BackgroundResistance to extended-spectrum cephalosporins among Enterobacteriaceae has been reported yet they serve as the last line treatment for severe infections in Uganda and other countries. This resistance often leads to nosocomial infection outbreaks and therapeutic failures from multidrug resistant bacteria. The main objective of this study was to determine the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in clinical samples of patients in various wards of Mulago Hospital; Uganda’s main national referral and teaching hospital.MethodsThis cross-sectional study was conducted between January-April, 2014. Purposive consecutive sampling was used to collect pus swab, urine, blood and CSF samples from patients in the various wards. A total of 245 consecutive, non-repetitive, clinical samples were obtained and tested for phenotypic ESBL production using the Double Disc Synergy Test using cefotaxime, ceftazidime, cefotaxime-clavulanic acid and ceftazidime-clavulanic acid.ResultsResults show that 47 % of the 245 samples had Enterobacteriaceae isolates. Of these isolates 62 % were ESBL producers while 38 % were of non-ESBL phenotype. E. coli was the most isolated organism (53.9 %), followed by K. pneumoniae (28.7 %). Majority of Enterobacteriaceae organisms were isolated from urine samples, followed by pus samples and of these 64.9 % and 47.4 % were ESBL-producers respectively. Klebsiella pneumoniae had the highest percentage of ESBL producers (72.7 %). There was a higher percentage of isolates showing resistance to ceftazidime (73 %) compared to cefotaxime (57.5 %). All Enterobacter cloacae isolates showed resistance to ceftazidime. There were no statistically significant association between phenotype (ESBL/non-ESBL) and patients’ age or gender or Enterobacteriaceae spp.ConclusionsThis study reveals a high prevalence of ESBL producing organisms in Mulago Hospital and high levels of resistance to third generation cephalosporins. In addition to undertaking appropriate infection control measures, there is urgent need for formulation of an antibiotic policy in Uganda to prevent spread of these organisms. This also calls for continuous monitoring and reporting of the presence of such organisms in order to ensure rational and judicious use of antibiotics by clinicians.

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Limited pharmacological studies have been conducted on plant species used against poultry helminths. The objective of this study was to provide a basis for plant based anthelmintics as possible alternatives against poultry anthelmintic resistance. The study justified the need for alternative anthelmintics. The study places emphasis on the increasing anthelmintic resistance, mechanism of resistance, and preparational protocols for plant anthelmintics and their associated mechanism of action. Pharmaceutical studies on plants as alternative therapies for the control of helminth parasites have not been fully explored especially in several developing countries. Plants from a broad range of species produce a wide variety of compounds that are potential anthelmintics candidates. Important phenolic acids have been found in Brassica rapa L. and Terminalia avicenniodes Guill. and Perri that affect the cell signaling pathways and gene expression. Benzo (c) phenanthridine and isoquinoline alkaloids are neurotoxic to helminths. Steroidal saponins (polyphyllin D and dioscin) interact with helminthic mitochondrial activity, alter cell membrane permeability, vacuolation and membrane damage. Benzyl isothiocyanate glucosinolates interfere with DNA replication and protein expression, while isoflavones from Acacia oxyphylla cause helminth flaccid paralysis, inhibit energy generation, and affect calcium utilization. Condensed tannins have been shown to cause the death of nematodes and paralysis leading to expulsion from the gastro-intestinal tract. Flavonoids from Chenopodium album L and Mangifera indica L act through the action of phosphodiesterase and Ca2+-ATPase, and flavonoids and tannins have been shown to act synergistically and are complementary to praziquantel. Artemisinins from Artemisia cina O. Berg are known to disrupt mitochondrial ATP production. Terpenoids from Cucurbita moschata L disrupt neurotransmission leading to paralysis as well as disruption of egg hatching. Yeast particle encapsulated terpenes are effective for the control of albendazole-resistant helminths.

Citropsis articulata, also locally known as the Omuboro is a popular plant in Central and Western Uganda for its claimed aphrodisiac properties. The plant naturally grows in forests and locals uproot it to obtain the roots for treatment of erectile dysfunctions. The root of this plant has been cherished as one of the most valuable herbal Viagra by most rural communities in Uganda. 1 The fast disappearance of these culturally important medicinal plants due to poor utilization practices certainly pose major threat towards a looming extinction. Conservationists in the country are concerned that demand for the roots of the plant threatens the survival of this species' genetic diversity in conservation areas like Mabira forest. 2 The roots are either chewed while fresh/dried or pounded into powder form and then mixed with water to form a concoction. Other plants like Warburgia ugandenesis, Cola acuminata, Prunus americana and Ekebergia capensis have been used in the ABSTRACT Background: Erectile dysfunction is the inability to sustain erection of the penis firm enough for sexual intercourse in males. Citropsis articulata is used locally by communities in Uganda for the management of erectile dysfunction. The current study evaluated the effect of ethanolic leaf extract of C. articulata on the serum level of testosterone and mounting frequency in Male albino rats. Methods: The study animals were divided into four groups and the extract groups dosed daily orally with 400 mg/kg and 600 mg/kg of extract for three weeks. Sildenafil citrate (1mg/kg) and distilled water (10 ml/kg) were used as positive and negative control respectively. The mounting frequencies of the males exposed to estrus induced females rats on day (7 and 21), testosterone levels (day 21) and phytochemicals present in the extract were determined. Results: At 400 mg/kg and 600 mg/kg, both testosterone level and mounting frequency increased significantly (p<0.05) by third week. The mean testosterone level at 600 mg/kg (2.678 ng/ml) of the extract was higher than that of group treated with 1mg/kg sildenafil citrate (2.18 ng/ml). The aphrodisiac activity of this extract may be associated with presence of saponins and basic alkaloids in the plant extract. Conclusions: Taken together, the crude leaf extracts of C. articulata could be used as a cheap alternative for the treatment of low libido due to testosterone deficiency. However, further studies are needed on the safety profile and the identification of the molecules responsible for the biological activity of the plant extract.