandins. In contrast to the reversible action of other nonsteroidal anti-inflammatory drugs, aspirin is known to irreversibly inactivate COX enzymes to suppress production of prostaglandins. COX-independent mechanisms of anticancer effects of aspirin include down-regulation of nuclear factor kappa B activity and Akt activation, modulation of Bcl-2 and Bax family proteins, suppression of vascular endothelial growth factor, induction of apoptosis, disruption of DNA repair mechanisms, and induction of spermidine/spermine N1-acetyltransferase that modulates polyamine catabolism.

A drug repositioning success: The repositioned therapeutic applications and mechanisms of action of thalidomide.

BACKGROUND: Thalidomide is the most teratogenic human medicine ever marketed and was associated with birth defects in approximately 10,000 children in the 1960s. The pharmacological effects of thalidomide are attributed to its anti-angiogenic, anti-inflammatory and modulatory effect on cytokines principally tumor necrosis factor-α, while the teratogenic effects are linked to two molecular targets, namely cereblon and tubulin. Teratogenicity is the gravest adverse effect of thalidomide depending on the dose and time of exposure. Nonetheless, with System for Thalidomide Education and Prescribing Safety program, the possibility of teratogenicity can be completely avoided. The sensitive period during pregnancy for thalidomide teratogenicity in humans is approximately 20-34 days after fertilization. METHODS: Relevant articles were identified from Google scholar and PubMed (MEDLINE) using different search strategies. CONCLUSION: Clinical trials showed that thalidomide has been found effective in the treatment of advanced renal cancer, esophageal cancer, chemotherapy refractory endometrial cancer and pancreatic cancer, which can suggest its future therapeutic potential in cancer treatment. Thalidomide is also used in the treatment of inflammatory skin disorders and has shown promising effect in the treatment of autoimmune disorders and inflammatory bowel disease. Despite thalidomide being a renowned teratogen and neurotoxin, it has been successfully repositioned and FDA approved for the treatment of erythema nodosum leprosum and multiple myeloma under strict control.

Antidiabetic and Anti-hyperlipidemic Effects of the Crude Hydromethanol Extract of Hagenia abyssinica (Rosaceae) Leaves in Streptozotocin-Induced Diabetic Mice.

BACKGROUND: The leaves of Hagenia abyssinica (Rosaceae) have been used traditionally for the management of diabetes mellitus. Thus, this study aimed to evaluate the antidiabetic and anti-hyperlipidemic activity of Hagenia abyssinica leaves crude extract in streptozotocin-induced diabetic mice. METHODS: Antidiabetic and anti-hyperlipidemic activity of the crude extract of Hagenia abyssinica was studied in streptozotocin-induced diabetic mice. The effects of the extract on fasting blood glucose level, body weight, and serum lipid profiles were analyzed. One-way ANOVA followed by Tukey's post hoc test was used for data analysis and p<0.05 was considered as statistically significant. RESULTS: Hagenia abyssinica leaves crude extract showed significant (p<0.05-p<0.001) blood-glucose-lowering activity. Moreover, the crude extract of H. abyssinica reduced the fasting blood glucose level by 23.21%, 38.20%, 43.53%, and 58.99%, respectively, for CE100, CE 200, CE 400, and GLC 5 mg/kg on the 14th day of treatment. After diabetic mice were treated with H. abyssinica (100, 200 and 400 mg/kg) for 14 days, there was a significant decrease in serum total cholesterol, very-low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and serum triglyceride and a significant increase in body weight, and HDL-cholesterol level as compared to diabetic control. CONCLUSION: The present findings revealed that H. abyssinica leaves could be useful for the management of diabetes mellitus and other abnormalities related to this metabolic disorder. Thus, the present study may support the traditional use of H. abyssinica for diabetes mellitus treatment.

Evaluation of Antidiabetic Activity of the Leaf Latex of Aloe pulcherrima Gilbert and Sebsebe (Aloaceae).

The leaf latex of Aloe pulcherrima has been used as remedy for diabetes mellitus. This was carried out to determine in vitro and in vivo antidiabetic activities of the leaf latex of Aloe pulcherrima. Methods. Sucrase and maltase inhibitory activity of the leaf latex of A. pulcherrima was determined in glucose oxidase assay, and α-amylase inhibitory activity was determined in dinitrosalicylic acid assay. Normoglycemic, glucose-loaded, and streptozotocin-induced diabetic mice were treated orally to determine blood glucose lowering activity of the latex. Effect of the latex on serum lipid level and body weight was measured in streptozotocin-induced diabetic mice. Additionally, DPPH assay was used to determine free radical scavenging capacity of the latex. Results. Antioxidant activity of the latex was concentration dependent; the strongest inhibition was measured at 800 µg/ml (80.57%). The leaf latex of A. pulcherrima inhibited sucrase (IC50 = 2.92 µg/ml), maltase (IC50 = 11.81 µg/ml) and α-amylase (IC50 = 14.92 µg/ml) enzymes. All doses of the leaf latex induced hypoglycemic effect after 4 h in normal mice, and low dose of the latex did not show significant effect after 6 h. Glucose reduction of the leaf latex of A. pulcherrima was significant (p < 0.05) in oral glucose-loaded mice compared to the vehicle control. Blood glucose level of diabetic mice was significantly (p < 0.05) reduced on week one and weak two in a streptozotocin-induced diabetic mouse model. Glucose reduction increased with increasing the doses of the leaf latex of A. pulcherrima on week one (p < 0.05 (200 mg/kg), p < 0.01 (400 mg/kg), and p < 0.001 (600 mg/kg)). Administration of the leaf latex of A. pulcherrima for two weeks significantly (p < 0.05) improved diabetic dyslipidemia and body weight of diabetic mice. Conclusion. The study confirmed that the leaf latex of the plant showed a significant antidiabetic activity justifying the traditional uses of the plant.

Evaluation of Hepatoprotective Activity of the Crude Extract and Solvent Fractions of Clutia abyssinica (Euphorbiaceae) Leaf Against CCl4-Induced Hepatotoxicity in Mice.

BACKGROUND: Liver is a vital organ that plays a major role in the elimination of xenobiotics from the body. Diseases that affect the liver become major health problems and challenge health-care professionals as well as the pharmaceutical industry. Since the conventional treatment of liver diseases is associated with a wide range of adverse effects, botanical agents are commonly used. Among these agents, Clutia abyssinica is the most widely used herb in Ethiopian traditional medicine. OBJECTIVE: To evaluate the hepatoprotective activity of the crude 80% methanol extract and solvent fractions of Clutia abyssinica leaves in mice. METHODS: The leaves of Clutia abyssinica were extracted by cold maceration using 80% methanol as a solvent, and the solvent fractions were obtained in liquid-liquid extraction with chloroform, n-butanol and distilled water. Male mice were treated with the vehicles (distilled water or 2% Tween 80), three different doses (100, 200 and 400 mg/kg) of the crude 80% methanol extract and three solvent fractions, the standard drug (silymarin 100 mg/kg), and the hepatotoxicant carbon tetrachloride (CCl4). Then, the levels of biomarkers of liver injury - such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) - and liver function such as total protein, albumin, and bilirubin were measured. Evaluation of the change in body weight and liver weight, histopathologic examination and in vitro antioxidant assay against CCl4-induced hepatotoxicity were also carried out. RESULTS: The 80% methanol extract decreased the absolute and relative weight of the liver of mice at the doses of 200 and 400 mg/kg (p<0.01 and p<0.001, respectively). It also suppressed the plasma levels of AST, ALT and ALP (p<0.001) in the aforementioned doses. Among fractions, the n-butanol fraction showed maximum hepatoprotective activity in its dose of 200 and 400 mg/kg (p<0.001, in all cases). Likewise, the chloroform fraction (400 mg/kg) reduced to a similar extent (p<0.001 in all cases). In stark contrast, the aqueous fraction failed to affect the levels of all biomarkers of hepatocyte injury. The crude methanol extract and n-butanol fraction were able to return the normal hepatic architecture of hepatocytes and scavenge free radicals in the 1,1-diphenylpicrylhydrazyl (DPPH) assay. CONCLUSION: Clutia abyssinica is endowed with hepatoprotective activity, probably mediated via its antioxidant activity. Thus, Clutia abyssinica can be taken as one candidate for the development of hepatoprotective agents because of its good safety profile.

A Retrospective Study of Acute Poisoning Cases and Their Management at Emergency Department of Dessie Referral Hospital, Northeast Ethiopia.

BACKGROUND: Poisoning causes significant patient morbidity and mortality worldwide. It is a common reason for emergency department visits and hospitalizations. Acute poisoning needs immediate effective management to prevent patient mortality or sequela. This study was carried out to determine the pattern of acute poisoning cases and their management at the emergency department of Dessie referral hospital, northeast Ethiopia. METHODS: A retrospective cross-sectional study of all registered poisoning cases managed at the emergency department of Dessie referral hospital was conducted from March 10 to May 2, 2018. RESULTS: There were a total of 147 registered poisoning cases listed in the registry during the study period, of which 120 cases (81.6%) had complete data and were included in the study. Among the total of 120 studied poisoning cases, 66 (55%) were females, and 53 (44.2%) were  in the age group of 21-30 years. The causative poison was documented for 118 cases. Organophosphates were the most common poisoning agents involved in 54 (45%) of the cases followed by sodium hypochlorite, 27 (22.5%), and food poisoning, 19 (15.8%). Among the total patients, 77 (64.2%) were self-poisoned intentionally, 31 (25.8%) were poisoned in an unintentional manner and the rest, 12 (10%), had an unknown manner of poisoning. Mental disorder, 25 (20.8%); family disharmony, 23 (19.2%); and marital disharmony, 19 (15.8%) were the three most common causes of intentional poisoning. In all cases of acute poisoning, both pharmacological and non-pharmacological treatment approaches were used. Cimetidine was the most commonly used pharmacologic treatment, 118 (98.3%), followed by antiemetic, 107 (89.2%); proton pump inhibitor, 87 (72.5%), and atropine, 67 (55.8%). ANOVA did not show a statistically significant difference (P>0.05) in the frequency of poisoning cases across seasons. CONCLUSION: Among 120 acute poisoning cases, 77 (64.2%) were intentional poisoning cases. Organophosphate poisoning accounts for 45% of the total poisoning cases. The three major reasons for intentional poisoning were mental disorders (20.8%), family disharmony (19.2%) and marital disharmony (15.8%). Cimetidine (98.3%) was the most commonly used pharmacologic treatment of the poisoning cases.

Helicobacter pylori And Duodenal Ulcer: Systematic Review Of Controversies In Causation.

BACKGROUND: There are controversies on the causal role of H. pylori in duodenal ulceration. Helicobacter pylori are curved gram-negative microaerophilic bacteria found at the layer of gastric mucous or adherent to the epithelial lining of the stomach. It's a public health significance bacteria starting from discovery, and the prevalence and severity of the infection varies considerably among populations. H. pylori are a risk for various diseases, while the extent of host response like gastric inflammation and the amount of acid secretion by parietal cells affects the outcome of infection. METHOD: Relevant literature were searched from databases such as Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct. RESULT: The review evidence supports a strong causal relation between H. pylori infection and duodenal ulcer, as patients are more likely to be infected by virulent strains which later cause duodenal ulceration. Thus, eradication of H. pylori infection decreases the incidence of duodenal ulcers, and prevents its recurrence by reducing both basal gastrin release and acid secretion without affecting parietal cell sensitivity. On the other hand, some studies show that H. pylori infection is not associated with the development of duodenal ulcers and such a lack of association revealed that duodenal ulceration has different pathogenesis. CONCLUSION: Despite controversies observed in the causal role of H. pylori to duodenal ulceration by various studies, Hill criteria of causation proved the presence of a causal relation between H. pylori infection and duodenal ulcers. Other factors are also responsible for the development of duodenal ulcers and such factors are responsible for the differences in the prevalence of the diseases.

Evaluation of hypoglycemic, antihyperglycemic and antihyperlipidemic activities of 80% methanolic seed extract of Calpurnia aurea (Ait.) Benth. (Fabaceae) in mice.

BACKGROUND: Diabetes mellitus is one of the most common chronic health problems in the world. As currently available antidiabetic medications have limitations in terms of safety, efficacy, and cost, it is an important research area to investigate medicinal plants for new antidiabetic compounds that can lead to effective, safe and less costly pharmacotherapy. The present study was done to evaluate the antidiabetic and antidyslipidemic activities of 80% methanolic seed extract of Calpurnia aurea (Ait.) Benth. (Fabaceae) in mice. METHODS: Blood glucose lowering activity of three doses (2.75 mg/kg, 5.5 mg/kg and 11 mg/kg) of the hydromethanolic seed extract of Calpurnia aurea was studied in three animal models: normoglycemic mice, oral glucose-loaded mice, and streptozotocin-induced diabetic mice. Additionally, the effect of the seed extract on body weight and serum lipid profile was studied in the streptozotocin-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all animal models of the study. Blood glucose level was measured using a glucose meter, whereas serum lipid level was measured using an automated chemistry analyzer. Data were analyzed using one-way analysis of variance followed by Tukey's post hoc multiple comparison test. RESULTS: Hydromethanolic extract of C. aurea seeds showed blood glucose lowering activity in all animal models, and it improved body weight loss and diabetic dyslipidemia in diabetic mice after 14 days of treatment. CONCLUSION: This study revealed that hydromethanolic extract of Calpurnia aurea seeds has significant hypoglycemic, antihyperglycemic and antihyperlipidemic activities.

Evaluation of in vivo antidiabetic, antidyslipidemic, and in vitro antioxidant activities of hydromethanolic root extract of Datura stramonium L. (Solanaceae).

BACKGROUND: The global morbidity and mortality rates of diabetes mellitus are persistently increasing. There is a demand for new antidiabetic drugs because the safety and efficacy of currently available medications are limited. The present study was therefore conducted to study the antidiabetic activities of the hydromethanolic root extract of Datura stramonium L. (Solanaceae) in mice. METHODS: Blood glucose lowering activity of three doses (100, 200, and 400 mg/kg) of the hydromethanolic root extract of D. stramonium was tested on normoglycemic, oral glucose-loaded, and streptozotocin (STZ)-induced diabetic mice models. The effect of the extract on body weight and diabetic dyslipidemia was also studied on STZ-induced diabetic mice. Additionally, antioxidant activity of the plant extract was determined using 2,2-diphenyl-1-picrylhydrazine free radical scavenging assay. Data were analyzed using one way ANOVA followed by Tukey's post hoc multiple comparison test. RESULTS: The hydromethanolic root extract did not show significant hypoglycemic activity in normoglycemic mice. The plant extract at doses of 100, 200, and 400 mg/kg significantly (P<0.05) reduced blood glucose levels of oral glucose-loaded and diabetic mice. All the three doses of the root extract significantly improved diabetic dyslipidemia and the body weight of diabetic mice. Free radical scavenging activity of the root extract was found to be comparable to ascorbic acid with an IC50 of 13.47 µg/mL. CONCLUSION: This study demonstrated that the hydromethanolic root extract of D. stramonium possesses significant antidiabetic, antidyslipidemic, and antioxidant activities.

Antidiabetic Activities of Hydromethanolic Leaf Extract of Calpurnia aurea (Ait.) Benth. Subspecies aurea (Fabaceae) in Mice.

Diabetes mellitus is one of the largest global health problems demanding preventive and new therapeutic interventions. Currently, there is a need for safe, effective, and less costly antidiabetic medications, and investigating medicinal plants for new antidiabetic medication is an interesting research area. Thus, the present study was done to evaluate the antidiabetic activities of 80% methanolic leaf extract of Calpurnia aurea (Ait.) Benth. subspecies aurea (Fabaceae) in mice. Hypoglycemic and antihyperglycemic activity of the three doses (100mg/kg, 200 mg/kg, and 400 mg/kg) of crude hydromethanolic leaf extract was studied on normoglycemic, oral glucose loaded, and streptozotocin-induced diabetic mice models. The effect of the extract on body weight and diabetic dyslipidemia was also studied on streptozotocin-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all cases. A glucose meter and an automated chemistry analyzer were used to measure blood glucose and serum lipid level respectively. Data were analyzed using one-way analysis of variance followed by Tukey's post hoc multiple comparison test. All the three doses of the plant extract (100mg/kg, 200 mg/kg, and 400 mg/kg) showed a significant (p<0.05) antihyperglycemic activity in the diabetic mice at the 7th and 14th day of repeated daily dose administration as compared to the negative diabetic control. But, the extract did not show significant blood glucose lowering activity in normoglycemic, oral glucose loaded, and diabetic mice after single dose administration, and it did not significantly improve the body weight loss and diabetic dyslipidemia of diabetic mice after repeated daily dose administration for 14 days. This study revealed that the hydromethanolic extract of Calpurnia aurea leaves possesses significant antihyperglycemic activity justifying the traditional use of the plant for diabetes.

A prospective observational study of drug therapy problems in medical ward of a referral hospital in northeast Ethiopia.

BACKGROUND: Drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. Drug therapy problems are common causes of patient morbidity and mortality. There was no study that has been done on drug therapy problems in the study area, Dessie referral hospital, northeast Ethiopia. METHOD: A prospective observational study was conducted among hospitalized patients in the medical ward of Dessie referral hospital from March 01 to May 31, 2014. Ethical approval was obtained and informed consent was signed by each study participant before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data regarding each patient's demographics, medical condition, drug therapy and patient compliance to the drug therapy were collected using pretested checklists, and drug therapy problems were determined based on the standard practice and textbooks. Descriptive statistical analysis was done using SPSS Version 20 Software. RESULT: A total of 147 patients were included, 75.51% of whom experienced at least one drug therapy problem. During the 3 month period a total of 159 drug therapy problems were identified of which needs additional drug therapy (35.85%) was the most common followed by unnecessary drug therapy (30.19%) and dosage too low (13.2%). Antibiotics, 75 (40.32%) was the most frequent drug class involved in drug therapy problems followed by cardiovascular drugs, 69 (37.1%) and nonsteroidal anti-inflammatory drugs, 9 (4.84%). Ceftriaxone (25.81%) was the most frequent specific drug prone to the drug therapy problems followed by spiranolactone (14.52%), enalapril (6.45%) and furosemide (6.45%). CONCLUSIONS: Three out of four patients experienced at least one drug therapy problem during their hospital stay in the medical ward, with the most commonly observed DTP being no drug therapy prescribed for a condition requiring drug treatment.