Patterns and determinants of prescribed drug use among pregnant women in Adigrat general hospital, northern Ethiopia: a cross-sectional study.

BACKGROUND: A vigilant prescription of drugs during pregnancy can potentially safeguard the growing fetus from the deleterious effect of the drug while attempting to manage the mother's health problems. There is a paucity of information about the drug utilization pattern in the area of investigation. Hence, this study was implemented to investigate the pattern of drug utilization and its associated factors among pregnant women in Adigrat general hospital, Northern Ethiopia. METHODS: An institution-based cross-sectional study was conducted among randomly selected 314 pregnant women who attended obstetrics-gynecology and antenatal care units of the hospital. Relevant data were retrieved from the pregnant women's medical records and registration logbook. The drugs prescribed were categorized based on the United States Food and Drug Administration (US-FDA) fetal harm classification system. Data analysis was done using SPSS version 20 statistical software. Multivariate logistic regression was employed to analyze the association of the explanatory variables with the medication use, and p < 0.05 was declared statistically significant. RESULTS: The overall prescribed drug use in this study was found to be 87.7%. A considerable percentage of the study participants (41.4%) were prescribed with supplemental drugs (iron folate being the most prescribed drug) followed by antibiotics (23.4%) and analgesics (9.2%). According to the US-FDA drug's risk classification, 42.5, 37, 13, and 7% of the drugs prescribed were from categories A, B, C, and D or X respectively. Prescribed drug use was more likely among pregnant women who completed primary [AOR = 5.34, 95% CI (1.53-18.6)] and secondary education [AOR = 4.1, 95% CI (1.16-14)], who had a history of chronic illness [AOR = 7.9, 95% CI (3.14-19.94)] and among multigravida women [AOR = 2.9, 95% CI (1.57 5.45)]. CONCLUSIONS: The finding of this study revealed that a substantial proportion of pregnant women received drugs with potential harm to the mother and fetus. Reasonably, notifying health practitioners to rely on up-to-date treatment guidelines strictly is highly demanded. Moreover, counseling and educating pregnant women on the safe and appropriate use of medications during pregnancy are crucial to mitigate the burden that the mother and the growing fetus could face.

Anti-Nociceptive and Anti-Inflammatory Activity of Hygrophila schulli Leaves.

PURPOSE: The management of pain and inflammation with non-steroidal anti-inflammatory drugs and opioid analgesics are currently encountering severe adverse reactions. To overcome these problems, herbal remedies may offer new alternative medicines. Hygrophila schulli is a medicinal plant traditionally used for the treatment of pain and inflammation-related disorders; yet, these claims are not scientifically validated. Hence, this study was aimed to validate the traditional use of Hygrophila schulli leaves as anti-inflammatory and analgesic remedy. METHODS: In vitro anti-hyaluronidase assay and in vivo carrageenan-induced hind paw oedema model were used to evaluate the anti-inflammatory property of ethanolic leaf extract of Hygrophila schulli. Tail immersion and acetic acid-induced writhing tests were performed to determine the central and peripheral analgesic activity of the leaf extract, respectively. RESULTS: The ethanolic leaf extract exhibited significant anti-hyaluronidase activity (P<0.001) and significant inhibition of carrageenan-induced paw oedema (P<0.05) compared to untreated controls. Similarly, the extract significantly prolonged the reaction time of mice (P<0.05) for the hot-water stimuli. Furthermore, an oral dose of the extract showed significant inhibition (P<0.01) of acetic acid-induced abdominal contractions of mice. Besides, the ethanolic leaf extract did not cause any obvious sign of acute toxicity at a single oral dose of 2 g/kg. CONCLUSION: The findings of this study may partially support the acclaimed traditional use of Hygrophila schulli leaves for the treatment of pain and inflammatory conditions.

Anti-inflammatory and anti-nociceptive property of Capparis tomentosa Lam. root extracts.

ETHNOPHARMACOLOGICAL RELEVANCE: Capparis tomentosa Lam. root is one of the commonly used traditional medicines for the treatment of pain and inflammatory conditions by the Kunama ethnic group of Ethiopia. Yet, its ethnomedicinal claim has not been scientifically investigated. AIM OF THE STUDY: This study aims to evaluate the anti-inflammatory and anti-nociception activities of root extracts of Capparis tomentosa Lam. MATERIALS AND METHODS: The anti-inflammatory activity of the 70% ethanolic extracts and solvent fractions was determined using invitro hyaluronidase inhibition assay and in vivo carrageenan-induced paw edema in Swiss albino mice model. The anti-nociception effect was determined using the acetic acid-induced writhing model and tail immersion model in Swiss albino mice. RESULTS: The root extract of Capparis tomentosa has exhibited significant hyaluronidase inhibition activity which was comparable with the reference drug, indomethacin. Significant inhibition of carrageenan-induced paw edema was observed in all the test sample treated mice compared to the negative control with the highest activity observed from butanol fraction which was equivalent to the effect of acetylsalicylic acid. All the root extract and solvent fractions have possessed a significant and dose-dependent abdominal writhing inhibition with the highest effect observed in the aqueous fraction. Additionally, the crude extract was found better in increasing the reaction latency of the mice to the hot water stimulus than the solvent fractions which were significant after 60-120 min compared to the distilled water treated group. The root extract and solvent fractions were also found safe at a single oral dose of 2 mg/g in Swiss albino mice. CONCLUSION: The findings of the present study may partially support the folkloric use of Capparis tomentosa root for the treatment of pain and inflammation.

In vitro α-amylase inhibitory effect of TLC isolates of Aloe megalacantha baker and Aloe monticola Reynolds.

BACKGROUND: About 425 million adults had diabetes mellitus globally in 2017. Type 2 diabetes accounts for the enormous majority of diabetes cases and it is gradually growing which is predicted to increase by 48% in 2045. Imbalanced cellular carbohydrate and lipid metabolism cause an increase in postprandial blood glucose level which eventually leads to the onset and progression of type 2 diabetes mellitus. The lack of effective and safe carbohydrate hydrolyzing enzyme inhibitors contributes to the increasing prevalence. Thus, this study was targeted to assess the α-amylase inhibitory potential of isolates obtained from Aloe megalacantha Baker and Aloe monticola Reynolds, which are among the commonly used folkloric remedies for the management of diabetes mellitus. METHOD: The α-amylase inhibitory effect of Aloe megalacantha Baker and Aloe monticola Reynolds were evaluated using the 3,5-dinitro salicylic acid method. 2, 2-Diphenyl-2-picrylhydrazyl free radical scavenging property was also used to test the antioxidant effect of both plants. Results were analysed using GraphPad Prism software version 8. RESULTS: The more polar isolates (AM1 and AG1) were possessed stronger α-amylase inhibition activity than the leaves latex and the other strains (AM2 and AG2). Leaf latex of A. megalacantha, AM1, AM2, leaf latex of A. monticola, AG1, and AG2 were found to have an IC50 value of 74.76 ± 1.98, 37.83 ± 3.31, 96.75 ± 1.98, 78.10 ± 1.88, 56.95 ± 1.88 and 64.03 ± 3.60 µg/mL, respectively (P < 0.001). The leaf latexes of A. megalacantha and A. monticola showed a significant (P < 0.001) free radical hunting property with an IC50 value of 890.1 ± 1.73 and 597.5 ± 2.02 µg/mL, respectively. CONCLUSION: Hence, the outcomes of the present investigation partly justify the acclaimed use of Aloe megalacantha and Aloe monticola for the treatment of diabetes.

In vivo hepatoprotective and In vitro radical scavenging activities of Cucumis ficifolius A. rich root extract.

ETHNOPHARMACOLOGICAL RELEVANCE: Cucumis ficifolius A. Rich is a perennial prostrate herb that stems up to 1 m long. Its root is widely used in traditional medicine to treat various diseases including liver diseases. Yet, scientific evidence is lacking to verify its ethno medicinal claims. AIM OF THE STUDY: The present study was conducted to assess the hepatoprotective and radical scavenging activity of 80% methanol crude extract and different fractions of Cucumis ficifolius root. MATERIALS AND METHODS: Radical scavenging activity was done applying the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay while hepatoprotective activity was assessed using pre- and post-treatment models of carbon tetrachloride (CCl4)-induced liver injury in Swiss albino mice of either sex weighing 25-30 g. A single oral dose of 2000 mg/kg was used for acute toxicity study, doses of 125, 250, and 500 mg/kg were used in the pre-treatment model, and 500 mg/kg of extract and chloroform fraction were used in the post-treatment model. Biochemical markers and histopathological parameters were used to measure hepatoprotective activities. RESULTS: C. ficifolius crude extract and its solvent fractions showed strong radical scavenging activity and the chloroform fraction had the highest activity. No sign of toxicity was shown in an acute toxicity test of the extract. Hepatoprotective activity evaluation on the crude extract by a pre-treatment model with 125, 250, and 500 mg/kg doses revealed a significant (p < 0.05) reduction of the serum level of CCl4-induced liver enzyme markers at the highest tested dose (500 mg/kg). The chloroform fraction that had highest radical scavenging activity and the crude extract, both at 500 mg/kg, were again evaluated in a post-treatment model and the results revealed that both the extract and the chloroform fraction demonstrated significant (p < 0.05) hepatoprotective activities which support the results of the pre-treatment model. CONCLUSION: The present study verified the hepatoprotective potentials of C. ficifolius extract and its chloroform fraction which might be, at least in part, through radical scavenging action.