Efficacy of Albizia malacophylla (A.Rich.) Walp. (Leguminosae) methanol (80%) leaf extract and solvent fractions against Plasmodium berghei-induced malaria in mice model.

ETHNOPHARMACOLOGICAL RELEVANCE: Novel drugs are needed to address the issue of malarial infection resistance; natural items can be a different source of these medications. Albizia malacophylla (A. Rich.) Walp. (Leguminosae) is listed as one of the antimalarial medicinal plants in Ethiopian folk medicine. However, there are no reports regarding the biological activity or phytochemistry of the plant. AIM OF THE STUDY: Thus, this study aimed to evaluate the A. malacophylla crude extract and solvent fractions' in vivo antimalarial activity utilizing 4-day suppressive, preventative, and curative tests in mice infected with P. berghei. MATERIALS AND METHODS: The parasite Plasmodium berghei, which causes rodent malaria, was used to infect healthy male Swiss Albino mice, weighing 23-28 g and aged 6-8 weeks. Solvent fractions such as methanol, water, and chloroform were given in addition to an 80% methanolic extract at 100, 200, and 400 mg/kg doses. A Conventional test such as parasitemia, survival time, body weight, temperature, and packed cell capacity were employed to ascertain factors such as the suppressive, curative, and preventive tests. RESULTS: Every test substance dramatically reduced the number of parasites in every experiment. Crude extract (with the highest percentage suppression of 67.78%) performs better antimalarial effect than the methanol fraction, which is the most efficient solvent fraction with a percentage suppression of 55.74%. With a suppression value of 64.83% parasitemia level, the therapeutic effects of 80% methanolic crude extract were greater than its curative and preventative effects in a four-day suppressive test. The survival period (17 days) was longer with the hydroalcoholic crude extract dose of 400 mg/kg than with other doses of the materials under investigation. CONCLUSIONS: The results of this investigation validate the antimalarial characteristics of A. malacophylla leaf extract. The crude extract prevented weight loss, a decline in temperature, and a reduction in PCV. The results demonstrate that the plant has a promising antimalarial effect against P. berghei, hence supporting the traditional use of the plant. Therefore, it could serve as a foundation for the development of new antimalarial drugs.

Sustained release local anesthetics for pain management: relevance and formulation approaches.

This review attempted to ascertain the rationale for the formulation of sustained-release local anesthetics and summarize the various formulation approaches designed to date to achieve sustained and localized local analgesic effects. The incidence of pain, which is the concern of patients as well as health care professionals, is increasing due to accidents, surgical procedures, and other diseases. Local anesthetics can be used for the management of moderate to severe acute and chronic pain. They also allow regional analgesia, in situations where the cause and source of the pain are limited to a particular site or region, without the need for loss of consciousness or systemic administration of other analgesics thereby decreasing the risk of potential toxicities. Though they have an interesting antipain efficacy, the short duration of action of local anesthetics makes the need for their multiple injections or opioid adjuvants mandatory. To overcome this problem, different formulations are being designed that help achieve prolonged analgesia with a single dose of administration. Combination with adjuvants, liposomal formulations, lipid-based nanoparticles, thermo-responsive nanogels, microspheres, microcapsules, complexation with multivalent counterions and HP-ß-CD, lipid-based nanoparticles, and bio-adhesive films, and polymeric matrices are among the approaches. Further safety studies are required to ensure the safe and effective utilization of sustained-release local anesthetics. Moreover, the release kinetics of the various formulations should be adequately established.

Antinociceptive and antiinflammatory activities of crude leave extract and solvent fractions of Commelina latifolia Hochst. ex C.B.Clarke (Commelinaceae) leaves in murine model.

Ethnopharmacological relevance: In the past, Ethiopian traditional medicine employed the leaves of the native Commelina latifolia Hochst. ex C.B. Clarke plant to treat wounds, pain, and malaria. Aim of the study: The crude extract and solvent fractions of C. latifolia Hochst. ex C.B. Clarke leaves were examined in the present investigation to determine their ability to have an antiinflammatory effect and provide an antinociceptive effect in animal models. Materials and methods: The leaves of C. latifolia were extracted with 80% methanol, and the CL crude extract was further fractionated with chloroform, pure methanol, and distilled water. The carrageenan-induced paw edema model was used to test the extracts' ability to reduce inflammation. The hotplate model and the acetic acid-induced writhing test on rodents were used to test the extracts' potential antinociceptive effect to reduce pain. Results: Inflammation was decreased by 64.59% with CL crude extract (400 mg/kg); 56.34% (400 mg/kg) of methanol fraction, 64.59% of aqueous fraction (400 mg/kg), and 38.27% of chloroform fraction in the carrageenan-induced inflammatory model. All extracts demonstrated a considerable lengthening of the nociception reaction time in the hot plate test, with a maximum antinociceptive effect of 78.98% (crude extract) and 71.65% (solvent fractions). At a dosage of 400 mg/kg, the natural C. latifolia crude extract and aqueous fraction demonstrated considerable antinociceptive effects against acetylsalicylic acid (ASA) during the writhing test (48.83% and 45.37than%, respectively). The current findings support Ethiopia's traditional user's assertions that the herb can alleviate inflammation and pain.

Acute coronary syndrome and its treatment outcomes in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Acute coronary syndrome (ACS) is the principal cause of death in developing countries including Ethiopia. No study reports the overall patterns of risk factors and burden of in-hospital mortality in Ethiopia. This study, therefore, aimed to assess the magnitude of risk factors, management, and in-hospital mortality of ACS in Ethiopia. METHODS: Electronic searching of articles was conducted using PubMed, Science Direct, EMBASE, Scopus, Hinari, and Google Scholar to access articles conducted in Ethiopia. The Preferred Reporting Items for Systematic Reviews checklist was used for identification, eligibility screening, and selection of articles. Data were extracted with an abstraction form prepared with Microsoft Excel and exported to STATA for analysis. Funnel plot, Begg's test, and Egger's test were used to determine publication bias. Heterogeneity between the studies was checked by I2 statistic. The pooled prevalence of risk factors and in-hospital mortality of ACS were estimated using a random-effects meta-analysis model. RESULTS: Most (59.367%) of the patients had ST-segment elevation myocardial infarction (STEMI). Hypertension (54.814%) was the leading risk factor for ACS followed by diabetes mellitus (38.549%). Aspirin (56.903%) and clopidogrel (55.266%) were most frequently used in patients with STEMI ACS, respectively. The pooled proportion of in-hospital mortality of ACS was 14.82% which was higher in patients with STEMI (16.116%). CONCLUSION: The rate of in-hospital mortality is still high which was higher in patients with STEMI. Initiation of treatment must consider the heterogeneity of each patient's risk factor and reperfusion therapy should be implemented in our setting.

Systematic Review of Safety of RTS,S with AS01 and AS02 Adjuvant Systems Using Data from Randomized Controlled Trials in Infants, Children, and Adults.

Background: Emergence of antimalarial drugs and insecticides resistance alarms scientists to develop a safe and effective malaria vaccine. A pre-erythrocytic malaria vaccine called RTS,S has made great strides. Aim: The review was aimed to assess the safety of the candidate malaria vaccine RTS,S with AS01 and AS02 adjuvants using data from Phase I-III randomized controlled clinical trials (RCTs). Methods: This systematic review was conducted based on PRISMA 2020. Regardless of time of publication year, all articles related with safety of RTS,S, RCTs published in the English language were included in the study. The last search of databases, and registry was conducted on 30 May, 2022. Pubmed, Google Scholar, Cochrane Library, Wiley Online Library, and Clinical trials.gov were thoroughly searched for accessible RCTs on the safety of RTS,S malaria vaccine. The studies were screened in three steps: duplicate removal, title and abstract screening, and full-text review. The included studies' bias risk was assessed using the Cochrane risk of bias tool for RCTs. This systematic review is registered at Prospero (registration number: CRD42021285888). The qualitative descriptive findings from the included published studies were reported stratified by clinical trial phases. Findings: A total of thirty-five eligible safety studies were identified. Injection site pain and swelling, febrile convulsion, fever, headache, meningitis, fatigue, gastroenteritis, myalgia, pneumonia, reactogenicity, and anemia were the most commonly reported adverse events. Despite few clinical trials reported serious adverse events, none of them were related to vaccination. Conclusion: Most of the adverse events observed from RTS,S/AS01 and RTS,S/AS02 malaria vaccines were reported in the control group and shared by other vaccines. Hence, the authors concluded that both RTS,S/AS01 and RTS,S/AS02 malaria vaccines are safe.

Magnitude of anemia and associated factors among adult patients at Baso Liben District: a cross-sectional study.

BACKGROUND: Despite the fact that anemia is a common health problem with many consequences, its magnitude among adults and the different contributing factors have not been documented in the study setting. Hence, this study aimed to determine the magnitude of anemia and associated factors among adult patients of Baso Liben District. METHODS: A facility-based cross-sectional study was conducted from 1 December 2019, to February 30, 2020. A total of 347 adult patients attending Yejubie Hospital were enrolled in the study. Socio-demographic data were collected through face-to-face interview. Patients' hemoglobin level was determined by a Mindray BC-5800 CBC hematology analyzer. The presence of intestinal parasites and malaria infection were assessed. RESULTS: The overall magnitude of anemia was 25.94% with moderate severity according to the WHO anemia classification. The prevalence of mild, moderate, and severe anemia was 13.54%, 8.36%, and 4.03%, respectively. Anemia was associated with age range ≥55 years (AOR = 31.66), large family size (AOR = 6.62), being married (AOR = 0.24), intestinal parasite infections (AOR = 4.05), malaria infection (AOR = 4.61), and pregnancy (AOR = 4.09). CONCLUSION: The prevalence of anemia was moderate. Intestinal parasitic infection, age, malaria, family size, and pregnancy were associated factors with anemia.

Antimalarial activity of the hydroalcoholic crude extract and solvent fractions of Commelina latifolia Hochst. ex C.B.Clarke (Commelinaceae) leaves against Plasmodium berghei in mice.

Ethnopharmacological relevance: In Ethiopia, the indigenous medicinal plant Commelina latifolia Hochst. ex C.B. Clarke leaves are used to treat malaria and wounds. Aim of the study: In this work, the antiplasmodial activity of Commelina latifolia crude leaf extract and solvent fractions against Plasmodium berghei-infected mice was investigated. Materials and methods: 80% methanol was used to extract the leaves of C. latifolia, and the crude extract was fractionated using chloroform, pure methanol, and distilled water. All test compounds were undergone an acute oral toxicity test before being put through Peter's 4-day suppressive test to see if they have antiplasmodial activity. The hydroalcoholic crude extract and chloroform fraction were additionally assessed for antimalarial activity using curative and prophylactic tests in P. berghei-infected laboratory mice. Results: All of the tested crude extracts were safe at a dose of 2000 mg/kg. At 400 mg/kg dose both the 80% methanol extract and chloroform fraction exhibited antimalarial activity with parasitemia suppression values of 86.31%, and 76.56% in the four-day suppressive test, 81.97% and 72.05% in Rane's test, and 69.05% and 62.88% in the prophylactic test, respectively. Conclusion: Collectively, the oral dose of Commelina latifolia is safe, and reveals promising antimalarial activity. The findings backed up the utilization of the plant in traditional medicine to treat malaria.

COVID-19-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of East Gojjam Zone, Ethiopia, 2020: a multi-center cross-sectional study.

Aim: This study aimed to assess COVID-19 (coronavirus disease 2019)-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of the East Gojjam Zone, Ethiopia. Subjects and methods: A multi-center cross-sectional study was conducted, from December 1-30, 2020. A total of 847 pregnant women were included in the study using a simple random sampling technique. To collect the data, we used an interviewer-administered questionnaire. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with pregnancy-related anxiety. A p-value of < 0.05 with a 95% confidence level was used to declare statistical significance. Results: The magnitude of COVID-19-related positive attitude and high-level risk perception among pregnant women was 51.12% and 37.2% respectively. Having adequate knowledge [AOR: 2.09, 95% CI = (1.49-2.95)], ≥ 3 ANC visits [AOR: 1.43, 95% CI = 1.0-1.98], and a low level of risk perception [AOR: 6.27, 95% CI = (4.42-8.89)] were factors associated with a positive attitude of pregnant women with regard to the COVID-19 pandemic. Being urban residents [AOR: 2.24, 95% CI: 1.6-3.10], having wanted pregnancy [AOR: 3.35, 95% CI: 1.18-9.49], having a negative attitude [AOR: 6.21, 95% CI: 4.43-8.70], and a complicated pregnancy [AOR: 1.67, 95% CI: 1.02--2.75] were factors significantly associated with risk perception of pregnant women with regard to the COVID-19 pandemic. Conclusions: Despite its high fatality, COVID-19 pandemic-related attitude and risk perception among pregnant women were low. As a result, health caregivers and other concerned bodies should consider interventions to improve pregnant women's risk perception and attitude during antenatal care and through various community information platforms. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01797-x.

Medicinal plants used for management of hemorrhoids in Ethiopia: A systematic review.

Background: Hemorrhoids have been reported to beset human beings since the earliest history of mankind. Utilization of herbal medicines is ever increasing as the demand for natural remedies is growing. In Ethiopia, many patients commonly use herbal medicines for hemorrhoids management despite lack of organized information at country level. This systematic review was aimed to document reports about utilization of medicinal plants for hemorrhoids management in Ethiopia. Method: A web-based systematic literature search was carried out through electronic databases like PubMed, Google Scholar, Web of Sciences, Science Direct, and websites of different organizations. All studies with complete ethnobotanical information were included in this review without regard to methodology and publication year. Results: A total of 23 articles were included in this systematic review. Majority (41.7%) of studies were reported from Oromia region followed by Amhara (33.3%) regional state. A total of 50 medicinal plants have been reported where Fabaceae and Solanaceae represent the most commonly used families. Herbs were the most (38%) commonly used medicinal plants followed by shrubs (34%) and trees (26%). Leaf (44%) and root (24%) were the first and second most commonly used plant parts, respectively. Most of the medicinal remedies (36%) were prepared by pounding the fresh part of the plant. Besides, 56.1% of the herbal preparations were administered through topical route. Conclusion and recommendations: Numerous medicinal plants from various families have been documented in this review as anti-hemorrhoidal remedies. Further studies could be anticipated in the search for new, effective, and safe plant-based medications from medicinal plants discussed in this review.

Prevalence of Medication Non-Adherence and Associated Factors among Diabetic Patients in A Tertiary Hospital at Debre Markos, Northwest Ethiopia.

Background: Non-adherence to prescribed medications is possibly the most common reason for poor treatment outcomes among people with diabetes although its rate is highly variable. Data on the magnitude of medication non-adherence and associated factors are scarce in the study area. This study aimed to assess the rate of non-adherence and associated factors among diabetic patients at Debre Markos Comprehensive Specialized Hospital. Methods: A cross-sectional study was conducted from June 17 to July 17, 2021. Study participants were selected using a simple random sampling technique. Data were collected with a pre-tested structured questionnaire and entered into SPSS version 25. Logistic regression was utilized to determine predictors of medication non-adherence at a significance level of ≤ 0.05. Results: A total of 176 study participants were enrolled in the study. About 59% of the study participants had type-2 diabetes mellitus. The prevalence of non-adherence to anti-diabetic medications was found to be 41.5%. Male sex, rural residence, being divorced, being merchant, self- or family-borne medical cost, and presence of comorbidities were significantly associated with increased rate of non-adherence to anti-diabetic medications. Conclusion: The prevalence of non-adherence to medications among diabetic patients is significantly high in the study area. Public health measures should be strengthened to decrease nonadherence among diabetic patients.

Gram-negative bacteria isolates and their antibiotic-resistance patterns among pediatrics patients in Ethiopia: A systematic review.

Objective: Antimicrobial resistance is one of the serious threats in the world, including Ethiopia. Even though several studies were conducted to estimate common bacteria and their antibiotic-resistance profile in Ethiopia, it is difficult to estimate the overall resistant patterns due to the lack of a nationwide study. This systematic review aimed to determine the prevalence of gram-negative bacteria isolates and their antibiotic-resistance profile among pediatrics patients in Ethiopia. Methods: A web-based search using PubMed, EMBASE, Science Direct, the Cochrane Database for Systematic Reviews, Scopus, Hinari, Sci-Hub, African Journals Online Library, and free-text web searches using Google Scholar was conducted from August to September 16, 2021. Each of the original articles was searched by Boolean search technique using various keywords and was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The data were extracted using Microsoft Excel format and exported to STATA 14.0 for statistical analyses. Results: The database search delivered a total of 2,684 studies. After articles were removed by duplications, title, reading the abstract, and assessed for eligibility criteria, 19 articles were included in the systematic review. Of a total of 1372 (16.77%) culture-positive samples, 735 (53.57%) were gram-negative. Escherichia coli was the most frequently isolated bacteria followed by Klebsiella species, 139/1372 (10.13%), and 125/1372(9.11%), respectively. More than 66.67% of isolates were resistant to ampicillin except for Neisseria meningitidis which was 32.35% (11/34). Pseudomonas aeruginosa, Klebsiela species, and Citrobacter species were 100% resistance for cefepime. Haemophilus influenzae was 100% resistant to meropenem. Salmonella species were 93.30%, 78.26%, and 63.64% resistant to tetracycline, chloramphenicol, and cotrimoxazole, respectively. Conclusion: Gram-negative bacteria were identified as the common pathogen causing infection in pediatrics and the level of resistance to commonly prescribed antibiotics was significantly higher in Ethiopia. Culture and susceptibility tests and well-designed infection control programs are important measures.

A systematic review on traditional medicinal Animal's parts and products used for the treatment of respiratory tract disorders in Ethiopia.

BACKGROUND: Respiratory diseases affect more than one billion people worldwide. Although medicinal animals have huge importance in primary health care, limited effort applied so far been in Ethiopia to properly identify, document, and conserve these animals and the related knowledge. This systematic review was aimed to identify the medicinal animals and document reports on the use of medicinal animals for the management of respiratory disorders. METHODS: Both published and unpublished articles on the ethnozoological use of medicinal animals were searched using electronic database (Science Direct, Pub Med, Google Scholar, Scopus, hinari, and research gate) and institutional repositories. Different keywords were used separately and in combination using Boolean operators "OR" or "AND" as well as medical subject heading [MeSH] terms. Studies that did not address respiratory disorders were excluded. Data were extracted using Microsoft excel spread sheet. RESULTS: Among 211 articles obtained from database searches, nine articles were eligible and included in the review. Thirty two medicinal animals were reported for treatment of respiratory disorders. Mammals were the most commonly (43.8%) used medicinal animals. Meat was reported as the most commonly (22.6%) used medicinal remedy. CONCLUSIONS: Most of the medicinal remedies were obtained from mammals and administered orally. As the majority of the medicinal animals were obtained from wild sources, due attention should be given to conserve them. Besides, this traditional medicinal knowledge should be integrated to modern medicine to investigate the acute and chronic toxicity profile and efficacy of these remedies to identify potential lead compounds to modern drugs.

Ethnozoological study of medicinal animals and animals' products used by traditional medicinal practitioners and indigenous people in Motta city administration and Hulet Eju Enessie District, East Gojjam, Northwest Ethiopia.

BACKGROUND: In Ethiopia, many ethnic communities use traditional/indigenous medicine for primary health care. However, this indigenous medicinal practice is being neglected and continued to be lost due to poor documentation as they are transferred from generation to generation through oral tradition. Therefore, this ethnozoological study aimed to assess and document the medicinal use of animals and animals' products used by traditional medicinal practitioners and indigenous people in Motta city administration and Hulet Eju Enessie Districts, East Gojjam Zone, Ethiopia. METHODS: Cross-sectional ethnozoological survey was conducted using a Semi-structured questionnaire among purposively selected respondents in Motta city administration and Hulet Eju Enessie District, East Gojjam Zone, Ethiopia from September 2020 to June 2021 GC. The ethnozoological data were analyzed using SPSS version 26 and Microsoft Excell Spreadsheet. Fidelity level, use-value, and informant consensus factor were determined. RESULTS: A total of 25 animal species were reported to be used for the treatment of different ailments by 33 informants. The majority of animals (64%) were mammals followed by birds (16%). The fidelity level ranged from 18.2 (Hyena for bad spirit) to 100% (stingless be for asthma, Tiger for rabies virus, Whisper for nightmare). CONCLUSION: This study showed the wide use of medicinal animals and their parts/products for meeting the primary healthcare needs of the community in the study area. Therefore, this ethnozoological medicinal knowledge needs to be integrated with modern medicine to use animals/animals' products as a potential source of effective drugs for different ailments.

In-vivo evaluation of immunomodulatory activity of crude extract and solvent fractions of Cyphostemma adenocaule (Steud. ex A.Rich).

Background: Various indigenous medicinal systems including Ethiopians used Cyphostemma adenocaule for managing tumors, helminthiasis, snake envenomation, rabis virus, splenomegaly, and other immunological disorders. However, no scientific study was conducted to validate these traditional medicinal claims of the plant. Therefore, this study aimed to evaluate the in-vivo immunomodulatory activity of the crude root extract and its solvent fractions. Methods: Carbon clearance rate and humoral antibody titer were determined for 100, 200, and 400 mg/kg of crude extract and solvent fractions among Swiss albino mice. Carbon ink and sheep red blood cells were used as antigens for carbon clearance assay and humoral antibody titer respectively. Results: Among all groups, an increase in both carbon clearance rate and the humoral antibody titer was observed with an increase in the dose of both crude extract and solvent fractions. Compared to the solvent fractions of comparable doses, the crude extract showed better activity. The crude extract at a dose of 400 mg/kg revealed the highest and statistically significant augmentation of carbon clearance rate (0.1100 ± 0.0124) and humoral antibody titer (96.00 ± 14.31) compared to the vehicle control group. Conclusion: From our study, it is concluded that crude extract and n-butanol fraction showed promising immunostimulant activity by enhancing carbon clearance rate and humoral antibody titer.

Evaluation of the Effect of Hydroethanolic Root Extract and Solvent Fractions of Cyphostemma adenocaule (Steud. ex A. Rich) Descoings ex Wild & Drummond on Cell-Mediated Immune Response and Blood Cell Count in Mice.

INTRODUCTION: Cyphostemma adenocaule (Steud. ex A. Rich) Descoings ex wild & Drummond (Vitaceae) has been used in traditional medicine for the management of various immunological and hematological disorders in different areas of Ethiopia and the rest of the world. In Ethiopia, the plant is used for the management of enlarged spleen, rabies virus, helminthic infection, snake bite, and various types of tumors. OBJECTIVE: To evaluate the effect of hydroethanolic root extract and solvent fractions of Cyphostemma adenocaule on cell-mediated immunity (delayed-type hypersensitivity), organ index (spleen and liver), and blood cell count in Swiss albino mice. MATERIALS AND METHODS: Acute oral toxicity test was conducted using nulliparous and nonpregnant Swiss albino mice following OECD 425 limit test method. Delayed-type hypersensitivity model was used to evaluate the effect on cell-mediated immunity. The experimental animals were divided into twelve groups which were sensitized and challenged with sheep red blood cells on day 0 and day 7, respectively. Levamisole 50 mg/kg was used as stimulant control, whereas cyclophosphamide 30 mg/kg was used as suppressant control. Hydroethanolic root extract (100 mg/kg, 200 mg/kg, and 400 mg/kg), aqueous fraction (100 mg/kg, 200 mg/kg, and 400 mg/kg), and n-butanol fraction (100 mg/kg, 200 mg/kg, and 400 mg/kg) were administered for seven days. The paw volume was measured using a digital plethysmometer before challenge and 24 hours after challenge. Blood was collected, and organs (spleen and liver) were isolated from each challenged mouse to determine blood cell count and organ index, respectively. RESULTS: No mortality and noticeable behavioral changes were observed among all mice receiving hydroethanolic root extract and solvent fractions at a dose of 2000 mg/kg. Hydroethanolic root extract and solvent fractions of Cyphostemma adenocaule showed enhancement of delayed-type hypersensitivity, organ index, and blood cell count. Hydroethanolic root extract at a dose of 400 mg/kg showed the highest and statistically significant stimulation of delayed-type hypersensitivity (0.123 ± 0.010) and blood cell count compared to the vehicle. CONCLUSION: Hydroethanolic root extract and solvent fractions of Cyphostemma adenocaule showed a stimulatory effect on cell-mediated immunity and hematopoiesis.