Molecular Characterization of Extended Spectrum Beta – Lactamase Producing Escherichia Coli Isolated from Pregnant Women with Urinary Tract Infections Attending Ante–Natal Clinics in Ilorin Metropolis

Background: The emergence of multidrug- resistance Enterobacteriaceae especially in E. coli bacteria associated with Urinary Tract Infections (UTIs) in pregnancy is a serious menace globally posing health challenges and confounding successful empirical treatment as well as increasing pregnancy – related complications.Objectives: The aim of this study is to determine the phenotypic and genotypic characteristics of Extended Spectrum Beta – Lactamases (ESBLs) producing E. coli (ESBLs – EC) isolates in pregnant women attending ante – natal clinics within Ilorin - Kwara State, Nigeria.Materials and methods: A total of 53 non - repeated E. coli isolates from urine samples of pregnant women were presumptively identified using standard bacteriological method and confirmed by commercially available Microgen® Identification Kits. Phenotypic detection of ESBLs was determined using antibiotics susceptibility test and double disc synergy Method for screening and confirmation respectively. Polymerase Chain Reaction (PCR) was further used for the genotypic detection of ESBLs genes.Results: A total 88.67% (47/53) of E. coli exhibited resistance to the cephalosporins of which aztreonam was the highest (75.47%) and the least was cefpodoxime (35.84%) while 85.10% were confirmed positive for ESBL production. The genotypic detection showed the most occurring genotype was blaTEM (50%) blaOXA (27.7%), blaGES (22.5%), blaSHV (15%), blaCTXM and blaVEB (7.5%) while sixty – four (64%) of isolates co – harbored two or more gene. BlaTEM and blaOXA were dominant.Conclusion: This study showed high resistance of E. coli to the third generation cephalosporins harboring different ESBL genes which increases UTIs complexity and limit therapeutic options in pregnancy. Therefore, continuous monitoring of resistance in E. coli, effective appraisal of antibiotic control policies and rational use of antibiotics is therefore encouraged.

Evaluation of the Potential Toxicity of the Starch from the Shoot of Borassus Aethiopum Mart in Wistar Rats

Background: The shoot of Borassus aethiopum is cultivated and consumed in Northern Nigeria. Its starch has been investigated for use in pharmaceutical formulation but have limited studies on its toxicity. Toxicity is the degree to which a substance (a toxin or poison) can harm humans or animals. The plant Borassus aethiopum Mart belongs to the family Aracaceae, commonly known as the African Fan Palm. The shoot of the plant is commonly referred to as “Muruchi” in Hausa and is widely available and edible.Objective: This experimental research was designed to examine the potential toxicity of the starch from the shoot of Borassus aethiopum in acute and subacute studies using Wistar rats.Material and Methods: Fresh shoots of Borassus aethiopum were obtained, washed, peeled and grinded using mechanical grinder. The starch was extracted using water. Acute toxicity was carried out using OECD guideline 425. Healthy rats of both sexes were randomly grouped into four groups of six rats each (n=6) for the 28-days oral toxicity study. Distilled water was administered at the dose of 2ml/kg to group I which served as the control while groups II, III and IV were orally administered the starch from the shoot of Borassus aethiopum at the doses of 300, 600 and 1200 mg/kg daily for 28 days respectively. The animals were sacrificed after 28-days at which the blood samples were collected through cardiac puncture into plain and EDTA-containing tubes for biochemical and haematological analyses respectively. The liver, kidney, heart and spleen were excised, weighed and examined macroscopically.Results: The phytochemical screening reveals the presence of alkaloids, tannins, and carbohydrate. The acute toxicity (LD50) of Borassus aethiopum was found to be greater than 4000 mg/kg body weight. No notable and significant changes in the relative organ weight as well as the levels of the renal and hematological biomarkers when compared with the control. However, there was significant increase in serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT).Conclusion: In conclusion, the results of this study indicated that the starch from the shoot of Borassus aethiopum showed some evidence of potential toxicity on the liver but did not affect the renal and haematological parameters.

Toxicity Study and Anticonvulsant Effect of Ethanol Leaf Extract of Piliostigma thonningii Milne-Redhead (Fabaceae)

Background: Piliostigma thonningii (Schumach) Milne-Redhead [Fabaceae] is a plant widely used locally for the treatment and management of several ailments which include epilepsy in Northeastern Nigeria.Objectives: This study aimed at evaluation of the toxicity and anticonvulsant effect of ethanol leaf extract of Piliostigma thonningii in rats and mice with a view to determining the efficacy of the plant as an anticonvulsant drug.Methods: Fresh leaves of Piliostigma thonningii were air-dried, pulverized and extracted using soxhlet extraction apparatus. Acute toxicity study was carried out by Lorke’s method and the anticonvulsant activity of the ethanol leaf extract was carried using pentylenetetrazole and strychnine-induced convulsion model on Wistar strain albino rats and mice respectively.Result: The soxhlet extraction yielded 21.04% w/w of extract after being concentrated. The oral and intraperitoneal LD50 were ≥ 5000 mg/kg implying that the extract is relatively safe according to literatures. Anticonvulsant effect of the ethanol leaf extract using pentylenetetrazole (PTZ), revealed the ability of the extract to confer protection on rats treated with doses of 200, 400 and 600 mg/Kg bd. wt. by exerting 60%, 80% and 80% protection on rat against PTZ induced convulsion respectively in a dose dependent manner as well as protected 20%, 60% and 80% of mice against death induced by strychnine when treated with 100, 200 and 400 mg/kg of ethanol extract.Conclusion: The ethanol leaf extract of Piliostigma thonningii was able to provide anticonvulsant effect and is relatively safe for consumption as medicine.

Investigation and Comparison of Medicine Use in the three Central Referral Hospitals in Sierra Leone

Background: An important goal of National Medicines Policy is to ensure that sufficient quantities of essential medicines are available to health care providers and affordable to patients.Objectives: To investigate and compare the prescribing indicators, patient care indicators and facility indicators in three central referral Hospitals in Sierra Leone.Methods: This was a simple randomized retrospective and prospective study. Three groups were obtained to assess prescribing, patient care and facility indicators in the study sites. About 10% of the prescriptions encountered from January to June 2019, were observed retrospectively. Direct observation of 30 randomly selected patients in each hospital was used to assess patient care. Data collected were organized using Microsoft Excel and analyzed using SPSS version 21. Ethical considerations were observed.Results: The average number of medicines prescribed in the three teaching hospitals (Connaught, PCMH and ODCH) were 4.07, 4.3and 3.3 respectively. Percentage encounter with injections were within standard in PCMT and ODCH. Antibiotics prescribing was slightly higher that WHO recommendation of 30% in all 3 hospitals. Percentage of medicines prescribed by generics were 75.4%, 53% and 77% respectively. The average consultation time was 5.47 minutes while the average dispensing time was 79.7 seconds. Patients that receive their medications at Connaught Hospitals had very little knowledge on how they should take their medicine(s), compared to PCMH and ODCH.Conclusion: This study has shown that irrational use of medicines is a major problem in the three referral hospitals occurring majorly during the prescribing and dispensing processes.

Effect of Hydrophile-Lipophile Balance (HLB) of Mixed Surfactants on In-Vitro Release Profile of Ibuprofen from Semi-Synthetic Suppository Bases

Background: The emphasis on the use of surfactants in enhancing drug release from fatty suppository bases has always been on the concentration and type of surfactants. However, the Hydrophile-Lipophile Balance (HLB) of the surfactants added can be of significant effect.Objective: The study aimed at evaluating the effect of HLB of the incorporated mixed surfactants on the physical and release properties of Ibuprofen suppositories formulated with semi-synthetic fatty bases.Methodology: The preparations were carried out using 1 g mould. Ibuprofen suppositories, each containing 200 mg of Ibuprofen with semi-synthetic fatty bases (Witepsol® H15, Suppocire® CM), were prepared by fusion method. Mixed surfactants (Span® 80 and Tween® 80) were added at 4 %w/w in varied ratios to give HLB values of 4.3 to 15.0. The physical properties and release profile of the suppositories were evaluated using established procedures.Results: The physical properties of the suppositories met the standard specified in the BP. Addition of mixed surfactants greatly influenced the release of the Ibuprofen from the formulations with optimum release at lipophilic HLB (4.3) and hydrophilic HLB (12.0) for formulations in Suppocire® CM and Witepsol® H15, respectively. The release parameters majorly fitted into Higuchi’s model. The release mechanism was non-Fickian and Fickian for formulations in Suppocire® CM and Witepsol® H15, respectively.Conclusion: The variations observed in the release profiles of Ibuprofen from the suppository bases indicate that HLB value of mixed surfactants can be employed in modifying drug release from semi-synthetic fatty bases

Effect of Pharmacist Intervention on Quality of Life of Patients with Major Depressive Disorder in Distressed North East Nigeria

Background: Quality of life is considered as an integral component and outcome indicator of mental illness and while pharmacist interventions have been proven to be effective in improving quality of life, no attention has been given to patients with depression in distressed North East Nigeria.Objectives: To explore the effect of pharmacist intervention on quality of life of patients with major depressive disorder.Materials and Methods: A longitudinal prospective randomized controlled trial approved by Ahmadu Bello University Ethics Committee on use of Human Subjects for Research (approval number: ABUCUHSR/2020/018) was conducted on 101 patients with major depressive disorder between April 2019 and March 2020 at a tertiary Neuro-Psychiatric Hospital in Maiduguri, Nigeria. Consenting patients were randomized into Usual Care or Intervention groups using a computer-generated list. The intervention consisted of pharmacist-delivered educational counseling sessions of between 15-30 minutes. Data were collected at baseline, 3 months and 6 months using the World Health Organization Quality of life Bref scale.Results: After the intervention, significant improvements (p <0.001) in mean scores of participants in the intervention group were observed in all of the quality-of-life domains including; physical health [42.49 (SD=11.48) vs 72.25 (SD=15.82], psychological health [45.15 (SD=15.24) vs 85.57 (SD=12.95)], social relationship [40.47 (SD=21.24) vs 78.20 (SD=18.23)] and environment [40.94 (SD=14.09) vs 87.74 (SD=9.78)].Significant improvements (p <0.001) were also observed in the general health [38.77 (SD=27.51) vs 86.53 (SD=21.27)] and overall quality of life [52.55 (SD=19.26) vs 76.92 (SD=25.16)] in the intervention group.Conclusion: Pharmacist’s intervention significantly improved quality of life in patients with major depressive disorder in this study.

Long Term Effects of Streptozotocin Induced Diabetes Mellitus on Hepatic, Nephrotic and Cardiac Physiology of Female Wistar Rats

Background: Diabetes mellitus is a metabolic disorder which leads to complications that affect the heart, kidney, liver and other vital organs. Most reports on diabetes have focused on diabetes induction using male rat models in short term studies.Objective: Here, we described the induction of diabetes in female rat and the complications of diabetes following long term hyperglycemia in female Wistar rats.Method: Rats were assigned into two groups: control (n=10) and diabetic (n=10). The latter was administered a single (50mg/Kg body weight) intraperitoneal injection of streptozotocin. Bodyweight and blood glucose were assessed for 14 weeks, after which the animals were sacrificed and biochemical and morphology parameters of the liver, kidney and heart were determined.Results: Diabetic rats showed continuous emaciation post STZ induction. The glycated haemoglobin, protein level, lipid profile, liver and kidney function markers were significantly different (p<0.05) from the control. Catalase, superoxide dismutase and glutathione-s-transferase activities were also significantly reduced in the heart, liver and kidney, and a concomitant increase in malondialdehyde concentration was observed. Focal tubular necrosis, pulmonary congestion and mild hyperplasia of kupffer cells were observed in the tissues and all tissues showed negative CD79a expression.Conclusion: This study provides data that could be useful for modelling long-term diabetes mellitus studies in female experimental rat models.

Factors Affecting Medication Dispensing and Counselling Practices in Hospital Pharmacy Settings in Northwest Nigeria

Background: Medication dispensing and counselling are routine but very important activities carried out by pharmacists in a wide variety of healthcare settings. While these processes are often overlooked when issues around the rational use of medication are being considered, any mistake(s) in one or both processes can seriously undermine patient care.Objective: To assess selected factors, and identify problems affecting medication dispensing and counselling in outpatient hospital pharmacies in northwest Nigeria.Methods: Mixed methods were used to collect data from 19 outpatient pharmacies in eight public hospitals located in Kaduna and Kano states from November 2019 to March 2020. Quantitative data was generated from a survey, while qualitative data was collected from key-informant interviews with heads of the pharmacies. Data collected from the survey were analyzed to generate descriptive statistics (frequencies and percentages), while interview data were transcribed and analyzed using thematic/content analysis.Results: Only two pharmacies (10.5%) had dispensing standard operating procedures, and only one (5.2%) had a completely private counselling area. Pharmacy technicians were present in most of the pharmacies (84.2%), and students were widely involved in medication dispensing and counselling activities (73.7%). Identified problems from the interviews included issues with prescribers and medication availability, inadequate staffing levels and absence of materials and/equipment required for dispensing and counselling.Conclusion: There is an urgent need for multi-faceted interventions to improve on several of these findings and enhance the quality of care provided to patients.

Anti-inflammatory Effect of the Alkaloid-rich Fraction of Landolphia owarensis

Background: Plants have several chemical compounds acclaimed to be responsible for the pharmacological actions produced when herbal products are administered to biological systems.Objectives: This study was designed to investigate the anti-inflammatory effect of the alkaloid-rich fraction of the ethanol leaf extract of Landolphia owariensis.Methods: Qualitative phytochemical analyses were carried on the crude extract using standard methods. The alkaloid-rich fraction was obtained from the crude ethanol extract, using the classical acid/base shake-up method and the obtained fraction tested positive to Dragendorf’s reagent. Oral acute toxicity was evaluated by OECD method (No 423). Anti-inflammatory effect of the fraction was evaluated using xylene-induce ear oedema and carrageenan-induced paw inflammation in mice at doses of 100, 200 and 400 mg/kg.Results: Phytochemical screening revealed presence of alkaloids, flavonoids, tannins, saponins, steroids/terpenes and glycosides. Acute toxicity studies showed no adverse symptoms of toxicity during the 14-day observation period and no mortality was recorded, thus the LD50 was estimated to be greater than 2000 mg/kg. The alkaloid-rich fraction dose-dependently inhibited inflammation induced by xylene and carrageenan. In the xylene test, the fraction produced significant inhibition of 41.70 % at 400 mg/kg (p ≤ 0.05) while in the carrageenan test 55.69 % significant inhibition (p ≤ 0.001) was recorded with 400 mg/kg at 60 mins after induction of inflammation.Conclusion: This study showed the anti-inflammatory potentials of the alkaloid-rich fraction of Landophia owariensis.

Microscopical Characterization and Physicochemical Standardization of Leaves, Stems and Roots of Spondias mombin L. (Anacardiaceae)

Background: Spondias mombin L. belongs to the family Anacardiaceae. Despite its wide ethnomedicinal applications in the management of diverse diseases, there is a paucity of documented reports on its standardization.Objectives: The present study evaluated microscopical characters and some physicochemical properties of different parts of the plant for its identification and standardization.Material and Methods: Epidermal tissue preparation of the leaf of Spondias mombin (SM) was obtained using physical method while thin sections (10-12 μm) of the stem bark and root were obtained using a rotary microtome. Physicochemical parameters were determined for the powdered samples of SM using standard methods.Results: Diagnostic characters from the epidermal tissue of the leaf revealed anomocytic, paracytic stomatal type, non-glandular trichome, smooth to slightly wavy anticlinal walls while sections of the stem bark and root were characterized with abundant sclereids and calcium oxalate crystals. The stomatal number and stomatal index of the abaxial epidermis were 23.70±0.86 and 24.62±0.78 %, respectively. Ethanol had the highest extractive value (17.84±0.50) % in the leaf whereas it was lowest in petroleum ether (1.92±0.08) %. The leaf had the lowest ash value (7.13±0.76) %.Conclusion: The microscopical characterization and some of the physicochemical parameters reported herein could be useful in the compilation of monograph for the correct identification of Spondias mombin, thus contributing to the knowledge of its collection and preservation.