School of Health Sciences (Western Campus)

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Drugs use practices in northern Uganda hospitals: a case study of Gulu Regional Referral Hospital
(Kampala International University.College of Health Science, 2012-09) Christine, Ojul Lakop
Background: Irrational use of medicines is a maJor problem worldwide. Studies conducted in several countries, including Uganda, indicate that more than 50% of all medicines used globally are used irrationally. Irrational use of medicines results in increased risk of adverse reactions, wastage of the scarce resources, and development of preventable resistance of organisms to commonly used antibiotics. To be able design appropriate interventions, there is need to carry out drug use studies and this was one of such studies but which targeted Gulu Regional Referral Hospital in Northern Uganda. Objective: To determine and document drug use practices in Gulu Regional Referral Hospital. Methods: The study was a cross-sectional case study involving eight hundreds (800) prescriptions, 44 staff respondents and 50 patients, and review of Health Sector Strategic Plan indicator medicines in the stores by simple random sampling. The study was based on the prescribing, patient care and health facility indicators as stipulated by WHO, as well as evaluation of use of herbal drugs. Results: The study established that a high number of drugs and antibiotics were being prescribed, consultation and dispensing times were very low, drug labeling was inadequate and there were insufficient prescribers and qualified dispensers. The study also found out that the percentage of prescribed drugs actually dispensed was fairly good, and most prescriptions were from the Essential Drugs List and by generic names. However prescription of injections was slightly above the recommended standards although most of the patients had reasonable knowledge of drug dosages.
Evaluation of sub-chronic toxicity and phytochemical screening of aqueous leaf extract of ocimum suave (lamaiceae)
(Kampala International University.College of Health Science, 2012-09) Lucy, Kioko Mutindi
Evaluation of sub-chronic toxicity of the aqueous leaf extract of Ocimurn suave was administered daily for 31 days at dose leve!s[200, 400 and 800mg/kg] in male wistar rats .Acute toxicity of aqueous leaf extract of Ocimum suave was done according to Lorke,s method up to 10,000mg/kg and was found to cause no death in the two phases of the test. Thus, the LD50 of Ocimurn suave in rats was estimated to be greater than 10,000mg/kg. This study principally aimed to assess the LDso of the aqueous leaf extract of Ocimum suave,the sub-chronic toxicity and to screen for phytochemicals present in this extract. This study was carried out in two centers; Kampala International university-Western campus Pharmacy laboratory in Ishaka-Bushenyi Uganda and Italian laboratory in Mbarara University of Science and Technology-Mbarara Uganda. This is an experimental study carried out between January and July 2012 at the above sites. The respondents were male wistar rats weighing 1 OOg and above. Selection of participants was done by simple random sampling .. Effects on relative organ weights and certain hematological and plasma biochemical parameters were measured as indices of organ toxicity. The aqueous extract caused a decrease in ALT levels but AST levels were higher in the treated groups as the increment was dose dependent. The aqueous leaf extract of Ocimum suave affected mean cell volume ,mean cell hemoglobin and mean cell hemoglobin concentration . CK levels were increased in all OSE treated groups as compared to the control group. The aqueous leaf extract caused mean body weight gain, but decrease in relative organ weight .The study suggests that the aqueous extract administered at normal therapeutic doses is not likely to produce severe toxic effects on some hematological and biochemical indices in rats and the organs tested[histology]. Chronic toxicity of aqueous leaf extract of ocimum suave should be done for histological, haematological and biochemical evaluation. There is a need to study the effect of the extract on female wistar rats so that toxic effects can be established in both sexes.
Factors associated with diarrhea among children under five years in Kalungu Sub county Kalungu District
(Kampala International University.College of Health Science, 2017-07) Ronald, Kiwalabye
INTRODUCTION: In Uganda Diarrhea contributes 14% to the Under-5 mortality. STUDY OBJECTIVE: The aim of this study was to assess the risk factors predisposing children below 5 years of age in Kalungu district, Kalungu Sub County. METHOD: This study was cross sectional in nature. A Simple random sampling method was used for qualitative data collection. Data was collected by conducting in-depth interview with the mothers available at the homes during the time of data collection and was. Data was presented using tables and be analyzed electronically using Statistical Product for Social Scientists (SPSS) version 17 In SPSS and excel 2010. RESULTS: Considering demographic data specifically age 20(26%) were between 2-11 months, 21(27%) were between 1-2 years 35(46%) were between 3-5 years. Considering the hygiene of children, 10(13.3%) cases were identified in children who could wash their hands after using the toilet, 36(47.3%) cases were identified in children who could not wash their hands after using the toilet. Considering ownership of the toilet facility, 31(40.7%) cases were identified in children who privately owned toilet facilities and 45(59.3%) cases were identified in children whose homes shared the toilet facility with other people Concerning the mode of water treatment, 20(26.4%) cases were identified in children whose families treated water by boiling, 4(5.2%) cases were identified in children whose families treated their water by chlorination, and 52(68.4%) cases were identified in children whose families dint treat water in anyway. CONCLUSION: Diarrhea was more in children above 3 years because they are more exposed to the environment and germs, children with, children with poor hygienic practices were found to have experienced dianhea more than those with un hygienic practices, children living in homes with shared toilet facilities because sharing toilets making them unhygienic thus. Homes that dint treat water had more risk of developing diarrhea because diarrheal germs live in un boiled water. RECOMMENDATION: Health education about the causes of diarrhea and preventive measures should be intensified by the government. More health educators should be trained to increase the man power and to cover a wider area.
Factors associated with under nutrition in children under five years in Bangaladesh Parish, Namasale Sub-County, Amolatar District
(Kampala International University.College of Health Science, 2017-07) Sharon, Awino
Introduction In Uganda, under nutrition remains a serious health and welfare problem affecting the under-five children to whom it contributes significantly to mortality and morbidity. General objective To assess factors associated with under nutrition in children under- five years in Bangaladesh parish, Namasale sub-county, Amolatar district. Methodology The study was a descriptive cross sectional study to determine the factors associated with under nutrition in children less than five years of age in Bangaladesh parish, Amolatar District among 130 respondents who answered a structural questionnaire. Data was collected, analyzed and presented in tables and descriptive words. Study results The study revealed that 71 % of the respondents were within the age group of 15-34 years, with one mother as young as < 15 years, the standard of education of mothers in the study area was found to be very low; none had attained tertiary level of education. Majority, 59% serve their children communally, 4% wean at 6 months and 75% of mothers don't take their children to a well fare clinic, 13%ofthe respondents did not have latrines and finally most of the respondents, 66% get water from lakes and 89% do not use any method of water purification. Conclusion In conclusion, the study showed that early marriage, low education level, communal serving of children, early weaning, poor attendance of the child welfare clinic, recent infections, lack of water purification practice, lack of latrines, poor child care are the factors associated with under nutrition in children under 5years in Bangaladesh parish, Amolatar district. Recommendation I therefore recommend that health education should be emphasized on the promotion of girl child education, discouraging early marriages, communal serving of children and early weaning, prompt treatment of infections, encouraging taking children to welfare clinic, construction of pit latrines, purification of water and improving the quality of services provided.
Investigation of antibacterial activity, phytochemical screening and the extractive value of different solvents on lawsonia inermi (henna) plant leaf extract.
(Kampala International University.College of Health Science, 2010-04) Paul, Mayengo Maranya
The purpose of this study was to evaluate the antibacterial activity, to determine the most efficiency extractive solvents and phytochemical profile of Hot water, Methanol alcohol and Lemon juice extract of Lawsonia inermis (henna) leaf. The plant attracted the attention of researchers because of its use as anti-infective agent. The oily and alcoholic extracts of the plant Lawsonia inermis dried powdered leaves were separately obtained by maceration, while the aqueous was obtained by Infusion extraction method. The bacteria organisms tested were Staphylococcus aureus and Escherichia coli. Extraction, Phytochemical screening and susceptibility test of the plant leaves were performed using standard procedures. The Phytochemical screening results revealed the presence of tannins, steroids and reducing sugars as the major bioactive constituents. The Lemon juice extractive value was relatively much higher than the alcoholic and aqueous. The result of susceptibility test showed that the extract had greater antibacterial effect against all the two test organisms with minimum inhibitory concentrations (MICs) used as compared with standard drugs. Submitted ............................................... . Reviewed ............................................... .. Internal defense ..................................... . Accepted ................................................ ..
Neuroprotective mechanisms of garlic (allium sativum) in modulation of hippocampus function in model of type ii Diabetic Wistar Rats
(Kampala International University.College of Health Science, 2017-05) Ibrahim, Semuyaba
Hippocampus functions have been reported to be affected by diabetes mellitus. Studies suggest that within diabetic rats, garlic (A.sativum) improves different forms of memory that depend on the hippocampus. However, the neuroprotective mechanisms of garlic (A.sativum) extract possibly mediated by the Na+/K+ ATPase, Ca2+ATPase and glutamine synthetase (GS) in the hippocampus of type II diabetic Wistar rats has not been fully demonstrated. Therefore, the present study determined the effect of ethanol extract of ga;rlic (A.sativum) on object location memory (OLM) and on hippocampus Na+/K+ATPase, Ca2 + ATPase and GS activities. Thirty male Wistar rats divided into five groups, six rats each were used. Normal control rats in group A received 1ml of normal saline, normal rats in group B received 1 000mg/kg of garlic extract, diabetic control rats in group C received 1 ml of normal saline, diabetic rats in group D received 1 000mg/kg of garlic extract and diabetic rats in group E received 50mg/kg of metformin. All treatments were administered orally for 21 days. Induction of hyperglycemia was achieved by a single intraperitoneal injection of 60mg/kg STZ followed by 120mg/kg nicotinarnide while extraction of garlic (A.sativum) was done by cold maceration method. OLM was tested befor) induction of diabetes mellitus type II and at the end ?f the experiment in all the groups. After thf test, the rats were sacrificed, the brain removed, the hippocampi were carefully excised and thef homogenized. Homogenate was analyzed forNa+/K+ATPase, Ca2+ ATPase and GS activities. Results obtained showed that, there was improvement in OLM. There was also a significant increase (p < 0.05) in hippocampus Na+/K+ ATPase, Ca2 + ATPase and GS activities. In conclusion, it can be suggested that, the neuroprotective mechanisms of garlic (A.sativum) in modulating hippocampus function could be mediated through increasing the activities of hippocampus Na+/K+ ATPase, Ca2 + ATPase and glutamine synthetase.
Pharmaco-economic analysis of brands of antacid formulations available in Ishaka town using titrimetric method
(Kampala International University.College of Health Science, 2017-12) Adriane, Kavuma
Pharmaco-economics involves comparing the cost and consequences of products and services and Cost-effectiveness is the relationship between cost and effectiveness of a given drug. ANC of an antacid is one of the ways of evaluating effectiveness of antacid brands. ANC (mEq per unit dose) is the ability of the antacid to neutralize gastric acid (Shery et al., 2013), and it should be greater or equal to 5mEq per unit dose(FDA), where a unit dose of 0.5g for tablets and 5ml for suspensions was used. Cost was evaluated using cost per unit dose. Antacid formulations (tablets/suspensions) act by neutralizing gastric acid which is mainly hydrochloric acid (]-!Cl). Normal concentration of stomach HCl is about 0.082M and a person experiences stomach acid when HCl concentration increases to about 0.1 M. Antacids are indicated for peptic ulcer disease (PUD), gastro esophageal reflux disease (GERD), acid indigestion and bloating. Antacids contain one of the following compounds as their active ingredients: Magnesium hydroxide, calcium carbonate, sodium bicarbonate, aluminum hydroxide, magnesium trisilicate or ammonium citrate. Side effects due antacid use include: milk-alkali syndrome, osteomalacia, hypophosphatemia, constipation, diarrhea, aluminum-intoxication and dose dependent rebound hyperacidity (Omotosobayomi et al., 2015). The study design was experimental and during this study, sixteen marketed brands of vanous dosage forms were purchased from pharmacies in lshaka and their details recorded. 0.5g of tablet powder or 5ml of suspension was weighed into a 250ml flask. A known volume of O. l M l !Cl (20ml for tablets and 30ml for suspensions) was added to the flask and mixture swirled, then boiled for 15 seconds and cooled to room temperature. 8 drops of bromothymol blue were added and the mixture turned yellow. If it was not yellow, more HCI could be added until it turned yellow. The volume of excess acid added was recorded. The mixture was then titrated against 0.1 M NaOH until a blue end point was reached. The data was entered into Microsoft Excel and analyzed using ST AT A version 12 in which the ANOVA was used to test for differences amongst the ANC values and the costs per unit dose of the selected antacids. A 5% level of significance was considered and a p value less than that was taken to be significant. In this study, the ANC values and costs per unit dose of different brands were significant (p<0.0001). In this study, ANC was classified into three groups; the high ANC (13.08 - 26.48), the intermediate ANC (5.09 - 5.09) and the low ANC (0.69 - 1.98). All tablets were in the low class plus a few suspensions. Most suspensions were in the intermediate and high ANC. For suspensions Maalox plus had the highest ANC value (26.48), followed by Magnesium trisilicate vi mixture (22), and Gaviscon (13 .68) whereas Stamachfit had the lowest ( I. 78), followed by Ccntacid ( 1.89) and Magnomint (5.10). Meanwhile, for tablets, Maalox plus had the highest ANC of l .52mEq and CMT the lowest of 0.85mEq. Antacids with anti-foaming agents had lower ANC values since all were in the intermediate and low ANC group. Antacids with anti-foaming agents in this study were; Acid, Relcergel, Centacid and Mucogel (all with simethicone as the anti-foaming agent). The unit price of antacid suspension was between shs 50 - 1333 .3 per 5ml dose, while that for the tablet antacids was between shs 35.7 - 666.7, thereby making tablets to be cheaper than suspensions. For suspensions Maloox plus had the highest cost per unit dose (shs 1333.33/5111]) followed by Gaviscon (shs 875/Sml) and Mucogel (shs 600/5111]) whereas Maaga, Magnant and Magnesium trisilicatc mixture (SEY) all with unit price of shs. 50/5111] had the lowest cost per unit dose. All local suspensions except Renege], had the same cost per 5ml of shs 50, however for impmied brands like Relcergel, Centacid, Alcid and Stomachfit from the same country (India) also had different cost per 5ml. Meanwhile for the chewable tablets, Maalox plus had the highest cost per unit dose ofshs 666.7/0.5g while CMTand Minto cool had the lowest ofshs 35.7/0.5g. Maalox plus suspension had the highest ANC (26.48) but was not the most cost-effective antacid brand rather it was Magnesium trisilicate mixture (SEY), followed by Maaga, one of the local brands. No positive correlation was found between cost and effectiveness of antacid since local brands of lower cost were found to be equally effective compared with the costly imported brands. Due to high J\NC, few tablet antacids can be substituted for liquid antacids. Antacids therefore, can be consumed judiciously provided ANC details are enclosed on the label of these products. Acid neutralizing capacity details of antacid brands should be incorporated on to the labels to improve good prescribing practices. Further research should be done on other brands. Other research studies like sodium content, physico-chemical parameters and heavy metal (lead) content of antacids should be carried out.
Toxicity study of two herbs used by traditional healer Rurarwe to treat herpes zoster in HIV patients
(Kampala International University.College of Health Science, 2016-06) Halilu, Mad
Despite the fact that herbal medicines are used by 80% of the World's population (WHO, 2002) and are the main source of health care in the rural communities and the most preferred form of treatment of HIV-related symptoms (Orisatoki and Oguntibeju, 2010), less than 10% of herbal products in the world market are truly standardized to a known active and/or toxic components (Winston et al., 2007). Study carried out in Western Uganda reported 32.8% of same-day use of herbal medicine and pharmaceutical drugs by HIV patients (Deanne et al., 2007). Herpes zoster as a common disease in HIV patients is treated by traditional healers of Rukararwe with herbal preparations without any knowledge on the possible interactions between the treatments and lack of documented evidences to support their claim. Aim The aim or the study was to participate in the compilation of their traditional knowledge and make it available for future research, and also to avail the healers with the information on scienti fie literature. The study also evaluates the toxicity and interaction with ARV s of herbs used by traditional healers of Rukararwe in the treatment of Herpes zoster infection in HIVpositive patients. Materials and Methods Different concentrations of aqueous and ethanol extracts of Warbugia ugandensis with or without food were fed on Drosophila melanogaster and acute toxicity, locomotion assay, longevity study of the flies was done in 3 replicates, together with preliminary phytochemical screening of different extracts. Sesbania sesban (l.33µg/100µ1) with or without ARVs (AZT, L VD and NVP) were fed on D. melanogaster and copulation and mating assay, locomotion assay. longevity study of the flies was done in 3 replicates. Results and Discussion Traditional healers mostly used oral formulation (80%), herbs for treating herpes zoster (40%). Steroids. Terpenoids and Glycosides were present in all extracts of W. ugandensis. Extracts of W ugandensis were not toxic after I hour of exposure. Ethanol extract of W. ugandensis decreased ix I I ,. I i f I I I I I I negative geotaxis (P<0.0 I) and aqueous extract also (P<0.05), S. sesban does not affect the performance. Copulation latency of female flies treated with ARVs plus S. sesban for 7 days was increased (P<0.05). After 14 days of treatment, the flies treated with ARVs plus S. sesban shows decreased copulation latency (P<0.01) associated with increased copulation index (P<0.00 I), flies treated with S. sesban alone shows decreased copulation latency (P<0.001) associated with increased copulation duration (P<0.05), and finally flies treated with ARVs alone shows increased copulation latency (P<0.05) associated with decreased copulation index (P<0.05). Finally longevity study has shown toxicity of ethanolic extract of W ugandensis at concentration of 1% and 2%. Conclusion and Recommendations These results showed how concomitant administration of ARVs plus S. sesban decrease copulation latency and increase copulation duration, especially after exposure for 14 days, at the same time results showed increase copulation latency and decrease copulation durations in flies treated with ARV s alone. My study provides some basic information on interaction between first line ARVs combination in Uganda and a commonly prescribed herb by Rukararwe traditional healers to treat herpes zoster and also give an insight into discovery of new drug or supplement for the improvement of sexual performance. Further studies should be carried out to find out the mechanisms at which these agents affect copulation behaviors at molecular level. Finally both S. sesban and W ugandensis were found to be non-toxic at therapeutic doses on experimental model and they can continue to be used without much fear.
Toxicity study of two herbs used by traditional healers of Rukararwe to treat herpes zoster in HIV Patients
(Kampala International University.College of Health Science, 2016-06) Ahmad, Halilu
Despite the fact that herbal medicines are used by 80% of the World's population (WHO, 2002) and are the main source of health care in the rural communities and the most preferred form of treatment of HIV-related symptoms (Orisatoki and Oguntibeju, 20 I 0), less than I 0% of herbal products in the world market are truly standardized to a known active and/or toxic components (Winston et al. , 2007). Study carried out in Western Uganda reported 32.8% of same-day use of herbal medicine and pharmaceutical drugs by HIV patients (Deanne et al., 2007). Herpes zoster as a common disease in HIV patients is treated by traditional healers of Rukararwe with herbal preparations without any knowledge on the possible interactions between the treatments and lack of documented evidences to support their claim. A im The aim or the stud) was to partic ipate in the compil ation of their traditional knowledge and make it available for future research, and also to avail the healers with the information on scientific literature. The study also evaluates the toxicity and interaction with ARVs of herbs used by traditional healers of Rukararwe in the treatment of Herpes zoster infection in HIVpositive patients. Materials and Methods Different concentrations of aq ueous and ethanol extracts of Warbugia ugandensis with or without food were fed on Drosophila 111elanogaster and acute toxicity, locomotion assay, longevity study of the flies was done in 3 replicates, together with preliminary phytochemical screening of different extracts. Sesbania sesban (1.33 ~tg/ l00µ1) with or without ARVs (AZT, LVD and NVP) were fed on D. 111e/anogaster and copulation and mating assay, locomotion assay, longevity study of the fli es was done in 3 replicates. Results and Discussion Traditional healers mostly used oral formulation (80%), herbs for treating herpes zoster (40%). Steroids, Terpenoids and Glycosides were present in all extracts of W ugandensis. Extracts of W ugandensis were .not toxic after I hour of exposure. Ethanol extract of W ugandensis decreased ix negative geotaxis (P

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