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Study’s Novelty/Excerpt • This study assesses heavy metal concentrations in traditional medicinal herbs consumed in Kano State, Nigeria, providing critical insights into their relative safety and potential health risks. • By analyzing ten powdered herbal samples using Atomic Absorption Spectrometry, the research identifies concerning levels of lead, chromium, cadmium, and mercury, with lead concentrations in one sample exceeding the WHO's safety limits. • The findings highlight significant variability in heavy metal content among different herbs, underscoring the need for stringent quality control and regulatory measures to ensure consumer safety. Full Abstract Herbs are extensively consumed in Nigeria, for their medicinal properties and availability. This study aimed at determining the concentration of heavy metals residues in some selected traditional medicinal herbs consumed in Kano State, Nigeria. This is to assess their relative safety and potential health risks to local inhabitants based on the World Health Organization standard limit. A total of ten (10) powdered samples of medicinal preparations were purchased from local markets in Kano metropolis and analyzed for the presence of lead, chromium, cadmium, and mercury contents. The samples underwent digestion, and heavy metal concentrations were determined using Atomic Absorption Spectrometry (AAS). The metals found to be present varied in different concentrations in the herbal samples. The presence of heavy metal ranges as follows: 0.6-6.5mg/kg for chromium, 3.10-22.10mg/kg for lead, 0.08-0.60mg/kg for cadmium, and 0.09-0.30mg/kg for mercury. However, mercury content was not detected in some samples. The study's findings conclude that the lead (Pb) values were found to be the highest in concentration, exceeding the W.H.O limits in sample J, which is used as a remedy for cough. This indicates that the sample is highly contaminated compared to others. Mercury was not detected in four of the samples, and when present, it was below the limits set by the World Health Organization, making all the samples free from mercury contamination.

The study evaluates the potential immunocytotoxic effect of aqueous leaf extract of Cassia occidentalis on human peripheral blood mononuclear cells (PBMCs) and Neutrophils. Different concentrations (25 µg/ml, 50 µg/ml, 100 µg/ml) of the extract were prepared. Six millilitres (6ml) of peripheral blood from consented healthy volunteers was collected and PBMCs and neutrophils were isolated on Histopaque media. The viability of PBMCs and neutrophils was determined using trypan blue dye exclusion methods. One-way analysis of variance was used in analysing the results. Total viable cell count (TVCC) for PBMCs and neutrophils yielded 298.9 x 104 cells/ml and 327.9 x 104 cells/ml respectively. The TVCC of the highest concentration (100 µg/ml) of the extract used for the treatment of PBMCs was 192.7 x104 cells/ml and that of neutrophil was 50.47 x104 cells/ml equivalent to 82.51% and 61.71% mean viability percentages respectively. The PBMCs and neutrophils treated with 25 µg /ml of the extract have the highest mean percentage viability scores of 94.88% and 74.61% respectively. There was a significant difference in the mean percentage viability when control PBMCs was compared with those treated with 100 µg/ml (p

Epidemic meningococcal meningitis is a major public health problem still affecting tropical countries, particularly in Sub-Saharan Africa, which lies within African meningitis belt. Repeated large scale epidemics of CSM have been reported in northern Nigeria for the past four decades. It is one of the important causes of morbidity and mortality in these regions. Mortality from the CSM remains high despite advances in treatment modalities. Neisseria meningitidis serogroup A have been the major cause of large scale epidemics in tropical countries, while serogroups B, C, Y and W-135 are responsible for most of invasive disease in America and other developed countries. Objective: To determine the pattern of epidemic CSM in children at Federal Medical Centre, Gusau. Method: The study was a retrospective one carried out in children aged six months to 12 years admitted into Emergency Paediatrics Unit (EPU) with a diagnosis of CSM within the period January to May, 2009. Results: Seventy- seven children with epidemic CSM were admitted and managed in EPU from January- May 2009. Conclusion: Neisseria meningitidis serogroup A CSM is becoming the disease of young infants, and stresses the need for inclusion of CSM vaccine in early infancy in routine immunization policy, in areas within the meningitis belt in Sub-Saharan Africa.

Omalhassan Amir Abdelkarim,1 Usman Abubakar,2 Mohamed A Hussain,3 Abd Elrahman Babiker Abadi,1 Ahmed Osman Mohamed,3 Wadah Osman,4,5 Asmaa E Sherif,4,6 Sara Altayep Ebrahim,1 Asmaa Hussein Ahmed,1 Marwa Omer Ahmed,1 Ahmed Ashour4,6 1Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 2Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 3Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 4Department of Pharmacognosy, Faculty of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-KharJ, Saudi Arabia; 5Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan; 6Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura, EgyptCorrespondence: Omalhassan Amir Abdelkarim, Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, PO Box 2469, Sudan, Email dromal409@gmail.comBackground: Adequate training in infectious diseases and antibiotic resistance is crucial for pharmacy students to participate in antibiotic stewardship programs and understand microbiology careers.Aim: The study was carried out to assess the knowledge and self-reported confidence in antibiotic resistance, antibiotic therapy, and antimicrobial stewardship (AMS) among final-year undergraduate pharmacy students in Sudan.Methods: A cross-sectional study was conducted in three universities using a 57-item online questionnaire between April and May 2022.Results: A total of 109 students (response rate 36%) participated and showed average knowledge scores of 5.6± 1.7 (out of 10.0) for antibiotic resistance, 4.9± 2.0 (out of 5.0) for appropriate antibiotic therapy, and 3.1± 1.4 (out of 5.0) for AMS. No significant differences were observed among schools. Some students reported poor knowledge about antibiotic therapy and the consequences of resistance. One-third of students lacked confidence in interpreting microbiological results. Knowledge of antibiotic resistance among students’ practice area after graduation was higher (p=0.017) and those interested in ID careers (5.8 vs 4.8) (p=0.037). Male students (5.6 vs 4.5) and those interested in ID careers (4.3 vs 3.4) (p< 0.001) had higher scores of appropriate antibiotic therapy. Students attended antibiotic resistance courses (51.5 vs 45.2), and those interested in ID significantly had higher self-confidence (55.3 vs 45.8) (p=0.008).Conclusion: Pharmacy students in Sudan have substantial knowledge of AMS and antibiotic resistance with poor knowledge of antibiotic therapy. Adequate training about infectious diseases and related topics is recommended to improve pharmacy students’ understanding of microbiological findings, other competencies, and skills to incorporate in antimicrobial stewardship.Keywords: antibiotic resistance, antimicrobial stewardship, antimicrobial therapy, Sudan, pharmacy students

Omalhassan Amir Abdelkarim,1 Usman Abubakar,2 Lubna Osman Taha,1 Sondos Ahmed Ashour,1 Wiaam Yousif Abass,1 Eslam Mohamed Osman,1 Mustafa Shith Muslih1 1Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 2Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, QatarCorrespondence: Omalhassan Amir Abdelkarim, Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Madani St, P.O Box 2469, Al Khartoum, Khartoum, 12223, Sudan, Tel +249912325691, Email dromal409@gmail.comBackground: Intensive Care Unit (ICU) is a specialized ward where critically ill patients are admitted to provide intensive health care Inappropriate antimicrobial therapy (AMT) and high mortality rates were documented in the ICU. The influence of irrational use of empiric antibiotics on clinical outcomes in ICU patients is not well studied in Sudan.Aim: This study aims to determine the rational use of antibiotics and its impact on clinical outcomes among ICU patients.Methods: Using data collection form, a retrospective longitudinal study was conducted among ICU patients at Omdurman Military Hospital, Khartoum State. Patients admitted from January 2019 to December 2019 were included in the study. Patients who stayed in ICU < 48 hr were excluded. Appropriateness of AMT is assessed using culture sensitivity test (CST) and the American Society of Infectious Diseases (IDSA) guideline.Results: Among 102 patients, 54.9% male, one-third of patients developed nosocomial infections, 80.4% received empiric therapy with broad-spectrum antibiotics. The CST is done in 19%, and 43% patients are prescribed inappropriate AMT. Inappropriate AMT is associated with recurrent infections 38.4% (p=0.028) and high mortality 33.8% (p=0.014). Overall mortality rate 63.7% ICU patients. Elevated mortality in nosocomial 57.8%, decreased with inappropriate AMT in 21.6% patients. Significantly higher mortality rates 90.7% among uncontrolled infections (p< 0.001), 80.6% nosocomial infections (p=0.001), and 76.7% renal compromised (p=0.002).Conclusion: Empirical AMT reduces the frequency of nosocomial infections, which has an impact on mortality. Inappropriate AMT is significantly associated with uncontrolled infections and lower mortality. Implementing a restrictive infectious control system and effective stewardship programs in hospital ICU wards is recommended.Keywords: rational use of antibiotics, mortality rate, intensive care unit, clinical outcomes, appropriate antibiotic therapy

Abdulsalam M Halboup,1,2 Karem H Alzoubi,3,4 Omar F Khabour,5 Mahmoud A Alomari,6 Moath Refat,7 Abdulrazzaq Y Al-Khazzan,1 Ammar Ali Saleh Jaber,8 Usman Abubakar9 1Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen; 2Discipline of Clinical Pharmacy, University Sains Malaysia, Penang, Malaysia; 3Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates; 4Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 6Department of Rehabilitation, Jordan University of Science and Technology, Irbid, Jordan; 7Department of Biochemistry and Molecular Biology, Xi’an Jiaotong, University, Xi’an, China; 8Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates; 9Department of Clinical Pharmacy and Practice, Qatar University, Doha, QatarCorrespondence: Abdulsalam M Halboup, Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen, Tel +967774960247, Email a_halboob@yahoo.com; a.halboup@student.usm.myBackground: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen.Methods: This was a cross-sectional study of the public in Yemen. The relationship between participants’ sociodemographic factors and their responses was assessed by the chi-square test.Results: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants’ perceptions regarding the nature of the virus and susceptibility to severe disease.Conclusion: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.Keywords: public perception, COVID-19, susceptibility, complications, Yemen

Inflammation is a physiological event that protects tissues from infection and injury. Chronic inflammation causes immune cell over activation and sustained release of inflammatory cytokines and chemokines cause pathologic conditions including autoimmune diseases. Heavy metals exposure affects innate and adaptive immune systems through triggering inflammatory responses. It seems that extended inflammatory responses could accelerate heavy metal-induced autoimmunity. In the present review we discuss the exposure route and toxicity of Cadmium (Cd), Lead (Pb), Mercury (Hg), Vanadium (V) and Platinum (Pt) and their effects on inflammatory responses by innate and adaptive immune system and autoimmunity.

Mohamed Hassan Elnaem,1,2 Nor Afifah Irwan,1 Usman Abubakar,1 Syed Azhar Syed Sulaiman,3 Mahmoud E Elrggal,4 Ejaz Cheema5 1Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; 2Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; 3Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 4Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia; 5School of Pharmacy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKCorrespondence: Ejaz CheemaSchool of Pharmacy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKTel +44-121-4146845Email E.Cheema@bham.ac.ukBackground: This study aims to identify interventions used to reduce medication regimen complexity and to assess their impact on medication adherence and clinical outcomes.Methods: A literature search was conducted using pre-defined search terms in three scientific databases, including ScienceDirect, ProQuest and MEDLINE. Original research articles published in English between 2009 and 2020 that assessed the impact of medication regimen simplification on medication adherence in patients with long-term medical conditions were eligible for inclusion. Review articles, meta-analysis studies and conference proceedings were excluded. Data charting was done in an iterative process using a study-specific extraction form.Results: Of the 684 studies identified through initial searches, 17 studies were included in the review. Nine studies involved simplification of medication regimen related to HIV, while three studies focused on patients with diabetes with or without coronary artery disease. The remaining five studies included medications used among elderly patients or medications related to hypertension, psychiatric disorders, glaucoma and kidney diseases. Three medication regimen simplification strategies were identified; fixed-dose combination (n = 7), once-daily dosing (n = 4) and the combination of both fixed-dose and once-daily dosing (n = 6). Overall, most of the regimen simplification strategies (14 out of 17) were found to be useful in improving medication adherence. There was no assessment of clinical outcomes in four out of 17 studies. Furthermore, more than half of the studies that assessed clinical outcomes did not show any additional impact on clinical outcomes.Conclusion: The findings suggest that there was an equal utilization of the three main approaches of regimen simplifications; fixed-dose combination, once-daily dosing and a combination of both. Overall, most of the regimen simplification strategies were found to be effective in improving medication adherence. However, the associated improvement in medication adherence did not extend to improvement in the clinical outcomes.Keywords: medication adherence, regimen simplification, clinical outcomes, review

Introduction: Plant is a friend to man in survival as it gives him food, shelter and medicine beyond the ages of human civilization. This paper evaluates the phytochemical constituents and the antimicrobial activities undertaken on Terminalia avicennioides and Ficus polita. Methods: Phytochemical screening was conducted on the root extracts according to the standard procedures. The hole-in-plate disc diffusion technique was used to determine the antimicrobial activities of the crude saponins and crude flavonoids against the tested microorganisms used in this study. Results: The results revealed the presence of alkaloids flavonoids, saponins, sterols, phlobatannins and terpenoids. The antimicrobial activities presented as diameter of inhibition zones showed high activity value of 34.70±0.57 mm against Staphylococcus aureus and Pseudomonas aeruginosa at a concentration of 100 mg/mL and by crude flavonoids portion of T. avicennioides while the least activity was shown by crude saponins portion of F. polita at a concentration of 25 mg/mL with value of 9.67±0.58 mm against Shigella dysenteriae. The crude flavonoids inhibited the growth of Candida albicans at all concentrations while resisitances were found towards the crude saponins portion of both plants. Hence, flavonoids extractives from the two plants appeared to be more effective than the saponins against the tested microorganisms. Conclusion: These findings justify their potential use as drug-plant against bacterial-related infections in African traditional medical system and also suggest a possible insight for the isolation of bioactive chemotherapeutic agents from T. avicennioides.

In the present article, our main goal is to study the new extended beta, Gauss and confluent hypergeometric functions defined by using the two Fox-Wright functions as their kernel. Some applications of the new extended beta function to distribution theory are also discussed. [ABSTRACT FROM AUTHOR]

In this article, generalized pathway integral operator with the classical Gauss hypergeometric function kernel and the fractional differential operators are used to studied new extended hypergeometric function. Furthermore, extended fractional kinetic equation involving new extended hypergeometric function that contained two Fox-Wright function as regularizer is investigated using Sumudu transform and Wiman's function. [ABSTRACT FROM AUTHOR]