No abstract

Introduction. In the management of hypertension (a cardiovascular disease and the leading metabolic risk factor in noncommunicable diseases) with herbal medicines, efficacy and safety are of uttermost concern. This study sought to establish hypotensive, antihypertensive, drug interaction, and safety for use of the aqueous leaf extracts of Annona muricata (AME), Persea americana (PAE), or their combination products (CAPE). Methodology. Systolic and diastolic blood pressure (SBP and DBP), mean arterial blood pressure (MAP), and heart rate (HR) were measured in normotensive Sprague-Dawley rats treated with 50–150 mg/kg of AME, PAE, or CAPE to establish a hypotensive effect. “Combination index” was calculated to establish interaction between AME and PAE. The antihypertensive effect of CAPE was established by measuring SBP, DBP, MAP, and HR in ethanol-sucrose- and epinephrine-induced hypertension. Full blood count, liver and kidney function tests, and urinalysis were determined in ethanol/sucrose-induced hypertension to establish safety for use. Results. AME, PAE, and CAPE significantly ( p ≤ 0.001 ) decreased BP in both normotensive and hypertensive animals. Effects of CAPE 1, CAPE 2, and CAPE 3 were synergistic (combination indices of 0.65 ± 0.07, 0.76 ± 0.09, and 0.87 ± 0.07, respectively). There was a significant decrease ( p ≤ 0.01 − 0.001 ) in SBP and MAP with 100 mg/kg CAPE 1 and 75 mg/kg CAPE 2 treatment in hypertension as well as with nifedipine ( p ≤ 0.001 ) treatment. Epinephrine-induced hypertension in anesthetized cats was significantly and dose-dependently inhibited ( p < 0.05 − 0.001 ) by 25–100 mg/ml CAPE 1 and 37.5–75 mg/ml CAPE 2. CAPE administration had no deleterious effect ( p > 0.05 ) on full blood count, liver and kidney function, and urine composition in hypertensive rats. Conclusion. The aqueous leaf extracts of Annona muricata, Persea americana, and their combination products possess antihypertensive properties, with combination products showing synergism and safety with use.

No abstract

The rapid emergence and spread of antimicrobial resistance has become a global public health concern that threatens the effective treatment of infectious diseases. One major approach adopted to overcome antimicrobial resistance is the use of plant extracts individually and/or with combination of antibiotics with plant extracts, which may lead to new ways of treating infectious diseases and essentially representing a potential area for further future investigations. In this study, the antifungal activities of Azadirachta indica leaf and Catharanthus roseus flower extracts against fluconazole-resistant Candida albicans strains (isolated from pregnant women with vulvovaginal candidiasis) and anti-methicillin-resistant Staphylococcus aureus (MRSA) were evaluated by agar well diffusion, microdilution, and biofilm inhibition assays. Subsequently, the determination of the combined antimicrobial activity of the individual plant extracts with (fluconazole and voriconazole) and (ampicillin, tetracycline, and streptomycin) against C. albicans strains and MRSA, respectively, was evaluated by checkerboard microdilution assay. Results from the study showed that the antimicrobial activity of the two plant extracts determined by time-kill kinetics was fungistatic with their MICs ranging from 0.1 to 4 mg/mL. Interestingly, all extracts were proved as good biofilm inhibitors of resistant C. albicans and MRSA from 10.1 to 98.82%. Their combination interaction with fluconazole, voriconazole, ampicillin, tetracycline, and streptomycin ranged from synergy to antagonism as per the parameters used. Overall, these results showed that A. indica leaf and C. roseus flower extracts have significant antifungal property. Furthermore, A. indica leaf and C. roseus flower extracts alone or in combination with fluconazole and voriconazole could provide a promising approach to the management of candidiasis caused by drug-resistant strains as well as their interaction with the antibacterial agents to combat the common infections caused by MRSA.

Despite the widely documented and economic burden of thromboembolic disease (TED) globally, data on the true impact of the disease in Ghana are scanty. This study, therefore, aimed to assess TED burden, risk perception, and thromboprophylactic practices across general medical, surgery, and obstetrics and gynecology specializations in Ghana. A quantitative cross-sectional study was conducted in tertiary regional/district, polyclinic, and private hospitals in the Kumasi Metropolis of the Ashanti region of Ghana. The study indicated that TED was classified as medium risk in most areas of clinical practice and mostly reported in inpatient settings. Deep vein thrombosis and ischemic stroke were the most commonly reported diseases, with pain being the most common symptom. The practice of thromboprophylaxis was averagely practiced in most areas of clinical practice. Pharmacological management of TED was preferred with low-molecular-weight heparins and warfarin being the most widely used therapeutic options. The cost was the greatest factor hindering therapy and choice of medication. Bleeding was the most common side effect observed with therapy. Although therapies for management and prophylaxis of TED are available and effective, it is still a burden and perceived as a risk in clinical practice and healthcare delivery in Ghana because of the high cost of therapy.