PHYSICOCHEMICAL CHARACTERIZATION OF STARCH ISOLATED FROM ETHIOPIAN POTATO (PLECTRANTHUS EDULIS)

Starch from the tubers of Ethiopian potato (Plectranthus edulis) (Fam. Lamiaceae) has been isolated and examined for its chemical composition, amylose content and physicochemical properties. The starch yield was about 80.4% on dry weight basis. The proximate composition of the starch on dry weight basis was found to be 0.14% ash, 0.21% lipid, 0.43% protein, and 99.2% starch. The amylose content was 30.6%. Its true density and moisture content values were 1.47 g/mL and 11.2%, respectively. Scanning electron microscopy (SEM) of the starch granules showed characteristic morphology that was by and large oblong (elliptical) with some oval-shaped granules. The starch has normal granule size distribution with a mean particle size of 36.2 µm. The DSC thermograms of the starch obtained from starch-water mixtures (1:1), exhibited gelatinization onset temp. (To) of 69.2 oC, peak temp. (Tp) of 74.3 oC and endset temp. (Te) of 83.3 oC. X-ray diffraction pattern of the starch was typical B-type with a distinctive maximum peak at 17.5o 2θ.The starch possesses higher swelling power and moisture sorption pattern but lower solubility values than those of potato starch at all temperatures studied. Considering the high yield and some similar physicochemical properties to those of potato starch, P. edulis (Ethiopian potato) can be explored as an alternative source of starch for various applications

Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member  states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a  pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production  as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is  needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional  dosage forms.The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports  and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical  market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the  purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia.  Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to  extract information for the review. &nbsp

PREPARATION AND EVALUATION OF CARBOXYMETHYL ENSET AND CASSAVA STARCHES AS PHARMACEUTICAL GELLING AGENTS

Starch is usually modified either chemically, physically or enzymatically to augment its convenience for industrial use. In the current study, starches from Enset and cassava plants were carboxymethylated, and factors which affect the carboxymethylation process and degree of substitution (DS) were studied. The application of the carboxymethyl starches as alternative pharmaceutical gelling agents for topical delivery of drugs was also investigated. Accordingly, nine different topical gel formulations of ibuprofen were prepared. All formulations were evaluated with respect to cosmetic qualities, pH, drug content, viscosity, spreadability, extrudability, in vitro drug release, anti-inflammatory activity and stability. The results showed that carboxymethylation was significantly affected by the starch source, reaction medium, temperature and time. All ibuprofen gel formulations showed homogeneous appearance, smooth texture and pleasant odor. The pH values of the formulations ranged from 6.80 to 7.22. Ibuprofen content ranged between 98.76 and 100.20% ensuring the uniformity of the drug content. The cumulative percent ibuprofen released over 12 h across cellulose membrane ranged from 43.8% cm-2 to 84.5% cm-2. Spreadability, extrudability, the cumulative drug release and diffusion coefficient of ibuprofen were influenced not only by the rheological properties of the formulations but also by the nature of the modified starches. Physicochemically stable ibuprofen gels were obtained with potent anti-inflammatory activities.   Keywords: Enset starch, cassava starch, carboxymethylation, degree of substitution, ibuprofen gel, in vitro drug release, anti-inflammatory activity, stability stud

PHYSICOCHEMICAL CHARACTERIZATION OF ACID MODIFIED DIOSCOREA STARCH AND ITS EVALUATION AS DIRECTLY COMPRESSIBLE EXCIPIENT IN TABLET FORMULATION

D. abyssinica was partially hydrolyzed in 6% HCl solution at room temperature for different lengths of time, (2, 4, 8, 16, and 32 days), dried using oven- and spray- drying techniques and subsequently investigated as directly compressible excipient in paracetamol tablet formulations. Native dioscorea starch (NDS) and oven dried acid modified dioscorea starch (AMDS) exhibited poor flow characteristics, whereas spray dried AMDS was found to be free flowing powder with 21.37 ± 1.39° angle of repose and 13.24 ± 0.76 g/sec flow rate. Both swelling power and percent solubility of the starches were found to increase with increase in temperature; AMDS showed higher percent solubility of 68.53%. Lubricant sensitivity and dilution potential of spray dried NDS and spray dried AMDS were investigated by incorporating magnesium stearate and paracetamol, respectively. In tablet formulations, spray dried AMDS and Starch 1500® tablets were produced with acceptable tablet characteristics up to 1% and 0.5% magnesium stearate concentrations, respectively. The spray dried AMDS was able to accommodate up to 40% paracetamol with acceptable criteria.  Thus, it can be concluded that AMDS can be used as an alternative directly compressible excipient in tablet formulations. Keywords:  Dioscorea starch, acid modification, spray drying, directly compressible excipient

Review of ethnobotanical and ethnopharmacological evidences of some Ethiopian medicinal plants traditionally used for the treatment of cancer

Background: Ethiopia is endowed with enormous diversity of plants. However, the majority of these plants have not been scientifically investigated. Traditional knowledge on the use of plants as medicinal agents has been transferred from generation to generation, as guarded secrets, through the word of mouth, and scientific studies on these herbs have not been properly compiled.Objectives: The main objective of this study was to review published ethnobotanical and ethnopharmacological evidences of Ethiopian medicinal plants with anticancer potentials.Material and methods: A total of 92 articles have been reviewed. They were obtained from search engines such as PubMed, Science Direct and Google Scholar. The following keywords were used to search for the literature inside the databases: plant extract, anticancer, Ethiopia, antioxidant compounds, cytotoxic compounds and in vivo toxicity.Results: The current literature review revealed that about 136 anticancer plants belonging to 57 families have been identified in Ethiopia. Among these, 98 plant species were reported for their traditional use to treat different types of symptomatic cancers. However, only 29 species were scientifically studied for their in vitro cytotoxic or free radical scavenging activities. Plant parts commonly used for preparation of anticancer remedies were leaves (41.4%) and roots (32.8%). Among the reported plant species, whilst the crude extracts of Artemisia annua, Acokanthera schimperi and Catha edulis were found to be potent cytotoxic agents (IC50<15 g/ml), the total extracts of Cassia arereh, Rubus steudneri and Thymus schimperi showed strong radical scavenging activity (IC50 <15 g/ml). Chronic administration of Syzygium guineense hydroalcoholic leaf extract, on the other hand, induced pathological changes in liver and kidney of mice.Conclusions: Although several Ethiopian plants traditionally used for the treatment of cancer were shown to possess cytotoxic and free radical scavenging activities, in most cases compounds responsible for such activities have not been identified. Therefore, activity-guided detailed phytochemical studies coupled with evaluation of the safety particularly on those plant extracts that demonstrated potent activities should be carried out as this may lead to the discovery of safe and cost effective anticancer agents. [Ethiop. J. Health Dev. 2017;31 (3):161-187]Keywords: Ethiopian medicinal plants, Antioxidant, Anticancer, Ethnopharmacology, Traditional us

ASSESSMENT OF GMP COMPLIANCE IN WATER TREATMENT SYSTEMS OF PHARMACEUTICAL INDUSTRIES IN ETHIOPIA

Water is widely used as a raw material, ingredient, and solvent in the processing, formulation, and manufacture of pharmaceutical products, and assessing its quality is of paramount importance. However, to the best of the authors’ knowledge, there hasn’t been any baseline assessment made with regard to the implementation status of Good Manufacturing Practices (GMP) principles in water treatment systems of pharmaceutical industries in Ethiopia. Hence, to assess the level of compliance to GMP in water treatment systems of pharmaceutical industries in Ethiopia, a national survey was conducted in all pharmaceutical industries of the country. Data were collected by employing quantitative and qualitative methods. Self-administered questionnaires were distributed to nine pharmaceutical industries and the response rate was 8 (88.5%). According to the results, none of the industries had an influent and effluent total organic carbon monitoring system. Among the available storage tanks for purified water and water for injection, 7 (87.5%) of them were of a sanitary material. However, in 4 (50%) industries pipes were not made of sanitary material, purified water was not kept circulating at 70-80 oC and there were dead legs in the water lines. The validation results were investigated and corrective action was taken only in 1 (12.5%) of the industries. The compliance of the water treatment systems of most of the industries to WHO GMP principles was found to be below the standard in many aspects. Therefore, it is recommended that the industries should exert maximum efforts to comply with GMP principles.   Keywords: Good manufacturing practices, water treatment system, pharmaceutical industry, Ethiopia, pharmaceutical wate

Conceptualising centres of excellence: a scoping review of global evidence

Objective- Globally, interest in excellence has grown exponentially, with public and private institutions shifting their attention from meeting targets to achieving excellence. Centres of Excellence (CoEs) are standing at the forefront of healthcare, research and innovations responding to the world’s most complex problems. However, their potential is hindered by conceptual ambiguity. We conducted a global synthesis of the evidence to conceptualise CoEs. Design- Scoping review, following Arksey and O’Malley’s framework and methodological enhancement by Levac et al and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Data sources- PubMed, Scopus, CINAHL, Google Scholar and the Google engine until 1 January 2021. Eligibility- Articles that describe CoE as the main theme. Results- The search resulted in 52 161 potential publications, with 78 articles met the eligibility criteria. The 78 articles were from 33 countries, of which 35 were from the USA, 3 each from Nigeria, South Africa, Spain and India, and 2 each from Ethiopia, Canada, Russia, Colombia, Sweden, Greece and Peru. The rest 17 were from various countries. The articles involved six thematic areas—healthcare, education, research, industry, information technology and general concepts on CoE. The analysis documented success stories of using the brand ‘CoE’—an influential brand to stimulate best practices. We identified 12 essential foundations of CoE—specialised expertise; infrastructure; innovation; high-impact research; quality service; accreditation or standards; leadership; organisational structure; strategy; collaboration and partnership; sustainable funding or financial mechanisms; and entrepreneurship. Conclusions- CoEs have significant scientific, political, economic and social impacts. However, there are inconsistent use and self-designation of the brand without approval by an independent, external process of evaluation and with high ambiguity between ‘CoEs’ and the ordinary ‘institutions’ or ‘centres’. A comprehensive framework is needed to guide and inspire an institution as a CoE and to help government and funding institutions shape and oversee CoEs

Understanding the key processes of excellence as a prerequisite to establishing academic centres of excellence in Africa

Background: Africa’s economic transformation relies on a radical transformation of its higher education institutions. The establishment of regional higher education Centres of Excellence (CoE) across Africa through a World Bank support aims to stimulate the needed transformation in education and research. However, excellence is a vague, and often indiscriminately used concept in academic circles. More importantly, the manner in which aspiring institutions can achieve academic excellence is described inadequately. The main objective of this paper is to describe the core processes of excellence as a prerequisite to establishing academic CoE in Africa. Methods: The paper relies on our collaborative discussions and real-world insight into the pursuit of academic excellence, a narrative review using Pubmed search for a contextual understanding of CoEs in Africa supplemented by a Google search for definitions of CoEs in academic contexts. Results: We identified three key, synergistic processes of excellence central to institutionalizing academic CoEs: participatory leadership, knowledge management, and inter-disciplinary collaboration. (1) Participatory leadership encourages innovations to originate from the different parts of the organization, and facilitates ownership as well as a culture of excellence. (2) Centers of Excellence are future-oriented in that they are constantly seeking to achieve best practices, informed by the most up-to-date and cutting-edge research and information available. As such, the process by which centres facilitate the flow of knowledge within and outside the organization, or knowledge management, is critical to their success. (3) Such centres also rely on expertise from different disciplines and ‘engaged’ scholarship. This multidisciplinarity leads to improved research productivity and enhances the production of problem-solving innovations. Conclusion: Participatory leadership, knowledge management, and inter-disciplinary collaborations are prerequisites to establishing academic CoEs in Africa. Future studies need to extend our findings to understand the processes key to productivity, competitiveness, institutionalization, and sustainability of academic CoEs in Africa

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Formulation and evaluation of sustained release paracetamol peroral matrix tablets: optimisation and in vitro evaluation

An optimised formulation of sustained release paracetamol peroral matrix tablets for a three-times-daily use was prepared with hydroxypropylmethylcellulose (HPMC). The levels of HPMC 4,000, polyethylene glycol (PEG) 6,000 and lactose were varied according to a 2 level 3-factor full factorial experimental design using the release rate of the drug from the matrices as the response variable. From the dissolution data of the eight tablet formulations that resulted from the experimental design, a polynomial regression equation was generated from which an optimum formulation was obtained. Three different batches of granules of the \'optimum formulation\' were compressed into tablets at a compression force of 15 kN with an instrumented EK-0 Korsch eccentric single punch tablet machine. Evaluation of tablet weight variation, crushing strength and friability demonstrated acceptable results. In vitro dissolution tests also revealed sustained release of the drug for an 8-hour period at the end of which almost complete release was achieved (96.22 ± 0.72%, 97.69 ± 0.20% and 98.94 ± 1.17%, respectively, for the three batches). Keywords: sustained release, paracetamol matrix tablets, hydroxypropylmethylcellulose, in vitro dissolution tests, optimization Ethiopian Pharmaceutical Journal, vol. 22 (2004): 27-3