Background: Chronic diseases such as diabetes mellitus are increasing in incidence in sub-Saharan Africa. African traditional medicine is part and parcel of the health care system in Uganda. Majority of the indigenous population will have visited a traditional health care practioner or self-administered herbal medicines before seeking conventional health care. However, documentation of the various medicinal plants is still lacking, necessitating a well-organized information search for such knowledge through research. Such information can lay a firm and clear foundation for scientific investigation of the purported therapeutic benefits of the said plants. The objective of this study was to collect names of medicinal plants used to manage diabetes mellitus type II in selected districts of central Uganda. Methods: In this ethnobotanical survey, names, of plants used to manage diabetes mellitus type II as well as the methods of preparation, routes of administration and the plant parts used in the districts of Mukono, Kampala, Wakiso and Masaka in the central region of Uganda were documented using a researcher administered questionnaire. Participants were recruited using a snow ball approach in which one individual directed us to another. Informant consensus was determined for each of the plants mentioned. Results: A total of 18 names of medicinal plants were recorded of which Aloe vera var, Solanum indicum and Vernonia amygydalina were the most commonly mentioned plants and thus had the highest informant consensus. Leaves were the main parts that were used to prepare the herbal medicine while water as the solvent used in all the preparations. In all the cases, only the oral route was used for administration of the medicines. Conclusion: Documentation of medicinal plants used to manage diabetes can further improve on the formalization process of the Ugandan traditional medicine system as well as lay a basis for further scientific investigation with emphasis on the plants whose informant consensus is high.
Background In low income countries such as Uganda progress has been made towards achieving the United Nations AIDS programme 95-95-95 target however efforts are still impeded by pretreatment drug resistance and adverse drug events (ADEs) hence introduction of dolutegravir-based antiretroviral therapy as first-line treatment due to a higher genetic barrier to resistance, better tolerability and safety profile. However, recent studies have raised concerns regarding its safety in real-clinical settings due to ADEs and being a recently introduced drug there is need to actively monitor for ADEs, hence this study aimed to establish the prevalence and factors associated with ADEs among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic- Mbarara Regional Referral Hospital (MRRH). Methods A mixed design study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at-least 12 weeks. These were interviewed to obtain data on socio-demographics, dietary habits and their files reviewed for ADEs. Data entry was done using Epi-data 3.0 and exported to SPSS 25.0 for analysis. Prevalence was determined as a percentage, and ADE associated factors assessed using bivariate analysis, those found significant were further subjected to multivariate analysis and considered significant at P < 0.05. Results The prevalence of ADEs among patients on DTG-based regimen was found to be 33.1% (124/375) with 5.6% (7/124) participants discontinued from treatment due ADEs, 4 due to hyperglycemia and 3 liver toxicity. The commonly experienced ADE was allergy at 36.3%. Male sex (AOR 1.571, 95% CI 1.433–1.984), WHO stage one at entry to care (AOR 4.586, 95% CI 1.649–12.754), stage two (AOR 4.536, 95% CI 1.611–12.776), stage three (AOR 3.638, 95% CI 1.262–10.488), were significantly associated with ADEs. Patients with undetectable viral load at initiation of DTG-based regimen were 67.6% less likely to experience ADEs (AOR = 0.324, 95% CI 0.1167–0.629). Conclusion This study reports a prevalence of 33.1% of ADEs among patients on DTG-based regimen. The most commonly experienced ADE was allergy. Male sex, early HIV disease stage at entry into care and detectable viral load at initiation of DTG-based regimen were significantly associated with ADEs. It is crucial to actively monitor patients with these characteristics for ADEs.
Throughout history women have tried to control their fertility using herbal remedies; traditionally Phytolacca dodecandra leaves have been used as an abortifacient. The objective of this study was to determine the abortifacient activity of the aqueous extract of P. dodecandra leaf in Wistar rats. Hundred grams of shaded dried powdered leaves were soaked in 0.5 L of cold water, and using cold maceration, an aqueous extract was obtained. Acute toxicity was carried out using Lorke's method. The abortifacient activity of the plant extract was tested using a modified method. Thirty pregnant rats were randomly distributed into five groups each consisting of 6 rats and were treated. The percentage number of rats that aborted per treated group was compared with those of the controls. Preliminary phytochemical screening of the extract revealed the presence of alkaloids, tannins, phenolics, steroids and triterpenoids. Toxicity signs such as reduced appetite, sleepiness, shivering and excessive urination were observed at a dose of 2048 mg/kg; however, no deaths were observed. In the groups in which 125 and 250 mg/kg of P. dodecandra extract was administered, 83.3% of the rats aborted, and in the group in which 500 mg/kg was administered, 100% of the rats aborted. This study has substantiated the abortifacient activity of the aqueous extract of P. dodecandra leaves which may be attributed to the phytochemicals.
Background: Highly Active Antiretroviral Therapy is efficacious in suppression of Human Immunodeficiency Virus (HIV) however, it is associated with numerous toxicities hence great effort has been put into development of antiretrovirals with better tolerability. The World Health Organization recommended dolutegravir as first-line antiretroviral therapy however, recent studies have raised concerns regarding its safety in real-clinical settings due to adverse drug reactions (ADEs). Hence the purpose of this study was to establish the prevalence and factors associated with adverse drug events among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic- Mbarara Regional Referral Hospital (MRRH).Methods: A retrospective cross-sectional study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at least 12 weeks. The patients were interviewed to obtain data on sociodemographics, dietary habits and thereafter their files reviewed to obtain data on ADEs. Data entry was done using Epi-data 3.0 and exported to SPSS version 25.0 for analysis. The prevalence of ADEs was determined as a percentage, and ADE associated factors were assessed using bivariate analysis, those found significant were further subjected to multivariate logistic regression model and were considered significant at P<0.05.Results: The prevalence of adverse drug events among patients on DTG-based regimen was found to be 33.1% (124/375) with 5.6% (7/124) participants discontinued from treatment due ADEs, 4 of which were due to hyperglycemia and 3 due to liver toxicity. The commonly experienced ADEs included abdominal pain, hyperglycemia and liver toxicity each at 7.3%, headache at 11.3%, and allergy at 36.3%. Male sex (AOR 1.571, 95% CI 1.433- 1.984), WHO stage one at entry to care (AOR 4.586, 95% CI 1.649-12.754), stage two (AOR 4.536, 95% CI 1.611-12.776), stage three (AOR 3.638, 95% CI 1.262-10.488), were significantly associated with ADEs. Patients with undetectable viral load at initiation of DTG-based regimen were less likely to experience ADEs (AOR = .324, 95% CI .1167-.629).Conclusions: Up to a third of patients on DTG-based regimen experienced ADEs. Male sex, WHO HIV disease stage and a detectable viral load at initiation of DTG-based regimen were significantly associated with ADEs. It is crucial to actively monitor patients with these characteristics for ADEs.
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