Hypoglycaemic effects of some medicinal plant extracts in streptozotocin-induced diabetic rats.

Thesis (Ph. D. - Physiology) - University of KwaZulu-Natal, 2007.Abstract available in PDF file

Chemical Profiling, Toxicity and Anti-Inflammatory Activities of Essential Oils from Three Grapefruit Cultivars from KwaZulu-Natal in South Africa

Introduction: This case report discusses the successful use of an improvised bubble continuous positive airway pressure (CPAP) apparatus made using items commonly available in a poorly resourced district hospital. Case presentation: A 64-year-old female with no co-morbidities presented with respiratory failure due to pulmonary tuberculosis and was not accepted into the regional Intensive Care Unit (ICU) on referral. She required 8 days of improvised bubble CPAP to maintain adequate oxygen saturation before weaning and eventual discharge. Discussion: Improvised bubble CPAP is commonly used in neonatal care in developing countries and well described in literature however, there are no reports of its successful use in adult patients. In the absence of access to ICU or other Non-invasive ventilation (NIV) equipment, improvised bubble CPAP may provide some therapeutic benefit

EVALUATION OF ANTIDIARRHEAL ACTIVITY OF ETHANOLIC LEAF EXTRACT OF ERIOBOTRYA JAPONICA LINDL

Objective: The study was carried out to investigate the antidiarrheal activity of ethanolic leaf extract of Eriobotrya japonica (EEJ) using various models of experimental diarrhea.Methods: Antidiarrheal property of EEJ at 100, 200, and 400 mg/kg/bwt was evaluated using castor oil-induced diarrhea, castor oil-induced enteropooling, and gastrointestinal propulsive models of experimental diarrhea in Sprague Dawley rats of both sexes, weighing 200–250 g. Cytotoxicity test of EEJ was performed using brine shrimp bioassay.Results: Toxicity assay of EEJ showed a lethal concentration value of 1225 μg/ml suggesting non-toxicity. EEJ significantly (p<0.05) and dose-dependently (100, 200 and 400 mg/kg/bwt) inhibited castor oil-induced diarrhea by 38.1%, 76.19%, and 100%, respectively, and enteropooling by 28%, 56%, and 88%, respectively, compared with control. Pre-treatment with yohimbine, α2-adrenoceptor blocker significantly reversed the protective effect of EEJ (400 mg/kg) against castor oil-induced diarrhea and against castor oil-induced enteropooling, suggesting the involvement of α2-adrenoceptors in antidiarrheal property of EEJ. Furthermore, EEJ significantly (p<0.05) and dosedependently (100, 200, and 400 mg/Kg/bwt) inhibited gastrointestinal motility by 28%, 62%, and 83.92%, respectively.Conclusion: The study has demonstrated the antidiarrheal potential of ethanolic leaf extract of EEJ, which may be attributable to its dual antisecretory and antimotility activities probably through activation of the sympathetic α2-adrenergic pathway

rine shrimp lethality and phytochemical determination of aqueous extracts of Senna singueana, Musa paradisiaca, and Ziziphus mucronata in Malawi.

Traditional medicine is still practiced in different parts of the world; with traditional healers as powerful and important members of the society. Senna singueana, Musa paradisiaca, and Ziziphus mucronata plants are commonly used by traditional healers to treat different ailments in Malawi. There is need to conduct a scientific lethality evaluation of these plants to assess their fitness for human consumption as traditional medicine. The aqueous extraction of leaves and roots of Senna singuenna, Musa paradisiaca, and Ziziphus mucronata mimicking similar environment as provided by traditional healers, afforded dry extracts. Brine shrimp toxicity testing was done following a modified procedure to determine in-vitro cytotoxicity for the herbal extracts. The findings suggest that the leaves and roots tested exhibited concentration dependent toxicity against brine shrimps with the exception of Ziziphus mucronata roots which showed some toxicity to brine shrimps after 48 hours of incubation. Brine shrimp results suggest that the plant extracts were virtually non-toxic on the shrimps save Senna singueana leaves, Ziziphus mucronata roots, which exhibited low toxicity on brine shrimps after 48 hours of incubation. The observed toxic activity for Ziziphus mucronata roots may be due to the presence of well documented cytotoxic compounds such as Swertish and Apigenine glucoside

A COMPARATIVE STUDY ON THE APHRODISIAC ACTIVITY OF FOOD PLANTS MONDIA WHITEI, CHENOPODIUM ALBUM, CUCURBITA PEPO AND SCLEROCARYA BIRREA EXTRACTS IN MALE WISTAR RATS.

Background: Any substance that increases erectile function, sexual performance and enjoyment is considered an aphrodisiac. The was to compare the effects of food plants Mondia whitei, Chenopodium album, Cucurbita pepo and Sclerocarya birrea extracts 200mg/kg body weight on sexual behavior, sperm parameters and testosterone levels in adult male rats. These are food plants also aphrodisiacs in South Africa, Zimbabwe and other parts of Africa. Materials and methods: Sexual behavior parameters assessed in this study included an arousal component (mount latency and intromission sexual potency (mount frequency and intromission frequency), erection (copulatory efficiency) and ejaculations. All treatments orally daily for 28 days. Sexual behavior parameters were quantified 2 hours after a single dose, at 14 days and at 28 days of treatment. Results: The order of efficacy in stimulating sexual behavior in male rats was M. whitei >S. birrea > C. pepo ≥C. album. Although change in number of ejaculations and sperm count (P>0.05) for all treatment groups compared to controls, all treatments increased motility. M. whitei and C. pepo treatments resulted in increased (

Predicting adherence to postdischarge malaria chemoprevention in Malawian pre-school children: A prognostic multivariable analysis

Chemoprevention with antimalarials is a key strategy for malaria control in sub-Saharan Africa. Three months of postdischarge malaria chemoprevention (PDMC) reduces malaria-related mortality and morbidity in pre-school children recently discharged from hospital following recovery from severe anemia. Research on adherence to preventive antimalarials in children is scarce. We aimed to investigate the predictors for caregivers’ adherence to three courses of monthly PDMC in Malawi. We used data from a cluster randomized implementation trial of PDMC in Malawi (n = 357). Modified Poisson regression for clustered data was used to obtain relative risks of predictors for full adherence to PDMC. We did not find a conclusive set of predictors for PDMC adherence. The distribution of households across a socio-economic index and caregivers’ education showed mixed associations with poor adherence. Caregivers of children with four or more malaria infections in the past year were associated with reduced adherence. With these results, we cannot confirm the associations established in the literature for caregiver adherence to artemisinin-based combination therapies (ACTs). PDMC combines multiple factors that complicate adherence. Our results may indicate that prevention interventions introduce a distinct complexity to ACT adherence behavior. Until we better understand this relationship, PDMC programs should ensure high program fidelity to sustain adherence by caregivers during implementation

Adherence to community versus facility-based delivery of monthly malaria chemoprevention with dihydroartemisinin-piperaquine for the post-discharge management of severe anemia in Malawian children: A cluster randomized trial

BACKGROUND The provision of post-discharge malaria chemoprevention (PMC) in children recently admitted with severe anemia reduces the risk of death and re-admissions in malaria endemic countries. The main objective of this trial was to identify the most effective method of delivering dihydroartemesinin-piperaquine to children recovering from severe anemia. METHODS This was a 5-arm, cluster-randomized trial among under-5 children hospitalized with severe anemia at Zomba Central Hospital in Southern Malawi. Children were randomized to receive three day treatment doses of dihydroartemesinin-piperaquine monthly either; 1) in the community without a short text reminder; 2) in the community with a short message reminder; 3) in the community with a community health worker reminder; 4) at the facility without a short text reminder; or 5) at the facility with a short message reminder. The primary outcome measure was adherence to all treatment doses of dihydroartemesinin-piperaquine and this was assessed by pill-counts done by field workers during home visits. Poisson regression was utilized for analysis. RESULTS Between March 2016 and October 2018, 1460 clusters were randomized. A total of 667 children were screened and 375 from 329 clusters were eligible and enrolled from the hospital. Adherence was higher in all three community-based compared to the two facility-based delivery (156/221 [70·6%] vs. 78/150 [52·0%], IRR = 1·24,95%CI 1·06-1·44, p = 0·006). This was observed in both the SMS group (IRR = 1·41,1·21-1·64, p<0·001) and in the non-SMS group (IRR = 1·37,1·18-1·61, p<0·001). Although adherence was higher among SMS recipients (98/148 66·2%] vs. non-SMS 82/144 (56·9%), there was no statistical evidence that SMS reminders resulted in greater adherence ([IRR = 1·03,0·88-1·21, p = 0·68). When compared to the facility-based non-SMS arm (control arm), community-based delivery utilizing CHWs resulted in higher adherence [39/76 (51·3%) vs. 54/79 (68·4%), IRR = 1·32, 1·14-1·54, p<0·001]. INTERPRETATION Community-based delivery of dihydroartemesinin-piperaquine for post-discharge malaria chemoprevention in children recovering from severe anemia resulted in higher adherence compared to facility-based methods. TRIAL REGISTRATION NCT02721420; ClinicalTrials.gov

Ursolic Acid and Its Derivatives as Bioactive Agents

Non-communicable diseases (NCDs) such as cancer, diabetes, and chronic respiratory and cardiovascular diseases continue to be threatening and deadly to human kind. Resistance to and side effects of known drugs for treatment further increase the threat, while at the same time leaving scientists to search for alternative sources from nature, especially from plants. Pentacyclic triterpenoids (PT) from medicinal plants have been identified as one class of secondary metabolites that could play a critical role in the treatment and management of several NCDs. One of such PT is ursolic acid (UA, 3 &beta;-hydroxy-urs-12-en-28-oic acid), which possesses important biological effects, including anti-inflammatory, anticancer, antidiabetic, antioxidant and antibacterial effects, but its bioavailability and solubility limits its clinical application. Mimusops caffra, Ilex paraguarieni, and Glechoma hederacea, have been reported as major sources of UA. The chemistry of UA has been studied extensively based on the literature, with modifications mostly having been made at positions C-3 (hydroxyl), C12-C13 (double bonds) and C-28 (carboxylic acid), leading to several UA derivatives (esters, amides, oxadiazole quinolone, etc.) with enhanced potency, bioavailability and water solubility. This article comprehensively reviews the information that has become available over the last decade with respect to the sources, chemistry, biological potency and clinical trials of UA and its derivatives as potential therapeutic agents, with a focus on addressing NCDs

Delivery strategies for malaria chemoprevention with monthly dihydroartemisinin-piperaquine for the post-discharge management of severe anaemia in children aged less than 5 years old in Malawi: a protocol for a cluster randomized trial.

BACKGROUND: Children initially hospitalized with severe anaemia in Africa are at high risk of readmission or death within 6 months after discharge. No intervention strategy specifically protects children during the post-discharge period. Recent evidence from Malawi shows that 3 months of post-discharge malaria chemoprevention (PMC) with monthly treatment with artemether-lumefantrine in children with severe malarial anaemia prevented 31% of deaths and readmissions. While a confirmatory multi-centre trial for PMC with dihydroartemisinin-piperaquine is on going in Kenya and Uganda, there is a need to design and evaluate an effective delivery strategy for this promising intervention. METHODS: This is a cluster-randomized trial with 5 arms, each representing a unique PMC delivery strategy. Convalescent children aged less than 5 years and weighing more than 5 kg admitted with severe anaemia and clinically stable are included. All eligible children will receive dihydroartemisinin-piperaquine at 2, 6 and 10 weeks after discharge either: 1) in the community without an SMS reminder; 2) in the community with an SMS reminder; 3) in the community with a community health worker reminder; 4) at the hospital with an SMS reminder; or 5) at the hospital without an SMS reminder. For community-based strategies (1, 2 and 3), mothers will be given all the PMC doses at the time of discharge while for hospital-based strategies (4 and 5) mothers will be required to visit the hospital each month. Each arm will consist of 25 clusters with an average of 3 children per cluster giving approximately 75 children and will be followed up for 15 weeks. The primary outcome measure is uptake of complete courses of PMC drugs. DISCUSSION: The proposed study will help to identify the most effective, cost-effective, acceptable and feasible strategy for delivering malaria chemoprevention for post-discharge management of severe anaemia in under-five children in the Malawian context. This information is important for policy decision in the quest for new strategies for malaria control in children in similar contexts. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02721420 . Protocol registered on 29 March 2016.The study was not retrospectively registered but there was a delay between date of submission and the date it first became available on the registry