Introduction Diarrhea is a cause of morbidity and mortality, especially in children. Patients with diarrhea have been suffering from limited treatment options due to poor drug tolerance, side effect, and multi-drug resistance to almost all the current drug treatments. Therefore, it is important to search for a new therapeutic medicine that can effectively prevent the disease and safe. Vernonia amygdalina is an indigenous medicinal plant used traditionally for the treatment of diarrhea in Ethiopia. The aim of this study was therefore to confirm the antidiarrheal activities of 80% methanol leaves extract using mice models. Materials and Methods The antidiarrheal activities of the 80% methanol leaves extract were investigated using castor oil-induced diarrhea, intestinal motility, and enteropooling models in mice. The negative control received distilled water orally, the test groups received three dose levels (100, 200, and 400 mg/kg) of the plant materials, and the positive control is given 3 mg/kg Loperamide orally. Results In the castor oil-induced diarrheal model, the extract delayed onset of diarrhea and reduced fecal parameters at all tested doses significantly as compared with the negative control. Results from the charcoal meal test revealed that the extract produced a significant anti-motility effect at all tested doses as compared with the negative control. In the enteropooling test, the extract produced a significant decline in the volume and weight of intestinal contents. The observed antidiarrheal activity could be associated with the phytochemicals present in this plant extract. It was also observed that the extracts have shown no acute toxicity at a dose of 2 g/kg. Conclusion This study provides the antidiarrheal activity of the crude extract in all three models. Hence, the findings provide scientific support for the traditional use of Vernonia amygdalina leaves as treatment of diarrhea.
Background: Deprescribing is a new approach in which healthcare providers try to improve a patient's prescription regimen by removing unnecessary drugs. The study was aimed to assess the knowledge, attitude, and practice of primary health care providers towards deprescribing in Ambo university referral hospital (AURH) and AGH (Ambo general hospital) and identify the perceived barriers that prevent primary health care workers not to practicing deprescribing.Method: A facility-based cross sectional study was done using a structured questionnaire on primary health care professionals from July to September 2021. The data was cleaned, coded, and entered into the SPSS version 20 statistical software for analysis. Descriptive statistics were used to describe the dependent and independent variables.Result: 223 primary health care providers in Ambo, West Shewa zone of Oromia, took part in the study. Among the participants, 155(69.5%) heard about deprescribing; around half 109 (48.9%) of the respondents perceived that deprescribing does well than harm to patients. 147 (65.9%) of the respondents reported that they had consciously practiced deprescribing, and 76 (34.1%) had never consciously practiced yet. Regarding barriers, 85(38.1%) of the respondents said that lack of organizational support followed by lack of clear risk benefits information, lack of time and access make them not to practice. Conclusion: The study showed that the majority of the respondents heard about deprescribing and believed that it is important when drugs’ potential harms out weight their benefits. The majority of the participants said that the involvement of pharmacists in medication review makes them to practice deprescribing.
Background: Deprescribing is a planned and supervised process of reducing, substituting, or discontinuing medicines that are unnecessary or deemed to be harmful that tailored to individual patient needs. The study aimed to assess the knowledge, attitude, and practice of healthcare providers towards deprescribing in Ambo university referral hospital (AURH) and AGH (Ambo general hospital), Ethiopia and identify the perceived barriers and enablers of deprescribing. Methods: A self-administered structured questionnaire was used to collect the information from healthcare providers with facilities based cross-sectional study design from July to September 2021. The data was cleaned, coded, and entered into the SPSS version 25 statistical software for analysis. Descriptive statistics were used to describe the finding.Results: Two hundreds twenty three (223) health care providers in AURH and AGH took part in the study. Among the participants, 155(69.5%) heard about deprescribing but 125(56.1%) reportedly had insufficient knowledge about deprescribing. More than three fourth of respondents (75.8%) agreed that deprescribing does benefits than harms the patients in terms of decreasing pills burden, cost of medication, drug-drug interaction, and improving overall treatment outcomes and quality of life. One hundreds forty-seven (65.9%) of the respondents reported that they had consciously practiced deprescribing. Respondents reported that 149 (66.8%) of them deprescribed antipsychotic which were followed by antidepressant 142(63.7%) and antihypertensive 112(50.2%) medications. Respondents noted that the engagement of pharmacists 83 (37.2%), the existence of evidence based user-friendly guidelines 78(34.9%), having sufficient deprescribing knowledge 57(25.6%) and effective multidisciplinary team collaboration and communication 51 (22.9%) were the most often reported enablers for practicing deprescribing. On the other hand, lack of organizational support 85(38.1%), lack of clear risk-benefit information regarding deprescribing 75(33.6%), time constraint and lack of access to evidence-based guidelines 54(24.2%) were the most frequently reported barriers for practicing barriers.Conclusion: More than half of respondents reported that they had insufficient knowledge about deprescribing. More than three-fourth of the respondents agreed that deprescribing does benefits than harms the patients. In general, the respondents identified interconnected patient-related, provider-related, and system-related barriers to deprescribing. Therefore, multi-level approach through innovations and initiatives should be sought to address the perceived barriers.
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