Showing papers in "The African Journal of Pharmacology and Therapeutics in 2016"

Patient factors impacting on oral anticoagulation therapy among adult outpatients in a Kenyan referral hospital

Abstract: Background : Patients’ factors such as knowledge on warfarin use are important in achieving desirable anticoagulation outcomes. Objective : To assess the patient factors impacting on oral anticoagulation control among adult outpatients taking warfarin at Kenyatta National Hospital. Methodology : A cross-sectional survey of 147out-patients on warfarin at Kenyatta National Hospital was carried out between March and April 2015. Data were collected using a pre-designed interviewer administered questionnaire. The data included patient characteristics such as indication and duration of anticoagulation; knowledge on anticoagulation; and international normalized ratio tests. The Oral Anticoagulation Knowledge test was used with a score of ≥75% indicating sufficient knowledge. Logistic regression was used to determine independent variables associated with anticoagulation control. Results : Females were majority (74.9%) while optimal anticoagulation control was at 43.5%. Only 10.1% had sufficient knowledge on anticoagulation. Anticoagulation knowledge scores were associated with marital status (p=0.015), education level (p=0.014) and indication (p=0.032). Independent predictors of poor anticoagulation were female gender (p=0.011) and lower education level (p=0.005). Optimal anticoagulation control was, however, not associated with knowledge on anticoagulation (p=0.794). Conclusion: Knowledge and control of anticoagulation among the patients are poor. Female gender and lower education level were predictors of poor anticoagulation. Provision of information on anticoagulation to patients on was warfarin is recommended. Key words: Knowledge, Warfarin, Anticoagulation, International normalized ratio

An assessment of antimicrobial prescribing at a tertiary hospital in north-western Nigeria

Abstract: Background: Inappropriate antibiotic use is a public health problem worldwide. Misuse of these agents is one of the drivers of antimicrobial resistance (AMR), which is believed to be the next pandemic. Consequently, auditing antimicrobial prescription patterns can provide useful information on the scope and extent of this problem. Objective: The aim of this study was to describe outpatient antimicrobial drug prescribing at the National Health Insurance Scheme (NHIS) unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methodology: This was a descriptive drug utilization study carried out prospectively during a 2 week period in May 2015. Six objective World Health Organization (WHO) indicators were used to assess the rationality of antimicrobial prescribing at the site. Data collected on antimicrobials included type, route of administration, dose and dosing frequency as well as length of therapy. Average costs (both prescription and antibiotic) were obtained by dividing the total drug costs by the relevant number of drugs. Results: A total of 167 prescriptions were analyzed. The average number of drugs per encounter in the facility was 3.7. Fifty seven percent of antimicrobials were prescribed using their generic names, while the average duration of treatment was 8.9 days. Thirty seven prescriptions (22%) contained more than one prescribed antimicrobial, out of which 7 were potentially pharmacologically antagonistic. Only 21% of the prescriptions had indications in line with the National Standard Treatment Guidelines (STG’s). Average cost of prescribed antimicrobials was about NGN 2,238 (approximately US$11). Conclusion: Several problems associated with rational antimicrobial prescribing were identified. There is a definite need for suitable interventions to help improve antimicrobial drug prescribing at the site. Keywords: Anti-infective agents, Costs, Drug use review, National Health Insurance, Nigeria

Determinants of Discontinuation of Contraceptive Methods among Women at Kenyatta National Hospital, Kenya

Abstract: Background : Contraceptive use prevalence in Kenya is at 58% according to the 2014 Kenya Demographic Health Survey. Several factors lead to discontinuation and switch of contraceptives. Discontinuation rate as per the 2008/2009 KDHS for one year was 35.8%. Objectives: To find out the determinants of discontinuation and switching of hormonal and IUD contraceptive methods. Methodology: The study was a cross-sectional hospital based one, where data was collected by use of an interviewer administered questionnaire at Kenyatta National Hospital, where 400 women were interviewed. The data was then analyzed by use of the statistical software, SPSS Version 20. Results: The study population mainly comprised married women with a mean age of 31.45±6.40 years. Most women chose a contraceptive method which they perceived had the least adverse effects. Discontinuation rate by the time of study in the study population was 60.8%, with adverse effects as the most cited reason for discontinuation. The method of contraception and presence of co-morbidity were the factors associated with discontinuation of a contraceptive. Survival analysis showed that depot injection and Jadelle® (Levonorgestrel releasing implant 75mg) had the highest median months of use and Impanon® (Etonogestrel implant 68mg) the least. Conclusion: The reasons for discontinuation of contraceptive use include primarily concerns for adverse effects, use inconvenience, desire for pregnancy, contraceptive failure, and doctor’s advice. Key words : Contraceptive discontinuation, adverse effects, duration of use

The prevalence of TEM and SHV genes among extended-spectrum beta-lactamase-producing klebsiella pneumoniae and escherichia coli

Abstract: Background : Antimicrobial resistance to cephalosporin, penicillin and aztreonam is mediated by Extended-Spectrum Beta-Lactamases (ESBL) via hydrolysis of antibiotics. The most common bacteria associated with ESBL among the Enterobacteriaceae are Escherichia coli and Klebsiella pneumonia . Pathogenic Escherichia coli is associated with diarrhoea affecting mostly elderly, children under five years and the immunocompromised. There are a number of antibiotic regimens for treatment among them cephalosporins. There is reported increase in microbial resistance to cephalosporin use and the resistance is mediated by either TEM or SHV genes. Objective: To investigate the prevalence of ESBL-producing E. coli and Klebsiella pneumonia from patients presenting with diarrhea in Machakos District Hospital, Kenya. Methods : Bacterial isolates were identified to species level by biochemical methods and tested for sensitivity to twelve different antibiotics including cephalosporins, aminoglycosides and quinolones. Those resistant to cephalosporins with a zone diameter of ≤20 mm were tested phenotypically for Extended Spectrum Beta Lactamase (ESBL) phantom development and confirmed by MicroScan. Resistant strains to cephalosporin were further tested for presence and frequency of TEM and SHV genes. Results: Out of the 200 K. pneumonia and 100 E.coli tested, 18 (6%) were positive for ESBL production phenotypically. These 18 (100 %) isolates demonstrated phantom phenomena phenotypically. Eight (4%) and 2 (1%) of the 200 K. pneumonia isolates had TEM and SHV resistant genes, respectively. There were 5 (5%) TEM and 3 (3%) SHV detected from 100 E. coli isolates. The 18 phenotypically detected and E-test-positive strains (10 Klebsiella spp. and 8 E. coli ) were retested with VITEK (GNS-532 card), and 17 of these strains (94.4%) were subsequently found to be ESBL positive. One strain (5.6%) tested ESBL negative by VITEK. The cefotaxime ESBL strip detected the presence of ESBL activity in these 18 phenotypically-positive strains. Discussion: The detection of ESBL-producing E. coli and Klebsiella isolates from Machakos District Hospital was 6%. The findings point out the need for continuous surveillance to determine prevalence of ESBL-producing Enterobacteria strains for better management of diarrheal illness. Key words: Extended spectrum Beta Lactamases; Cephalosporin resistance genes; Enterobacteriaceae

Evaluation of the management of hypertension among diabetic and non-diabetic adult outpatients at a referral hospital in Kenya

Abstract: Background: Hypertension is a common non-communicable illness that can occur either alone or in combination with diabetes and other diseases. Diabetic hypertensive patients are more vulnerable to cardiovascular and renal complications compared to non-diabetic hypertensive patients. Target blood pressures in these two patient populations are different; nevertheless, optimal blood pressure control is paramount in both groups. Objective: To evaluate the management of hypertension among diabetic and non-diabetic outpatients at the medical outpatient clinic in Kenyatta National Hospital, Nairobi, Kenya. Methodology: A tertiary hospital based cross-sectional study was carried out at the medical outpatient clinic in Kenyatta National Hospital. This study comprised of two study groups: 48 diabetic hypertensive patients and 48 non-diabetic hypertensive patients. Face to face interviews were conducted and additional data was extracted from the patient’s file. The main outcomes of interests were the BP readings that formed the dependent variable and the covariates or factors that influenced BP control that formed the independent variables in both the two arms of study. Data was analyzed using SPSS version 19.0 software. The level of significance was determined using Pearson chi square set at 0.05 and p values 2 antihypertensive drugs compared to 98% of the non-diabetic patients. Conclusion : Control of hypertension in both diabetic and non-diabetic hypertensive patients is poor. We suggest that patient involvement, patient education and continuous counseling on hypertension are essential in the overall management of hypertension. Key words: Diabetes, Hypertension, Blood Pressure

Evaluation of analgesic and behavioural effects of ethanol root bark extract of Erythrina senegalensis DC (Fabaceae)

Abstract: Background: The ethnomedicinal uses of Erythrina senegalensis including its antinociceptive and sedative properties have been documented in literature. Objective: This study evaluated the analgesic and behavioural effects of the ethanol root bark extract of E. senegalensis in mice. Methodology: Phytochemical screening and acute toxicity studies were conducted. Analgesic activity in mice was assessed using acetic acid induced writhing and hot plate method, while behavioural effects were evaluated using diazepam-induced sleeping test and hole-board test. These evaluations were carried out on E. senegalensis ethanol root bark extract at doses of 75, 150 and 300 mg/kg. Results: The intraperitoneal median lethal dose was found to be 1,137 mg/kg, while alkaloids, flavonoids, saponins, tannins and reducing sugars were found to be present in the plant material. E. senegalensis ethanol root bark extract at 150 and 300 mg/kg exhibited significant (p< 0.001) analgesic activity which offered 17.6% and 25.8% inhibition above ketoprofen in the acetic acid test respectively. At 300 mg/kg, E. senegalensis ethanol root bark extract demonstrated comparative analgesia with pentazocine in hot plate test. At the same dose, it produced a significant (p< 0.05) potentiation of diazepam-induced sleeping time. A significant increase in number of head-dips was demonstrated by E. senegalensis ethanol root bark extract at 150 mg/kg. Conclusion: The study shows that E. senegalensis ethanol root bark extract possesses analgesic, sedative and anxiolytic principles, thus supporting the ethnomedicinal rationale for its uses in management of painful conditions and sleep disturbances. Keywords: Erythrina senegalensis , analgesic, sedative, behavioural

Prevalence of Opportunistic Infections in HIV-infected adult patients at Kenyatta National Hospital, Kenya

Abstract: Background: Opportunistic Infections (OIs) constitute the first manifestation of HIV infection, indicating significant immunodeficiency. OIs remain a leading cause of morbidity and mortality in HIV-infected persons. Since most of OIs are readily treatable and preventable, every effort should be made to facilitated their management. However, there is a need to establish local prevalence of OIs and evaluate their management. This would guide in prioritizing resource and support development of suitable management strategies. Objective: The main objective of this study was to establish the prevalence of HIV-related OIs in adult patients. Methodology: A hospital-based cross-sectional study conducted between July and August 2011 at Kenyatta National Hospital –Comprehensive Care Center (KNH-CCC). Adult patients who were HIV positive and attending outpatient clinic at KNH-CCC were included. Information was collected on patients’ demographics, clinical characteristics and presence of new or active OIs. Data was analyzed using Statistical Package for social Sciences (SPSS) version 11.5. Results: The prevalence of opportunistic infections was 14.1 % (95% CI: 10.7-18.5). Overall, the most commonly reported bacterial infection was pneumonia (6.4%) whereas pulmonary tuberculosis was reported in 3.6% of patients. Significant association was found between a patients’ current OI status and WHO stage when HIV was diagnosed (AOR= 3.79 [95% CI = 1.43 – 10.03], P=0.007) and duration since HIV diagnosis (AOR 3.89 [95% CI= 1.58-9.59], P=0.003. 90% of patients were prescribed Co-trimoxazole as chemoprophylaxis agent. Conclusion: There was a high prevalence of OIs among the HIV/AIDS patients at KNH-CCC. Bacterial Pneumonia and pulmonary tuberculosis were the most commonly observed OIs. Keyword : Prevalence, Opportunistic-Infections, HIV, Patients.

Effect of Magnesium Sulphate in Mothers suffering from Toxemia of Pregnancy and their Neonates

Abstract: Background: Severe pre-eclampsia is one of the major causes of high maternal mortality rate in both developed and developing countries. The goals of management are to prevent progression to eclampsia thus preventing convulsions, to control the blood pressure and to prevent untoward effects in the foetus. The first-line option for the treatment and prevention of eclamptic seizures is magnesium sulphate. Objective: To determine the serum magnesium, urea and electrolyte levels in neonates of mothers treated with magnesium sulphate and compare the findings with the levels in non-exposed neonates. Methodology: A quasi experimental design was adopted where test s ubjects were neonates of mothers suffering from preeclampsia and severe eclampsia and were being treated with magnesium sulphate just before delivery at Pumwani Maternity hospital. The control group comprised neonates of hypertensive mothers without preeclampsia being treated using other drugs. Blood samples were obtained from the mother at onset of labor and from the neonates at birth and analyzed in the clinical chemistry laboratory of the University of Nairobi. Results : A total of 54 mothers and their neonates were enrolled with 27 in each arm of the study. The mean maternal serum magnesium in the test group was significantly higher than in the control group (p = 0.008). The mean neonatal serum magnesium in the test group was also significantly higher compared to the control group (p = 0.008). There were statistically significant differences in serum sodium (p = 0.015), urea (p = 0.043) and creatinine (p = 0.008) levels between the maternal test and control groups. There were significant differences in serum urea (p = 0.007) and chloride (p = 0.017) between the neonatal test and control groups. The calcium and potassium levels were elevated in the test group but not to significant levels. There was a positive correlation between maternal and neonatal serum magnesium levels in both groups stronger in the test group (r = 0.56, p = 0.003) as compared to the control group (r = 0.35, p = 0.087). Conclusion : Maternally administered magnesium sulphate raises urea and creatinine levels to significant levels in mothers. Calcium levels are also raised while in mothers not receiving magnesium sulphate they were slightly lower. In neonates the urea and chloride levels are elevated to significant levels while the calcium and potassium levels are not significantly elevated. We suggest monitoring of both in the immediate post-partum period. Keywords : Preeclampsia, eclampsia, magnesium sulphate, neonate, serum urea and electrolytes.

Factors that influence adequacy of asthma control in children residing in Naivasha, a flower growing area in Kenya

Abstract: Background: In Kenya, asthma affects 10% of the population. One of the modifiable risk factors contributing to asthma morbidity and mortality is environmental exposure . Naivasha flower farms introduce pesticides persistently into the environment and these may drift onto residential property or other areas where children play. Proximity of households to the pesticide treated farms may also increase exposure of children to the pesticides. Pesticide exposure has been shown to exacerbate already existing asthma, a relationship that has not been studied in Kenya. Objectives: To identify risk factors that exacerbate asthma and influence adequacy of Asthma control in children residing in a flower growing area in Kenya. Methodology: The design was a cross-sectional study that involved 150 asthmatic children aged 5-12 years residing a flower growing area. The study was conducted between May and July, 2014 in Naivasha, which is home to Kenya’s largest horticultural flower farms. Participants were interviewed using a structured questionnaire while asthma control was measured using a validated Asthma control tool. Logistic regression was done to identify variables that affected asthma control. Results: Majority of the asthmatic children were males (56.7%) while females were 43.33%. Risk factors that were found to be significantly associated with asthma control were; duration of stay in or near a flower farm (OR = 0.723, 95%CI (0.538-0.975), presence of a smoker in the family (OR = 0.463, 95%CI (0.094-22.629) and presence of household pet (OR = 4.358, 95%CI (1.182-16.057). There was no significant relationship between the child’s asthma control and age of child, sex of child, distance of school from flower, guardian’s level of education, guardian’s income, and guardian’s occupation as a flower farm worker, child’s age of diagnosis and use of indoor pesticides. Conclusion : The use of Integrated Pest Management (IPM) should be promoted as it keeps environmental exposure pesticides to a minimum. Key words: asthma, household pet, flower farm, pesticide, smoking

Gastroprotective Effects of the Aqueous Seed Extract of Entada gigas (Linn.) Fawc. and Rendle (Fabaceae) in Ulcer Models in Rats

Abstract: Background: The extract of Entada gigas Linn (Fabaceae) is used for the treatment of ulcer in Nigerian local medicine Objectives: This study investigated the gastroprotective effects of the aqueous seed extract of E gigas on gastric ulcers in rats Methodology: The ethanol- (EIU), pylorus ligation- (PLIU) and cold restraint stress (CRSIU)-induced ulcer models were used The aqueous seed extract was administered at doses of 50-400 mg/kg po Estimations of gastric content volume, pH and titratable acidity in PLIU test and ulcer score/index in all models were done Results: In the EIU test, E gigas produced significant reduction ( p < 005) in ulcer scores, with peak effect elicited at 100 mg/kg (230 ± 099; 8722% inhibition), compared with control (1080 ± 080) This effect was comparable to that of misoprostol (300 ± 131; 8333% inhibition) In the PLIU test, the extract caused significant reduction ( p < 005) in the ulcer score compared with control (630 ± 070) Peak effect was elicited at the dose of 200 mg/kg (ulcer score 290 ± 083; 6317%) This effect was comparable to that of cimetidine (260 ± 093; 6698%) Also, the extract at 50 and 200 mg/kg, and cimetidine 100 mg/kg (024 ± 007, 106 ± 022 and 102 ± 016 mL/4 h, respectively) significantly reduced ( p < 005) the volume of gastric content relative to control (232 ± 033 mL/4 h) In the CRSIU test, E gigas caused significant reduction ( p < 005) in the ulcer score, with the greatest effect produced at the dose of 50 mg/kg (080 ± 049; 9238% inhibition), relative to control (420 ± 064) This effect was comparable to that of misoprostol (140 ± 060; 80% inhibition) Conclusion: The aqueous seed extract of E gigas possess significant antiulcer activity mediated via cytoprotective and anti-secretory mechanisms Keywords: Entada gigas , Fabaceae, ulcer, gastroprotective effect, cytoprotective, anti-secretory

Antinociceptive and anti-inflammatory activities of root extract of Zea mays

Abstract: Background: Zea mays is used in Ibibio traditional medicine in Nigeria for the treatment of various ailments such as pains, malaria and hemorrhoids. Objective: To evaluate the anti-inflammatory and analgesic activities of Zea mays ethanol root root extract in mice. Methodology: The crude ethanolic extract (45 – 135 mg/kg) of Zea mays root was investigated for anti-inflammatory and analgesic activities in mice using various experimental models; acetic acid and thermal- induced pains and carrageenan, egg albumin and xylene – induced oedema. The activity of the extract was compared to that of standard drug, acetyl salicylic acid (100 mg/kg). Results: The extract caused a significant (p<0.05 – 0.001) dose-dependent reduction of inflammation and pains induced by different phlogistic agents used. These effects were comparable to that of the standard drugs, acetyl salicylic acid (100 mg/kg) used in some models. Conclusion: The anti-inflammatory and analgesic effects of this plant may in part be mediated through the chemical constituents of the plant and the results of the analgesic action suggest central and peripheral mechanisms. The findings of this work confirm the ethno medical use of this plant to treat inflammatory conditions. Key words : Zea mays, antiinflammatory, analgesic

Mother-To-Child HIV Transmission using Single, Dual and Triple ARV Prophylaxis Regimens and their Correlates in Western Kenya: Chart Review - SUPPORTING INFORMATION

Abstract: Background: It is estimated that 2.1 million individuals worldwide became newly infected with HIV in 2013, and this included 240,000 children (<15 years). Most of these children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Objective: This study sought to ascertain the different PMTCT approaches or regimens that mothers and infants receive, their Mother-To-Child Transmission of HIV (MTCT) rates and associated correlates in Western Kenya. Methods: A retrospective cohort study using prospectively collected data in Ministry of Health HIV-Exposed Infant (HEI) register from 24 health facilities. The study population was HIV-positive mothers enrolled from January 2012 to June 2013. The main outcomes were infant HIV status at 6 weeks, 9 to <18 months and 18-24 months. The correlates were maternal haemoglobin levels, WHO staging, CD4 counts, duration between enrolment and delivery, duration between enrolment and ART initiation, TB status, place of delivery, mode of delivery, and infant feeding options at 6 weeks, 9 to <18 months and 18-24 months. Proportions were analyzed using Chi-square tests while associations between MTCT correlates and outcomes were established using logistic regression. Results: 1,751 HIV mother-baby pairs were enrolled in the 24 health facilities: 78.1% received Highly Active Antiretroviral Therapy (HAART), 14.2% received Zidovudine (AZT), 1.7% received Single-dose Nevirapine (SdNVP), and 4.3% received no prophylaxis. MTCT rates were 5.5%, 7.4% and 5.6% at 6 weeks, 9 to <18 months and 18-24 months, respectively. MTCT rate at 18-24 months showed a significant difference ( p <0.001) across PMTCT regimens. Women with CD4 cells between 350 to 500 cells/mm 3 were about twice as likely to have HIV-negative babies compared to those with CD4 cells count <350cells/mm 3 . Women on TB treatment are less likely to have HIV-negative babies compared to those without TB. Exclusive breastfeeding at 6 weeks was associated with lower MTCT rates. Feeding option at 6 weeks is a strong predictor of HIV status ( p <0.001) as compared to babies on exclusive breastfeeding (EBF). Conclusion: Most of the mother-baby pairs received HAART. AZT depicted the lowest MTCT rate at 18-24 months. Higher CD4 counts, no TB signs, and EBF at 6 weeks were associated with lower MTCT rates at 18-24 months Key words : Antiretroviral prophylaxis, Mother-To-Child Transmission of HIV rates.

Antioxidant Activity of Acalypha wilkesiana var. lace-acalypha (Muell &Arg.)

Abstract: Background: The incidence of free-radicals has become a major concern in health issues such as wounds, respiratory dysfunctions, heart troubles, cancers and inflammations amongst many others. The search for natural antioxidant drug templates led to the screening of Acalypha wilkesiana var. lace- acalypha for potential antioxidant activity. Objectives of study . The crude extract, butanol fraction and four compounds previously obtained from the plant were to be screened for antioxidant activity. Methodology: The extract, butanol fraction and four compounds designated as 5A-II (3), 5B (1), 5C (2) and 5D (H-2) obtained from silica-gel column chromatography of the butanol fraction were to be screened for antioxidant activity using DPPH reagent. Results and Discussion : The extract and butanol fraction of A. wilkesiana var. lace-acalypha demonstrated marginal antioxidant activity (IC 50 ) of at 0.79 and 0.77 μg mL -1 respectively. However, 5B (1) and 5C (2) (both polyphenols) gave moderate antioxidant activities of 0.47 and 0.56 μg mL- 1 respectively which compare favourably with the IC 50 values obtained with vitamins C and A at 0.46 and 0.58 μg mL- 1 respectively. However, 5D (H-2) demonstrated a relatively similar antioxidant activity as vitamin E at 0.66 and 0.60 μg mL- 1 respectively. The antioxidant activities demonstrated by the plant extract/ fraction/compounds were not surprising because the phytochemical investigations carried out on the plant revealed the presence of terpenes and tannins which have been reported in previous studies to exhibit antioxidant activities. Conclusion: The results of the antioxidant assays have revealed that compounds isolated from the plant especially 5B (1) and 5C (2) could serve as potential antioxidant templates which could be further investigated in detailed in-vitro and in-vivo studies with the aim of improving on their activities for the fights against the destructive free-radical oxygenated species. Keywords : Free-radicals; antioxidant activity; DPPH; assay; Acalypha wilkesiana

Analysis of Ethyl succinate and Ethyl β-riboside from Acalypha wilkesiana var. golden-yellow (Muell & Arg.)

Abstract: Background : The genus, Acalypha is one of the many genera in the Euphorbiaceae family. A. wilkesiana var. golden-yellow ( Muell & Arg.) syn. A. wilkesiana var. tropical tempest is a species and variety employed in traditional medicine for the treatment of gastrointestinal disorders, inflammations, bacterial and skin fungal infections amongst many others. Before now, some biological investigations had been done but very limited chemical studies have been carried out on the plant. Objectives : This study was principally done to isolate chemical compound(s) inherent in the plant and also evaluate their antimicrobial potential. Methodology: The leaves were to extracted cold with 50% ethanol and the resultant aqueous crude extract partitioned with butanol. Isolates obtained from the silica-gel column chromatography of the butanol fraction were analysed for antimicrobial activities using the hole-in agar diffusion technique. The compounds were screened for both antibacterial and antifungal activities using the microbes namely, B. subtilis , S. aureus , E. coli , P. aeruginosa , S. typhi, V. cholerae and C. albicans. Results: Two compounds, designated as compounds W-1 [ R f ( 0.76); [n] 20 D (1.4333 )] and W-2 [ R f (0.58)] were isolated. The structures of W-1 and W-2 have been established to be 4-ethoxy-4-oxobutanoic acid (ethyl succinate) and 2-ethoxy-5(hydroxymethyl)-oxalane-3,4-diol (ethyl β-riboside) respectively using the 1 H NMR, 13 C NMR, MS and IR spectral techniques. Both compounds were inactive against B. subtilis , S. aureus and E. coli . Interestingly, W-1 and W-2 demonstrated very minimal activity against P. aeruginosa , S. typhi and V. cholerae. However, neither gave any anticandidal activity. Conclusion: The two isolates (though generally weakly active) would serve as chemotaxonomic markers for this species and variety in particular and the genus, Acalypha in general. Keywords : Ethyl succinate ; ethyl β-riboside; A. wilkesiana var. golden-yellow ( Muell & Arg.)

Acute Toxicological, Analgesic and Anti-Inflammatory Effects of Methanol Extract of Laggera aurita Linn F (Compositae) in Mice and Rats

Abstract: Background : The plant Laggera aurita is an annual or biannual plant belonging to the family Compositae that has been used for management of pain related conditions locally. It reportedly has anti-oxidant as well as antimicrobial properties. Objectives : To conduct LD 50 and phytochemical studies, evaluate the analgesic and anti-inflammatory properties of the methanol extract of L. aurita and determine possible mechanism of action. Methodology : Analgesic and anti-inflammatory properties of the extract were investigated using acetic acid induced writhing, thermally-induced pain, and formalin induced inflammation in rats and mice. Phytochemical and acute toxicological screenings were also conducted. Results : The LD 50 was found to be above 5000 mg/kg with slight changes in histological architecture observed in the kidney, liver, lungs and stomach. The extract at dose 200, 400 and 800 mg/kg significantly (p<0.05) inhibited acetic acid induced writhes in mice and increased mean reaction time in the thermal pain model, both dose dependently. The effect on thermally induced pain was blocked by naloxone, a non-specific opioid antagonist, suggesting opioid receptor involvement in analgesia. The extract also significantly (p<0.05) decreased formalin induced paw edema dose dependently. Conclusion : These findings suggest that the methanol extract of L. aurita possesses analgesic and anti-inflammatory properties that justify its ethnomedicinal use in management of pain and inflammation. Keywords : Laggera aurita , anti-inflammatory, analgesic, acute toxicity.

Antimicrobial activity of compounds isolated from the leaves of Aspilia africana (Pers.) C. D. Adams (Asteraceae)

Abstract: Background: Incidences of serious failures in the treatment of infectious disease by antibiotics caused by the emergence and spread of drug resistant strains of the microorganisms/multiple drug resistant bacteria have led to new global search for more effective anti-infective microbial agents from natural sources This study intends to examine the anti-microbial potentials of the leaves of Aspilia africana, which is employed in the treatment of wounds and sores by traditional medical practitioners in Nigeria Objective : To evaluate the anti-microbial potentials of the isolates from leaves of Aspilia africana (Pers) C D Adams (Aristeraceae), using isolated clinical strains of pathogens such as Staphylococcus aureus, Methicillin Resistant Staphylococcus aureus (MRSA), Streptococcus pyogenes, Bacillus substilis, Proteus vulgaris, Salmonella typhi, Shigella dysenteriae, Escherichia coli, Klebsiella pneumonia, Candida albicans and Candida stellafoidea Methodology: Three compounds isolated from butanol fraction of the methanol extract of the dried powdered leaves of Aspilia africana through repeated silica gel column-chromatography and sephadex gel filtration, were evaluated for anti-microbial potentials using Agar-well diffusion method Results: The isolated compounds identified as oleanolic acid, ursolic acid, and corosolic acid by 1D, 2D-NMR and FITR spectroscopic analyses inhibited the growth of all the pathogens with inhibition diameters ranging between 25 – 33 mm compared with the standard drugs used The MIC, MBC/MFC of the plant extracts ranged from between 500 and 1000 mg/mL while that of the isolated compounds ranged between 00125 and 00500mg/mL Discussion: From the results, we conclude that isolated compounds namely oleanolic acid, ursolic acid and corosolic acid are the bioactive constituents responsible for the anti-microbial activity of Aspilia africana Key words: Aspilia africana, Anti-microbial, Oleanolic acid, Ursolic acid, Corosolic acid

Molecular Surveillance of Adamantane Resistance among Human Influenza A Viruses Isolated in Four Epidemic Seasons in Kenya

Abstract: Background: Adamantanes impede influenza A virus replication and are important in the treatment and prophylaxis of disease caused by these viruses. Genotypic characterization of influenza A viruses for mutations associated with resistance to adamantanes has not been fully investigated in Kenya. Objective: To characterize susceptibility of influenza A virus subtypes that circulated in Kenya from 2008-2011 to adamantanes. Methods: Archived influenza A virus strains obtained from 2008 to 2011 were propagated in MDCK cells prior to sequencing of the matrix and hemagglutinin gene segments, followed by bioinformatics analyses. Results: Ninety two virus strains consisting of 21 A/H3N2, 18 A/H1N1 and 53 A/H1N1pdm09 were analyzed. All A/H3N2 and A/H1N1pdm09 viruses displayed resistance to adamantanes due to the S31N/S31D amino acid substitution. All A/H1N1pdm09 virus strains belonged to the N-lineage characterized by S203T amino acid substitution in the HA1. All A/H1N1 viruses were sensitive to adamantane and were characterized by K140E amino acid substitution in the HA1. Conclusion: All Kenyan influenza A/H3N2 and A/H1N1pdm09 virus strains were resistant to adamantanes while seasonal A/H1N1 strains were sensitive to these drugs. During the study period, Amantadine and Rimantadine were inappropriate for prophylaxis and treatment of influenza disease caused by A/H3N2 and A/H1N1pdm09 virus subtypes in Kenya. Key words: Kenya, influenza A/H3N2, A/H1N1pdm09, A/H1N1, adamantanes

Molecular characterization of fluoroquinolone resistance genes in isolates obtained from patients with diarrhea in Machakos District Hospital, Kenya

Abstract: Background: Diarrhea caused by Enterobacteriaceae such as Shigella species and Escherichia coli ( E. coli ) is endemic throughout the world, and is one of the most important causes of global childhood mortality and morbidity. There is a range of antibiotics that can be used for treatment among them quinolones. However, there is emerging increase in microbial resistance to quinolones use, with E. coli and Shigellae among the species of bacteria commonly associated with quinolone resistance. Objective : To investigate the prevalence of quinolone resistance genes in Shigellae and E. coli from patients presenting with diarrhea in Machakos District Hospital. Methods: Bacteria isolates were identified to species level by biochemical methods and serology and thereafter tested for 12 different antibiotics including quinolones, cephalosporins and aminoglycosides. Those resistant to quinolones with a zone diameter of ≤20 mm were tested for the presence of quinolone resistance genes using PCR. The gyr A resistance genes were further analyzed by sequencing to determine mutations within the quinolone resistance regions. Results : There were different E. coli pathotypes and Shigellae spp. They resisted more than four antibiotics: Ciprofloxacin (4%), (Chloramphenical (28%), Cotrimoxazole (78%), Co-amoxilav (70%) Erythromycin (98%) Cefotoxime (18%) and Tetracycline (56%). Mutations responsible for fluoroquinolone resistance in the gyr A, gyr B, par C, and par E genes of E. coli and Shigella spp were: gyr A (17/30, 36%) gyr B (7/30, 23.3%) topoisomerase (parC 3/30, 10%) par E (3/30, 10 %). Discussion : There is an increase in fluoroquinolone resistance in Shigellae and E.coli which points to a major challenge in current treatment strategies. In addition, detection of high resistance found to commonly used antibiotics should serve as a warning call for close surveillance and understanding of the epidemiology of the resistance. Key words: Quinolone antibiotics, resistance, Shigella , Escherichia coli

Impact of depression on adherence to antiretroviral therapy among HIV/AIDS patients at a Kenyan referral hospital

Abstract: Background: Kenya is faced with an increasing challenge of co-morbid psychological and social factors among HIV-Infected patients which has had a profound impact on their medication adherence. A major psychosocial factor that is a barrier in adherence is depression associated with HIV. This study aimed at measuring the effect of depression on participants’ own reported adherence to antiretroviral therapy. Objectives: To determine the impact depression has had on adherence to antiretroviral therapy among HIV-infected patients at a Kenyatta Hospital. Methodology: A cross-sectional study design was carried out at Kenyatta National Hospital, Nairobi, Kenya. Three hundred and eighty four (384) HIV infected participants were assessed for HIV related depression and adherence to ART. Levels of HIV related depression and adherence to ART were ascertained. Results: The prevalence of depression was 23.3 %. The prevalence of mild, moderate and severe depression was 21.2 %, 1.8 % and 0.3 % respectively. The mean non adherence and average mean adherence rate were 27.9 % and 22.4 % respectively. Conclusion: There was a minimal relationship between depression and non-adherence to antiretroviral therapy among adult HIV infected patients. Depression was not statistically significantly associated with adherence to antiretroviral therapy. Key words: Depression, adherence, antiretroviral therapy

Performance of selected HIV testing centers in a HIV Proficiency Testing Scheme in Kenya: a case study

Abstract: Background: The Proficiency Testing (PT) for Human Immunodeficiency Virus (HIV) using Lateral flow assays provides an avenue for participating institutions/individuals to assess their technical competence in testing for HIV using LFAs that are recommended in the National HIV Testing Algorithm (NHTA) in Kenya. It also provides confidence to the participating institutions and potential users of their services besides giving the institutions an opportunity for improvement. Objective: To determine the performance of selected HIV testing centers in a HIV PT Scheme in Kenya Methods: Fifty one participants (51) in Kenya were selected from 7 sites (Kisumu, Mombasa, Kilifi, Nairobi and Malindi) to participate in this PT round. The sites comprised both private sector and institutions that do not participate in the National HIV referral Lab-PT scheme. They were provided with panels containing six samples to analyze using the current NHTA in Kenya. Obtained results were sent to our laboratory electronically. Results: Eighty nine percent (89.0%) of the panels were correctly identified by the participants as positive or negative. Of the 11.0% errors, 74.2% were committed in one or more test result obtained while 12.9% committed in failure to follow NHTA. Two minor errors repeated by participants were; failure to record the final results in spite of obtaining correct tests and correct reactive results with the first and second test kits but in conclusion the participant recorded negative (12.9%). Root cause analysis revealed that the error committed by participants were as a result of failure to observe the kit manufactures’ instructions and NHTA guidelines. Conclusion: The results of this PT Scheme enhance the need for constant training of personnel conducting HIV testing and Counseling in Kenya on proper techniques of carrying out HIV testing using Lateral flow assays in the NHTA. Key words : HIV, Proficiency Testing, errors, false negative, false positive.

Serotype Diversity of Respiratory Human Adenoviruses amongst Pediatric Patients from Western Kenya, 2010-2012

Abstract: Background: Respiratory illnesses are common among pediatric patients in Kenya, and many are attributed to viral causes. However, there is limited knowledge of the diversity of viral etiologies associated with these illnesses. Objective: To characterize respiratory adenoviruses isolates using serological and molecular approaches. Methods: A total of 1,879 samples were collected from symptomatic pediatric patients seeking medical care at New Nyanza Provincial General Hospital during the period of June 2010 to June 2012 and screened for adenoviruses as well as other respiratory viruses. Sixteen respiratory human adenoviruses (HAdVs) were isolated in Hep2 cell culture and characterized them using Immunofluorescence Assay, viral DNA amplification, sequencing and phylogenomics. Results: Phylogenetic characterization of the HAdVs using the hyper variable region 7 of the hexon gene identified HAdV B and C as the major species associated with respiratory infections during the study period. Amongst these, a single B-type and four C-type serotypes were identified. The serotype distribution consisted of 31% HAdV B7, 25% HAdV C1, 25% HAdV C2, 6% HAdV C5, and 13% HAdV C6. Positive selection was observed in the nucleotide sequences from HAdV B7 and HAdV C5 signaling evolution of these two serotypes. Conclusion: These finding may be useful to policy makers regarding appropriate strain selection for vaccination in Kenya. Keywords: Respiratory Human adenovirus, Kenya, Pediatric, Serotype, Hexon, HVR-7

Antimalarial and analgesic activities of root extract of Panicum maximum

Abstract: Background: Panicum maximum is used as malarial remedy traditionally and the leaf extract has been found to possess antimalarial, analgesic and anticancer properties. Objective: The ethanol root extract of Panicum maximum were evaluated for antiplasmodial and analgesic activities in rodents. Method s : The crude root extract (137 – 547mg/kg) of Panicum maximum were investigated for antiplasmodial activity against chloroquine sensitive Plasmodium berghei infections in mice. The antiplasmodial activity during early and established infections as well as prophylactic were investigated. Artesunate 5mg/kg and pyrimethamine 1.2mg/kg were used as positive controls. Analgesic activity of the crude extract/fractions was also evaluated against acetic acid, formalin and heat-induced pains. Results: The extract dose-dependently reduced parasitaemia induced by chloroquine sensitive Plasmodium berghei infection in prophylactic, suppressive and curative models in mice. These reductions were statistically significant (p<0.001). They also improved the mean survival time (MST) from 13 to 28 days relative to control (p<0.001). The activity of extract was weak compared to that of the standard drugs used (artesunate and pyrimethamine). On chemically and thermally- induced pains, the extract inhibited acetic acid and formalin-induced inflammation as well as hot plate-induced pain in mice. These inhibitions were statistically significant (p<0.001) and in a dose-dependent fashion. Conclusion: Panicum maximum root extract has antiplasmodial and analgesic activities which may in part be mediated through the chemical constituents of the plant. Key words: Panicum maximum , analgesic, antimalarial

Synergistic antiplasmodial activity of artemisia annua fractions against in vitro cultures of plasmodium falciparum

Abstract: Background : Artemisia annua has a very rich phytochemistry comprising several classes of compounds, mainly monoterpenes, sesquiterpenes, and flavonoids. It has been used in China for about 2000 years in the treatment of fever. Objective: The aim was to determine if there is any synergistic effect on the Artemisia annua phytochemicals. Materials and methods: Artemisia annua used in this study was obtained from a hybrid of the plant grown in the Tanzania highlands (2000-2200 m altitude) in Arusha by Natural Uwemba System for Health (N.U.S.Ag). The dried leaves were ground, and sequentially extracted with hexane, dichloromethane (DCM), methanol and water and the extracts were then combined. The extract was then fractionated using high performance liquid chromatography (HPLC). The effect of the combined crude extract was tested at different doses on in-vitro cultures (a CQ sensitive isolate D6 and CQ resistant isolate W2) of Plasmodium falciparum . The fractions and different blends of these were tested at different doses to determine their role, if any, on the activity of the full blend of the plant. Results: Of nine fractions thus tested against D6 and W2, four had activities of less than 3.9µg /ml, three fractions had activities of between 4.77 - 14.76 µg/ml and the remaining two had activities above 250g/µml. The seven more active fractions were re-evaluated in a subtractive bioassay procedure, in which one of each fraction was excluded at a time from the full 7-component blend. The activity of the combined seven active compounds was 10.40 + 0.50 µg/ml against W2. Of these, one showed IC 50 of less than 3.9 µg/ml and all blends showed IC 50 at below 27µg/ml. Conclusion: The results show that different components of A. annua contribute to the synergistic anti- Plasmodium activity. The results constitute a useful basis for identifying the components of the plant other than artemisinin that contribute to the activity of herb. Key words - Artemisia annua , malaria, Plasmodium falciparum , artemisinin, synergy.

Treatment of chronic heart failure in adults at a referral hospital in Kenya: adverse drug reactions and determinants of adherence

Abstract: Background : Chronic Heart Failure is a major health problem with a prevalence of between 1 and 12% in USA and Europe, and approximately 5.7% in Sub-Saharan Africa, and has socio-economic relevance owing to its high prevalence, mortality and impact on young economically active individuals. In 1999 chronic heart failure constituted 3.3% of all medical admissions at Kenyatta National Hospital. Objective: The purpose of the current study was to determine factors that affect adherence to treatment among patients with Chronic Heart Failure at Kenyatta National Hospital and assess any association between any such factors Methodology: This was a descriptive cross-sectional study involving patients >18 years diagnosed with Chronic Heart Failure at Kenyatta National Hospital. Eighty three eligible and consenting study participants were recruited into the study using a convenient sampling technique. Data were collected by means of an interviewer administered questionnaire adapted from the Revised HF Adherence Questionnaire. Results: Data from 83 patients was analyzed majority (n=51, 61.4%) of whom were women. The age of the patients ranged from 18 to 80 years with the majority (n= 37, 44.6%), between 21-40 years. Majority (n=58, 68.9%) of the patients considered appointment keeping, compliance to medication (n= 64, 77.1%), dietary restriction (n=59, 72%), regular exercise (n=49 59.0%), smoking cessation (n=59, 71%), and alcohol cessation (n=58, 69.9%) as very important. Fifty three (63.9%) respondents had not failed to take their medicines at any time. Majority (n=72, 86.8%) of the study participants were aware of the disease condition they were suffering from while valvular heart disease was the commonest comorbidity (n= 17 27.9%). The study revealed an association between sex and some adverse drug reactions using Pearson χ² test through bivariate analysis. Sleep disturbances and nausea occurred more in males than females while headache and drowsiness were more prevalent in females and in both cases the relationships were statistically significant (p< 0.05) Conclusions: Adherence to medicines among patients with Chronic Heart Failure is reasonably high at Kenyatta National Hospital despite patients’ knowledge level about the condition being generally low. Valvular heart disease was the most common comorbidity while hyponatremia was the most prevalent electrolyte disturbance, and tachycardia, vomiting and rash the most common adverse drug effects. Key words Chronic heart failure; adherence; compliance; adverse drug reactions.

Antimalarial activities of crude stembark fractions of Cylicodiscus gabunensis

Abstract: Background: Malaria is one of the greatest health challenges worldwide threatening millions of people especially children in sub Saharan Africa. Cylicodiscus gabunensis (Taub.) Harms (Mimosaceae) is a tree plant of Tropical Africa used in traditional medicine for the treatment of malaria and other diseases. Objective: The objective of this work was to evaluate the antimalarial activities of Cylicodiscus gabunensis stembark fractions to ascertain the folkloric claim of its antimalarial activity. Methodology: The stembark fractions of Cylicodiscus gabunensis (n-hexane, dichloromethane, ethyl acetate and methanol; 40 mg/kg) of C. gabunensis were investigated for antimalarial activities against chloroquine-sensitive Plasmodium berghei infections in Swiss albino mice. Chloroquine (5 mg/kg) and pyrimethamine (1.2 mg/kg) were used as positive controls. Thin films made from tail blood of each mouse were used to assess the level of parasitaemia. Results : The fractions significantly (p<0.01-0.001) reduced parasitaemia in suppressive, prophylactic and curative antimalarial mouse models with the chloroform and ethyl acetate fractions exerting the most significant activities (p<0.05-0.01) than other fractions. The mean survival time (MST) was significantly (p<0.01-0.001) improved to 20.0 days compared to control (10.00 days). Conclusion: The results indicate that chloroform and ethyl acetate fractions of C. gabunenesis stembark are the most potent antimalarial fractions with active antimalarial compounds that can be use as lead to the development of new antimalarial drug. Keyword: Antiplasmodial, Cylicodiscus gabunensis , medicinal plant, ethnomedicine

Isolation and Characterization of Antichloramphenicol Antibodies using SDS Page

Abstract: Background: Antichloramphenicol antibodies can be produced in small or large animals depending on the requirement of the researcher. Previously most researchers have raised antibodies in small animals such as rabbits due to their easy availability and handling. In the present study antichloramphenicol antibodies were produced in large animals because large volumes of serum was needed for various studies. Objective: The objective of the present study was to isolate and characterize antichloramphenicol antibodies produced in camels, donkeys and goats for development of a CAP Enzyme Linked Immunosorbent Assay. Methods: The methods employed were SDS-PAGE electrophoresis which involved the analysis of crude and purified goat, camel and donkey antichloramphenicol antibodies. Purification of the antichloramphenicol antibodies was carried out by precipitation using ammonium sulphate. Immunization of experimental animals was carried out using standard immunological methods. Results: The results indicated that the crude anti-CAP antibody produced in camels, goats and donkeys showed 7 protein bands of molecular sizes 11.7, 40, 61.6, 134.3, 145, 169.5 and 182 kda. However the protein band of molecular weight 11.7 kda was not observed in the purified antibody from the 3 animal species. The protein bands of the camel appeared smaller and were more distinct as compared to those of donkeys and goats. Conclusion: From this study it was concluded that purified camel antibodies are smaller and more specific followed closely by goat antibodies and donkey antibodies. Keywords: anti-chloramphenicol (CAP) antibodies, camels, goats and donkeys

Mother-To-Child HIV Transmission using Single, Dual and Triple ARV Prophylaxis Regimens and their Correlates in Western Kenya: Chart Review

Abstract: Background: It is estimated that 2.1 million individuals worldwide became newly infected with HIV in 2013, and this included 240,000 children (<15 years). Most of these children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Objective: This study sought to ascertain the different PMTCT approaches or regimens that mothers and infants receive, their Mother-To-Child Transmission of HIV (MTCT) rates and associated correlates in Western Kenya. Methods: A retrospective cohort study using prospectively collected data in Ministry of Health HIV-Exposed Infant (HEI) register from 24 health facilities. The study population was HIV-positive mothers enrolled from January 2012 to June 2013. The main outcomes were infant HIV status at 6 weeks, 9 to <18 months and 18-24 months. The correlates were maternal haemoglobin levels, WHO staging, CD4 counts, duration between enrolment and delivery, duration between enrolment and ART initiation, TB status, place of delivery, mode of delivery, and infant feeding options at 6 weeks, 9 to <18 months and 18-24 months. Proportions were analyzed using Chi-square tests while associations between MTCT correlates and outcomes were established using logistic regression. Results: 1,751 HIV mother-baby pairs were enrolled in the 24 health facilities: 78.1% received Highly Active Antiretroviral Therapy (HAART), 14.2% received Zidovudine (AZT), 1.7% received Single-dose Nevirapine (SdNVP), and 4.3% received no prophylaxis. MTCT rates were 5.5%, 7.4% and 5.6% at 6 weeks, 9 to <18 months and 18-24 months, respectively. MTCT rate at 18-24 months showed a significant difference ( p <0.001) across PMTCT regimens. Women with CD4 cells between 350 to 500 cells/mm 3 were about twice as likely to have HIV-negative babies compared to those with CD4 cells count <350cells/mm 3 . Women on TB treatment are less likely to have HIV-negative babies compared to those without TB. Exclusive breastfeeding at 6 weeks was associated with lower MTCT rates. Feeding option at 6 weeks is a strong predictor of HIV status ( p <0.001) as compared to babies on exclusive breastfeeding (EBF). Conclusion: Most of the mother-baby pairs received HAART. AZT depicted the lowest MTCT rate at 18-24 months. Higher CD4 counts, no TB signs, and EBF at 6 weeks were associated with lower MTCT rates at 18-24 months Key words : Antiretroviral prophylaxis, Mother-To-Child Transmission of HIV rates.

Performance of methylcellulose and Avicel overlays in plaque and focus assays of Chikungunya virus

Abstract: Background: Chikungunya virus is a re-emerging pathogen that is responsible for Chikungunya fever periodic outbreaks along the Kenyan coast and in other African countries. Epidemiological data from the World Health Organization show that in 2014-2015, there was a major outbreak of Chikungunya fever in the Americas and Pacific Islands. Surveillance and correct diagnosis are therefore key in controlling the spread and management of the disease. Plaque and focus assays are key techniques in viral characterization or quantification, and both assays typically require overlay with gelling polymers to limit the spread of viruses in cell culture. There are anecdotal reports that Avicel may be superior to methylcellulose in assay of Influenza virus. However, it is unclear whether this would apply to other viruses. Objective: The objective of this study was to determine the performance of methylcellulose and Avicel overlays in plaque and focus assays of Chikungunya virus. Methods: Confluent Vero cells were seeded in 6- or 96-well plates for plaque and focus assays respectively. Cells were inoculated with serially diluted Chikungunya virus, and incubated to allow adherence of the virus to the cells. The inoculum was removed; replaced with Avicel or methylcellulose overlay at various concentrations and stained with crystal violet or immunostained. Statistical significance was computed using the Holm-Sidak test. Results: The size of plaques formed by Chikungunya virus was dependent on the concentration of both Avicel and methylcellulose gels used as overlays, with Avicel overlays giving consistently larger plaques than methylcellulose. Chikungunya virus formed plaques nearly 2.5 times larger in diameter (2 vs 0.8 mm) with 1.2 % Avicel than with 1.25 % methylcellulose after 60 hr growth. Plaques formed with Avicel were better defined and easier to count after 48 hr growth period compared to a 60 hr period. However, methycellulose overlays provided smaller, more distinct and better defined foci in focus assays. Conclusion: Both methylcellulose and Avicel are good overlay media for viral assays. Avicel is marginally better for plaque assays while methylcellulose provides more distinct and easier to count foci in focus assays. Key words: Chikungunya virus, plaque assay, focus assay, methylcellulose, Avicel

The safety of Kigelia africana on pregnancy and pregnancy outcomes in Sprague-Dawley rats

Abstract: Background: Kigelia africana , belongs to the family of Bignoniaceae . It has been used commonly in folk medicine to energise and improve fertility in both males and females. Decoctions of Kigelia africana are taken as abortifacients. Therefore, there is need to scientifically substantiate and validate these claims. Objective: This study was carried out to determine the effect of Kigelia africana on pregnancy and pregnancy outcomes in Sprague-Dawley rats. Methodology: Twenty female adult Sprague-Dawley rats divided into 4 groups (N=5) were used. Rats were mated on proestrus with males of proven fertility. Spermatocytes in the vaginal smear confirmed pregnancy. Kigelia africana was given at 100, 300 and 500 mg/kg bodyweight daily from the 1 st to 20 th day of pregnancy while control rats received distilled water. Rats were anaesthetized with ketamine on day 20 of pregnancy and a ventral laparotomy was performed. Foetuses were removed and parameters taken. The uterus was excised and assayed for antioxidant activities of superoxide dismutase, catalase and malondialdehyde, an index of lipid peroxidation. Result: Significant increases were observed in crown-rump length, tail length and litter size. Superoxide dismutase activities increased significantly while significant reductions were recorded in malondialdehyde levels. In addition, uterine weights increased in the treated groups compared with the control. Conclusion: Kigelia africana is uterothrophic and is safe with no deleterious effect on pregnancy and the foetuses in Sprague-Dawley rats. Keywords: Kigelia africana, pregnancy, malondialdehyde, catalase, superoxide dismutase.

Evaluation of the anticonvulsant activity of aqueous leaf extract of Emilia praetermissa Milne-Redh (Asteraceae) in rats and mice

Abstract: Background: Emilia praetermissa has been used for the treatment of convulsive disorders in children by herbalists in Eastern Nigeria. It is also used for the treatment of ulcers, fever, splenomegaly, filarial infections, bacterial infections and ringworms. Objective: This objective was to investigate the inhibitory property of the aqueous leaf extract of E. praetermissa (AEP) against electrically and chemically induced convulsions in rats and mice. Methodology: Groups of rats were administered 5, 10 and 20 mg/kg aqueous leaf extract of E. praetermissa and after one hour they were subjected to maximal electroshock. Groups of mice treated with same doses of the extract were subjected to chemically-induced convulsion using pentylentetrazol or strychnine. Phenobarbitone (30 mg/kg) and/or diazepam (0.5 mg/kg) were used as standards. Comparisons were made by use of Student’s t -test. All data were analyzed using GraphPad Instat software (USA). P < 0.05 indicated statistically significant difference. Results: The doses of aqueous leaf extract of E. praetermissa significantly ( P < 0.05) reduced the extensor seizure latency in maximal electroshock model, and onset of tonic convulsion in the chemical models. Aqueous leaf extract of E. praetermissa (20mg/kg; P < 0.007) was significantly superior to diazepam (0.5 mg/kg; P < 0.04) in reducing the onset of strychnine-induced seizure. Conclusion: These results suggest that the ethnomedicinal application of E. praetermissa in Eastern Nigeria has scientific basis that requires further investigation. Key words: Emilia praetermissa, aqueous extract, anticonvulsant activity.