Vernonia amygdalina is commonly used for food and health purposes. Processing of the leaf for food is aimed at removing bitter tasting antinutritional principles like saponins. This study was designed to determine the antipyretic and antinociceptive property of the crude saponin from Vernonia amygdalina leaf. Standard procedure for antipyretic study using Saccharomyces cerevisiae induced pyrexia in rats; and acetic acid induced writhe, hot plate and cold tail flick tests for antinociceptive study in mice were used. Data for the crude saponin showed significant (P ≤ 0.05) dose dependent anal temperature decrease. The antinociceptive data in mice was significant (P ≤ 0.05) in the writhing test contrary to the cold tail flick test. In acute toxicity study, an LD 50 of 5.1523 g/kg using oral route indicated it was practically non-toxic. Finding suggests that Vernonia amygdalina leaf prepared as diet could be of potential benefit to ailing persons with fever and/or pains, if processing technique adopts minimal loss of principles like saponins.
Modern drug therapy of epilepsy is complicated by the inability of drugs to control seizures in some patients and side effects that range in severity from minimal impairment of the central nervous system to death from aplastic anemia or hepatic failure. Medicinal plants used in traditional medicine for the treatment of epilepsy have been scientifically shown to possess promising anticonvulsant activities in animal models for screening for anticonvulsant activity and can be a source of newer anticonvulsants. The aim of this study was to investigate the preliminary phytochemical properties, anticonvulsant and anxiolytic activities of Melanthera scandens aqueous and ethanolic extracts. Phytochemicals from the aqueous and ethanolic extracts were screened by standard methods. Anticonvulsant activity was evaluated against pentylenetetrazol (PTZ)-induced seizure model in rats. The effect of the extract at oral dose levels of 250, 500 and 1000 mg/kg was evaluated in an experimental rat model, using diazepam (5 mg/kg) as positive control. Anxiolytic activity was performed using elevated plus maze method. Phytochemical screening revealed that M. scandens extracts contain carbohydrates, flavonoids, saponins, glycosides, tannins, terpenoids, phenols and phytosterols. The aqueous extract at a dose of 500 mg/kg significantly increased seizure latency (P=0.0023), while the ethanolic extract did not have a significant effect on seizure latency. Both extracts significantly reduced the seizure severity (P= 0.0155), and provided up to 100% protection against PTZ induced death at 1000 mg/kg. Both extracts had no significant effect on the duration of PTZ induced seizures. Both extracts were found to increase the number of entries and the time spent in the open arms of the maze at a dose of 250 mg/kg, indicating anxiolytic activity, which was not seen at higher doses (500 and 1000 mg/kg). The total numbers of entries into the closed arm were significantly reduced at 500 and 1000 mg/kg oral doses of both extracts, indicating a reduction in locomotor activity of the rats. The results obtained in this study suggest that both the aqueous and ethanolic extracts of M. scandens possess anticonvulsant and anxiolytic activities in a rat model.
Background The objectives of this study were; (I) to determine the proportion of pathogens isolated from patients with infected chronic wounds in the surgical ward of MRRH that are resistant to the third-generation cephalosporins and (II) to determine the factors associated with resistance to third-generation cephalosporins in the surgical ward of MRRH. Method(s) This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Bacterial culture and identification was performed using standard microbiology laboratory procedures whereas broth microdilution method was used to establish the susceptibility of the identified pathogens. Data for objective one (1) was summarized as proportions while the categorized variables were analyzed using logistic regression to determine whether they were associated with the resistance patterns. The level of significance was preset at 5% and p-values less than 0.05 were considered statistically significant. Results Generally, all isolates had complete susceptibility (100%) to Cefoperazone+Sulbactam 2g except 7.1% of proteus spp that were resistant. Of all the bacterial isolates studied, Staphylococcus aureus, Enterobacter agglomerans, providencia spp and pseudomonas earuginosa had complete resistance (100%) to Cefopodoxime 200mg while providencia spp and pseudomomas earuginosa had complete resistance (100%) to Cefixime 400mg and cefotaxime 1g. Finally, higher odds of bacterial resistance to more 2 brands of the third generation cephalosporins were observed among participants who had prior exposure to the third generation cephalosporins (OR, 2.22, 95% CI, 0.80–6.14), comorbidities (OR, 1.76, 95% CI, 0.62–4.96) and those who had more than two hospitalizations in a year (OR, 1.39, 95% CI 0.46–4.25). However, multivariate logistic regression was not performed since no factor was significantly associated with resistance to more than two brands of third generation cephalosporins (p >0.05). Conclusion This study found that cefixime and cefpodoixme had high rates of resistance and should not be used in routine management of infected chronic wounds. In addition, the factors investigated in this study were not significantly associated with bacterial resistance to more than two brands of third generation cephalosporins.
Studies have shown that Vernonia amygdalina possess saponin as one of the bitter phyto-constituents. This study was aimed at determining the anti-inflammatory and antipyretic activity of the aqueous extract of the leaf, root and saponin fraction from the herb. Standard procedures using ear thickness measurement in xylene induced inflammation and anal temperature readings in Saccharomyces cerevisiae induced pyrexia in rats were followed. Data indicated significant (p≤0.05) inhibitory activity for all the dose levels of the extracts in the antiinflammatory and antipyretic evaluations. Saponin fraction at the dose of 100 and 200 mg/kg with 10.5 and 19.6% inhibition respectively, showed significant (p≤0.05) anti-inflammatory activity. The antipyretic evaluation of the saponin fraction showed no anal temperature reduction at 50 mg/kg dose level. Finding suggests the antipyretic and non-steroid like anti-inflammatory activity of the saponin fraction. This may partly explain the observed activity of the herbal extract which has found use traditionally as remedy for similar ailments.
Vernonia amygdalina is commonly used for food and health purposes. The processing of the leaf for food is usually aimed at removing bitter tasting principles like saponins. This study was designed to determine the antipyretic and antinociceptive properties of the aqueous extract, crude saponin and the chromatographic fraction of the crude saponin from the leaf. In the antipyretic evaluation, anal temperature change in fasted rats with prior induced pyrexia using intra-peritoneal administered 15% w/v Saccharomyces cerevisiae, was measured four hours after dose administration. In the antinociceptive evaluation, 0.6% acetic acid solution administered by intra peritoneal route at a dose of 15 ml/kg was used to induce writhing in the writhing test; hot plate at 55 °C ± 1 to induce thermal pain in the hot plate test; and cold mixture of water and ethylene glycol (1:1) maintained at -10 °C to initiate pain sensation in the cold tail flick tests. Antipyretic data showed significant (P ≤ 0.05) anal temperature decrease for all the test doses compared to the placebo. This was markedly observed with the aqueous extract at 0.55 oC ± 0.03 anal temperature decrease, compared to the 0.29 0C ± 0.01 of the crude saponin, at a similar dose level of 400 mg/kg. At 200 mg/kg dose, the crude saponin induced an anal temperature decrease of 0.14 0 C ± 0.02. This was higher than the response obtained with the chromatographic fraction which produced 0.06 0C ± 0.01 anal temperature decrease. Antinociceptive data was significant (P ≤ 0.05) for the crude saponin in the writhing (52.58 % antinociceptic effect) and hot plate tests (14.24 maximum percent analgesia), contrary to observation in the cold tail flick test. Findings showed the antipyretic and non-steroid like antinociceptive property of the crude saponin, which may support the rationale for the use of Vernonia amygdalina leaf to reduce fever and/or pain.
Background Initiation of HAART among people living with HIV (PLWH) having a CD4 count ≤ 350cells/µl, produces poor immunological recovery, putting them at a high risk of opportunistic infections. Artemisia annua and Moringa oleifera are among the herbs commonly consumed by PLWH on HAART to boost their immunity, but their clinical benefits and potential interactions with ARVs remain unknown. This study investigated the effect of A.annua and M.oleifera on CD4 count, viral load, and other clinical and haematological indices among PLWH on HAART at an HIV clinic in Uganda. Methods 282 HIV-positive participants on HAART with a CD4 count ≤ 350cells/µl were randomized in a double-blind clinical trial to receive daily, in addition to their routine standard of care; 1) A.annua leaf powder, 2) A.annua plus M.oleifera, and 3) routine standard of care only. Our primary outcome was change in the CD4 count at 12 months. Secondary outcomes included change in viral load, complete blood count, renal function tests, liver function tests, ARV plasma levels, and quality of life (QoL). Participants were followed up for a year and outcomes were measured at baseline, 6 and 12 months. Results At 12 months of patient follow-up, administration of A.annua + M.orifera plus routine standard of care produced an absolute mean CD4 increment of 105.06 cells/µl, (P < 0.001), while administration of A.annua plus routine standard of care registered an absolute mean CD4 increment of 60.84 cells/µl, (P = 0.001) compared to the control group. The viral load reduced significantly (P = 0.022) for participants on the A.annua + M.orifera compared to those receiving standard of care only. There were significant differences in White blood cell count (P = 0.03), platelet count (P = 0.025), perceived QoL (P < 001) among participants who received A.annua + M.oleifera compared to those who received standard of care only. There were no significant differences in the other secondary outcomes. Conclusion A combination of A.annua and M.oleifera leaf powders taken once a day together with the routine standard of care produced significant improvement in CD4 count, viral load suppression, WBCs, platelets, and quality of life among individuals on HAART.
Background: Achieving favorable HIV treatment outcomes is a major challenge, particularly due to non-adherence and consequent sub-therapeutic plasma antiretroviral drug levels. This is often complicated by the development of resistant strains due to mutations. Monitoring antiretroviral drug levels in the blood of patients enrolled on ART can reveal if levels are too high, enough, or too low. High levels may lead to dose-dependent side effects and sub-therapeutic levels could promote treatment failure and resistance. In Uganda, as part of routine HIV care, plasma antiretroviral drug level is estimated indirectly by clinic-based pill counts and patient self-reported adherence, which give no evidence of ingested medication. This study aimed at exploring steady-state nevirapine and efavirenz drug levels in HIV patients accessing ART at a rural referral hospital in South Western Uganda. Methods: This study was nested into a randomized clinical trial that evaluated the effect of Artemisia annua L. and Moringa oleifera on immunological response and viral load among persons living with HIV (PLHIV). In the parent study, 250 HIV-infected patients with continued immunologic suppression (CD4 count < 350cells/µL) despite a minimum of one-year on ART were enrolled. Out of 250 clinical trial participants, 95 were randomly selected for steady-state efavirenz and nevirapine plasma concentration sampling having taken the last at bedtime. Additionally, CD4 count, HIV load, liver, and renal function tests were determined. Participants were also interviewed for adherence, and factors that affect blood drug levels.Results: Of the 95 participants sampled, 67 (71%) and 28 (30%) were on efavirenz or nevirapine based ART respectively. The median viral load for participants on the efavirenz regimen was 490 copies/mL (IQR 116, 1900) while that for the participants on the nevirapine regimen was 500 copies/mL (IQR 137, 1270). The median plasma level for the participants on the nevirapine regimen (6.56 mg/L IQR 4.50, 9.80) was higher than that for the participants on the efavirenz regiment (2.54 mg/L IQR 1.47, 5.12). The prevalence of virologic failure among participants sampled on the efavirenz regimen was higher (37%) compared to that of the participants on the nevirapine regimen (21%). 30% of all plasma samples tested had sub-therapeutic levels of either efavirenz or nevirapine, including 2% in which no drugs were detected.Conclusion: Periodic therapeutic drug monitoring should be incorporated as one of the components in the monitoring of ART adherence to ensure adequate blood levels among adults accessing ART at MRRH, SW Uganda.
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