Antidiabetic Activities of Hydromethanolic Leaf Extract of Calpurnia aurea (Ait.) Benth. Subspecies aurea (Fabaceae) in Mice

Diabetes mellitus is one of the largest global health problems demanding preventive and new therapeutic interventions. Currently, there is a need for safe, effective, and less costly antidiabetic medications, and investigating medicinal plants for new antidiabetic medication is an interesting research area. Thus, the present study was done to evaluate the antidiabetic activities of 80% methanolic leaf extract of Calpurnia aurea (Ait.) Benth. subspecies aurea (Fabaceae) in mice. Hypoglycemic and antihyperglycemic activity of the three doses (100mg/kg, 200 mg/kg, and 400 mg/kg) of crude hydromethanolic leaf extract was studied on normoglycemic, oral glucose loaded, and streptozotocin-induced diabetic mice models. The effect of the extract on body weight and diabetic dyslipidemia was also studied on streptozotocin-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all cases. A glucose meter and an automated chemistry analyzer were used to measure blood glucose and serum lipid level respectively. Data were analyzed using one-way analysis of variance followed by Tukey’s post hoc multiple comparison test. All the three doses of the plant extract (100mg/kg, 200 mg/kg, and 400 mg/kg) showed a significant (p<0.05) antihyperglycemic activity in the diabetic mice at the 7th and 14th day of repeated daily dose administration as compared to the negative diabetic control. But, the extract did not show significant blood glucose lowering activity in normoglycemic, oral glucose loaded, and diabetic mice after single dose administration, and it did not significantly improve the body weight loss and diabetic dyslipidemia of diabetic mice after repeated daily dose administration for 14 days. This study revealed that the hydromethanolic extract of Calpurnia aurea leaves possesses significant antihyperglycemic activity justifying the traditional use of the plant for diabetes

A prospective observational study of drug therapy problems in medical ward of a referral hospital in northeast Ethiopia

Abstract Background Drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. Drug therapy problems are common causes of patient morbidity and mortality. There was no study that has been done on drug therapy problems in the study area, Dessie referral hospital, northeast Ethiopia. Method A prospective observational study was conducted among hospitalized patients in the medical ward of Dessie referral hospital from March 01 to May 31, 2014. Ethical approval was obtained and informed consent was signed by each study participant before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data regarding each patient’s demographics, medical condition, drug therapy and patient compliance to the drug therapy were collected using pretested checklists, and drug therapy problems were determined based on the standard practice and textbooks. Descriptive statistical analysis was done using SPSS Version 20 Software. Result A total of 147 patients were included, 75.51% of whom experienced at least one drug therapy problem. During the 3 month period a total of 159 drug therapy problems were identified of which needs additional drug therapy (35.85%) was the most common followed by unnecessary drug therapy (30.19%) and dosage too low (13.2%). Antibiotics, 75 (40.32%) was the most frequent drug class involved in drug therapy problems followed by cardiovascular drugs, 69 (37.1%) and nonsteroidal anti-inflammatory drugs, 9 (4.84%). Ceftriaxone (25.81%) was the most frequent specific drug prone to the drug therapy problems followed by spiranolactone (14.52%), enalapril (6.45%) and furosemide (6.45%). Conclusions Three out of four patients experienced at least one drug therapy problem during their hospital stay in the medical ward, with the most commonly observed DTP being no drug therapy prescribed for a condition requiring drug treatment

Evaluation of Antidiabetic Activity of the Leaf Latex of Aloe pulcherrima Gilbert and Sebsebe (Aloaceae)

The leaf latex of Aloe pulcherrima has been used as remedy for diabetes mellitus. This was carried out to determine in vitro and in vivo antidiabetic activities of the leaf latex of Aloe pulcherrima. Methods. Sucrase and maltase inhibitory activity of the leaf latex of A. pulcherrima was determined in glucose oxidase assay, and α-amylase inhibitory activity was determined in dinitrosalicylic acid assay. Normoglycemic, glucose-loaded, and streptozotocin-induced diabetic mice were treated orally to determine blood glucose lowering activity of the latex. Effect of the latex on serum lipid level and body weight was measured in streptozotocin-induced diabetic mice. Additionally, DPPH assay was used to determine free radical scavenging capacity of the latex. Results. Antioxidant activity of the latex was concentration dependent; the strongest inhibition was measured at 800 μg/ml (80.57%). The leaf latex of A. pulcherrima inhibited sucrase (IC50 = 2.92 μg/ml), maltase (IC50 = 11.81 μg/ml) and α-amylase (IC50 = 14.92 μg/ml) enzymes. All doses of the leaf latex induced hypoglycemic effect after 4 h in normal mice, and low dose of the latex did not show significant effect after 6 h. Glucose reduction of the leaf latex of A. pulcherrima was significant (p<0.05) in oral glucose-loaded mice compared to the vehicle control. Blood glucose level of diabetic mice was significantly (p<0.05) reduced on week one and weak two in a streptozotocin-induced diabetic mouse model. Glucose reduction increased with increasing the doses of the leaf latex of A. pulcherrima on week one (p<0.05 (200 mg/kg), p<0.01 (400 mg/kg), and p<0.001 (600 mg/kg)). Administration of the leaf latex of A. pulcherrima for two weeks significantly (p<0.05) improved diabetic dyslipidemia and body weight of diabetic mice. Conclusion. The study confirmed that the leaf latex of the plant showed a significant antidiabetic activity justifying the traditional uses of the plant

In Vitro α-Amylase and α-Glucosidase Inhibitory and Antioxidant Activities of the Crude Extract and Solvent Fractions of Hagenia abyssinica Leaves

Background. The leaves of Hagenia abyssinica have been used in the management of diabetes mellitus in Ethiopian folk medicine. Thus, this study is aimed at investigating the in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities of the crude extract and solvent fractions of H. abyssinica leaves. Methods. The in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities of the plant extract were assessed using 3,5-dinitrosalicylic acid (DNSA), p-nitro-phenyl-a-D glucopyranoside (p-NPG), and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays, respectively. Each value of percent inhibition of α-amylase, α-glucosidase, and DPPH scavenging effect was presented as means±SEM (n=3). Results. The α-amylase inhibitory activity of the crude extract and solvent fractions was found to be concentration-dependent. The strongest activity was exhibited by the crude extract at the highest concentration with a percentage inhibition of 74.52% (IC50, 14.52 μg/ml) followed by water fraction 68.24% (IC50, 16.31 μg/ml), ethyl acetate fraction 61.57% (IC50, 18.73 μg/ml), and chloroform fraction 56.87% (IC50, 21.57 μg/ml) of H. abyssinica leaves. In the α-glucosidase inhibition assay, the maximum activity was exhibited by the aqueous fraction 62.54% (IC50, 11.67 μg/ml) followed by ethyl acetate fraction 54.97% (IC50, 15.89 μg/ml), crude extract 46.79% (IC50, >16.5 μg/ml), and chloroform fraction 36.44% (IC50, >16.5 μg/ml). In the antioxidant assay, the crude extract exhibited the highest antioxidant activity 86.36% (IC50, 10.25 μg/ml) followed by water fraction 78.59% (IC50, 13.86 μg/ml), ethyl acetate fraction 71.58% (IC50, 16.34 μg/ml), and chloroform fraction 63.65% (IC50, 18.83 μg/ml). Conclusion. This study has revealed that H. abyssinica leaves possess noticeable in vitro α-amylase and α-glucosidase inhibitory and antioxidant activities

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

A retrospective study of drug related problems and contributing factors among type 2 diabetes mellitus patients on follow up at public health institutions of kemisse town, north east Ethiopia

Background: Drug related problems interfere with the desired treatment outcomes of type 2 Diabetes mellitus. This study was conducted to determine prevalence of drug related problems and associated factors among patients with type 2 Diabetes Mellitus in public health institutions of Kemisse town, northeast Ethiopia from May 01 to 30, 2019. Methods: Institution based retrospective cross sectional study was conducted among type 2 Diabetes Mellitus patents on follow up at public health institutions of Kemisse town, northeast Ethiopia. Result: From the total of 156 patients included in the study, 126 (80.8%) patients have at least one drug related problem with a total of 149 drug related problems. The most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Identified causes of need for additional drug therapy were the need for prophylactic drug therapy (statins and antiplatelet), 83.3%; presence of untreated medical condition (Hypertension, diabetic nephropathy and diabetic foot ulcer), 11.7%; and the need for combination therapy for better efficacy, 5%. This study revealed that age ≥45 years (AOR = 5.59, 95% CI = 1.38–20.64, P = 0.016), presence of comorbid condition (AOR = 3.22, 95% CI = 1.75–13.47, P = 0.014 and emergency visit in the last one year (AOR = 5.08, 95% CI = 1.14–18.71, P = 0.033) were significantly associated with the occurrence of drug related problems. Conclusion: A total of 149 drug related problems were identified in 80.8% of type 2 diabetes mellitus patients. The three most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Additionally, age ≥45 years (AOR = 5.59, P = 0.016), presence of comorbidity (AOR = 3.22, P = 0.014) and emergency visit in the last one year (AOR = 5.08, P = 0.033) were significantly associated with the occurrence of drug related problem

The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Pourshams A, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY &amp; HEPATOLOGY. 2019;4(12):934-947.Background Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51.9%) were in males. The age-standardised incidence rate was 5.0 (4.9-5.1) per 100 000 person-years in 1990 and increased to 5.7 (5.6-5.8) per 100 000 person-years in 2017. There was a 2.3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2.1 times increase in DALYs due to pancreatic cancer, increasing from 4.4 million (4.3-4.5) in 1990 to 9.1 million (8.9-9.3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17.4 [15.8-19.0] per 100 000 person-years) and Uruguay (12.1 [10.9-13.5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1.9 [1.5-2.3] per 100 000 person-years) had the lowest rate in 2017, and Sao Tome and Principe (1.3 [1.1-1.5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21.1% [18.8-23.7]), high fasting plasma glucose (8.9% [2.1-19.4]), and high body-mass index (6.2% [2.5-11.4]) in 2017. Interpretation Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd