Background: Although research has been undertaken on medicine prices, there has so far been insufficient progress in improving medicine affordability and availability for individual patients in many countries. Hypertension is a major risk factor for cardiovascular disease (CVD) such as acute myocardial infarction (AMI), stroke, heart failure and death. WHO has estimated that hypertension alone accounts for 4.4% of all disability adjusted life years that are ranged from NGN1200 to NGN4250. The aim of this study is to do a pharmacoeconomic evaluation of hypertension and hypertension comorbid with diabetes medications in selected health facilities in Jos and environs, Central Nigeria. Patients’ income per month was assessed ranging from <20,000.00 to ≥ NGN181, 000.00. The medications presented to the patients first were rotated for different patients to eliminate bias. There was a relatively higher cost of treatment in Nasarawa compared to Plateau state. The cost of treatment was highest in private facilities, higher in Faith-based institutions than the public facilities. It cost an unskilled labourer between 27 to 45 days wages to treat hypertension (catastrophic). The monthly cost of medication ranges from NGN1000 to NGN3725 cost. Results show that the monthly cost of treating hypertension ranged from NGN1000 to NGN3000 and NGN1200 to NGN4250 for comorbid cases. Prices of essential medicines used in the management of hypertension and hypertension comorbid with diabetes is quite high compared with the international reference prices. The treatment in both cases were mostly unaffordable for the threshold of an unskilled labourer and majority of the patients. Policy options towards ameliorating these catastrophic effects as the main focus of government and relevant stakeholders is hereby recommended.
The effect of acute and chronic administration of the chloroform extract of the stem bark of P. americana on the blood glucose concentration (BGC) of normoglycaemic and streptozotocin (STZ)-induced hyperglycaemic mice was investigated. Firstly, fifteen (15) young albino mice allocated into three groups of five animals each after a 12 hour overnight fast were treated as follows: group 1 – equi-volume of distilled water, group 11- a single acute dose of 1200 mg/kg IP chloroform extract of P. americana (equivalent to 75% of LD50) and group 111 – 20 mg/kg IP tolbutamide. Immediately after treatment, BGC was measured at 0, ½, 1, 2, 4, and 8 hrs. Secondly another population of 15 animals were shared into 3 groups of 5 animals each. Animals in group 1 were administered equi-volume of distilled water daily, group 11 and group 111 400 mg/kg IP (equivalent to 25% of LD50) extract of P. americana and 10 mg/kg IP of tolbutamide respectively daily for twenty- five days. BGC was measured on days 1, 5, 10, 15,20, 25. Changes in BGC of normoglycaemic and STZ-induced hyperglycaemic mice as a result of acute and chronic administration of extract was compared with values for tolbutamide (positive control) and distilled water (negative control). Results show that in normoglycaemic mice unlike the acute dose of 20 mg/kg IP reference drug tolbutamide, an acute dose of the extract (1200 mg/kg IP) did not significantly lower BGC. In the STZ-induced hyperglycaemic mice however, both the extract and the reference drug tolbutamide significantly lowered the BGC. With chronic administration both the extract and the reference drug significantly lower BGC in STZ-induced hyperglycaemic mice. It can be concluded therefore that acute and chronic administration of the chloroform extract of P. americana does have a hypoglycaemic activity only in STZ-induced hyperglycaemic mice. This may support the use of the stem bark of P. americana in the treatment of Diabetes mellitus.
The challenge of comorbid diseases and especially their management. Posing greater challenge are phytomedical approach without proper scientific testing and more also paucity of modern equipment for research and funding. The need to authenticate medicinal herbs used in the management of Diabetes Mellitus (DM) as one of the common metabolic diseases becomes imperative. This study aimed at evaluating the effect of acute and chronic administration of hot water extract of P. americana on some metabolic parameters in diabetic rats. Thirty young adult healthy male albino rats (wistar strain) weighing between 205-251 g were made diabetic by administration of 80 mg/kg streptozotocin (STZ). The animals were divided into two equal groups of 15 rats each, singly placed in metabolic cages for the acute and chronic treatments studies. The rats were further divided into three groups of 5 animals each and treated with different concentrations of stem-bark hot water extract of Persea americana (HWE-PA) and distilled water while the body weight, food intake, faecal output, water intake and urine output were measured and recorded daily for a period of 5 days for the acute and 28 days for the chronic treatments. Results showed a higher percentage change in body weights, higher food intake and faecal output and lower values in water intake and urine output in both acute and chronic administration of HWE-PA to STZ-induced hyperglycaemic rats compared to the control groups. Both acute and chronic administration of Hot water extract of the stem-bark animals extracts of Persea americana (HWE-PA) presented antidiabetic activity STZ-induced hyperglycaemic rats as evident its ameliorating effect on the body weight, food intake, faecal output, water intake and urine output in STZ-induced hyperglycaemic rats, thus supports its phytomedicine use as an antidiabetic agent.
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