Plasmodium falciparum: Assessment of Selectivity of Action of Chloroquine, Alchornea cordifolia, Ficus polita, and Other Drugs by a Tetrazolium-Based Colorimetric Assay

A tetrazolium-based colorimetric selective assay (MTT-based CSA) was developed to assess the selectivity of antimalarial drugs. This in vitro assay, unlike all others, measures the ability of drugs to indirectly protect red blood cells (RBCs) from Plasmodium-falciparum-induced destruction. Optimum incubation time and number of cells needed were 5 days and 23 × 106 RBCs per well, respectively. A parasitemia range of 0.375% to 3% was found to be suitable for this assay. The MTT-based CSA determined anti-P. falciparum strain DD2 activity of chloroquine at a higher 50% effective concentration (EC50) value (21.0 μg/mL) than the isotopic microtest (10.0 μg/mL). Artesunate and oxytetracycline achieved 90% effect against DD2 with minimal or no toxicity to RBCs. Against chloroquine sensitive strain 3D7, chloroquine and Alchornea cordifolia had EC50 values of 0.025 μg/mL and 4.9 μg/mL respectively, and selective index (SI) values of >2,000 and >69.4 μg/mL, respectively

Susceptibility pattern of uropathogens to ciprofloxacin at the Ghana police hospital

Introduction: Reports of increasing resistance of uropathogens to antimicrobials is of global concern. Culture and drug susceptibility tests remain a vital guide to effective therapy. The aim of this study was to determine the susceptibility pattern of isolated uropathogens to ciprofloxacin at the Ghana Police Hospital. Methods: A total of 705 mid-stream urine samples were collected from patients suspected of having  urinary tract infection, and visited the Ghana Police Hospital's laboratory from December 2013 to March  2014. Samples were cultured and isolates identified by standard methods, after which isolates  susceptibility to ciprofloxacin was determined. Results: Prevalence of urinary tract infection among patients' whose samples were analyzed was 15.9%. Predominant uropathogens isolated were E .coli (46.4%), Coliform (41.1%) and Coliform spp. with Candida (6.2%). Other isolates were Pseudomonas spp. (2.7%), Salmonella spp. (1.8%), Candida spp. (0.9%) and Klebsiella spp (0.9%). The overall resistance among the top three isolated uropathogens to ciprofloxacin was 35.9%. Resistance pattern demonstrated by  respective isolates to ciprofloxacin were: E. coli (38.5%), Coliform (54.3%), and Coliform spp. with Candida (15%). The other isolates showed 100% sensitivity.Conclusion: This study revealed a relatively high ciprofloxacin resistance among isolated uropathogens,  hence, the need for prudent prescribing and use of  ciprofloxacin in urinary tract infection management.Key words: Urinary tract infection, isolates, susceptibility, antibiotics, uropathogen

Susceptibility pattern of uropathogens to ciprofloxacin at the Ghana police hospital

Abstract Introduction: Reports of increasing resistance of uropathogens to antimicrobials is of global concern. Culture and drug susceptibility tests remai

Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial

<div><p>Objective</p><p>To determine if metformin monotherapy or metformin in combination with insulin is equally effective as insulin monotherapy at glycemic control in diabetes mellitus in pregnancy among Ghanaians.</p><p>Methods</p><p>This was a study involving 104 pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM) at 20-30 weeks gestation. Participants were randomized into metformin and insulin treatment groups. Starting dose of metformin was 500 mg once a day and increased gradually over two (2) weeks, to meet glycemic targets. Insulin was added if targets could not be reached on metformin alone at maximum doses. Total daily dose of premixed insulin at initiation was calculated as 0.3 IU/kg body weight and titrated upwards to achieve glycemic control. Glycemic profile monitoring was done every two weeks.</p><p>Results</p><p>The two hour post prandial blood glucose (2HPG) levels were significantly lower in the metformin group than the insulin group (p= 0.004).</p><p>Conclusion</p><p>The findings of this study suggest that metformin monotherapy is effective in achieving glycemic targets in the management of diabetes in pregnancy. It is more effective than insulin in lowering the 2HPG level.</p><p>Trial Registration</p><p>Australian New Zealand Clinical Trials Registry (ANZCTR) <a href="http://www.ANZCTR.org.au/ACTRN12614000942651.aspx" target="_blank">ACTRN12614000942651</a></p></div

Demographic characteristics of participants.

<p>*One patient each in the metformin group had malaria, multiple uterine fibroid, anemia as a co-morbid condition whiles one each for insulin had hepatitis B, G6PD and goiter</p><p>**One patient each in the metformin group had intrauterine fetal demise (IUFD), gestational diabetes, and gestational hypertension in their obstetric history whiles insulin group had one patient each with gestational diabetes, post-partum hemorrhage and IUFD.</p><p>Demographic characteristics of participants.</p

Mean glycemic profile from enrolment till term.

<p>Mean glycemic profile from enrolment till term.</p

Mean 2HPG levels at baseline, one month from enrolment and at term for the two treatment groups.

<p>Mean 2HPG levels at baseline, one month from enrolment and at term for the two treatment groups.</p