Antimicrobial Prescription Pattern in Ho Teaching Hospital, Ghana: Seasonal Determination Using a Point Prevalence Survey.

A standardised Global Point Prevalence Survey (PPS) tool was used to determine the antimicrobial prescription pattern in the Ho Teaching Hospital on two separate occasions in a total of 14 wards in the hospital, including dedicated wards for paediatrics and neonates. Manually collected and anonymised data were entered, validated, analysed and reported using a web-based global PPS application. With 147 and 153 patients considered in the July 2019 and January 2020 surveys, respectively, 98 patients (66.7%) and 84 patients (54.9%) had received one or more antimicrobials. The prevalence of antimicrobial use in the adult wards was 64.3% (72/112) and 53.4% (63/118) in the first and second surveys, respectively. The prevalence in the paediatric wards was 60.0% (12/20) and 62.5% (10/16), respectively, in the two surveys, while that in the neonatal wards was 93.3% (14/15) and 57.9% (11/19), respectively. β-lactams were the most used antibiotics in both periods. Malaria was the most common diagnosis requiring the use of antimicrobials in July 2019, accounting for 19.4% of the diagnoses, whereas in January 2020, it was skin and soft-tissue conditions (28.1%). This reflects a seasonal association between malaria and rainfall patterns. Out of the antimicrobials prescribed during each of the survey periods, 95% were used for empirical treatment, and this could be attributed to a number of reasons, including logistical challenges, among others, that require further exploration in the context of local, national and international policy recommendations

Knowledge, Awareness and Practice with Antimicrobial Stewardship Programmes among Healthcare Providers in a Ghanaian Tertiary Hospital

Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings

Anti-inflammatory effects of Napoleona imperialis P. Beauv. (Lecythidaceae) on rat model of inflammation

Background: Methanolic extract of Napoleona imperialis, was evaluated for anti-inflammatory effect. Method: Inflammogens used were carrageenan, histamine and formaldehyde. Napoleona imperialis (200-600mg/kg) was administered orally 30 minutes before the induction of inflammation. Diclofenac (10-100mg/kg) and chlorpheniramine (10-100 mg/kg) was administered intraperitoneally. Results: Extract and Diclofenac significantly (F4, 12=15.55, P<0.01; F4, 12=13.76 P<0.01, respectively) inhibited inflammation induced with carrageenan, with extract's maximal inhibitory effect of 64% at dose 400 mg/kg. Diclofenac showed maximal inhibitory effect of 67% at dose 30 mg/kg. Extract and chlorpheniramine significantly (F4, 12=22.14, P<0.01; F4, 12=16.81, P<0.001, respectively) reduced histamine-induced edema with extract having maximal inhibitory effect of 73% at 200 mg/kg. Chlorpheniramine also had maximal inhibitory effect of 70% at 10 mg/kg. Extract and diclofenac significantly (F3, 16=11.06 P<0.001; F3, 16=22.4 P<0.0001, respectively) reduced acute phase of the formaldehyde-induced arthritis. Extract produced maximal effect of 67% at 200 and 400 mg/kg. Diclofenac had a maximal effect of 85% at 100 mg/kg. The chronic phase was ameliorated by extract and diclofenac significantly (F3, 16=11.18 P<0.001; F3, 16=18.07 P<0.0001, respectively). Extract and diclofenac also significantly (F3, 24=19.38 P<0.0001; F3, 24=59.89 P<0.0001, respectively) minimized progression of inflammation from acute to chronic phase. Extract produced a maximal effect of 83% at 400 mg/kg at chronic phase. Diclofenac also had maximal effect of 98% at 30 and 100 mg/kg. Extract and diclofenac, significantly (F4, 12=5.09 P<0.05; F4, 12=31.98 P<0.001, respectively) reduced arthritic score. Conclusion: This study shows methanolic extracts of Napoleona imperialis leaves have anti-inflammaory effects

The possible mode of antitussive and expectorant activity of the ethanol seed extracts of Picralima nitida ((Stapf) Th. & H. Durand)

It has been established that Picralima nitida has antitussive effect. This study therefore aimed at determining the possible mode of antitussive and expectorant activity of an ethanolic seed extract of P. nitida (PNE). The muco-suppressant, mast cell stabilization, and the anxiolytic effects of PNE were ascertained using ammonium chloride-induced phenol red secretion in BALB/c mice; compound 48/80-induced mesenteric mast cell degranulation assay; and the open field and the elevated plus maze models respectively. Antibacterial potential was ascertained by the agar plate diffusion method and its antioxidant potential by the 2,2-diphenyl-1-picrylhydrazyl hydrate (DPPH) free radical scavenging, linoleic acid lipid peroxidation, reducing power, and total antioxidant assays. Data obtained was analyzed using One-way analysis of variance (ANOVA) with Dunnett's Multiple Comparison post hoc test. PNE (100–500 mg/kg) reduced (P ≤ 0.05–0.001) tracheal phenol red secretion. The extract (100–500 μg/ml) also dose-dependently (P ≤ 0.05–0.0001) stabilized mast cells. PNE (100–500 mg/kg) increased open arm activities in the elevated plus maze (P ≤ 0.05) as well as central zone exploration (P ≤ 0.05) in the open field test. PNE (10–50 mg/ml) showed activity against Staphylococcus aureus, Streptococcus pneumonia, Escherichia coli, Klebsiella pneumonia, and Salmonella typhi. By the assays, PNE showed significant antioxidant effect. The ethanolic seed extract of P. nitida has demonstrated very significant mast cell stabilizing, mucus suppressant, and antioxidant activity as well as substantial antibacterial and anxiolytic properties; all of which could contribute to its antitussive and expectorant property

Myrianthus libericus: Possible mechanisms of hypoglycaemic action and in silico prediction of pharmacokinetics and toxicity profile of its bioactive metabolite, friedelan-3-one

The hypoglycaemic and anti-hyperlipidaemic effects of the 70% ethanol stem bark extract of Myrianthus libericus (MLB), used traditionally in the management of diabetes in Ghana, was evaluated in this study using streptozotocin (45 mg/kg)-induced diabetic rats. In vitro hypoglycaemic activities of the extract and one of its principal compounds, friedelan-3-one were then investigated using α-amylase inhibitory and glucose uptake assay in C2C12 myotubes. In silico analysis of the pharmacokinetic and toxicity properties of the compound was also performed. MLB significantly (p < 0.001) reduced the elevated blood glucose levels and corrected considerably (p < 0.01) the altered serum lipid profiles of the diabetic rats which was comparable to glibenclamide (5 mg/kg). Together with friedelan-3-one, the extract markedly inhibited the activity of α-amylase and promoted glucose uptake in C2C12 cells. Whereas MLB significantly (p < 0.001) up-regulated PI3K and PPARγ transcripts with a corresponding increase in GLUT-4 transcripts within the muscle cells, friedelan-3-one only up-regulated PI3K and GLUT-4 transcripts to promote glucose transport. Friedelan-3-one was shown to be non-carcinogenic, non-hepatotoxic, has decent oral bioavailability and a good compound for optimisation into a drug candidate. The study has demonstrated that MLB possess hypoglycaemic and anti-hyperlipidaemic activities and could be used as a therapeutic agent in the management of diabetes mellitus

Progressive review of solar drying studies of agricultural products with exergoeconomics and econo-market participation aspect

An analysis of review articles on solar drying of agricultural products is presented. The review also discusses detailed economic evaluation methods and market participation approaches for transitioning solar dryers from the workshop to the market. This study aims to serve as a model for future solar drying reviews. In addition to broad perspective reviews, most reviews focused on using thermal storage, hybrid technologies, solar greenhouses, 4E evaluations, software applications and crop quality. From most of the reviews, solar dryers with thermal storage are now a viable substitute for fossil energy source dryers and can provide the continuous temperature range of 40–60 °C required to dry food crops. When phase change material is deployed, the transition temperature should be at 5 °C above the desired drying temperature. However, all reviews included sections on types, classification, mode of airflow through the collector, and use of thermal storage in solar drying. Hence, the authors review nearly the same research material, but review gaps remain. Thus that aspect was covered by examining the economic and exergoeconomic analysis methods used in solar dryer evaluations. Again agribusiness inter-phasing between researchers and users, which will spore market participation of solar dryer fabricators lacking in the literature were presented. Therefore, for a more market-oriented development of solar thermal technologies, solar dryer producers must engage in market-oriented production. The nature of markets located at different places calls for better strategies to improve market orientation and access to solar dryers and fabricators

Glycine/NMDA Receptor Pathway Mediates the Rapid-onset Antidepressant Effect of Alkaloids From Trichilia Monadelpha

Introduction: Major depressive disorder is often associated with suicidal tendencies, and this condition accentuates the need for rapid-acting antidepressants. We previously reported that Alkaloids (ALK) from Trichilia monadelpha possess antidepressant action in acute animal models of depression and that this effect is mediated through the monoamine and L-arginine-NO-cGMP pathways. This study investigated the possible rapid-onset antidepressant effect of ALK from T. monadelpha and its connection with the glycine/NMDA receptor pathway. Methods: The onset of ALK action from T. monadelpha was evaluated using the Open Space Swim Test (OSST), a chronic model of depression. The modified forced swimming and tail suspension tests were used to assess the effect of the ALK on the glycine/NMDA receptor pathway. The Instutute of Cancer Research (ICR) mice were treated with either ALK (30–300 mg/kg, orally [PO]), imipramine (3–30 mg/kg, PO), fluoxetine (3–30 mg/kg, PO), or saline. To identify the role of glycine/NMDA receptor pathway in the effect of ALK, we pretreated mice with a partial agonist of the glycine/NMDA receptor, D-cycloserine (2.5 mg/kg, intraperitoneally [IP]), and an agonist of glycine/NMDA receptor, D-serine (600 mg/kg, IP), before ALK administration. Results: ALK reversed immobility in mice after the second day of drug treatment in the OSST. In contrast, there was a delay in the effects induced by fluoxetine and imipramine. ALK also increased mean swimming and climbing scores in mice. ALK was more efficacious than imipramine and fluoxetine in reducing immobility and increasing distance traveled. It is noteworthy that ALK was less potent than fluoxetine and imipramine. D-cycloserine potentiated mobility observed in the ALK- and fluoxetine-treated mice. In contrast, D-serine decreased mobility in the ALK-treated mice. Conclusion: The study results suggest that ALK from T. monadelpha exhibits rapid antidepressant action in mice, and the glycine/NMDA receptor pathway possibly mediates the observed effect