Physiological Sciences

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    Zambia abortion survey report : incidence and determinants of abortion in Zambia.
    (Golden Touch Graphical Printers, 2009) Likwa, Rosemary Ndonyo
    Abortion remains the major risk factor to maternal morbidity and mortality in many parts of Africa and more so in the Zambian situation, even though the level of its incidence is still uncertain. Despite Zambia having the most favourable and liberal abortion law in Africa, morbidity and mortality that have accounted for unsafe abortion remain a major reproductive health challenge, demonstrating gaps in application of abortion law compounded by institutional and socio-cultural barriers, as social norms of Zambian societies. The purpose of a national abortion survey in Zambia was to estimate abortion incidence ratio rate and examine its determinants in order to better understand the magnitude of unsafe abortion and seek further approaches for improving safe abortion services and other related reproductive health services in the country. Specifically, it involved collecting annual abortion data, from June 2008 to May 2009 in major referral hospitals, alongside determining abortion complications by demographic characteristics in relation to age, education, occupation, marital status, religion, parity and method used for abortion over a period of six months. The other objective was to examine the mode of abortion practice and its occurrence by type of abortion complications, as whether legal, unsafe (illegal practice), or spontaneous abortion prevalent at the health facilities. Aretrospective cross sectional hospital-based survey was conducted to review 4174 abortion case records over a period of six months, January to June 2009, in four major hospitals of Kitwe Central, Ndola Central, University Teaching Hospital (UTH) and Kabwe General Hospital in three provinces of Lusaka, Copperbelt and Central. These study sites were selected purposively on the basis of population concentration and serving as major referral hospitals in the country. A ratio estimation of abortion incidence rate was applied to the annual abortion data for June 2008 to May 2009 estimated on the basis of annual expected pregnancies for 2009. Other measures included demographic characteristics and abortion status in relation to its classification as, legal termination of pregnancy (TOP), unsafe abortion (Illegally induced), or spontaneous, method used for abortion and parity as main variables. A record review checklist was used to collect all abortion data. Data were analyzed by SPSS statistical package for descriptive statistics and statistical tests for associations in the occurrence of abortion and its characteristics, method used and parity. The findings show the abortion incidence ratio rate of 12.3 percent per 100 live births of expected annual number of pregnancies for 2009 for the three provinces. There are greater significant associations in the prevalence of abortion with education, marital status, occupation, religion, parity, methods used for abortion and type of health facility (pvalue< 0.000- 0.001), which determines the extent to which abortion affects women in Zambia. Age was not found significantly statistical difference in its association with the prevalence of abortion (pvalue > 0.558). However, abortion affected all age-groups of women in the age range from 10 to 49 years, with a mean of 26.29 years, even though there were some variations in the distribution of abortion incidences according to their age-groups. Significant differences were also observed in the practice of legal abortions (2.5 percent) and those presenting with complications of unsafe abortion and spontaneous abortions as incomplete abortion accounting for 92.4 percent (pvalue < 0.000). Mortality is highest in Ndola Central (45.5 percent) followed by Kitwe Central (27.3 percent) than UTH and Kabwe General Hospital with limited figures, giving the overall percent of 0.3 percent of all abortion deaths. More women are surviving from the risk of abortion morbidity in Zambia. Use of MVA is found highly significant in reducing abortion mortality at health facilities. The findings suggest greater unmet needs for family planning and safe abortion services directing to improvement in family planning programme, policies and future innovation research approaches including the effective process of monitoring and evaluating abortion trend and strategies alongside strengthened health information system are imperative. Abortion is a highly risk factor to morbidity more than mortality which directs to better effective preventive measures of unwanted pregnancies than reliance on case management strategies of abortion care.
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    Indigenous Knowledge Systems for the Treatment of Hypertension in Lusaka, Zambia: Perceptions, Knowledge and Practice.
    (Zambian Medical Association, 2016-01) Prashar, Lavina; Goma, Fastone; Kalungia, Chichony Aubrey; Bwalya, Angela Gono; Hamachila, Audrey; Mutati, Ronald Kampamba; Zingani, Ellah; Mwila, Chiluba; Musoke, Pamela
    Indigenous knowledge systems and traditional technologies have made and can continue to make a significant contribution to modern medicines with discovery of novel molecules in the treatment of various conditions. The traditional knowledge in our communities is passed on from generation to generation. Scientific evaluation of these compounds from traditional medicines can lead to discovery drugs with better efficacy and novel mechanism. The study aimed at determining the indigenous knowledge based preparations used for hypertension in Lusaka, Zambia. The specific objectives were: a). To determine the knowledge and practice of Traditional Health Practitioners in the management of HTN, b). To identify the parts of the plants utilized in the preparation of the IKS-based preparation used in the management of hypertension. c). To determine the procedure employed in preparing the IKS-based preparations used in the management of hypertension. d). To recommend for further elucidation of the possible active compounds in the indigenous based preparations and postulate possible pharmacological mechanisms of actions. The study adopted structured interviews complemented by non-participatory observations. Samples used by traditional healers were collected for identification and characterization A total of twelve (12) traditional healers registered with Traditional Health Practitioners of Zambia who manage hypertension were interviewed. The traditional healers interviewed had knowledge of causes of hypertension, only three (3) indicated bewitchment as one of the causes. spiritual method constituted an important method of diagnosis. The beliefs of Traditional Healers with regard to hypertension indicates their alignment to agreeing the scientific understanding of hypertension in terms of its causes, risk factors and complications. Traditional Healers in Zambia believe hypertension can be managed by some mode of action of the herbs. Common themes that emerged to determine the effectiveness of the herbs used included; patient feedback, physical appearance, confirmation at local clinic and increased urine output. Majority (5/12) felt that there herbs take atleast 7-14 before the effects are seen. All the traditional healers indicated using atleast two (2) types of herbal preparations to manage hypertension. Of the preparations mentioned three (3) were not of plant origin. These include; crocodile fat, pebble and honey. This study observed that the traditional healers of Zambia knowledge of causes and complications of hypertension are alligned to the scientific knowledge. Divination is however still the most important (50%) method used for diagnosis and witchcraft/ spiritual method forms an important method for some for diagnosis of hypertension. It is noteworthy that traditional healers in Zambia believe hypertension can be managed by some mode of action of the herbs a belief shared by the conventional management.
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    Opuntia stricta cladode Extract reduces blood glucose levels in Alloxan-induced diabetic mice.
    (Scientific and Academic Publishing, 2018-07) Prashar, Lavina; Kalungia, Chichony Aubrey; Mataka, Mary; Kaonga, Patrick; Bwalya, Angela Gono; Munkombwe, Derrick
    Opuntia stricta (commonly called prickly pear cactus) is a natural plant that grows in some parts of Zambia where its fruits and cladodes are commonly consumed for nutritional and medicinal purposes, including glycaemic control among some patients with diabetes mellitus (DM). There is insufficient evidence whether Opuntia stricta indigenously growing in Zambia possess antidiabetic effects.To assess in vivo antidiabetic effects of the aqueous extract of Opuntia stricta cladodes in alloxan-induced diabetic mice. A laboratory-based experimental study was conducted involving 20 adult Swiss albino mice (Mus musculus) weighing 18-30 g. DM was induced using a single intraperitoneal dose of alloxan monohydrate 90 mg/kg. Opuntia stricta aqueous extract was administered orally and blood glucose levels (in mmol/L) monitored daily for 10 days. Alloxan induced a 4- to 5-fold sustained increase in blood glucose levels at 72 hours after administration in mice. Within a 10-day experimental period, Opuntia stricta cladode aqueous extract (1 mg/kg) significantly reduced blood glucose levels in vivo (from 16.6 ± 1.4 mmol/L, 95% CI: 14.9-18.3 at baseline to 7.5 ± 1.0 mmol/L, 95% CI: 6.2-8.9 at endpoint, p < 0.001, n = 5). Similarly, at a dose of 2 mg/kg, the extract significantly reduced blood glucose levels (from 18.7 ± 4.6 mmol/L, 95% CI: 13.0-24.4 at baseline to 6.9 ± 1.7 mmol/L, 95% CI: 4.7-9.0 at endpoint, p = 0.001, n = 5). Opuntia stricta cladode aqueous extract attained a greater reduction in blood glucose levels compared to Glibenclamide 0.25 mg/kg. Opuntia stricta cladode aqueous extract demonstrated a presence of alkaloids, flavonoids, saponins, sterols, carbohydrates, phenols and tannins. Opuntia stricta cladode from Zambia demonstrates antidiabetic effects to reduce blood glucose levels in vivo.