Medicines Wastage and Its Contributing Factors in Public Health Facilities of South Gondar Zone, Amhara Regional State, Ethiopia.

Background: In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited. Methods: A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25. Results: The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine's wastage were near-expiry medicines (<6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities. Conclusion: There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.

Antibiotic Prescription Pattern, Appropriateness, and Associated Factors in Patients Admitted to Pediatric Wards of Tibebe Ghion Specialized Hospital, Bahir Dar, North West Ethiopia.

Background: Irrational prescribing of antibiotics leads to the emergence of resistant bacteria. Despite this fact, antimicrobial agents are commonly prescribed in the inpatient setting, especially in infants and children. Objective: The aim of this study was to assess the pattern of antibiotic prescription, appropriateness, and associated factors in pediatric wards of Tibebe Ghion Specialized Hospital (TGSH), Bahir Dar, North West Ethiopia, September 11th, 2021 to October 12th, 2021 GC (Gregorian Calendar). Methods: An institution-based cross-sectional study was conducted in the pediatric wards of TGSH from September, 2020 to August, 2021 GC. Data were collected using a structured checklist containing each patient's socio-demographic characteristics, clinical information, list of prescribed drugs, and reason for prescription. A systematic random sampling technique was used to select pediatric patients' medical records containing prescribed antibiotics. The collected data were entered and analyzed using SPSS version 25 software. Results: A total of 279 pediatric patients' medical cards including at least one antibiotic were reviewed. The study revealed that antibiotics were prescribed for most of the patients (88.9%) for empiric treatment purposes. The main medical conditions for which antibiotics were prescribed were pneumonia (16.8%) and early-onset neonatal sepsis (14.0%). Ceftriaxone was the most widely used (84.9%) antibiotic among the monotherapeutic antibiotics, while ceftriaxone plus metronidazole (23.5%) was the most frequently used combination of antibiotics. A high proportion (30.8%) of the pediatric patients was exposed to inappropriate treatment. Residence in rural areas (P=0.046) and being 1 year old or younger (P<0.05) were found to be independent determinants of inappropriate drug use. Conclusion: Antibiotics were the most prescribed class of medications for pediatric patients in TGSH. Ceftriaxone and ampicillin were the most frequently prescribed antibiotics in the pediatric wards of TGSH. A high proportion of patients had been exposed to inappropriate antibiotic treatment. Early age and rural residence were found to be the factors that were significantly associated with inappropriate antibiotic utilization.

Evaluation of Antimalarial Activity of 80% Methanolic Root Extract of Dorstenia barnimiana Against Plasmodium berghei-Infected Mice.

BACKGROUND: Due to resistance of parasites, costs, and safety issues with currently available drugs, there is a need to discover new antimalarials. Medicinal plants are one of the most important sources of new drugs. The purpose of this study was to evaluate the antimalarial activity of a methanolic root extract of Dorstenia barnimiana in Swiss albino mice infected with Plasmodium berghei. METHODS: Four-day suppressive, curative, and prophylactic tests were performed on mice infected with P. berghei to evaluate the antimalarial activity of a methanolic root extract of the plant. Parasitemia suppression, survival time, body-weight change, rectal temperature change, and packed-cell volume were used to evaluate the activity of the extract. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test for comparisons between and within groups, with P<0.05 considered statistically significant. RESULTS: The D. barnimiana root extract showed significant (P<0.01) parasitemia-suppressive activities in all models compared to the negative control. The extract increased mean survival time and prevented weight loss, reduction in temperature, and anemia significantly in all tested doses in 4-day suppressive and curative tests. CONCLUSION: Based on these findings, D. barnimiana root has promising antimalarial activity and can considered a potential source to develop new agents.

Hypoglycemic and Antihyperglycemic Activities of 80% Methanol Root Extract of Acanthus polystachyus Delile (Acanthaceae) in Type 2 Diabetic Rats.

BACKGROUND: The morbidity and mortality rate from diabetic mellitus are increasing in the world especially in low- and middle-income countries; hence, it is necessary to evaluate the efficacy and safety of medicinal plants to support existing drugs in treating diabetes mellitus. Therefore, the aim of this study was to evaluate the hypoglycemic effect of 80% methanol root extract of Acanthus polystachyus in normoglycemic, hyperglycemic, and streptozotocin-nicotinamide induced diabetic rats. METHODS: Male albino Wistar rats were divided into five groups (n=6) in all three models. In all models, group one rats served as a negative control and were received vehicle (10mL/kg distilled water), whereas group two (APRE100), three (APRE200), and four (APRE400) were treated with 100, 200, and 400mg/kg of extract, respectively, and group five were treated with glibenclamide (5mg/kg) and served as a positive control. Blood glucose levels were measured at different time points by taking blood from their tails. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test to carry out comparisons between and within-group and P < 0.05 was considered as statistically significant. RESULTS: The root of Acanthus polystachyus reduces peak blood sugar levels significantly after the loading of oral glucose at all tested doses. In streptozotocin-nicotinamide-induced type 2 diabetic rats, the daily oral administration of the crude extracts showed a significant reduction of blood glucose level at all tested doses compared to the negative control group. However, the extract did not reduce blood glucose levels in normoglycemic rats at all tested doses compared to both negative and positive control. CONCLUSION: From this study, it can be concluded that the root extract of Acanthus polystachyus showed an antihyperglycemic effect in hyperglycemic and diabetic rats but lack hypoglycemic effect in normoglycemic rats. Hence, the plant root may be a good candidate for the development of new antidiabetic drugs.

Phytochemical and Antiulcer Activity Screening of Seed Extract of Cordia africana Lam (Boraginaceae) in Pyloric Ligated Rats.

INTRODUCTION: Peptic ulcer disease represents a worldwide health problem because of its high morbidity, mortality and economic loss. It is a very prevalent condition affecting around 10%-15% of the general population worldwide. Most of the available antiulcer drugs are costly and have an incidence of relapse, drug interactions and several side effects upon chronic usage. Hence, the use of herbal medicine may be safe, economical and effective in such cases when drugs are used for long periods. Ethnobotanical reports showed traditional claims on the use of Cordia africana seeds for the treatment of gastric ulcers. However, the safety and efficacy of these remedies are not well known. The aim of this study is, therefore, to evaluate the antiulcer activity and safety of a crude extract of C. africana seeds in animal models. METHODS: Shade-dried seeds of C. africana were extracted by 80% methanol and dried by the rotator evaporator and lyophilized. The crude extract was used to evaluate antiulcer activity in vivo with pylorus ligation method, on Wistar albino rats weighing 230-250g. Preliminary phytochemical screening was performed using a standard procedure. Acute toxicity study was carried out in Swiss albino mice before antiulcer activity tests. RESULTS: No sign of toxicity was observed upon the administration of 2000 mg/kg of the crude extract to mice. Single-dose administration of 400 and 600 mg/kg extract showed a significant reduction in the volume of secretion and acidity of the stomach (p <0.01). The doses 400 and 600 mg/kg have reduced the ulcer score by 83.58% and 88%. CONCLUSION: The result of this study showed that the hydromethanolic crude extract of C. africana has strong antisecretory and ulcer protective activities against ulcers produced by pylorus ligation.

Antimalarial Activity of Hydroalcoholic Root Extract of Acanthus polystachyus Delile (Acanthaceae) Against Plasmodium berghei-Infected Mice.

Failure of the efficacy of antimalarial drugs is recognized in different classes of medicines for treating malaria, which urges the need for new drugs. This study tried to check the in vivo antimalarial activity of the root extracts of Acanthus polystachyus Delile against Plasmodium berghei-infected mice. The study revealed that the methanolic crude extract of the root of Acanthus polystachyus Delile showed significant (P < .01) parasitemia suppressive activities in both models compared with the negative control. Parasitemia suppressive activities were 25.26%, 33.46%, and 51.48% in a 4-day suppressive test and 23.31%, 31.20%, and 43.54% in prophylaxis test at 100, 200, and 400 mg/kg of the extract, respectively, as compared to the negative control. Besides, the extract increases mean survival time significantly in all tested doses in a 4-day suppressive test, but in the prophylaxis model, only mice treated with 200 and 400 mg/kg significantly lived longer. Based on this finding, the root of Acanthus polystachyus Delile has strong antimalarial activity, which may be a good candidate for new antimalarial agents.

Corrigendum to "Investigation of the Antidiarrheal and Antimicrobial Activities of 80% Methanolic Leaf Extract of Discopodium penninervum (Hochst.)".

[This corrects the article DOI: 10.1155/2018/1360486.].

Investigation of the Antidiarrheal and Antimicrobial Activities of 80% Methanolic Leaf Extract of Discopodium Penninervum (Hochst.).

Diarrhea is a major health problem throughout the world and it has become more problematic in developing countries like Ethiopia. People, in several parts of the world, use different traditional medicines for treating diarrhea and it has been reported that the roots, leaves, and flowers of various species are used for the same purpose. In Ethiopia, for instance, Discopodium Penninervum is used for the treatment of diarrhea and also to control infection. The aim of the present study was, therefore, to evaluate the in vivo antidiarrheal and in vitro antimicrobial effect of Discopodium Penninervum in mice. For the antimicrobial activity test, four standard bacteria and disc diffusion method were used, while for antidiarrheal experiment, animals had been used, which were divided into 5 groups. The first group served as negative control and was administered with vehicle (0.2-0.3ml of distilled water). Groups two (D100), three (D200), and four (D400) were administered 100, 200, and 400 mg/kg of the extract, respectively. Group five served as positive control group and was administered with either loperamide (3mg/kg) for castor oil induced diarrhea and castor oil induced enteropooling diarrhea models or atropine (1mg/kg) for charcoal meal test. Safety study was performed using a standard acute toxicity study procedure. The effect of the extract on castor oil induced diarrheal drops, onset of diarrhea, weight of faeces, small intestinal fluid accumulation, and intestinal motility was measured and analyzed using one-way ANOVA. Preliminary phytochemical screening of the leaves powder of the plant indicated the presence of various components. Inhibition of castor oil induced diarrhea was observed at all tested doses. It can be concluded that crude extracts of Discopodium Penninervum showed strong activities against diarrhea indicating that it contains some chemical constituents that possibly lead to antidiarrheal drug development.