Medicinal herbs including Senna alata, Ricinus communis, and Lannea barteri have been utilized for centuries to cure a variety of illnesses caused by microbial infections. This study looked at the synergistic effects of these drugs with traditional antibiotics on clinical isolates of Candida albicans, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. The test bacteria were chosen based on their minimal potential for monotherapy and susceptibility to at least one antibiotic with a known genetic basis. The interactions of plant extracts with antibiotics against the chosen pathogenic microorganisms were investigated using the agar well diffusion, broth microdilution, and checkerboard methods. Calculated fractional inhibitory concentration index (FICI) values were used to describe how the extracts and antibiotics interacted. All the extracts from the three plants combined with fluconazole exhibited a synergistic interaction against C. albicans (FICI < 0.5). The minimum inhibitory concentration (MIC) of ampicillin against E. coli was demonstrated to be reduced by the combination of the ethanol extract of S. alata with ampicillin, with a FICI value of 0.4 indicating a synergistic effect. With a synergistic action (FICI ˂ 0.5) against P. aeruginosa, the ethanol extract of S. alata and amoxicillin were successful in reducing the MIC of amoxicillin from 0.32 to 0.17 mg/mL. Aqueous L. barteri extract combined with amoxicillin exhibited synergism (FICI < 0.2) against S. aureus with a reduction of MIC from 0.20 to 0.03 mg/mL. The current study is the first to investigate the aforementioned plants in combination with conventional antibiotics for their antimicrobial activities. The findings of this study could be used to create a useful, applicable, feasible, and alternative source of novel antimicrobial agents.

Herbal extracts are a well-known source of therapeutically important bioactive chemicals since they are widely available, relatively inexpensive, and have fewer adverse effects. The three plants' leaves have been used to treat a variety of illnesses in Ghana, including skin conditions and wound infections. Their effectiveness as an ointment in treating the aforementioned illnesses has not yet been shown, though. The extracts were made into an ointment with polyethylene glycol (PEG), and both the ointment and the raw extracts were examined for in vitro antibacterial activity. The three (3) chosen bacterial isolates were subjected to potential activities of the plant extracts from different extractants. The minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) values for the plant extracts were both low. The herbal ointment made with Sida acuta extract from both extractants showed significantly different activity (P < 0.05), against the test pathogens when compared to the reference medication (Madecassol (R)). However, the activities of formulated herbal ointment from both P. amarus and P. biglobosa extracts were comparable at higher concentrations to the standard drug used. Notably, both plant extracts and extract-PEG manufactured ointments exhibit significant in vitro efficacy against the disease-causing bacterial species. The current study is the first in-depth account of Parkia species with regard to an examination of herbal ointments made from leaves extract obtained utilizing solvents such as water and ethanol. Our research findings have important implications for the pharmaceutical industry in terms of providing a suitable, workable, and alternative supply of bioactive compounds and anti-infective agents.

Serpin E1/PAI-1, N-terminal pro-brain natriuretic peptide (NTpro-BNP) and neuropilin-1 are markers which have been associated with endothelial dysfunction. However, data on the levels of these markers in PE is limited. The limited data on the pathophysiology of PE in relation to these markers necessitated the study. This was a multicentre case-control study conducted at the Obstetrics and Gynaecology Department of the Tamale Teaching Hospital, the Bawku Presbyterian Hospital and the Bolgatanga Regional Hospital. Out of 520 consenting pregnant women, 127 pregnant women met the inclusion criteria (53 with PE and 74 controls) and were included in this study. Venous, placental, cord and peripheral blood were collected for biomarker assay, haematological parameters and placental parasite determination. Placental tissue sections were obtained for placental malaria and histopathological lesions associated with hypoperfusion. Maternal heart rate and foetal umbilical artery Doppler impedance indices; resistance index (RI) and systolic diastolic (SD) ratio were determined to confirm utero-placental hypoperfusion. Significantly higher proportions of foeto-maternal complications; eclampsia, low birth weight (LBW), neonatal intensive care unit admissions (NICU), intrauterine growth restriction (IUGR), caesarian deliveries and early gestational age at delivery were associated with PE. Women with PE had lower concentrations of platelet (p = 0.02) whereas red cell distribution width (RDW) was markedly elevated (p = 0.01). NTPro-BNP concentration was markedly elevated (p = 0.01) in women with PE whereas neuropilin-1 concentration was lower (p = 0.03) compared to the non-PE group. Maternal heart rate was elevated in women with PE and Doppler resistance indices (RI and SD) were significantly elevated in foetuses of PE women than foetuses of the controls. Placental mal-perfusion lesions were higher in women with PE compared to the non-PE group. Women with PE had increased risk of adverse foeto-maternal complications, significantly associated with placental mal-perfusion lesions, had reduced platelet concentration and elevated RDW-CV levels. NTPro-BNP, RI and SD are elevated in women with PE whereas neuropilin-1 concentration is reduced. Significant changes in these pathological variables in PE women is indicative of significant derangement in endothelial function culminating in adverse maternal and perinatal outcomes of pregnancy.

This chapter evaluated the aetiology of anaemia in pregnant women in Northern Ghana. Maternal anaemia has significant adverse effects on both mothers and infants. The risk of death among pregnant women with severe anaemia has been reported to be twice that of mothers without severe anaemia. This hospital-based cross-sectional case-control study was conducted in the Obstetrics and Gynecology Department of the Regional Hospital Bolgatanga (RHB), Ghana, West Africa, from May 2013 to May 2014. A total of 400 pregnant women, comprising 253 anaemic and 147 non-anaemic pregnant women attending the antenatal clinic at the Bolgatanga Regional Hospital, Ghana, were selected for the study. Venous blood was collected and haemoglobin genotype, complete blood count and biochemical parameters [ferritin, iron, total iron binding capacity (TIBC), transferrin saturation (TfS), C-reactive protein (CRP) and bilirubin] were determined. Per the manufacturer's instructions, daily quality control checks were run on control specimens within specified limits. Thick blood films were prepared for malaria parasitemia, while early morning stool and midstream urine samples were examined for enteric and urogenital parasites, respectively. Anaemic pregnant women had a significantly lower mean HGB, HCT, MCV, and MCHC than their non-anaemic counterparts (p<0.0001). Conversely, there was a significantly higher mean WBC and RDW amongst anaemic pregnant women than non-naemic women (p<0.05). There were significantly reduced levels of HGB (p<0.0001), HCT (p<0.0001), MCV (p<0.0001), iron (0.0273), ferritin (p=0.018) and transferrin saturation (0.0391) and an increased WBC (p=0.006), RDW (p=0.0480), TIBC (p=0.0438) and positivity of CRP in the anaemic group compared to non-anaemic pregnant women. Plasmodium falciparum, Schistosoma hematobium, increased hemoglobinopathies (AS, SS, and SC), and intestinal parasite infections were associated with anaemic women. Iron deficiency is linked to a notable disruption in haematological and iron indices in pregnant women who are anaemic. Hemoglobinopathies and parasite infections further complicate this outcome.

Liver ailment is a key public health menace, principally in developing nations. Quite a lot of medicinal florae have been identified to have liver shielding activities. The current study was designed to assess in vitro antioxidant and in vivo hepatoprotective activities of seed extracts of Cleome viscosa Linn. (Capparaceae). Phytochemical screening of C. viscosa seed ethanol extract was carried out. Free radical scavenging activity of crude seed extract of the plant was conducted using the DPPH assay method. DNA damage protection potential of the crude seed extract was carried out using extract of the genomic DNA nicking assay. Hepatoprotective activity of the crude seed extract of the plant was carried out based on CCl4-induced liver damage in Wister albino rats. Serum biomarkers (aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and total protein (TP)) were evaluated to find out the effect. Histopathological scrutiny was also carried out for all groups of rats to further confirm the discoveries. The phytochemical screening was positive for alkaloids, flavonoids, saponins, steroids, terpenes, tannins, and phenolic compounds in the seed extract. The antioxidant assay revealed that the ethanol crude extract of C. viscosa exhibited free radical scavenging activity with IC50 value of 17.82 ± 0.32 μg/mL, and this was further confirmed by the DNA damage protection activity. Pretreatment of the rats with the crude extract of C. viscosa significantly reduced ALP (p < 0.05). The hepatoprotective activity of the seed extract was confirmed by histopathological studies. From this study, it can be concluded that the crude seed extract revealed antioxidant and hepatoprotective activities. For that reason, in the future, oral intake of C. viscosa seed extract as an adjunct natural therapy may be worthwhile to protect against liver failure-mediated inhibitory effects on reproductive function.

Abstract Background: The study evaluated the risks for developing low birth weight (LBW), preeclampsia (PE) and postpartum hemorrhage (PPH) in relation to maternal socio-demographic, obstetric characteristics and clinical laboratory information obtained at 1st antenatal care (ANC) visit.Methods: The study included 268 pregnant women attending 1st ANC visit at the Bolgatanga Regional Hospital. Structured questionnaires were used to obtain socio-demographic and obstetric data from respondents. The main variables were LBW, PPH, PE, mode of delivery, residency, gestational age at 1st ANC visit, maternal age, sickling positivity, Hb at 1st ANC visit, Hb genotype and G6PD status. Odds ratio [OR, 95% confidence interval (CI)] for the association between sociodemographic, obstetric characteristics and clinical variables in relation to PE, LBW and PPH were assessed using logistic regression model.Results: The prevalence of PE, LBW and PPH were 25.4% (68/268), 15.7% (42/268) and 6.0% (16/268), respectively. For PE, delayed 1st ANC visit (AOR=16.82, 95% CI (3.61-78.5), p=0.000) and younger maternal age (AOR= 15.19, 95% CI (1.85-124.56), p=0.011) were independently associated with higher odds whereas vaginal delivery (AOR=0.32, 95% CI (0.15-0.71), p=0.015) was independently associated with reduced odds. Delayed 1st ANC visit (AOR=0.12, 95% CI (0.03-0.47)), p=0.002) independently reduced the risk of PPH whereas the male gender (AOR=7.75, 95% CI (1.60-37.51), p=0.011) independently increased the risk of PPH. Lastly, delayed 1st ANC visit (AOR=3.26, 95% CI (1.05-10.10), p=0.041) was independently associated with increased odds of LBW whereas vaginal delivery (AOR=0.36, 95% CI (0.17-0.74), p=0.006) was an independent risk factor for LBW in the multivariate model.Conclusion: The study identified delayed ANC visit as an independent risk factor for PE, LBW and PPH in Northern Ghana. Vaginal delivery and younger maternal age were also independent risk factors for PE. Additionally, the male gender was independently associated with PPH whereas vaginal delivery was independently associated with LBW. We recommend that public health education for pregnant women that highlights the importance of early ANC visit be enhanced. This will facilitate early identification and intervention for women with risk of foeto-maternal complications. Younger women should be educated on the dangers 48 of early marriages with its attendant foeto-maternal complications.

BACKGROUND:Parasitic infections remain widespread in developing countries and constitute a major public health problem in many parts of sub-Saharan Africa. It is prevalent among children under 5 years and pregnant women; however, studies among the later high risk group is limited in the northern part of Ghana. Here, we evaluated the prevalence and associated factors of parasitic infections among pregnant women at first antenatal care visit in northern Ghana.METHODS:This was a cross-sectional study conducted at the Department of Obstetrics and Gynecology, Bolgatanga Regional Hospital, Upper East Region-Ghana. A total of 334 consecutive consenting pregnant women were included. Questionnaires were administered to obtain socio-demographic data. Venous blood, stool and urine samples were collected for parasite identification using microscopy. Factors associated with parasitic infections were evaluated using regression models. Statistical analysis was performed using R.RESULTS:Parasitic infections identified were giardiasis (30.5%), P. falciparum malaria (21.6%) and schistosomiasis (0.6%). Polyparasitic infection was identified in 6.6% of the population. Increasing age [Age of 20-29 years: AOR = 0.16, 95% CI (0.06-0.38); Age of 30-39 years: AOR = 0.21, 95% CI (0.08-0.50); Age >39 years: AOR = 0.30, 95% CI (0.11-0.83)] was associated with lower odds whiles presence of domestic animals [AOR = 1.85, 95% CI (1.01-3.39)], being in the second trimester of pregnancy [AOR = 2.21, 95% CI (1.17-4.19)], having no formal education [AOR = 3.29, 95% CI (1.47-7.35)] and basic education as the highest educational level [AOR = 6.03, 95% CI (2.46-10.81)] were independent predictors of increased odds of giardiasis. Similarly, having no formal education [AOR = 2.88, 95% CI (1.21-8.79)] was independently associated with higher odds of P. falciparum malaria. The use of insecticide treated net (ITN) [AOR = 0.43, 95% CI (0.21-0.89)] and mosquito repellent [AOR = 0.09, 95% CI (0.04-0.21)] were independent predictors of lower odds of P. falciparum malaria.CONCLUSION:Giardiasis and P. falciparum malaria are common among pregnant women in northern Ghana. The major associated factors of giardiasis are lack of or low level of formal education, the presence of domestic animals and being in the second trimester of pregnancy. Increasing age confers protection against giardiasis. Likewise, lack of formal education is an associated factor for P. falciparum malaria among pregnant women in northern Ghana. The use of ITN and mosquito repellents reduce the risk of P. falciparum malaria. Given the possible role of parasitic infections in adverse pregnancy outcomes, our findings highlight the need for regular screening and treatment of infected women in the northern parts of Ghana. Public health education and improving socio-economic status could help reduce the risk of parasitic infections among pregnant women in the region.

Anemia in pregnancy may not only be associated with maternal morbidity and mortality but can also be detrimental to the fetus. A definitive diagnosis of anemia is a pre-requisite to unravelling possible cause(s), to allow appropriate treatment intervention. It is hypothesised that measured hemoglobin (HGB), complemented by biochemical and other hematological parameters would enhance anemia diagnosis.

The aim of this study was to determine how well the measurements from a glucometer (SD Codefree) correlated with those from a standard auto analyser (BT-3000) using blood samples from diabetic and non-diabetic patients at the Bolgatanga Regional Hospital in Ghana. A cross-sectional study was conducted with a total of 150 randomly selected patients; 100 diabetic patients (4 type 1 and 96 type II) and 50 non diabetic patients. Ante-cubital venous and finger pricked blood samples were obtained from the patients following standard procedures, and blood glucose concentrations were determined using the two methods respectively.

The study determined the sociodemographic and obstetric characteristics of pregnant women which contribute to the risk of developing anaemia. A cross-sectional study was conducted among 400 pregnant women attending their first antenatal visit at the Bolgatanga Regional Hospital Antenatal Clinic. Anaemia was significantly associated (p < 0.05) with younger maternal age, parity, gravidity, trimester of pregnancy, and source of drinking water. Multivariate logistic regression identified the following factors with adjusted odds ratios (aOR) and 95% confidence intervals (CI): unemployment (aOR = 4.76 (CI: 2.26–11.33); p < 0.0001), rural dwelling (aOR = 3.10 (CI: 2.16–4.91); p = 0.0071), primigravida (aOR = 2.13 (CI: 1.34–3.18); p = 0.0201), nulliparity (aOR = 1.92 (CI: 1.23–2.86); p = 0.0231), first antenatal visit at second trimester (aOR = 1.71 (CI: 1.33–3.12); p = 0.0149) and first antenatal visit at third trimester (aOR = 2.73 (CI: 1.24–4.35); p = 0.0017), drinking from well and boreholes (aOR = 2.78 (CI: 2.27–5.21); p < 0.0001), and the presence of domestic livestock (aOR = 2.15 (CI: 1.33–3.68); p = 0.0019). This study has shown the various sociodemographic and obstetric factors which significantly contribute to anaemia in pregnancy.