Ethiopian Pharmaceutical Journal

Evaluation of Sweet Orange (Citrus sinensis) Waste-Derived Pectin as a Sustained Release Excipient in Matrix Tablets of Nifedipine

Bedilu Amare — 2024-07-31

Pectin is a natural polymer that has a wide range of pharmaceutical applications including in controlled drug delivery. The annual orange production of Ethiopia is reported to be about 26,000 tons in 2022. From this amount, the peels account for 30 - 40% of the total weight of the fresh fruit which are damped as a waste material resulting in ecological and economic burden of disposing the accumulated waste products. This waste material can be converted to 590 - 780 tons of pectin annually, generating a huge sum of money. The objective of this research work was to isolate and characterize the physicochemical properties of orange peel (Citrus sinensis) waste-derived pectin as a matrix-forming polymer for sustained release tablet formulations using nifedipine as a model. Pectin was extracted from the dried orange peel powder by acidified hot water extraction method. The extracted pectin was found to be a non-free-flowing, poorly compressible powder with a degree of methyl esterification of 39% and is classified as low methoxy pectin. The galacturonic acid (GalA) content of the extracted pectin was found to be 90 ± 2%. Pectin-based matrix tablets of nifedipine were prepared by the non-aqueous wet granulation method with and without incorporating zinc chloride and calcium chloride and showed successful sustained release effect. The weight variation, hardness, friability, tensile strength, and disintegration time of the formulations were within acceptable ranges. The formulated matrix tablets sustained the drug release for more than 12 h. At equal concentrations, zinc pectinate showed a better sustaining effect than calcium pectinate. The drug release data were fitted into different release kinetics models and the Hixson- Crowell model best fitted the release data. In conclusion, Citrus sinensis peel waste-derived pectin can be employed as a safe natural excipient in a sustained drug delivery system.

Comparative in vitro Quality Evaluation of Four Brands of Atenolol Tablets Available in Addis Ababa, Ethiopia

Abebe Birsew — 2024-07-31

The circulation of substandard medicines remains a serious problem in resource-limited countries in subSaharan Africa, where most of the drugs available are imported. Antihypertensive drugs are one of the drug categories with numerous brands having significant price variations. Therefore, it is essential to compare and evaluate the bioequivalence of such drugs. The aim of the present study was to evaluate the physicochemical quality attributes and in vitro equivalence of four brands of atenolol tablets available in different retail outlets in Addis Ababa, Ethiopia. Four brands of atenolol 50 mg tablets were purchased from different community pharmacies in Addis Ababa, and were randomly coded as brand A, B, C, and D. Physicochemical quality control parameters of tablets such as tablet hardness, friability, weight variation and disintegration time were evaluated. Dissolution profile and active pharmaceutical ingredient (API) content was also determined by UV absorption spectrophotometry. The study revealed that all the studied brands meet official pharmacopoeial requirements of weight variation, hardness, thickness, friability, disintegration and dissolution profile. On the other hand, the API content of all the brands except D (118.30%) complied with the limit of USP. In water medium, disintegration time of the sample tablets ranged from 1.82 ± 0.47 to 16.95 ± 0.88 min and all the brands released >85% of the label claim within 15 min. Hence, all the studied brands except D can be considered as pharmaceutically equivalent and could be prescribed interchangeably.

Standardization Methods for the Roots of Echinops kebericho Mesfin: An Endemic Medicinal Plant of Ethiopia

Awraris Anbasie — 2024-07-31

Echinops kebericho Mesfin is one of the most important medicinal plants of Ethiopia with a long traditional use against a range of ailments. The major limitation to the use of herbal medicines such as E. kebericho, however, is the absence of quality control parameters. The present study aims to standardize the roots of E. kebericho using samples collected from two different geographical locations. The standardisation was validated by using standard protocols such as microscopy, physicochemical parameters, chemo profiling with liquid chromatography-quadrupole time of flight-mass spectrometry (LC-QTOF-MS), gas chromatography-mass spectrometry (GC-MS), and spectroscopic methods using fourier transform infrared spectroscopy (FTIR). Microscopically, the transverse section of the root showed vascular cambium and secondary xylem, while the longitudinal view of the root displayed vascular cambium. LC-QTOF-MS and GC-MS analyses identified 16 and 40 compounds, respectively. The major constituents identified in the studied extracts were selected as marker compounds. Thus, pyrocurzerenone and lappaconitine which were identified in the 80% methanol extract by LC-QTOF-MS, and dehydrocostus lactone and dihdrodehydrocostus lactone detected in the n-hexane extract by GC-MS analysis were used as marker compounds. IR spectral analysis further indicated that the rootextractsof E. kebericho are rich in terpenoids. These parameters describesome physicochemical features of E. kebericho, which can be useful in its quality control and safe use. Furthermore, results from the chemo-profiling could help in the isolation of medicinally significant compounds.

The Pattern of Dyslipidemia and its Associated Factors among Recently Diagnosed Patients with Type 2 Diabetes Mellitus at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia: A Comparative Cross Sectional Study

Abraham Degaga — 2024-07-31

Dyslipidemia which is a common phenomenon in type-2 diabetes mellitus (T2DM) patients, significantly increases cardiovascular events. In this study, the prevalence and pattern as well as possible risk factors of dyslipidmia in Ethiopian patients recently diagnosed with T2DM was determined. This hospital-based crosssectional study enrolled 127 patients with T2DM from a tertiary referral hospital, St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. A semi-structured questionnaire was used to obtain demographic and cardio-metabolic risk factors while information on comorbidities, full fasting lipid profile, fasting blood glucose, and glycated hemoglobin A1c were abstracted from the medical charts. Dyslipidemia was defined according to the Third Report of the National Cholesterol Education Programme (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults criteria, while elevated levels of non-HDLc was defined as non-HDLc levels ≥ 130 mg/dl. A Chi-square test, student’s t-test and Kruskal-Wallis test were used accordingly. Multivariate logistic regression analyses were performed to determine factors associated with component lipid abnormalities. The prevalence of dyslipidemia in T2DM patients was 92.1%. There was no significant difference in the prevalence of dyslipidemia between the female and male sexes (95.12 % vs. 86.67 %, p = 0.17), although the prevalence of individual lipid abnormality varied with gender. The prevalence of high total cholesterol, high triglycerides, low HDLc and high LDLc was 28.35%, 52.76%, 64.57%, and 69.29%, respectively. The prevalence of low HDLc (p = 0.002) and high LDLc (p = 0.037) was significantly higher among females than males, though the difference was barely significant for high total cholesterol (p = 0.05). The prevalence of mixed atherogenic dyslipidemia, combined dyslipidemia and isolated dyslipidemia was 37 (29.1%), 34 (26.8%), and 27 (21.3%), respectively. The mixed atherogenic dyslipidemia was the most common pattern of dyslipidemia (37, 29.1%), with the proportion being higher in women than in men (36.6% vs. 15.6%, p = 0.013). The female gender, age less than 50 years, and not being on statin treatment, physically inactive, not being hypertensive, and being on metformin + insulin regimen were significantly associated with different component lipid abnormalities in patients with T2DM. The study indicated a high prevalence of dyslipidemia in patients with T2DM attending clinic at SPMMCH with atherogenic mixed dyslipidemia being the commonest pattern. This implies that most of the T2DM patients are at a higher risk of cardiovascular disease. Therefore, it is mandatory to screen, implement routine treatments, and educate diabetic patients about diabetic dyslipidemia and its associated risk factors.

Thromboembolism Risk and Management in Hospitalized COVID-19 Patients: A Single-Center Experience in Ethiopia

Ashenafi Teklu — 2024-07-31

COVID-19 predisposes patients to venous thromboembolism (VTE) due to excessive inflammation, hypoxia, immobilization, diffuse intravascular coagulation (DIC), and pulmonary thrombotic microangiopathy. COVID-19 patients who developed VTE were at a higher risk of developing complications and death than those who did not. This study aimed to evaluate the risk, incidence, and management of VTE in hospitalized COVID-19 patients at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. A crosssectional retrospective study was conducted among 146 COVID-19 patients admitted to TASH. The modified Caprini risk score was used to assess the risk of VTE in COVID-19 patients. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Of the 146 patients included in the study, 84 (57.53%) were males and the age was between 18 and 89 (mean 45.56 ± 18.17) years. More than one- third of the patients (69.2%) had a ≥ 5 VTE risk score for developing VTE, with a mean score of 3.63 ± 0.60. The most frequently observed VTE risk factors were symptomatic COVID-19 (88.40%), serious lung disease (56.2%), and age > 40 years (52.10%). Thromboprophylaxis was prescribed to 98 patients (67.12 %). The incidence of VTE was 15.75%, and most patients (91.3%) had the highest VTE risk (score ≥ 5). It can be concluded that all patients with COVID-19 were at risk of developing VTE, with low utilization of thromboprophylaxis. The incidence of VTE was high and majorly occurred in patients who did not receive prophylaxis. Radiological methods should be used to diagnose VTE for optimizing its diagnosis and management.

Knowledge and Practice of Community Pharmacy Professionals on Medication Safety during Pregnancy in Addis Ababa, Ethiopia

Mekdes Worku — 2024-07-31

Community pharmacists, the most ccessible healthcare professionals and experts in medicine should have relevant and updated knowledge and skills regarding dispensing medicines during pregnancy. The purpose of this study was to assess the knowledge and practice of community pharmacy professionals regarding medication safety during pregnancy in Addis Ababa, Ethiopia. A cross-sectional study using a semistructured questionnaire was conducted among 117 community pharmacy professionals working in community pharmacies and drug stores in the Lideta sub-city, Addis Ababa, Ethiopia. The lists of medicines were prepared based on the US FDA drug risk category (A, B, C, D, and X) during pregnancy, and then revised and validated by an expert pharmacist working in the community pharmacy and a senior clinical pharmacist practicing in a university teaching hospital. Data were analyzed using SPSS version 26. All participants provided verbal informed consent prior to participating in the study. Most of the respondents [80 (68.4%), 90 (77.8%), and 90 (77.8%)] knew that amoxicillin was safe in all three trimesters. Only approximately one-third of the pharmacy professionals believed that budesonide inhalers were safe during all pregnancy periods. Regarding knowledge of the safety of over-the-counter drugs, 77.8% and 59.8% identified acetaminophen and ibuprofen as safe and unsafe, respectively, during the third trimester. Approximately 78.6% of the respondents were asked about the pregnancy status of women of reproductive age and advised pregnant women about over-the- counter drugs (65.8%) and herbal medicines (23.9%) that should not be taken during pregnancy. The overall knowledge score on medication safety during pregnancy was 59.8%, and 51.3% of community pharmacists followed safe practices while dispensing medicines to pregnant women. Approximately 80.3% of the respondents updated their knowledge regarding the safety of medications during pregnancy. The overall knowledge of medication safety during pregnancy by community pharmacy professionals is suboptimal, and there are gaps and variations in the knowledge and practice of medication safety during pregnancy, which mandates in-service training programmes to provide better dispensing quality services for pregnant women based on correct and evidence-based information.