Showing papers in "The African Journal of Pharmacology and Therapeutics in 2014"
Journal Article•
TL;DR: In this paper, two polyphenolic compounds, designated as compounds 1 [m.pt (148-150 0 C); R f ( 0.67); [n] 20 D (1.4118 )] and 2 [mpt 130-132 0 C]; R f(0.4079)] were isolated.
Abstract: Background: Acalypha wilkesiana var. lace - acalypha (Muell & Arg.) is a cultivated ornamental plant used in folkloric medicine for the treatment of fever, bacterial, skin fungal infections, wounds, tumors, inflammations and gastro-intestinal troubles. To date, there are no reports of any isolated compounds from this species/variety which could serve as chemotaxonomic markers. Hence, the need for this study. Objectives : The leaves of the plant were to be collected and extracted cold in 50 % ethanol to obtain the crude extract. The aqueous solution of the crude extract was to be partitioned with butanol. The obtained butanol fraction was to be separated on a silca-gel column to obtain isolates which were to be screened for antimicrobial activities. Methodology: Isolates expected to be obtained from the silica-gel column chromatography of the butanol fraction were to be analyzed for antimicrobial activities using the hole-in agar diffussion method. The compounds were to be screened for both antibacterial and antifungal activities using the microbes namely, B. subtilis , S. aureus , E. coli , Ps. aeriginosa and S. typhi. and C. albicans. Results and Discussion: Two polyphenolic compounds, designated as compounds 1 [m.pt (148-150 0 C); R f ( 0.67); [n] 20 D (1.4118 )] and 2 [(m.pt 130-132 0 C); R f (0.46); [n] 20 D (1.4079)] were isolated. The structures of 1 and 2 have been established to be ethyl 3, 4, 5-trihydroxybenzoate (ethyl gallate) and 1, 2, 3-benzenetriol (pyrogallol or fouramine brown) respectively using the 1 H NMR, 13 C NMR, MS and IR spectral techniques. Both polyphenols were strongly bacteriostatic against B. subtilis , S. aureus , E. coli , Ps. aeriginosa and S. typhi. Furthermore, 2 was more suppressive of the bacterial strains than 1 . However, neither gave any anticandidal activity. The crude extract and butanol fraction demonstrated comparatively weaker antimicrobial activities than the two isolated compounds. Conclusion: The two polyphenols would serve as chemotaxonomic markers for this species/variety and the genus, Acalypha in general. Also the results of the antimicrobial screening have lent scientific credence to the traditional uses of the plant. Key words: Polyphenols; ethyl gallate; pyrogallol; bacteriostatic; A. wilkesiana var. lace-acalypha
9 citations
Journal Article•
TL;DR: Comparing availability and funding of essential medicines at Webuye District Hospital, Kenya before and after implementation of the new National Hospital Insurance Fund Medical Scheme, there was no change in the stock-out rate.
Abstract: Background: Financing is an important determinant of access to essential medicines. In Kenya, the National Hospital Insurance Fund Civil Servants and Disciplined Services Medical Scheme is a key contributor to financing the procurement of essential medicines. Main Objective: To compare availability and funding of essential medicines at Webuye District Hospital, Kenya before and after implementation of the new National Hospital Insurance Fund Medical Scheme. Methods: This was a longitudinal before-after study of four years (January 2010-December 2013); the latter two of which the scheme was in operation. Results: After introduction of the scheme, there was a higher allocation for the medicines budget from the Facility Improvement Fund, which hosts finances from the National Hospital Insurance Fund (p=0.008). The actual expenditure on essential medicines was also higher. Expenditure on essential medicines by the government, reduced (p<0.0001). The stock out rate decreased by 2.28% though this change was not statistically significant (p=0.099). The Facility Improvement Fund expenditure on essential medicines was a significant negative predictor of stock out rate. Conclusion: Although financing of medicines through the facility improvement fund increased after introduction of the new scheme, there was no change in the stock-out rate. Key words : financing, availability, essential medicines, insurance
6 citations
Journal Article•
TL;DR: This research presents a novel and scalable approaches that can be applied to the rapidly changing environment and provide real-time information about the response of the immune system to chemotherapy drugs.
Abstract: a Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Kenya b University of Nairobi African Institute of Biomedical Science and Technology (UoN-AiBST) Laboratory, University of Nairobi, Kenya c African Institute of Biomedical Science and Technology (AiBST), Harare, Zimbabwe _____________ * Corresponding author: Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202 KNH, Nairobi, Kenya; Tel: +254-72-2604216; Email: olukamarga@yahoo.com
6 citations
Journal Article•
TL;DR: This work partially supports the traditional antimicrobial use of the various plants in the Luo community of Kenya and is hoped that the results will form the basis for further research that could lead to isolation and/or development of antibacterial and antifungal medicines for use in primary health care.
Abstract: Background: The Luo community of Kenya rely mostly on ethno-medicine to manage human ailments. This study was set to survey, record and report the medicinal plant species they use to manage infectious conditions. Objective of this study was to screen the plants used by this community to treat microbial infections, to demonstrate their in-vitro antibacterial and antifungal activities. Methodology: Eight plants namely Lannea stuhlmanii, Carissa edulis, Combretum fragrans, Conyza sumatrensis, Ormocarpum trichocarpum, Sida cuneifolia, Plumbago zeylanica, and Rhoicissus revoilii, used by the Luo for treatment of microbial infections, were studied. Observations and semi-structured interviews were used to gather ethno-botanical data for each plant. About 3 kg of suitable specimens were harvested, with leaves pressed and preserved for identification at University of Nairobi’s Department of Botany Herbarium. Voucher specimens were also deposited at the University’s School of Pharmacy Herbarium and excess material powdered and kept dry. The pressed specimens were dried at 20 0 C to 25 0 C using plant blower. Their ethanolic extracts were screened for their antimicrobial activity against Candida albicans, Escherichia coli, Staphylococcus aureus and Bacillus pumulus . Results: Extracts from Conyza sumatrensis, C. fragrans, C. edulis, S. cuneifolia, R. revoilii and leaf C. sumatrensis had good activity against E. coli . Activity against B. pumulus was observed in all extracts except those of L. stuhlmanii bark and R. revoilii tubers. Good activity against S. aureus was observed with C. fragrans, S . cuneifolia and L. stuhlmanii . Rhoicissus revoilii, L. stuhlmanii, C. fragrans and C. edulis exhibited good antifungal activity against Candida albicans. Conclusion: This work partially supports the traditional antimicrobial use of the various plants, and it is hoped that the results will form the basis for further research that could lead to isolation and/or development of antibacterial and antifungal medicines for use in primary health care. The results also confirm that plants are a potential source of antimicrobial compounds. Key words: Luo ; Antimicrobial; Ethanolic extracts; screening
5 citations
Journal Article•
TL;DR: The incidence of stress ulcers was high and methods for prophylaxis of stress Ulcer need to be improved and histamine receptor antagonists did not seem to confer protection.
Abstract: Background: Stress ulcers develop due to extreme physiological stress among critically ill patients. Data on it management is scant in resource limited settings. Objectives: To determine the incidence, risk factors and management of stress ulcers among adult patients admitted to the Critical Care Unit of a Kenyan referral hospital, Kenyatta National Hospital. The outcome of the prophylaxis was also evaluated. Methodology: This was a retrospective cohort study among 186 critically ill adult patients admitted between January and December, 2012. The data was extracted from patient files. Logistic regression was performed to determine the risk factors for development of stress ulcers by manual forward stepwise model building. Results: Ninety percent of the patients received prophylaxis and this was done within 72 hours of admission. Twenty patients did not qualify for prophylaxis but received it. Most (76.4%) patients received prophylaxis with histamine 2 receptor blockers. The incidence of stress ulcers was 36.6% which was mainly treated with ranitidine (57.4% of cases) and omeprazole (38.8% of cases). The only diagnostic criteria were presence of the following clinical signs: epigastric tenderness (60 patients, 36.6%) and melena (3, 4.4%) and hematemesis (5, 7.4%). Mechanical ventilation of patients was the most important risk factor for stress ulcer development (adjusted OR: 43.76, 95% CI [5.067, 377.9]; followed by hospital stay for more than 7 days (adjusted OR: 11.88, 95% CI [3.923, 36.9]). Antibiotics (adjusted OR: 0.044, 95% CI [0.002, 0.936]) and benzodiazepines (adjusted OR: 0.074, 95% CI [0.013, 0.419] appeared to confer protection. Prophylaxis with histamine receptor antagonists did not seem to confer protection. Conclusion: The incidence of stress ulcers was high and methods for prophylaxis of stress ulcer need to be improved. Key words: Stress ulcers, Critical care, antibiotics, benzodiazepines, antibiotics, CNS depressants
4 citations
Journal Article•
TL;DR: This research presents a novel and scalable approaches that can be applied to the rapidly changing and rapidly changing landscape of herbal medicine and its applications in Nairobi and beyond.
Abstract: Stanley N. , Beatrice K. Amugune , Grace N. Thoithi , Julius W. Mwangi , Hannington N. Mugo a and Isaac O. Kibwage a a Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, Kenya b Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Kenya * Correspondent author: Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202 KNH, Nairobi, Kenya; Tel: +254-20-716962; Email: snndwigah@uonbi.ac.ke
4 citations
Journal Article•
TL;DR: Findings suggest that suggest that M. sericea water extracts do not penetrate the egg chorion, thus the lack of activity, and the inability of P. duboscqi to digest the chlorophyll of M.Sericea so as to release rotenone could be responsible for absence of entomocidal effect.
Abstract: Background: The sand fly, Phlebotomus duboscqi is the vector for zoonotic cutaneous leishmaniasis caused by Leishmania major . No definite control method for P. duboscqi is known. Of the plants known for entomocidal properties, Mundulea sericea is one, with the toxic principle being rotenone. Dried crude M. sericea powder extract mixed with water is used by the Giriama people of Coastal region, Kenya, to kill cat fleas and bedbugs. A recent laboratory study using M. sericea non-polar and polar extracts displayed remarkable entomicidal potential. Against this backdrop, M. sericea was chosen for this study. Objective: To evaluate water extracts of Mundulea sericea leaves for efficacy against P. duboscqi eggs and larvae. Methodology: The plant leaves were ground into fine powder and extracted using water. 1 g leaf powder was extracted using 100 ml distilled water, and then filtered. The eggs were then exposed to 1 ml of the filtered extract. Further, 0.001 g of leaf powder was mixed with 1 g of larval food and fed to larvae. The eggs were incubated at 25 0 C and 80% relative humidity and observed for eclosion, and larvae for hatching to adult stage. Results: The filtered extracts did not inhibit eggs from hatching. Additionally, all the larvae that were fed on food mixed with ground M. sericea leaves survived. Conclusion: These findings suggest that suggest that M. sericea water extracts do not penetrate the egg chorion, thus the lack of activity. Moreover, the inability of P. duboscqi to digest the chlorophyll of M. sericea so as to release rotenone could be responsible for absence of entomocidal effect. Key words: Mundulea sericea; Phlebotomus duboscqi; Leishmania major.
4 citations
Journal Article•
TL;DR: Adherence to anti-TB medication in this population of children was relatively high, and could be attributed to the structures that have been put in place to ensure that TB patients have access to treatment services at the community level.
Abstract: Background: Non-adherence to anti-tuberculosis treatment increases the risk for development of drug resistance, TB recurrence and mortality. Objectives: This study was designed to determine the rate and predictors of adherence to anti-tuberculosis treatment in paediatric TB patients. Methodology: This was a cross sectional study carried out at the Kenyatta National Hospital TB clinic. Caregivers of children were interviewed and the patients requested to provide a urine sample which was tested for the presence of isoniazid to verify adherence to medication. Results: Adherence to anti-TB medications measured by urine testing and self-report, was 91.8% and 44.9% respectively. Patients who administered medication at 24 hour intervals were more likely to adhere to medication (OR = 7.70 [1.85 - 33.33], 95% CI). There was no significant association between adherence and regimen complexity factors, relationship between health care provider and caregiver or the pattern of healthcare delivery. The results suggested a slight agreement between self-reported adherence and the isoniazid urine test (κ= 0.20). Conclusion: Adherence to anti-TB medication in this population of children was relatively high, and could be attributed to the structures that have been put in place to ensure that TB patients have access to treatment services at the community level. Keywords: Adherence, tuberculosis in children, anti-tuberculosis treatment, isoniazid
3 citations
Journal Article•
TL;DR: The plant extracts tested exhibited antifertility activity, suggesting potential alternative to the current birth control methods, and compounds such as steroids, terpenoids, alkaloids, saponins and flavonoids present in the bioactive extracts may have contributed to the anti-fertility activity.
Abstract: Background: Medicinal plants are reported in folklore to play a role as fertility control agents. Very few studies have been carried out to confirm the safety and efficacy of medicinal plants used as anti-fertility agents. Objective: To establish anti-fertility activity, safety, effect on genital organs and estrous cycle, and phytochemical profile of total extracts from Terminalia brownii , Ximenia americana , Bridelia micrantha, Rhoicissus revoilii, and Ocimum masaiense . Methodology: Extracts of water and organic solvents were administered to female mice at a dose of 800 mg/kg orally for antifertility tests and at a dose of 0 to 5000mg/kg orally for acute toxicity test. Phytochemical screening was done using thin layer chromatography. Results: The leaf water extracts of the Bridelia micrantha , Ximenia americana showed a reversible anti-fertility effect while ethyl acetate extracts of the stem bark of Terminalia brownii had an irreversible anti-fertility effect. The bioactive extracts had an effect on the estrus cycle and had different phytochemical compounds with no signs of toxicity. Discussion: The plant extracts tested exhibited antifertility activity, suggesting potential alternative to the current birth control methods. Compounds such as steroids, terpenoids, alkaloids, saponins and flavonoids present in the bioactive extracts may have contributed to the anti-fertility activity. Key words: Anti-fertility; Bridelia micrantha ; Terminalia brownii ; Ximenia Americana
3 citations
Journal Article•
TL;DR: The ethanolic extracts exhibited alterations in the indices of liver function as well as enlargement of the liver in a dose-specific manner, which could possibly be due to hepatotoxicity resulting from the metabolites of the Ficus natalensis.
Abstract: Background: Traditional healers have used medicinal plants to treat infectious diseases since time immemorial These natural products have not only played a vital role in healing, but have also contributed to the discovery of many pharmaceutically active agents Objectives: This research was aimed at assessing the effects of crude extract of Ficus natalensis on the liver Methodology: Test and control Wistar albino rats were fed on either Water or Ethanolic extract of Ficus natalensis and water-only (control) respectively and their serum harvested Biochemical analysis of liver function tests was performed and Human Diagnostic Test Kits were used to assay for the enzymes ALT (alanine aminotransferase), (AST (serum aspartate aminotransferase) and γ-GT (gamma glutamyl transpeptidase)The organ body weight ratio was also recorded Results: The cold water decoction once administered to the rats showed adverse effects leading to death of the experimental animals by day 3 The ethanolic extract results showed that there was a dose-dependent alteration in the indices of liver function as well as enlargement of the liver following feeding on the ethanolic extract of Ficus natalensis All the serum enzyme activity of ALT, AST and GGT were increased in a dose-dependent manner and the groups of animals being fed on the ethanolic extract, showed a reduction in weight Discussion: The cold water extraction might have extracted all the active ingredients including some that were toxic to the laboratory animals leading to their death The ethanolic extracts exhibited alterations in the indices of liver function as well as enlargement of the liver in a dose-specific manner All the serum enzyme activity of ALT, AST and GGT was increased in a dose-dependent manner This could possibly be due to hepatotoxicity resulting from the metabolites of the Ficus natalensis Key words: Ficus natalensis , Ethanolic extract, Liver toxicity
2 citations
Journal Article•
TL;DR: Investigation of antibacterial properties of C. rotundus root extracts against three gram-positive and two gram-negative bacteria causing respiratory tract infections showed that methanol extract was most active as comparison to other extract.
Abstract: Background: Cyperus rotundus has a long history of medicinal use in Indian Ayurvedic medicine and Chinese Traditional Medicine (CTM) including antipyretic, digestive system disorders, dysmenorrhoea and other maladies. Objectives: T he present study aimed to investigate antibacterial properties of C. rotundus root extracts against three gram-positive and two gram-negative bacteria causing respiratory tract infections. Methodology: Dried plant materials were crushed and extracted in petroleum ether, acetone, methanol and aqueous by using Soxhlet apparatus. The agar well diffusion method was adopted to examine antibacterial activity of extracts against test organisms. Phytochemical analysis was also done for the plant extracts. Results: Results showed that methanol extract was most active as comparison to other extract. The maximum inhibition was found against H. influenzae (18.4±0.07 mm) followed by S. pyogenes (17.3±0.13mm), P. aeruginosa (16.2±0.07 mm) and S. pneumoniae (15.5±0.15 mm) and minimum against S. aureus (15.3±0.05 mm) respectively. The phytochemical screening revealed the presence of alkaloids, flavonoids, glycosides, steroids, saponins and tannins in plant extracts. Conclusion: The results signify traditional values of C. rotundus in treatment of respiratory diseases which might be accountable for its antimicrobial potential. Key words: Antibacterial activity, agar well diffusion method, Cyperus rotundus , respiratory diseases
Journal Article•
TL;DR: The study shows that Momordica charantia aqueous leaf extract has dose dependent effect on both force and rate of cardiac muscle contraction, and there was significant, dose dependent, increase in the force and rates of contraction after administering the extract.
Abstract: Background: Momordica charantia is one of the most commonly used medicinal plants for both ritual and ethnomedical practices. Its use includes as an abortifacient, laxative and in the treatment of pneumonia. Despite the widespread use of its aqueous leaf extract, its pharmacological effects on the heart are not sufficiently investigated. Objectives: The main objective was to determine the effect of Momordica charantia aqueous leaf extract on the isolated mammalian heart. A secondary objective was to investigate possible effects on β adrenergic receptors of the heart. Methodology: Six healthy rabbits were included in the study. Each rabbit was sacrificed and the heart mounted on the Langerndorff apparatus. Baseline rate and force of contraction were taken, after which the aqueous leaf extract administered in increasing doses and changes in rate and force of contraction noted. The effects of the extract on the heart were similarly investigated in the presence of propranolol (a non-selective β adrenergic receptor antagonist) were also noted. Unpaired T-test and repeated measures ANOVA were used to test for statistical significance. P-values greater than < 0.05 indicated statistical significance. Results: There was significant, dose dependent, increase in the force and rate of contraction after administering the extract (P < 0.0001). However, in the presence of propranolol, the increase noted was not statistically significant. Discussion: The study shows that Momordica charantia aqueous leaf extract has dose dependent effect on both force and rate of cardiac muscle contraction. Keywords : Momordica charantia, aqueous extract, rate and force of contraction, heart.
Journal Article•
Journal Article•
TL;DR: The combination of clove and eucalyptus oils possesses synergistic activity against most of the test pathogens and therefore may be combined for enhanced antimicrobial activity against a wide range of skin disease-causing microorganisms.
Abstract: Background: The increasing proportion of skin infections encountered in general practice represents a substantial level of morbidity. The emergence of multi-drug resistant strains is a formidable threat to the fight against skin diseases and hence alternative forms of treatment are essential. Syzygium aromaticum and Eucalyptus citriodora oils as single entities have demonstrated potency against some of the concerned micro-organisms and any synergistic activity between the two oils could minimise development of resistance by the microorganisms to the two oils. Objective: The aim of this study was to evaluate for synergism between Eucalyptus citriodora and Syzygium aromaticum essential oils against selected pathogenic microorganisms of the skin. Materials and methods: Eucalyptus citriodora (eucalyptus oil) and Syzygium aromaticum (clove oil) essential oils were used in this study. In-vitro antimicrobial activities of Sysygium aromaticum and Eucalyptus citriodora oils, alone and in combination were tested against Staphylococcus aureus ATCC 25923 , Pseudomonas aeruginosa, E. coli ATCC 25922 , MRSA, Candida albicans , Trichophyton mentagrophytes, Microsporum gypseum and Cryptococcus neoformans. Results: The combination of the two oils exhibited synergistic activity against Staphylococcus aureus (FICI: 0.240), E. coli (FICI: 0.54), MRSA (FICI: 0.48), and Microsporum gypseum (FICI: 0.36) while the combination exhibited additive activity against Candida albicans (FICI: 2.04). Conclusion: The combination of clove and eucalyptus oils possesses synergistic activity against most of the test pathogens and therefore may be combined for enhanced antimicrobial activity against a wide range of skin disease-causing microorganisms. Keywords: antifungal, antibacterial, synergism, Eucalyptus citriodora , Syzygium aromaticum , essential oils
Journal Article•
TL;DR: The plant extract inhibited the growth of all the bacteria tested, suggesting the presence of antibacterial compounds in the extract, however further research needs to be done to isolate these active compounds and perform in vivo studies to investigate their mode of action, safety and dosage.
Abstract: Background : The continued emergence of drug resistant microorganisms has always been a concern to scientists and pharmaceutical companies. Plants have shown great potential in the fight against this challenge, therefore creating the need for scientist to turn in to plants to get new antimicrobial agents. Objective: The objective of the current study was to qualitatively analyze the phytochemical composition and the antibacterial activity of aqueous methanolic extracts of Indigofera arrecta leaves. Methodology: The plant samples were extracted using methanol-water solvent system. The phytochemical analysis was done using standard procedures while the bioassay study was done using well diffusion method. Results : The plant extract was found to contain all tested phytochemicals. The plant extract inhibited the growth of all the microorganisms tested. Bacillus cereus had the highest zone of inhibition while Escherichia coli was the least inhibited. Discussion : The plant extract inhibited the growth of all the bacteria tested, suggesting the presence of antibacterial compounds in the extract. However further research needs to be done to isolate these active compounds and perform in vivo studies to investigate their mode of action, safety and dosage. Key words: phytochemical, antibacterial, plant extract, Indigofera arrecta
Journal Article•
TL;DR: In this paper, a cross-sectional study was carried out targeting 400 women in their reproductive age at Kenyatta National Hospital, Nairobi, Kenya to assess the prevalence, types and level of knowledge on the correct use of hormonal contraceptives among women of reproductive age.
Abstract: Background: Contraception is the intentional use of temporary, long-term or permanent methods to prevent pregnancy. The consistent and correct use of contraceptives ensures that unintended pregnancies and pregnancy-related health risks are prevented. Objectives: To assess the prevalence, types and level of knowledge on the correct use of hormonal contraceptives among women of reproductive age at Kenyatta National Hospital. Methodology: A cross-sectional study was carried out targeting 400 women in their reproductive age at Kenyatta National Hospital, Nairobi, Kenya. Data was collected using an interviewer administered questionnaire and analyzed using SPSS version 20 into descriptive and inferential statistics. Results: The prevalence of contraceptive use was 42.8%. Contraceptive use was associated with number of children [OR 1.7 (1.3-2.1)] p<0.001. 56.1% of contraceptive users were on hormonal contraceptives. Injectable contraceptives were the most preferred followed by implants and pills. The choice of contraceptive methods was associated with age [OR 2.003 (1.330-3.017)] p=0.001 and level of education [OR 1.697 (1.135-2.539)] p=0.010. The level of knowledge on the correct use of hormonal contraceptive use was limited and was associated with the level of education [OR 1.389 (1.144-2.051)] p=0.000. Conclusion: Contraceptive use is low compared to knowledge of contraceptives. Injectable contraceptives are the most preferred hormonal contraceptives. The level of knowledge on the correct use of hormonal contraceptive is low. Key words : contraceptive use, hormonal contraceptives, knowledge, correct use
Journal Article•
TL;DR: Injectable contraceptives are the most preferred hormonal contraceptives among women of reproductive age at Kenyatta National Hospital and the level of knowledge on the correct use of hormonal contraceptive use was limited.
Abstract: Background: Contraception is the intentional use of temporary, long-term or permanent methods to prevent pregnancy. The consistent and correct use of contraceptives ensures that unintended pregnancies and pregnancy-related health risks are prevented. Objectives: To assess the prevalence, types and level of knowledge on the correct use of hormonal contraceptives among women of reproductive age at Kenyatta National Hospital. Methodology: A cross-sectional study was carried out targeting 400 women in their reproductive age at Kenyatta National Hospital, Nairobi, Kenya. Data was collected using an interviewer administered questionnaire and analyzed using SPSS version 20 into descriptive and inferential statistics. Results: The prevalence of contraceptive use was 42.8%. Contraceptive use was associated with number of children [OR 1.7 (1.3-2.1)] p<0.001. 56.1% of contraceptive users were on hormonal contraceptives. Injectable contraceptives were the most preferred followed by implants and pills. The choice of contraceptive methods was associated with age [OR 2.003 (1.330-3.017)] p=0.001 and level of education [OR 1.697 (1.135-2.539)] p=0.010. The level of knowledge on the correct use of hormonal contraceptive use was limited and was associated with the level of education [OR 1.389 (1.144-2.051)] p=0.000. Conclusion: Contraceptive use is low compared to knowledge of contraceptives. Injectable contraceptives are the most preferred hormonal contraceptives. The level of knowledge on the correct use of hormonal contraceptive is low. Key words : contraceptive use, hormonal contraceptives, knowledge, correct use
Journal Article•
TL;DR: There was a significant (P<0.05) dose depended increase in jejuna rate and force of contraction with the administration of the various extract preparations, which is dose depended and irreversible.
Abstract: Background: Momodica charantia is a highly valued herb in tropical and subtropical region for its numerous medicinal advantages. These include: management of bacterial infections and diabetes. In spite of wide consumption of its aqueous leaf extract stored and prepared in various conditions, their pharmacological activities on the jejuna are yet to be documented. The potential of differently prepared extracts having varied effects on the jejuna focused the researcher’s attention. Objectives: To demonstrate the effects of Momordica charantia aqueous leaf extract prepared and stored under various conditions on the isolated mammalian jejuna. Methodology: Six healthy rabbits were included. Each rabbit was sacrificed and the jejuna mounted on the Langerndorff apparatus. Baseline rate and force of contraction were recorded, after which each of the various aqueous leaf extract was administered in increasing doses and changes in rate and force of contraction noted. Paired T-test and repeated measures ANOVA were used to test for statistical significance. P values less than 0.05 indicated statistical significance. Results: There was a significant (P<0.05) dose depended increase in jejuna rate and force of contraction with the administration of the various extract preparations. The increase noted was highest and lowest after the administration of fresh boiled extract and fresh aqueous leaf extract respectively. Discussion: Momordica charantia aqueous leaf extract stored under different conditions have a significant (P<0.05) dose related effect on jejuna rate and force of contraction. The increase is dose depended and irreversible. Keywords: Momordica charantia , various extract, jejuna.
Journal Article•
TL;DR: In this article, the prevalence of inappropriate antibiotic dosing in patients with chronic kidney disease (CKD) in the largest referral hospital in eastern Africa was identified, and variables associated with inappropriate dosing were identified.
Abstract: Background: Reduced renal function in chronic kidney disease (CKD) necessitates appropriate dose alterations to avoid drug accumulation. Objectives : The main objective of the study was to determine the prevalence of inappropriate antibiotic dosing in patients with CKD in the largest referral hospital in eastern Africa. Variables associated with inappropriate dosing were identified. Methods : The design was a retrospective review of patients’ records. The study population was adult patients, with CKD admitted between January, 2006 and December, 2010. Data was abstracted from patient files. Logistic regression was used to determine variables associated with appropriate antibiotic dosing. Results: Ceftriaxone and amoxicillin-clavulanic acid were the most frequently prescribed antibiotics. Dose adjustment was required for 379 (59.9%) antibiotic prescriptions. Of these, 105 doses (27.7% [95% CI: 23.2 – 32.2%]) were appropriate and 274 (72.3% [95% CI 67.8 – 76.8%]) were inappropriate. The resultant dosing errors were: 271 (98.9%) and 3 (1.1%) cases of over and under dosing respectively. Key explanatory variables for appropriate dosing were: stage of renal disease (adjusted odds ratio (OR) 0.159 [95% CI: 0.082, 0.309]); administration; (adjusted OR 1.724 [95% CI:1.185, 2.508]); and treatment with amoxicillin-clavulanic acid (adjusted OR 0.101 [95% CI 0.024, 0.420]. Conclusion : Antibiotic doses in patients with CKD were often inappropriate. Keywords : Antibiotic, dose adjustment, chronic kidney disease
Journal Article•
TL;DR: A majority of trainees have limited scope on various modalities of CAM, with scant usage of online scientific resources for increasing knowledge, and the medical curriculum developers should consider these factors when instituting changes in medical education.
Abstract: Background: The substantial increase in the consumption of complementary and alternative medicine (CAM) has spawned renewed interest in assessing determinants underlying this phenomenon. The present study aimed at describing the demographic profile, knowledge and information seeking behavior of medical trainees towards CAM. Methodology : A cross sectional study was performed among medical trainees of University of Nairobi between March 2012 and May 2012. The respondents were asked to volunteer information on bio data, knowledge of various CAM modalities and sources of information using a questionnaire based tool of data collection. Descriptive data was compounded using SPSS version 17. Results: A total of 124 trainees participated in the study, representing a response rate of 83%. There were more female respondents (52%) compared with males (48%). Despite more than 75% of the respondents having heard of Pub Med and Cochrane databases, less than 47% of the respondents use them. Generally, more than 50% of the respondents were more versed with herbal, African tradition, diet, support and spirituality modalities of treatment. Conclusion : A majority of trainees have limited scope on various modalities of CAM, with scant usage of online scientific resources for increasing knowledge. The medical curriculum developers should consider these factors when instituting changes in medical education. Keywords: complementary medicine, alternative medicine, medical trainees, knowledge, behaviour
Journal Article•
TL;DR: Findings suggest that New World Leishmania may have evolved new ortholog genes to produce PGF 2 α synthase - like proteins, and may have mutated or been lost due to speciation during evolution.
Abstract: Background: Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania and spread by the bite of infected sand fly species. The disease is characterized by an increase in prostaglandin production in the host. PGF 2α is among the prostaglandins that are synthesized by Leishmania sp . Objectives: To compare the expression profiles of PGF 2α synthase-like proteins in Old and New World species of Leishmania so as to provide insight into the role of these proteins. Methodology: To detect gene expression at transcription level, polymerase chain reaction was carried out using L. major PGF 2α synthase gene specific primers and cDNA from L. major, L. donovani, L. tropica, L. amazonensis, L. braziliensis, L. mexicana and L. chagasi promastigotes. To detect expression at translation level, total protein from promastigotes of the above parasites was analyzed on a Western blot using T. brucei -specific rabbit anti-PGF 2α synthase polyclonal antibodies. Results: At the transcription level, PGF 2α synthase gene expression was detected in Old World species L. major , L. donovani and L. tropica , but was absent in the New World L. amazonensis and L. mexicana. It was expressed at low levels in the New World L. chagasi. Western blot analysis confirmed the presence of PGF 2α synthase - like proteins in Old World and not in New World species. Discussion: These findings suggest that New World Leishmania may have evolved new ortholog genes to produce PGF 2α . Alternatively, the ancestral PGF 2α synthase gene may be present in the New World species but has mutated or been lost due to speciation during evolution. Key words: Prostaglandins; PGF 2α synthase; Leishmania