A comprehensive review on the ethnobotanical, phytochemical, and pharmacological aspects of the genus Malvastrum.

The genus Malvastrum, from the family Malvaceae, is a small genus of twenty four species, distributed worldwide. Some of the species have a long and rich history of ethnobotanical and traditional medicinal uses. Few reports of systematic scientific studies can be found in the literature which highlight the rich chemical profile and pharmacological properties of the genus. This is the first ever attempt to compile the available literature and provide a critical overview for future studies on the genus. For this purpose, several databases, such as PubMed, Scifinder, Elsevier, Google Scholar, and others were utilized. Literature records the presence of bioactive metabolites in the genus, effective against dysentery, gastrointestinal distress, fever, enteritis, hepatitis, cough, sore throat, arthritis, and diabetes. Seventy four biologically active secondary metabolites have been identified from different species of Malvastrum, including four pure isolates. Furthermore, this report also documents their potential properties. This article may prove as a milestone for new researchers, eager to work on Malvastrum species and perform further in-depth studies on this genus.

Adherence to inhalers and associated factors among adult asthma patients: an outpatient-based study in a tertiary hospital of Rajshahi, Bangladesh.

BACKGROUND: Adherence to inhaler medication is an important contributor to optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence levels and to identify the potential factors associated with non-adherence to the inhalers among asthma patients. METHODS: This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI).. Both descriptive and inferential statistics were used to express the socio-demographic of the patients and predictors of poor adherence to inhaler. RESULTS: A substantial number of participants were non-adherent (86%) to inhaler medication. Patients non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67-146.08), lived in the rural area (23.28, 95% CI 2.43-222.66), less year of schooling (5.69, 95% CI 1.27-25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11-44.9) than those adherent with the inhaler. The presence of comorbidities (12.91, 95% CI 1.41-117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22-26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10-55.26) were the significant contributor of non-adherence. CONCLUSION: Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found to contribute. Regular monitoring and a guided patient-centered self-management approach might be helpful to address them in long run.