Background. Cancer-related pain (CRP) is a major problem with a potential negative impact on quality of life of the patients and their caregivers. Purpose. To assess the adequacy of cancer-related pain management in Ayder Comprehensive Specialized Hospital (ACSH). Methodology. A facility-based cross-sectional study design was conducted in ACSH from January to March 2019. A well-structured professional-assisted questionnaire using Brief Pain Inventory-Short Form (BPI-SF) was used to collect data concerning the severity of pain, functioning interference, and adequacy of pain management in cancer patients. Data were analyzed using SPSS v.21. Result. Out of 91 participants, 47 (51.6%) were male and 52 (57.1%) were between the age group of 18–45, with the mean age of 44.8 ± 13.6 years. According to the pain assessment tool (BPI), 85 (93.4%) patients experienced pain and 90 (98.9%) patients had activity interference; negative pain management index (PMI) was observed in 40 (43.95%) patients, showing that 43.95% were receiving inadequate pain management. Out of 38 patients who received no analgesics, 35.2% were found to have inadequate pain management, whereas those who took strong opioids had 100% effective pain management and the majority of the patients were in stage III. Among 38 (41.76%) only 20 (52.63%) received adequate pain management, based on patients’ self-report in which 18.7% of the participants stated that they got 30% pain relief and only 1.1% got 90% relief. The predictors of undertreatment were presence of severe pain, metastasis, comorbidity, and stage of the cancer and could also be due to the educational level and monthly income, as evidenced by significant association. Conclusion. This study suggests that cancer pain management in ACSH was sufficient for only 56%. However, large numbers of individuals are suffering from a manageable pain. Hence, remedial action should be taken, including increasing awareness of symptom management in medical staff and incorporating existing knowledge into routine clinical practice.

Background Aloe megalacantha Baker (Xanthorrhoeaceae) is one of the Aloe species widely distributed in Ethiopia. The leaf latex of the plant is used for treatment of wounds, inflammation, and other multiple ailments in Ethiopian traditional medicine. Purpose The aim of this study was to evaluate in vivo wound healing and anti-inflammatory activities of the leaf latex of Aloe megalacantha in mice. Methods The wound healing activity of the leaf latex of the plant was studied topically by incorporating the latex in simple ointment base in a concentration of 5% (w/w) and 10% (w/w) using excision and incision models. In these models, wound contraction, period of epithelialization, and breaking strength of the wounded skin were determined. Carrageenan induced inflammation of paw model was also used to assess the anti-inflammatory activity of the leaf latex at doses of 200 mg/kg, 400mg/kg, and 600 mg/kg. The level of inflammation suppressions were measured at 1, 2, 3, and 4 hrs after carrageenan injection, and then the percentages of inflammation inhibition were computed as compared with the negative control. Result In both wound models, mice treated with 5% (w/w) and 10% (w/w) latex ointment showed a significant (p<0.05) increment in the rate of wound contraction, reduction in epithelialization time, and higher skin breaking strength. Besides, the latex also exhibited a dose-dependent significant (p<0.05) reductions of inflammation as compared to negative control groups. Conclusion The overall results of this study demonstrate that the leaf latex of A. megalacantha possesses wound healing and anti-inflammatory activities which can scientifically substantiate the traditional use of the plant as a wound healing agent.

Background: Becium grandiflorum has been used traditionally for treatment of different ailments including diabetes mellitus although it lacks scientific evidence. Thus, the present study was aimed at evaluating the antidiabetic effect of Becium grandiflorum in streptozotocin (STZ)-induced diabetic mice. Methods: The antidiabetic activity of hydro-ethanolic (30:70) leaf extract of Becium grandiflorum was evaluated in STZ (45 mg/kg)-induced diabetic and normal mice. Antihyperglycemic, hypoglycemic, oral glucose tolerance and body weight change effects of the extract were assessed after administering three doses of the extract (200, 400 and 600 mg/kg), glibenclamide 5 mg/kg (reference drug) and 2% Tween 80 (vehicle). One-way analysis of variance and Tukey's post hoc test were used for data analysis. Results: All doses of the extract (200 mg/kg (p<0.05), 400 mg/kg (p<0.05) and 600 mg/kg (p<0.01)) and glibenclamide 5 mg/kg (p<0.001) showed statistically significant blood glucose level reduction in normal mice as compared to Tween 80. The hydroalcoholic extract at a dose of 200 mg/kg (p<0.05), 400 mg/kg (p<0.01) and 600 mg/kg (p<0.001) showed better blood glucose tolerance after 60, 120 and 180-minute treatment duration in normal mice as compared to negative control. In diabetic mice, Becium grandiflorum doses and the reference drug caused maximum reduction in blood glucose level at the end of the 15th day of treatment by 17.61%, 22.52%, 24.62% and 34.12%, respectively. The extract's doses and the standard drug showed significant (p<0.05) improvement in body weight while the diabetic control continued to lose their body weight. Conclusion: Thus, Becium grandiflorum exhibits antihyperglycemic activity in STZinduced diabetic mice, and shows improvement in oral glucose tolerance and body weight, which justifies the claimed use of the plant in ameliorating diabetes mellitus in Ethiopian folk medicine.

Malaria’s global impact, fueled by resistance to several antimalarial drugs, has necessitated a quest to new antimalarial drugs from several sources with traditional medicinal plants being one of them. This study was conducted to assess the antimalarial activity of a traditionally used medicinal plant, Leonotis ocymifolia, against Plasmodium berghei. The plant has been extracted using maceration technique, and doses ranging from 100–800 mg/kg of Leonotis ocymifolia were used to test its antimalarial activity. Tween 80 (2% in water) and chloroquine 25 mg/kg were used as negative and positive controls, respectively. The antimalarial activities of the plant were determined by measuring parasitemia, survival time, packed cell volume, temperature, and weight. The plant’s hydroalcoholic extract, as compared to negative control, maximally decreased parasite load by 41.4% at 800 mg/kg (p < 0.001). This parasite suppression was followed by longer survival time in the groups taking 400 mg/kg (p < 0.05) and 800 mg/kg (p < 0.05) in a four-day suppressive test and in those taking 800 mg/kg (p < 0.05) in Rane’s test. The plant did not prevent weight and PCV reduction but prevented temperature reduction at 400 mg/kg (p < 0.05) and 800 mg/kg (p < 0.05) in a four-day suppressive model, and at 800 mg/kg (p < 0.05) in Rane’s model. The average but consistent antimalarial activity of the plant across the test models corroborates the folkloric antimalarial use of the plant. The study recommends further pharmacological screenings, isolation, and identification of active compound(s) of the plant Leonotis ocymifolia.

Objectives: In light of population ageing and health technology innovation, cancer drug is one of the major contributors for pharmaceutical expenditure growth in many countries. This study aims to explore the determinants of cancer drug cost expansion in recent two decades and review the drug pricing policies of the singlepayer system in Taiwan. Methods: Data of fiscal year 2001, 2006, 2011 and 2016 of the Taiwanese National Health Insurance (NHI) Scheme was selected as study source and was obtained from the NHI Research Database. Two established methods for decomposition were employed in light of methodological advantages: the Fisher Ideal Index decomposition method (Morgan, 2004) and the decomposing formula developed by Patented Medicine Prices Review Board of Canada at 2013. Considering the defined daily doses established by WHO are generally unavailable for cancer drugs, the authors set uniformed daily dosage for each ingredient based on product information and/or clinical consensus to estimate drug volume in a more delicate way. Policies were reviewed from the prospective of NHI. Results: The total expenditure of cancer drugs increased from USD$ 77.1 million in 2001 to USD $ 646.5 million in 2016. The contribution of novel agents, such as monoclonal antibodies and protein kinase inhibitors, surged from 29.0% to 83.6%. The decomposing analysis revealed that price effects were negative to drug expenditure growth (Period 1[2001-2006], 1.01; Period 2 [2006Period 2 [ -2011 Period 3 [2011 Period 3 [ -2016, 0.74). By contrast, therapeutic choices and volume effects had positive impacts, yet the degrees of effects were decreasing (Volume effects/Therapeutic choices: Period 1, 1.63/1.56; Period 2, 1.45/ 1.28; Period 3, 1.30/1.17). Conclusions: Patient volume was the major driver of cancer drug expense in Taiwan, followed by therapeutic choices. This finding may be associated with the established health technology assessment for insurance coverage and effective price control strategy under the single-payer scheme.