Correlates of patient satisfaction with pain management at the Ho Teaching Hospital in Ghana: A cross-sectional study

Pain is a symptom that many people who visit the hospital with various illnesses experience. Inadequate pain management has been regularly shown to have a negative impact on patients' health and reduce patient satisfaction. Patients' satisfaction with pain management is therefore important. The aim of this study was therefore to assess patients’ satisfaction and experience with pain management at the Ho Teaching Hospital, Volta Region, Ghana. The study was a prospective cross-sectional investigation and was carried out among 196 adult patients (older than 18 years) at the emergency, medical, and surgical wards. Data was collected using the 2010 version of the patient outcome and satisfaction survey questionnaire developed by the American Pain Society. Descriptive and inferential statistical analysis were employed in analysing the data obtained from the respondents. p-value less than 0.05 was considered as statistically significant.The results revealed that 96% of the respondents were satisfied with their pain management. Expectations for pain treatment (r = 0.221, p-value=0.002), percentage of pain relief in first 48 h (r = 0.439, p-value<0.001) and how helpful the information was (r = 0.158, p-value=0.027) were positively correlated with satisfaction with pain treatment. In addition, the median satisfaction with pain treatment was higher for those with knowledge on pain medication (p-value=0.043), and patients who were allowed to participate in decision-making indicated a higher level of satisfaction.The majority of patients (95% with acute pain and 100% with chronic pain) were satisfied with their pain management. Aside the effective use of analgesics, it was found that patient satisfaction can also be enhanced by good patient-provider relationships, providing patients with helpful information about their pain treatment, and allowing patients to participate in decisions about their pain management. This research is the first to provide such information for pain management in the Volta Region of Ghana

Antipleuritic and Vascular Permeability Inhibition of the Ethyl Acetate-Petroleum Ether Stem Bark Extract of Maerua angolensis DC (Capparaceae) in Murine

Maerua angolensis has been used traditionally in the management of pain, arthritis, and rheumatism in Ghana and Nigeria but no scientific evidence is currently available to give credence to its folkloric use. The aim of this study was therefore to evaluate the anti-inflammatory effects of a stem bark extract of Maerua angolensis DC (MAE) in acute inflammatory models. The effects of MAE (30-300 mg kg−1) on neutrophil infiltration, exudate volume, and endogenous antioxidant enzymes in lung tissues and lung morphology were evaluated with the carrageenan induced pleurisy model in Sprague Dawley rats. The effects of MAE (30-300 mg kg−1) on vascular permeability were also evaluated in the acetic acid induced vascular permeability in ICR mice. MAE significantly reduced neutrophil infiltration, exudate volume, and lung tissue damage in carrageenan induced pleurisy. MAE increased the activities of antioxidant enzymes glutathione, superoxide dismutase, and catalase in lung tissues. The extract was also able to reduce myeloperoxidase activity and lipid peroxidation in lung tissues in carrageenan induced rat pleurisy. Vascular permeability was also attenuated by the extract with marked reduction of Evans blue dye leakage in acetic acid induced permeability assay. The results indicated that Maerua angolensis is effective in ameliorating inflammation induced by carrageenan and acetic acid. It also has the potential of increasing the activity of endogenous antioxidant enzymes

Maerua angolensis

Introduction. The stem bark of Maerua angolensis DC. (Capparaceae) is traditionally used for management of epilepsy. Our aim was to evaluate the antiseizure potential and identify possible mechanisms by which the effects are registered. Methods. The petroleum ether/ethyl acetate extract (100–1000 mg kg−1) was administered per os to male Sprague-Dawley rats after pretreatment with flumazenil (0.3 mg kg−1) or L-arginine (150 mg kg−1) or sildenafil (5 mg kg−1) and they subsequently received a subcutaneous injection of pentylenetetrazole (65 mg kg−1). Rats were observed for latency to and duration of myoclonic seizures and additionally the level of protection against oxidant markers and products was assessed in vitro and in vivo. Results. The extract (300 and 1000 mg kg−1, p.o.) significantly delayed the onset and decreased the duration and frequency of PTZ-induced convulsions. The anticonvulsant effect of MAE (300 mg kg−1, p.o.) was reversed by pretreatment with flumazenil, L-arginine, or sildenafil. Also, MAE (300 mg kg−1) treatment reversed significantly PTZ-induced oxidative stress in rat brain tissue. Conclusion. The petroleum ether/ethyl acetate fraction exhibits antiseizure activity by affecting GABAergic and nitric oxide-cGMP pathways. In addition, the extract protects against the generation of free radicals and the oxidative products of the PTZ-induced seizures

Synergistic antidepressant-like effect of xylopic acid co-administered with selected antidepressants

Background: Xylopic acid (XA), a kaurene diterpene from the dried fruits of Xylopia aethiopica, has anxiolytic- and antidepressant-like activity in mice and zebrafish. We aimed to assess the potential synergistic antidepressant-like effects of XA when combined with selected antidepressants in the mouse forced-swim test. Materials and methods: The antidepressant-like effect of xylopic acid (XA) (10, 30, 100 mgkg−1), fluoxetine (Flx) (3, 10, 30 mgkg−1), sertraline (Sert) (3, 10, 30 mgkg−1), imipramine (Imi) (10, 30, 100 mgkg-1) and ketamine (Ket) (0.1, 0.3, 1.0 mgkg−1), was evaluated in forced swim test. The dose (ED50) that achieved a 50% reduction in immobility time was determined from the respective log-dose response curves. XA and the selected antidepressants were co-administered in fixed-dose ratio combinations (1/2:1/2, 1/4:1/4, 1/8:1/8) of the ED50 to identify the experimental ED50 (ED50mix). The theoretical ED50(ED50add), of all combinations was determined using isobolograms and compared with the ED50mix to identify the nature of the interaction. The effect of dose combinations on general locomotor activity was assessed in the open-field test. Results: The interaction index (γ) for the following XA combinations, XA/Flx, XA/Sert, XA/Imi and XA/Ket were 0.42, 0.41, 0.31 and 0.34. An independent sample t-test revealed that the experimental ED50 (ED50mix) was significantly lower than the theoretical ED50 (ED50add) in all combinations of XA, indicative of a synergistic antidepressant-like effect. However, combinations of XA with ketamine significantly reduced general locomotor activity at all dose combinations. Conclusion: The co-administration of xylopic acid and fluoxetine, imipramine, sertraline and ketamine produces a synergistic antidepressant-like effect in mice

Anxiolytic and Antidepressant Effects of Maerua angolensis DC. Stem Bark Extract in Mice

Introduction. The stem bark extract of Maerua angolensis DC. (Capparaceae) is used as a traditional remedy for management of anxiety, psychosis, and epilepsy. Aim of the Study. We therefore aimed at evaluating the anxiolytic and antidepressant potential of the plant in mice models. Methods. The dried stem bark was extracted with petroleum ether/ethyl acetate (50:50) mixture to obtain the extract, MAE. We employed Irwin’s test to identify the preliminary behavioral and autonomic effects. Subsequently, MAE was administered per os to male mice and subsequently assessed, 1 h later, for anxiety parameters in the elevated plus maze (EPM) and the regular Suok tests. The forced swim (FST) and tail suspension (TST) tests were employed to assess the antidepressant potential of the extract (100-1000 mg kg−1). Results. In our preliminary assay, MAE (100-5000 mg/kg) exhibited analgesic effects and a reduction in fear response in the Irwin’s test. The spontaneous locomotor activity was reduced at 1000 mg/kg. Additionally, MAE (1000 mg/kg) increased the latency to PTZ-induced convulsions, and duration to sleep in the pentobarbitone induced sleeping time assay. MAE (1000 mg/kg), similar to diazepam, in the anxiolytic assay, increased the percentage time spent in the open arms while decreasing protected head dips and unprotected stretch attend postures in the EPM. Correspondingly, there was a reduction in anxiety-induced immobility and freezing in the Suok test (300 mg/kg) without loss of sensorimotor coordination. Additionally, there was a significant reduction in immobility duration in the FST (300 mg/kg) and TST (1000 mg/kg). Conclusion. The petroleum ether/ethyl acetate fractions of Maerua angolensis stem bark possess anxiolytic and acute antidepressant effects in mice

Toxicological Assessment of Pseudospondias microcarpa (A. Rich.) Engl. Hydroethanolic Leaf Extract in Rats: Haematological, Biochemical, and Histopathological Studies

Pseudospondias microcarpa is used traditionally for treating various diseases. However, although parts of the plant are extensively used in African traditional medicine, no scientific study has been reported on its toxicity. Therefore, this study evaluated the acute and subacute toxicity studies of the ethanolic extract of P. microcarpa in rats. Male Sprague-Dawley rats (120–150 g) were treated orally with the extract (30, 100, 300, 1000, and 3000 mg kg−1) or distilled water (10 ml kg−1) for 2 weeks and observed daily for general appearance and signs of toxicity. In addition, blood was collected for both biochemical and haematological assays. Sections of tissues from liver, kidney, spleen, brain, and stomach were also used for histopathological examination. Administration of the extract for 14 consecutive days caused no deaths, with an LD50 above 3000 mg kg−1. Except for lymphocytes (%) that showed a significant decrease (F5,23=3.93, P=0.013), all other haematological parameters remained unaffected by the extract. The extract at 100 mg kg−1 showed a significant decrease in the levels of triglyceride and very-low-density lipoproteins (both at P<0.05). Weight change as well as histological evaluation of the organs indicated no toxicity. The study demonstrates that an ethanolic extract of P. microcarpa given orally to rats is safe