The anti-hyperglycemic effect of Solenostemma argel compared with Glibenclamide

The current study aimed to compare the anti-hyperglycemic effect of Solenostemma Argel, which widely used for the treatment of diabetes mellitus in Sudan, with the antidiabetic drug (Glibenclamide). Twenty four albino rats were used in this experiment. Rats were assigned to 4 groups (N=6). All groups have fasted for 18 hrs. Group (1) was administered with glibenclamide (10 mg/kg b.w.) and served as control, groups (2, 3, and) were orally administered with aqueous extract of Solenostemma Argel leaves and bark (200, 400, and 800 mg/kg b.w.), respectively, after loading with 5% glucose (2 mg/kg b.w). Blood samples were obtained to assess blood glucose, lipid profile and α-amylase concentrations. Subchronic toxicity of Solenostemma Argel has been evaluated which clearly demonstrated the non-toxic nature and safety profile. Obtained results indicated that Solenostemma Argel aqueous extract significantly decreased blood glucose level in treated group received 800 mg/kg b.w. compared with glibenclamide treated group. At the dose of 200 mg/kg b.w. of Solenostemma Argel aqueous extract, the activity of α-amylase decreased in comparison with that treated with glibenclamide and registered low concentrations of cholesterol and HDL as well. In conclusion, both blood glucose level and α-amylase activity can be ameliorated in diabetic rats by administration of Solenostemma Argel aqueous extract. However, in prospective study more investigation has should be carried out to explain the mechanism of Solenostemma Argel in hypoglycemic animals

Comparative study on the biological effect of Trigonella foenum graecum (Fenugreek) and Lupinus termis in diabetic albino rats

A number of herbs are traditionally used in Sudan to treat different diseases. In the present study the therapeutic effects of Trigonella foenum graecum (Fenugreek), and Lupinus termis aqueous extracts in glucose-induced diabetic albino rats and the subchronic toxicity of these plants was investigated. Forty-two albino rats of either sex (weighing 135-250 g and aged 60 days) were used. Animals were assigned to seven equal groups (N=6); intact control and six diabetic groups. Diabetes was induced by 5% glucose (2mg/kg b.w). Group (1) was administered with drinking water and assigned as control, groups 2, 3 and 4 were administered with Trigonella foenum aqueous extract (200, 400 and 800 mg/kg b.w, respectively) and groups 5, 6 and 7 were administered with Lupinus termis aqueous extract (200, 400 and 800 mg/kg b.w, respectively). Blood samples were obtained to assess blood glucose level, α-amylase, cholesterol, high-density lipoprotein (HDL) and triglycerides concentrations. In treated diabetic rats, blood glucose level markedly decreased to the normal range. Reduction in cholesterol, triglycerides, and HDL was also observed. Reduction of α-amylase concentration was shown with a low dose (200 mg/kg b.w.) of the extracts of both plants. The present studied plants clearly demonstrate the non-toxic nature and safety profile. The combined history human use of these plants and the data from the current study support the safe use of these plants. It can be concluded that Trigonella foenum graecum seed and Lupinus termis fruit aqueous extract have anti-hyperglycemic effect by affecting both blood glucose level and α-amylase. Trigonella foenum graecum has higher hypoglycemic than Lupinus termis

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century