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Aims: Oculomycosis is a major cause of visual impairment and blindness in the tropical regions of the world. Practitioners’ perception of the prevalence of oculomycosis and its associated risk factors could aid in the prevention of this ocular disorder. This study therefore investigated the eye care practitioner’s perception of oculomycosis in Ghana. Study Design: A cross-sectional survey. Place and Duration of Study: Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, between January and September, 2014. Methodology: A cross-sectional survey of 120 eye care practitioners in six regions of Ghana was conducted, using a structured questionnaire, to obtain information on their perception regarding the prevalence, seasonal variations and risk factors of oculomycosis. Results: Optometrists, Ophthalmic nurses, and Ophthalmologists sampled were 43.3%, 42.5% and 14.2% respectively. More than one-third (39.2%) of the respondents reported that oculomycosis was commonly encountered in clinical practice, with the majority 66 (55.0%) stating that the prevalence was higher in April to November i.e. the planting and harvesting periods in the year. The practitioners’ perception of the prevalence of oculomycosis showed strong association with their gender (P = .01), duration of practice (P = .01), profession (P = .05) and facility type (P = .03). Risk factors commonly associated with oculomycosis were trauma from vegetative matter (80%) and non-vegetative matter (50%) and the use of herbal preparations on the eye (41.7%). Conclusion: Oculomycosis is a prevalent ocular condition encountered by eye care practitioners in Ghana, especially during the rainy season. Intensification of health education on its risk factors could help minimize or prevent occurrence of this ocular condition.
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Background: Polyscias fruticosa is been used in Ghanaian folkloric medicine for the management of asthma and its related complications. Aim: This study evaluated the muco-suppressant, anti-tussive, and safety profile of an ethanolic leaf extract of Polyscias fruticosa in its use as an anti-asthmatic. Place and Duration of Study: Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, KNUST, Kumasi, Ghana and the School of Physical Sciences, University of Cape-Coast, Cape-Coast, Ghana; between December, 2013 and May, 2014. Methodology: Preliminary phytochemical screening was carried out on the extract. Ammonium chloride-induced tracheal mucus phenol red secretion in ICR mice and the suppression of citric acid-induced cough in Dunkin-Hartley guinea pigs were determined after treatment of experimental animals with 100 mg/kg sodium cromoglycate, or 20 mg/kg dihydrocodeine respectively, as well as with 100, 250, or 500 mg/kg of the extract. A 100, 250, and 500 mg/kg dose of the extract was administered daily for 28 days to groups of guinea pigs to establish a safety profile in a sub-chronic toxicity study. Results: Phytochemical screening revealed the presence of saponins and cyanogenetic glycosides, alkaloids, and sterols. The extract significantly inhibited (P ≤ .01 - 0.001) tracheal mucus phenol red secretion, and suppression of citric acid-induced cough. There were no significant changes in body weight, haematological profile, as well as liver and kidney functions in the sub-chronic toxicity study. Conclusion: The findings indicate that the ethanolic leaf extract of Polyscias fruticosa has muco-suppressant and anti-tussive properties, and is safe to use; hence a suitable adjunct/remedy for the management of asthma.
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Management of allergic conjunctivitis with conventional anti-allergic drugs usually cause the discomfort of dry eyes. This study, therefore, sought to evaluate the effect of Pistia stratiotes, a herbal remedy with anti-allergic properties, on tear secretion and tear film stability. ICR mice were grouped and treated with 5 mg/kg cetirizine, 10 mg/kg prednisolone, 100 mg/ kg leaf extract of P. stratiotes (LEPS), or 2 ml/kg normal saline per os for 7 consecutive days. With the phenol red thread test and the determination of fluorescein tear film break-up time, tear secretion and tear film stability before and after drug interventions were determined. Results recorded indicated that tear secretion and tear film stability declined significantly with cetirizine treatment (1.188 ± 0.4369 mm; P ≤ 0.05, and 2.688 ± 0.6185 s; P ≤ 0.001 respectively), while only tear secretion reduced significantly (P ≤ 0.05) in mice treated with prednisolone (0.9380 ± 0.4422 mm). Treatment with LEPS showed no significant effect (P > 0.05) on tear secretion and tear film stability (0.7050 ± 0.4236 mm, and 0.9790 ± 0.6145 s respectively); comparable to normal saline treatment. Per the findings, Pistia stratiotes does not affect tear secretion and tear film stability and hence is not likely to exhibit the adverse effect of dry eyes, as conventional anti-allergic drugs do, in the management of allergic conjunctivitis.
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Background: Morbidity and mortality resulting from malaria remains a serious obstacle for social and economic development. Accurate diagnosis and prompt treatment are therefore essential components of case management strategy. The aim of this study therefore was to examine the diagnostic procedure of uncomplicated malaria, and patients’ understanding and satisfaction of treatment in Community Health Care Facilities, three years after the deployment of Malaria Rapid Diagnostic Tests in Ghana. Methodology: A prospective and data collation was done randomly, by means of cluster and stratified multistage surveyat three government hospitals and three private pharmacies in Kumasi, Ghana, between July and September, 2013. Patients treated for uncomplicated malaria, while leaving the health facility, upon consent, were selected and requested to answer questionnaires which served as a source of data to address the objective of the study. Bivariate statistics from the SPSS v 19 was employed to predict the relationships between health institutions and mode of diagnosis, patients’ understanding and satisfaction of services. Results: Fifty-three (53) out of 65 patients responded. The study indicated presumptive diagnosis [44 (83.0%)] to be predominantly used over test-based diagnosis [9 (17.0%)]. The mean age of patients was 34.44±14.8 years (Range 17-66). Out of 52 patients who provided information on educational level, those with tertiary education were 24 (46.2%), secondary were 9 (17.3%), primary were 14 (26.9%) and no formal education were 14 (26.9%). Male patients were 25 (47.2%) and female 28 (52.8%). All 53 patients were given Artemisinin-based Combination Therapy at the various health facilities. Of 35 patients at hospitals/clinics, 15 (42.9%) rated “very good value” to explain their understanding and satisfaction of services provided, and of 18 patients from private pharmacies, 10 (55.6%) rated as “very good value”. Patients with tertiary education [14/25 (56.0%)] showed better understanding and satisfaction of services than those with no formal education [1/25 (4.0%)]. Not a single use of Malaria Rapid Diagnostic Tests for diagnosis was recorded. Conclusion: Diagnosis of malaria at the periphery of health systems is still mainly presumptive three years after deployment of the Malaria Rapid Diagnostic Test. Patients’ good rating on the diagnosis of uncomplicated malaria at private pharmacies, should be an advantage to introducing the Malaria Rapid Diagnostic Tests by healthcare practitioners.
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Aims: In much of Africa, Ghana inclusive, malaria has traditionally been diagnosed and treated presumptively: any patient with fever was presumed to have malaria and treated with antimalarial drugs. In this study, the retail pharmacies practitioners’ perspectives on the implementation of Malaria Rapid Diagnostic Tests was sought and decisions analyzed in themes, using Realist Conceptual Approach. Study Design: Cross-sectional quantitative and purposive study. Place and Duration of Study: Registered private pharmacies in Ashanti Region of Ghana, between September and November, 2013. Methodology: A structured pre-tested questionnaires (in non-study area) was selfadministered to 99 practitioners in retail pharmacies to generated information on Practitioner’s characteristics, knowledge and experience on the MRDT kits, acceptance and willingness to use the test kits and challenge towards the use of the kit, for the thematic analysis. Results: Practitioners within the age bracket of 30-40 years were highest (43%) and male representation was 67%. Pharmacists were 67% of practitioners and 17.1% had postgraduate qualification. 96.03% had ample knowledge of test kit and 0.99% use it always and logistic regression indicated no significance (Chi-square=0.751; LR=0.540 at p<0.05). Of the patients, 47.52% strongly agree to implement and 48.51 agree. 60.39% were definite to suggest to colleague and logistic regression indicated significant relation (Chi-square=0.000; LR=0.006 at p<0.05). 44.4% were very satisfied with presumptive diagnosis while 1% very dissatisfied. Conclusion: The findings indicated willingness to implement the policy but presumptive diagnosis is still the practice. The evidence provides an opportunity to adapt a conceptual framework leading to the uptake of the policy.
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Aims: To investigate the influence of patient information leaflets on Ophthalmic patients’ education and medication compliance. Study Design: Hospital-based cross- sectional survey. Place and Duration of Study: Department of Optometry, School of Physical Sciences, UCC, Cape Coast, Ghana, between September 2012 and May 2013. Methodology: A semi - structured questionnaire with sections on patient demographics, patient information leaflets impact on therapeutic education, and medication compliance, was administered to 400 ophthalmic review patients in three eye care facilities in Central Region of Ghana. Patient information leaflets (PILs) of common ophthalmic medications prescribed in these eye centers were also reviewed and assessed on their readability using the Rudolph Flesch’s readability ease calculator. Obtained data was analyzed using SPSS version 19. Pearson’s Chi-square statistical analysis was used to test for significant association between variables. Results: Of the 400 ophthalmic patients, 140 (35%) were males and 260 (65%) females The mean age was 50.2 ± 19.5. Patients had varying opinion on the purpose for the PIL: 228 (57%) thought the PIL only gives instructions on the use of the medication; 108 (27%) did not know why the PIL have been provided. The remaining 64 (16%) provided no response. There was significant association between higher educational level and reading of the leaflet (P < 0.001). The kind of ophthalmic condition one suffered had a positive influence on reading the PIL ( X2=28.594, P < 0.001). A greater proportion of the patients (88.04%) said various components of information on the leaflet were beneficial in ensuring compliance to therapy. All the PILs from the five different companies (where medication were obtained for retail) had very low readability score (0-29) except some PILs of topical analgesic drug. The low readability score indicated that the text was difficult to comprehend; the reason for which most patients did not read the leaflets. Most patients 91(99%) who read the PILs indicated that they were beneficial but were difficult to understand. Conclusion: Ophthalmic patients’ opinion on patient information leaflets was reasonably good and had a positive influence on patients’ medication compliance. It however, did not have much influence on patient education due to low readability and comprehensible.
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Aim: To assess the nephroprotective and curative effects of an aqueous seed extract of Parkia clappertoniana on gentamicin-induced renal damage (GIRD) in Sprague-Dawley rats. Study Design: Experimental Place and Duration of Study: Department of Medical Laboratory, University of Cape Coast, Ghana between September, 2012 and May 2013. Methodology: In assessing nephro protective effect, rats were pretreated (10 days) with P. clappertoniana aqueous seed extract (1-2 g kg-1; p.o) prior to induction of renal damage by treatment with gentamicin (0.08g kg-1; p.o, for 8 days. Serum biochemical markers (Creatinine, Urea, Na+ and K+) and urine parameters (leukocyte, protein, specific gravity and pH) of renal damage were determined and compared with baseline values. In a curative study, GIRD in rats was treated with Normal Saline (2 ml kg-1; p.o), Losartan (0.05 g kg-1; p.o), or extract (1-2 g kg-1; p.o) for 14 days and serum and urine parameters determined for all treatments. Histopathology and changes in kidney weights for normal and treated rats in both studies were assessed. The extract was screened for DPPH radical scavenging activity. Results: The extract significantly (P ≤ .001) reduced elevated serum creatinine and urea secondary to GIRD (P ≤ .05) and significantly (P ≤ .05) reduced elevated serum Na+ but had no effect on K+. Elevated urine proteins and leucocytes secondary to GIRD was significantly (P ≤ .05) reduced; but had no significant effect on urine pH and specific gravity. Elevated kidney weights associated with GIRD was significantly (P≤ .01) reduced. Histopathological assessment revealed healing effect by extract to GIRD. Effects of the extract were similar to Losartan. Pretreatment with extract however had no significant effect on GIRD as serum and urine parameters, as well as kidney weights were significantly (P≤ .01) elevated on induction of renal damage. Conclusion: The aqueous seed extract of Parkia clappertoniana has curative but no nephroprotective effect on gentamicin-induced renal damage in Sprague-Dawley rats.
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Aims: To establish the presence of monosodium glutamate (MSG) as an ingredient of artificial food seasonings on the Ghanaian market, and to evaluate the anti-fibroid property of an ethanolic stem bark extract of Blighia unijugata on MSG-induced uterine leiomyoma in Sprague-Dawley rats and its safety for use. Study Design: Survey and Experimental. Place and Duration of Study: Department of Pharmacology, CHS; September 2012 and May 2013. Methodology: A survey was conducted to ascertain MSG as an ingredient of Food and Drugs Board approved artificial food seasonings on the Ghanaian Market. Phytochemical screening was performed on an ethanolic, aqueous, and petroleum ether extract of B. unijugata. Thin layer and high performance liquid chromatographic analysis were performed on the ethanolic extract of B. unijugata (EBU), selected after phytochemical screening, to obtain fingerprint chromatograms for identification. Preventive and curative studies (measuring total plasma cholesterol and plasma estradiol and uterus weight) using 50 and 100 mg kg-1 EBU, per os, on 600 and 800 mg kg-1 MSG-induced uterine leiomyoma in Sprague-Dawley rats was conducted. Acute and Delayed toxicity on EBU was tested. Results: Of 21 FDB approved artificial food seasonings, 85.7% had MSG as an ingredient. MSG administration to rats elevated significantly (P ≤ .001) cholesterol, estradiol and uterus weight and size (indicating hyperplasia). Curative treatment reduced significantly (P ≤ .01-.001) the elevated plasma cholesterol and estradiol than preventive treatment. Both treatments however significantly decreased (P ≤ .01-.001) elevated uterus weight. The lethal dose was less than 1000 mg kg-1 p.o. Conclusion: MSG is found in almost all artificial food seasoning on the Ghanaian market which could be a risk factor to the development of uterine leiomyoma. The ethanolic extract of Blighia unijugata reversed hyperplasia induced in the uterus by MSG, making it useful as an anti-fibroid drug.