BACKGROUND:Globally, cardiovascular diseases (CVDs) are becoming the major cause of death. Urtica simensis is one of endogenous plant which treats a wide range of disease conditions including heart diseases. However, there is limited information on safety and efficacy of the plant.OBJECTIVE:To evaluate the in vitro antioxidant, the in vivo cardioprotective activity of crude extract and solvent fractions of Urtica simensis leaves on cyclophosphamide-induced myocardial injury.METHODS:The cardioprotective activity of the crude extract, aqueous and hexane fraction of Urtica simensis leaves was evaluated based on anatomical, biochemical and histopathological methods. The in vitro antioxidant activity of the plant was also assayed in terms of free radical scavenging activity (RSA).RESULTS:Crude extract and solvent fractions of Urtica simensis significantly prevented the deleterious effect of cyclophosphamide on body weight (P<0.001), heart weight to body ratio (P<0.01), cardiac biomarkers including troponin I (P<0.01), alanine transaminase (ALT) (P<0.001), aspartate aminotransferase (AST) (P<0.01) and lipid profiles including triglycerides (P<0.001) and total cholesterol (P<0.01). The histopathological study confirmed presence of necrosis, oedema and haemorrhage on cyclophosphamide alone-treated groups while the 200mg/kg and 400mg/kg of the crude extract and aqueous fraction showed normal cardiocytes. The antioxidant assay of Urtica simensis plant exhibited free radical scavenging activity of inhibitory concentration of 50% (IC50) for the crude extract with the values of 63.27µg/mL, aqueous fraction with the values of 136.38µg/mL and hexane fraction with the values of 258.70µg/mL.CONCLUSION:Crude extract and solvent fractions of Urtica simensis leaves have cardioprotective activities. The cardioprotective effect could be attributed to the antioxidant activity of the plant extracts. However, this requires further in-depth understanding.

Background: Congenital malformations are defects of the morphogenesis of organs or body during the pregnancy period and are identifiable at pre- or postnatal. It is identified as the major cause of child mortality worldwide. There is a need to understand the prevalence of congenital malformations in Tigray in particular and Ethiopia in general as surveillance data are lacking. Hence, this study was designed to investigate the burden of gross congenital malformations in the Tigray Region, Northern Ethiopia. Methods : This cross-sectional study was conducted of birth outcomes diagnosed with structural malformations in the labor ward admitted to Ayder comprehensive specialized university hospital and five general hospitals namely Alamata, Lemlem Karl, Adwa, St Mary and Shul Hospitals from Tigray region between January 2018 and January 2019. Data on demographic and clinical findings of the mothers and their pregnancy outcomes were collected using a standard data collection tool. Simple descriptive statistics were used to characterize the study subjects. Statistical analysis was done using chi-square analysis and P value<0.05 was considered significant. Results: A total of 12225 births were recorded in the six hospitals during the study period. Of these, 383 births had gross congenital malformations of different degrees of severity and 12 of them were stillbirths. The overall occurrence of congenital malformations was 3.1 % of the total births (live births and stillbirths) examined. Central nervous system anomaly mainly Neural tube defect were found the commonest anomalies observed in this study. The maternal factors (maternal age, gravidity, abortion history, parity) and fetal factors (birth weight and gestational ages were significantly associated with the occurrence of the gross congenital malformations (p<0.05). Conclusion: This study has shown a high prevalence of gross congenital anomalies exists in the study communities. High prevalence of central nervous system-related malformations was observed in the Tigray region, given the high prevalence of nutritional deficiency and lack of periconceptional care that can impact the formation of the nervous system in the current study population. Hence, there should be an immediate food fortification with folic acid and periconceptional folic acid supplementation for all reproductive-age women in the region and the country at large.

Addiction is a disorder of brain reward system, motivation and memory manifested by certain biological, psychological, and social problems. The Lack of most effective and long-term pharmacotherapies that can improve quality of life, necessitate the need to understand the biology of addiction for possible identification of drug targets in the brain circuit and conduct large-scale clinical studies with the hope of finding efficacious and safe medicines. Because of the wide projections of orexinergic neurons and their complicated linkage with other neurons along with the diffused distribution of orexin receptors, the orexin system is involved in the regulation of multiple central nervous system functions including addiction. Rigorous studies on the molecular and cellular bases are highly important emphasizing on how the orexinergic system is interacting with addictive substances and can modify the brain reward circuit. Therefore, the aim of this review is to discuss the existing knowledge and evidence on orexin’s cellular connectivity with addiction-related brain structure and the emerging role of orexinergic system in the treatment of addiction.

IntroductionIntramuscular benzathine penicillin G (BPG) injections are a cornerstone of secondary prophylaxis to prevent acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Uncertainties regarding inter-ethnic and preparation variability, and target exposure profiles of BPG injection are key knowledge gaps for RHD control.MethodsTo evaluate BPG pharmacokinetics (PK) in patients receiving 4-weekly doses in Ethiopia, we conducted a prospective cohort study of ARF/RHD patients attending cardiology outpatient clinics. Serum samples were collected weekly for one month after injection and assayed with a liquid chromatography-mass spectroscopy assay. Concentration-time datasets for BPG were analyzed by nonlinear mixed effects modelling using NONMEM.ResultsA total of 190 penicillin concentration samples from 74 patients were included in the final PK model. The median age, weight, BMI was 21 years, 47 kg and 18 kg/m2, respectively. When compared with estimates derived from Indigenous Australian patients, the estimate for median (95% confidence interval) volume of distribution (V/F) was lower (54.8 [43.9–66.3] l.70kg-1) whilst the absorption half-life (t1/2-abs2) was longer (12.0 [8.75–17.7] days). The median (IQR) percentage of time where the concentrations remained above 20 ng/mL and 10 ng/mL within the 28-day treatment cycle was 42.5% (27.5–60) and 73% (58.5–99), respectively.ConclusionsThe majority of Ethiopian patients receiving BPG as secondary prophylaxis to prevent RHD do not attain target concentrations for more than two weeks during each 4-weekly injection cycle, highlighting the limitations of current BPG strategies. Between-population variation, together with PK differences between different preparations may be important considerations for ARF/RHD control programs.

Background Cyclophosphamide is an alkylating antineoplastic agent and its major limitation is injury to normal tissue, leading to multiple organ toxicity, including kidney, heart, liver and reproductive toxicity. Croton macrostachyus (Euphorbiaceae) has been used in Ethiopian traditional medicine to manage renal diseases. Objective The present study aims to assess the protective effect of the stem bark extract and solvent fractions of Croton macrostachyus on cyclophosphamide-induced nephrotoxicity in rats. Methods Nephrotoxicity was induced using cyclophosphamide 200 mg/kg i.p injection on the first day of the experiment. The negative control groups were administered with cyclophosphamide alone (200 mg/kg, i.p.). The crude extracts were administered at three dose levels (100, 200, and 400 mg/kg), while aqueous and ethyl acetate fractions were given at two dose levels (100 and 200 mg/kg). Excepting the normal control, all groups were subjected to cyclophosphamide toxicity on the first day. Results Treatment with crude extract 100 mg/kg and ethyl acetate fraction significantly decreased kidney-to-body weight ratio (P < 0.001). In addition, treatment with Croton macrostachyus crude extract and solvent fractions significantly decreased serum blood urea nitrogen (BUN) level (P < 0.001). Treatment with 100 and 200 mg/kg of ethyl acetate fraction significantly decreased serum creatinine level. Histopathological results confirmed the protective effect of the crude extract and solvent fractions of Croton macrostachyus. Conclusion Croton macrostachyus possesses nephroprotective activities and it could be a possible source of treatment for cyclophosphamide-induced nephrotoxicity.

OBJECTIVE:To evaluate the antioxidant and cardioprotective activities of stem bark extract and solvent fractions of Croton macrostachyus on cyclophosphamide-induced cardiotoxicity in rats. Materials and Methods. DPPH free radical scavenging assay method was used to determine antioxidant activity whereas Sprague-Dawley rats were used to evaluate the cardioprotective activity. Except for the normal control, all groups were subjected to cyclophosphamide (200 mg/kg, i.p.) toxicity on the first day. Enalapril at 10 mg/kg was used as a reference. The hydromethanolic crude extract (100, 200, and 400 mg/kg) and aqueous and ethyl acetate fractions (100 and 200 mg/kg, each) were administered for 10 days. The cardioprotective activities were evaluated using cardiac biomarkers such as Troponin I, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total cholesterol (TC), triglyceride (TG), and histopathological studies of heart tissue. RESULTS:Crude extract and ethyl acetate and aqueous fractions exhibited free radical scavenging activities at IC50 of 594 μg/mL, 419 μg/mL, and 716 μg/mL, respectively. Crude extract at 400 mg/kg decreased the levels of troponin, AST, ALT, and ALP to 0.29 ± 0.06 ng/mL, 103.00 ± 7.63 U/L, 99.80 ± 6.18 U/L, and 108.80 ± 8.81 U/L, respectively. In addition, ethyl acetate fraction at 200 mg/kg decreased the levels of troponin, AST, ALT, and ALP to 0.22 ± 0.02 ng/mL, 137.00 ± 14.30 U/L, 90.33 ± 6.13 U/L, and 166.67 ± 13.50 U/L, respectively, compared with the cyclophosphamide control group. CONCLUSIONS:Croton macrostachyus possesses cardioprotective activities and it could be a possible source of treatment for cardiotoxicity induced by cyclophosphamide.

The chemotherapeutic and immunosuppressive agent cyclophosphamide has previously been shown to induce complications within the setting of bone marrow transplantation. More recently, cardiotoxicity has been shown to be a dose-limiting factor during cyclophosphamide therapy, and cardiooncology is getting wider attention. Though mechanism of cyclophosphamide-induced cardiotoxicity is not completely understood, it is thought to encompass oxidative and nitrative stress. As such, this review focuses on antioxidants and their role in preventing or ameliorating cyclophosphamide-induced cardiotoxicity. It will give special emphasis to the cardioprotective effects of natural, plant-derived antioxidants that have garnered significant interest in recent times.

Background: Societies in developing countries use traditional medicine as alternatives for management of pain and inflammation. The plant Cucumis ficifolius has been used in Ethiopia to treat many ailments including inflammation and pain. The objective of this study was to evaluate the antinociceptive and anti-inflammatory activities of the crude root extract and solvent fractions of C. ficifolius. Methods: The analgesic activity of crude extract and solvent fractions of C. ficifolius was evaluated with acetic acid-induced writhing, hot plate, and formalin-induced paw licking tests. The anti-inflammatory effect of crude methanolic root extract and solvent fractions of C. ficifolius was evaluated using carrageenan-induced paw edema. The crude extract was given at 200, 400 and 800 mg/kg. Butanol and aqueous fractions were given at 100 and 200 mg/kg doses. The negative control groups were treated with distilled water (10 mL/kg). Standard drugs used were acetylsalicylic acid (ASA) in acetic acid, formalin tests and carrageenan-induced paw edema and morphine (20 mg/kg) in hot plate test. Results: The crude extract, at its maximum dose, produced comparable analgesic activity (72.5%) to ASA in acetic acid writhing test. In the hot plate test, both the crude extract and solvent fractions exhibited a significant prolongation of nociception reaction time. Formalin test result indicated a significant reduction of mean lick time with maximal protection of 64% (early phase) and 83% (late phase). Aqueous and butanol fractions showed good analgesic activity in the three models. Inflammation was decreased by 69% with butanol (200 mg/kg); 71% (800 mg/kg) of crude extract and by 41% and 56% with the use of aqueous fraction at 100 and 200 mg/kg, respectively (p<0.001). Conclusion: The present study indicates that the crude methanolic root extract, as well as butanol and aqueous solvent fractions, showed anti-nociceptive and anti-inflammatory activities.

Exercise induces several cardiorespiratory and hematological changes in the body. In spite of the latest advancements in exercise physiology, the effects of time-of-day on these quantities remained inconclusive. A total of 2070 potential citations were identified through PubMed, MEDLINE, SPORTDiscus, EMBASE, Physical Education index and Google Scholar searches. Based on the eligibility criteria, 17 studies remained for analysis. Using the random effect model, the overall pooled time-of-day effect of exercise on erythrocytes were, RBC= Std. MD= 0.35(95% CI, -0.008 to 0.79), I-2=71%, HGB= Std. MD = 0.37(at 95% CI, -0.19 to 0.94), I-2=64% and HCT=Std. MD = -0.03(at 95% CI, -0.46 to 0.39), I-2=36%, leukocytes WBC=Std. MD = -1.46(at 95% CI, -1.84 to -1.07), I-2=42% and NEU=Std. MD = -1.01(at 95% CI, -1.16 to -0.42), I-2=69%, thrombocytes PLT=Std. MD = 0.01(at 95% CI -0.31, 0.29), I-2 = 0% heterogeneity and Vo(2)Max=SMD = -1.15(95%CI, -2.64,0.34; P>0.13) and I-2 = 87 heterogeneity. Our study partly confirms the time-of-day variations of aerobic exercise on cardiorespiratory and hematological levels in athletes. However, conducting further meta-analysis aiming to investigate the concomitant effect of aerobic exercise and time-of-day in relation to different environmental settings are imperative, such as hypoxia, tropical and neutral environments.

Objective The objective of this study was to ascertain the effects of high-intensity chronic endurance training on cardiovascular markers of active populations and athletes. Methods This review was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We used databases of PubMed, Science Direct, SPORTDiscus, Google Scholar and grey literatures with Mesh and free-text search as well as manual searches to identify relevant studies from June 2017 to September 2019. Weighted standardised mean differences and effect size of the intervention group versus the control group were calculated using a random effect model with 95% CI. Result There was significant improvement in high-density lipoprotein with weighted standardised mean difference and effect size=−1.06 (−1.83 to −0.30), p=0.006. We have also observed a significant reduction in low-density lipoprotein and total cholesterol with weighted standardised mean difference and effect size=−0.97 (−1.58 to −0.36), p=0.002, and = −0.78 (−1.34 to −0.22), p=0.007, respectively. There was a significant reduction in interleukin 6 (IL-6) using a fixed effect model with weighted standardised mean difference and effect size=−0.87 (−1.33 to −0.40), p=0.0003 and C reactive protein (CRP) with weighted standardised mean differences and effect size=−0.41 (−0.73 to −0.09), p=0.01. Conclusion Chronic high-intensity endurance training improves healthy lipid profiles (increase high-density lipoprotein, decreased low-density lipoprotein and total cholesterol). And decreased inflammatory markers (IL-6 and CRP) independent of age and sex and cannot be associated with an increased risk of developing cardiovascular disease. PROSPERO registration number CRD 42017081369.

BACKGROUND:Previous research has been highly suggestive that patients of African ancestry are less responsive to beta-blockers and angiotensin converting enzyme inhibitors. However, clinical practice within Ethiopia has continued to recommend all drugs for treatment of hypertension despite the lack of evidentiary support. Therefore this study aims to compare the effectiveness of the three major antihypertensive drugs currently prescribed in an Ethiopian health care setting to further the potential for evidence based prescribing practices.METHODS:A prospective, randomized, open label comparative study was used to determine the mean reduction in blood pressure (primary outcome) and assess cardiovascular events (secondary outcomes) among patients receiving one or more of three common antihypertensive drugs (i.e., nifedipine, hydrochlorothiazide, and enalapril) in routine clinical practice between November 2016 and April 2017. Patients were followed for three months. Analysis was based on an intention-to-treat approach. One way analysis of covariance was used to compare the difference in therapeutic effectiveness in reducing blood pressure.RESULT:A total of 141 patients were randomized to one of three recipient groups-nifedipine (n = 47), enalapril (n = 47) or hydrochlorothiazide (n = 47). Three months after randomization, 44 patients in each group completed the follow-up. Patients randomized to nifedipine had significantly higher mean reduction in systolic blood pressure than those randomized to enalapril(p = 0.003) or hydrochlorothiazide(p = 0.036). The mean reduction in systolic blood pressure was -37.35(CI:-40, -34.2) in the nifedipine group; -30.3(CI: -33.5, -27.1) in patients receiving enalapril; and -32.1(CI:-35, -29.3) in patients assigned hydrochlorothiazide. However, nifedipine did not have a significance difference in reduction of mean diastolic blood pressure compared than those receiving enalapril (p = 0.57) or hydrochlorthiazide (p = 0.99).CONCLUSION:This study revealed that amongst the three drugs nifedipine was found to be the most effective drug in reduction of systolic blood pressure. Hydrochlorothiazide and enalapril did not show a difference in reduction of mean blood pressure. Further, long term randomized trials are highly recommended to inform revision of Ethiopia-centric hypertension treatment guidelines.

Objective: To evaluate gastric anti-ulcer potency of ethanolic extract of Sesbania grandiflora Linn (EESG) (Fabaceae) leaves in experimental animals. Methods: EESG was investigated in pylorous ligation and ethanol induced ulcer models in Wister rats. In both models ulcer index was determined as common parameters. The extract was ingested orally at doses of 250 and 500 mg/kg to the ulcer induced rats for determining the potency of ulcer inhibition. Results: The extract (250 and 500 mg/kg) showed significant (P<0.05) reduction in gastric volume and ulcer index as compared to the control in both of the ulcer models. Conclusions: It can be concluded that EESG possesses anti-ulcer effect as well as ulcer healing properties, which might be due to antisecretory properties.

The present study was conducted to evaluate the hepatoprotective activity of aqueous extract of leaves of Sesbania grandiflora Linn (AESG) at the dose of 250 and 500 mg/kg body weight per oral using Carbon tetrachloride induced liver damage in wistar albino rats. Aqueous extract showed significant (p<0.05) hepatoprotective effect by lowering the serum levels of various biochemical parameters such as serum glutamic oxaloacetate transaminase (SGOT), serum glutamic pyruvates transaminase (SGPT), alkaline phospatase (ALP), total bilirubin (TBL), total cholesterol (CHL) and by increasing the levels of total protein (TPTN) and albumin (ALB), in the selected model. These biochemical observations were inturn confirmed by histopathological examinations of liver sections and were comparable with the standard hepatoprotective drug Silymarin (100 mg/kg body weight i.p.) which served as a reference control. It was concluded from the result that the aqueous extract of Sesbania grandiflora L. possesses hepatoprotective activity against Carbon tetrachloride induced hepatotoxicity in rats.

Assessment of antimicrobial use can be performed by evaluating their use. Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. The objective of this study was to evaluate the rational use of ceftriaxone in Ayder referral Hospital, Mekelle-Ethiopia. Retrospective cross sectional study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 296 patients who received ceftriaxone during hospitalization at Ayder referral Hospital from September 11, 2009 to September 10, 2010. A systematic sampling method was used to select inpatient prescriptions with ceftriaxone and patient cards were located based on the medical record number on the prescription papers. Data was collected by using structured format and evaluated against WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia. Most patients were dosed as 2 g/day (79.4%). The duration of therapy was found to be high in the range 2-7 days (51.69%). Ceftriaxone was mainly used as preoperative prophylaxis (38.8%). Maintenance fluids were the most commonly co-administered medications with a frequency of 62.16%. The use of ceftriaxone was appropriate only in 106 cases (35.8%) for the justification of use. Most of inappropriate uses were seen in terms of duration. Consistency of prescriber to the national standard treatment guideline was found to be low. To improve rational use and prevent the development of resistance; prescribers should adhere to the national standard treatment guideline. Intensification of short term trainings and antibiotic control systems are some of the possible solutions the hospital has to do.

Self-medication is the selection and use of non-prescription medicines by individuals’ own initiatives to treat self-recognized illnesses or symptoms. It is practiced significantly worldwide even though its type, extent and reasons for its practice may vary. No data is available on the current status of self-medication practices among health sciences students of Ayder campus of Mekelle University (ACMU). Descriptive cross sectional study was conducted on 307 health sciences students in ACMU from April to June 2011. Pre-tested and validated questionnaires were employed as tools for data collection. Study populations were determined by using two stages stratified random sampling methods. Among 148 reported illnesses prior to the study period, 94(63.50%) were males and 48(36.50%) were females with mean age of 21.5(18-25) years. The prevalence of self-medication in this study was 43.24% with most frequently reported symptom being headache 33(51.56%) followed by cough and common cold 28(44.80%). The two main reasons for self-medication were prior experience 25(39.10%) and mildness of the disease 24(37.50%). Paracetamol 31(48.44%) and NSAIDs 27(42.20%) were the two most frequently consumed medications with drug retail outlets 26(40.63%) as the main source of drugs to practice self-medication. Self-decisions 41(64.00%) followed by family/friends 20(31.65%) were the two most frequently reported source of drug information for self-medication in this study. More than half of the respondents disagreed with the practice of self-medication in the present study. Moreover there were statistically significant differences between respondents who reported practicing self-medication based on gender, specific field of study and study year.