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Natural polymers, specifically mucilages, have been used as a suspending agent for a long period of time. Natural excipients can serve as an alternative to synthetic products since they are less expensive, less toxic, and devoid of environmental pollution. There are many species of Aloe found in Ethiopia which can be used as a source of mucilage. In this study, mucilage from Aloe weloensis, which is found in Wollo floristic region, was extracted and tested as a suspending agent at different suspending agent concentrations and compared with standard suspending agents (acacia and sodium carboxy methylcellulose (NaCMC)) by formulating zinc oxide suspension. The mucilage obtained from Aloe weloensis leaves has shown comparable suspending agent ability with acacia. The rate of sedimentation and viscosity was higher at 1% and 4% mucilage concentrations than acacia though the difference was not significant (p > 0.05). The suspension was slightly basic and easily dispersible than NaCMC. Suspensions formulated from NaCMC were superior in terms of viscosity and sedimentation volume which was significantly different (p < 0.05) accompanied by lower flow rates than suspensions formulated from acacia and Aloe weloensis mucilages. The results suggested that Aloe weloensis mucilage could be used as an alternative suspending agent.
RESUMO
BACKGROUND: Surgical site infections are global healthcare problems. Although surgical site infections are preventable, they still cause significant morbidity, high death rates, and financial stress on national budgets and individual patients. Inappropriate uses of surgical antimicrobial prophylaxis are increasing and worsening patients' quality of life. This study determined the incidence and risk factors of surgical site infections. METHODS: Institution-based retrospective cross-sectional study was conducted using a structured data abstraction format on patients who were attending at the surgical ward of Borumeda hospital from April 1, 2017, to March 31, 2019. The data were collected during July 15-30, 2019. A systematic random sampling technique was employed to select 227 surgical cases. Multivariate logistic regression was computed using the statistical package for social sciences version 23. RESULTS: The incidence of surgical site infections was 46.7%. Prophylaxis was administered to 188 (82.8%) surgical cases. Prophylaxis was recommended for 151 (66.5%). Out of these, only 143 (94.7%) received prophylaxis. One hundred seventy-four (78.4%) of the procedures had appropriate indication. The compliance of surgical antimicrobial prophylaxis use was 13.7%. The predictors of surgical site infections were receiving prophylaxis more than 24 h after surgery (AOR=3.53, 95% CI: 1.22-10.17), clean-contaminated wounds (AOR=4.54, 95% CI: 1.33-15.53), surgical procedure of thyroidectomy (AOR=5.2, 95% CI: 0.9-21.4), appendectomy (AOR = 29, 95% CI: 6.2-141.7), cholecystectomy (AOR = 21, 95% CI: 3.5 -126.7), hernia (AOR= 8.8, 95% CI: 1.2-62.2), skin and deep tissue (AOR = 125, 95% CI: 7.8-196.7), and orthopedic (AOR=57, 95% CI: 1.6-209.5). CONCLUSION: There was high inconsistency between surgical antimicrobial prophylaxis practice and international surgical site infections prevention guideline. Wrong selection of antimicrobial agents was the most noncompliant to the guidelines. The incidence of surgical antimicrobial prophylaxis was high and requires due attention. The duration of postoperative prophylaxis should be kept to less than 24 h.
RESUMO
BACKGROUND: Lack of clear and precise oral and written information from both the doctors and/or pharmacists on the management of prescribed medication has led to therapeutic failure, as a result of patients not comprehending instructions. Incorrect interpretation of labels can lead to incorrect usage of medication therefore the occurrence of medication error and/or adverse event. The concern of this study was to assess misunderstanding of dosing instructions among outpatients in Dessie Referral Hospital (DRH). METHODS: An institution-based cross-sectional study was conducted on 384 outpatients at DRH from February 10 to March 15, 2019. Study subjects were selected by using a systematic random sampling technique and data was collected by using questionnaires and observation. The data was coded individually and entered in a computer using Epi Info™ version 3.5.1 and then exported to SPSS version 23.0 for analysis. Univariate analyses were used to describe the categorical variables. Chi-square test was used to assess association of variables with primary outcome. P-value <0.05 was considered as statistical significance. RESULTS: This study showed that most of the respondents n=298 (77.6%) misunderstood more than one dosage instruction, 8.75% misunderstood the dose, 51.3% misunderstood the frequency while 58.59% misunderstood the duration of treatment. The misunderstanding was higher for labeled medications (11.4%) than unlabelled (7.7%). CONCLUSION: The prevalence of misunderstanding of dosing instruction was high in outpatients of DRH. Hence standard procedures must be developed to provide easy and clear dosing instructions to patients, and continuous training must be provided for pharmacists on proper communication of dosing instructions to patients.
RESUMO
BACKGROUND: Antibiotic resistance is increasing to dangerously high levels globally with subsequent higher medical costs, prolonged hospital stays and increased levels of mortality. Ensuring patients' knowledge, attitude, and proper use of antimicrobials is one of the strategies to control resistance. The aim of this study is to evaluate the public awareness, attitude, and practice regarding antimicrobial use and resistance in Kemissie Town, Northeast Ethiopia. METHODS: A community-based, cross-sectional study was conducted on 385 adults selected using systematic random sampling in Kemissie town from March 1 to May 1, 2019. A home-to-home visit interview was done using a structured interview guide. The data were coded individually and entered into a computer using Epi-info version 3.5.1 and then exported to SPSS version 23.0 for analysis. Univariate analyses were used to describe the categorical variables. RESULTS: Of the 345 respondents who took antibiotics, three quarters (74.78%) received antibiotics with a prescription. Of the total respondents, 17.7% of the participants believed unnecessary use of antibiotics enhances resistance to bacteria. Of those who took antibiotics, the majority (72.5 %) finished the full course of treatment. Out of the total 374 respondents, 41.6% had awareness on the fact that antibiotics resistance can affect the development of resistance in the whole community. More than half (51.9%) of the respondents believed that the rational use of antibiotics can reduce the risk of antimicrobial resistance. CONCLUSION: The majority of the respondents were still unaware of antibiotic resistance and its implications. This requires close attention from policy-makers and healthcare professionals. The community of Kemissie town had a positive attitude towards finishing antibiotic regimens. This study also identified crucial gaps in the practices of the community about the use of antibiotics.
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BACKGROUND: Tuberculosis is said to be one of the prevalent opportunistic infections and the leading cause of death among people living with human immunodeficiency virus. Although isoniazid preventive therapy (IPT) is thought to reduce the incidence of TB in HIV patients, its implementation has faced many obstacles. This study was concerned with the assessment of the outcome of IPT among people living with HIV who were on follow-up at Dessie referral Hospital (DRH), Northeast, Ethiopia. METHODS: A retrospective study of medical records of 220 patients, who were enrolled at Dessie Referral Hospital from January 10/2016 to December 11/2018, were conducted from March 23/2019 to April 6/2019. A systematic random sampling method was used to select the samples for the study, and a data abstraction format was used to capture the data. All data were entered, cleared and analyzed using SPSS version 21. Chi-square test was used to identify the association of outcome between the two IPT groups, and P-value <0.05 was considered as statistical significance. RESULTS: The total TB prevalence in this study was 25 (11.36%). The occurrence of TB in the IPT group was 9(4.09%) and 16 (7.27%) for the non-IPT group but not statistically significant (p=0.137). From the study, about 40.9% of patients developed opportunistic infections. Of these, 62.81% and 37.18% of opportunistic infections were developed among patients in the non-IPT and the IPT groups, respectively (p=0.002), which were statistically significant, and the IPT completion rate was 61.81%. CONCLUSION: Although the current study showed that the IPT had not significantly reduced the prevalence of TB between IPT and the non-IPT group, the IPT has shown to significantly reduce the prevalence of opportunistic infections.
RESUMO
Balanites rotundifolia (BR) (Van Tiegh.) Blatter (Balanitaceae) has been used in Ethiopian folk medicine to treat malaria, despite the lack of scientific validation. Therefore, the present study was carried out to evaluate the antiplasmodial activity of 80% methanol leaf extract of BR in mice. Both the 4-day suppressive test and Rane's test were employed. Three extract doses (BR100 mg/kg, BR200 mg/kg, and BR400 mg/kg/d) were given orally, and chloroquine was the standard drug administered through the same route. Outcome measures for evaluating antiplasmodial efficacy were parasitemia level, packed cell volume, survival time, and body temperature as well as body weight change. Moreover, preliminary phytochemical and acute toxicity studies were carried out. With the 4-day suppressive test, BR demonstrated dose-dependent significant reduction in parasitemia level at all test doses compared to the negative control: BR400 (67%, P<0.001), BR200 (42%, P<0.01), and BR100 (37%, P<0.05). With Rane's test as well, BR significantly (P<0.001 for all test doses) reduced the parasitemia level by 38% (BR100), 45% (BR200), and 69% (BR400) in comparison to vehicle treatment. The crude extract was estimated to have oral median lethal dose higher than 2,000 mg/kg, and the presence of alkaloids and cardiac glycosides was confirmed. Therefore, this study for the first time validated the antiplasmodial activity of crude leaf extract of BR. Further investigations for isolating specific phytochemicals and elucidating mechanisms are needed to address the quest for novel antimalarial drugs.
