Magister Pharmaceuticae - MPharm
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Item A Community Pharmacy perspective on the epidemiology of antimicrobial drugs in the Kuilsriver urban area(University of the Western Cape, 2017) Mhlanga, Miriam Rufaro; Obikeze, KThe epidemiology of drugs is 'defined as the manner in which drugs are used by doctors, nurses, pharmacists and patients. As such epidemiology of antimicrobial drugs is the manner in which this class of drugs is used by healthcare professional, patients or caregivers. Antimicrobial drugs have a pivotal role worldwide in preventing infections and treating infectious diseases. The challenge that lies in the health sector is to maintain antimicrobials' effectiveness by using them appropriately to avoid toxicity, adverse reactions and resistance among other problems. The world faces a future in which ten million people could die annually due to infections that are resistant to available antibiotics. Despite people already dying of drug-resistant infections in private and public hospitals, doctors are still prescribing antibiotics for viral infections, for which they have no effect. The aim of this research is to study the epidemiology of antimicrobial drugs and factors that lead to the inappropriate use of antimicrobials, which is resulting in a steep rise of antimicrobial resistance in the private sector from a community pharmacy perspective.Item Acute and chronic toxicity of the flavonoid-containing plant, Artemisia afra in rodents(University of the Western Cape, 2005) Mukinda, James Tshikosa; Syce, James A.; School of Pharmacy; Faculty of Community and Health SciencesThe aim of this study was to investigate the possible toxicity of the flavonoid-containing plant, Artemisia afra and especially establish the safety of the aqueous extract of this plant after acute and chronic administration to mice and rats respectively.Item Adverse effects experienced by patients on first line antiretroviral drugs used at Keetmanshoop Hospital (Namibia).(University of the Western Cape, 2015) Mutenda, Nicholus Mbangu; Mugabo, PierreAdverse effects are a significant factor that determine how long patients will tolerate a given antiretroviral drug regimen. They also influence treatment options, and play an important role in the much needed adherence to treatment by patients on Highly Active Antiretroviral Therapy (HAART). This study is aimed at understanding adverse effects experienced by patients on the first line antiretroviral therapy at Keetmanshoop Hospital in Namibia. Methods : A retrospective quantitative method was used to review records of patients on first line antiretroviral treatment who started treatment between November 1st 2007 and December 1st, 2008 and followed up until they reached 36 – 48 months on treatment. Records of 94 patients were found eligible to be included in the study. Data was analysed using Stata 12 data analysis software. Results : The most reported adverse effect was musculoskeletal disorders (25%) whereas headache (16%) was the least reported. Low haemoglobin (78%) was the most common recorded hematologic adverse effect whereas low red cell distribution width and low mean platelet volume were the least recorded adverse effects (0%). A Male patient was more likely to experience a low haemoglobin levels compared to a female patient (adjusted OR: 3.29, 95% CI: 1.3 – 8.3). A male patient was found to be 64% times less likely to experience a higher mean cell haemoglobin compared to a female patient (adjusted OR. 0.31, 95% CI: 0.11 – 0.87). A patient on nevirapine was more likely to experience an elevated creatinine level compared to a patient on efavirenz (adjusted OR; 36.0, 95%CI: 2.02 – 62.5). At baseline, a patient who had prior exposure to ART had an 81 times (adjusted OR: 81.4, 95%CI: 5.3 – 119, p-value=0.00) increased odds of experiencing a high mean cell volume (MCV) compared to a patient with no ART exposure. A patient with a higher CD4 count was also less likely to experience a low hemoglobin compared to a patient with low CD4 count (adjusted OR; 0.31, 95% CI: 0.12 – 0.77). The author recommends further studies with higher sample size to confirm whether higher creatinine levels are more prevalent in patients on nevirapine compared to patients on efavirenz; this will have clinical implications especially in patients with impaired renal system. Antiretroviral treatment increases chances of developing macrocytosis anaemia; clinical implication of this condition may need to be investigated.Item Adverse Foetal Outcomes in Gestational Diabetes: A Systematic Review and Meta-analysis(University of the Western Cape, 2020) Chukwuemeka, Scholarstica Chinwe; Obikeze, KenechukwuGestational diabetes mellitus (GDM) is a condition that affects pregnant women and is one of the most common complications related to pregnancy. According to the World health organisation (WHO), the usual window for diagnosing GDM is between 24 and 28 weeks of gestation and the primary aim of diagnosing gestational diabetes is to identify women and infants at risk of short- or longer-term adverse outcomes. Recent results from the hyperglycaemia and adverse pregnancy outcome (HAPO) study have suggested that even mild levels of hyperglycaemia can have adverse effects on foetal outcomes but there are uncertainties about the prevalence of these outcomes in GDM diagnosed according to the latest WHO 2013 guideline and/or IADPSG 2010 criteria in diverse populations. GDM prevalence has been studied by different researchers, but the prevalence of adverse foetal outcomes in GDM diagnosed based on the latest WHO 2013 guideline and/or IADPSG 2010 criteria have not yet been explored except for the data published by the HAPO study. Due to the lack of sufficient knowledge on foetal outcomes in GDM, this study was conducted to review the evidence on the prevalence of adverse foetal outcomes in GDM diagnosed according to WHO 2013 guideline and/or the IADPSG 2010 criteria. Different databases including PubMed, Science Direct, Google Scholar and CINAHL as well as bibliographic citations were searched using a well-formulated search strategy to find the relevant observational studies (prospective/retrospective cohort and case-control) using explicit inclusion and exclusion criteria. The following search terms were used, “gestational diabetes”, “pregnancy”, “adverse fetal outcomes” and “adverse foetal outcomes”. The findings of this study were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the obtained data analysed using MetaXL ® version 5.3. This review was registered online on PROSPERO, the International prospective register of systematic reviews (registration number: CRD42020155061). Fifteen studies with 88,831 pregnant women (range: 83-25,543 participants) from 12 countries around the world were identified, with a wide variation in the prevalence of foetal outcomes in GDM using the stipulated criteria. These studies were unevenly distributed geographically as six of them were conducted in Asia, four in Europe, four in North America, one in Australia and none in Africa, Antarctica and South America. A meta-analysis found that the overall prevalence of foetal outcomes ranged from 1% (perinatal mortality) to 11% ( large for gestational age). The finding is limited due to the paucity of data on the prevalence of foetal outcomes in GDM. However, more studies using these criteria in low- and middle- income countries (LMICs) are needed by health care providers, to inform practice and allocate resources for control of GDM and its adverse foetal outcomes in diverse settings and ethnic groups, especially in LMICs.Item Analysis on access to antiretroviral therapy for patients with different income and educational level, and the effect of treatment on quality of life after two to three months of therapy(University of the Western cape, 2017) Mokobori, Mpato; Van Huyssteen, MeaAccess to antiretroviral therapy (ART) for HIV positive patients has brought hope and a chance to a healthier longer life with improved quality of life (QoL). In this study we explored the difference in health related quality of life (HRQoL) between participants eligible for ART and those not yet eligible for ART as per the 2015 South African HIV treatment guidelines. We also considered the impact of ART access on HRQoL and the effect of employment status and education level. The study was conducted at one tertiary hospital and two primary health care facilities in Johannesburg, South Africa.Item Antiasthmatic properties of Lippia javanica and Myrothamnus flabellifolius using an in vitro model(University of the Western Cape, 2022) Alnamni, Ayiman; Khoza, StarAsthma is a reversible, chronic inflammatory disease that causes obstruction to the airways that causes an increase in airway hyperresponsiveness that leads to recurrent episodes of chest tightness and coughing. Lippia javanica and Myrothamnus flabellifolius are among the most widely used medicinal plants in Southern Africa for asthma management, control, and treatment. The aim of this study was to investigate the potential antiasthmatic properties of L. javanica and M. flabellifolius in a cell culture model.Item Antimicrobial discovery from South African marine algae(University of the Western Cape., 2018) Rufaro Mabande, Edmund; Beukes, Denzil RAntimicrobials are chemical compounds that destroy or inhibit the growth of microorganisms. The majority of these antimicrobials are actually natural products or natural product derived with key examples being the pioneer antibiotics penicillin and cephalosporin. Antimicrobials are an extremely important class of therapeutic agents; however, the development of drug resistance and slow pace of new antibiotic discovery is one of the major health issues facing the world today. There is therefore a crucial need to discover and develop new antibacterial agents. In this study, the potential of marine algae as a source of new antibiotics was explored. Crude organic extracts and chromatographic fractions obtained from small-scale extraction of 17 different marine algae were used to prepare a pre-fractionated library that would be tested against several disease causing microorganisms. The activity of the pre-fractionated library and purified compounds was determined against a panel of drug resistant microorganisms namely Acinetobacter baumannii ATCCBAA®-1605™, Enterococcus faecalis ATCC® 51299™, Escherichia coli ATCC® 25922™, Staphylococcus aureus subsp. aureus ATCC® 33591™ and Candida albicans ATCC® 24433™. Finally, cytotoxicity tests of 50 selected library extracts and isolated compounds were done against two cell lines namely MCF-7 (breast cancer) and HEK-293 (kidney embryonic).Item The antimicrobial screening of four South African Asteraceae species and the preliminary structural investigation of an antipseudomonal compound from Arctotis auriculata(University of the Western Cape, 1998) Salie, Fuad; Eagles, Peter; Leng, H.M.JInfectious diseases represent one of the main causes of morbidity and mortality in developing countries, like South Africa. The indiscriminate use of antibiotics has also resulted in the emergence of a number of resistant bacterial strains. Four plants belonging to the Asteraceae (Daisy) Family, which forms part of the Fynbos Biome, were screened for their phytochemical composition and antimicrobial activity. The plants investigated were: Helichrysum crispum, Felicia erigeroides, Eriocephalus africanzs and Arctotis auriculata. The plants were selected on the basis of their ethnobotanical use in various infectious diseases. The results from the phytochemical identification showed that all the plants tested positive for tannins. Flavonoids were detected in the leaves and stems of A. auriculata and F. erigeroides and the stems of E. africanus. Saponins were present in the leaves of H. crispum and the leaves and roots of F. erigeroides. Triterpene steroids were found in the stems of E. africanus and F. erigeroides. Akaloids were only detected in the leaves of A. auriculata and cyanogenic glucosides were in the stems of H. crispum and the leaves of A. auricula/a. None of the plants tested positive for quinones. The disc diffirsion method was used to determine the antimicrobial potential of the selected plant species. The results from this initial study showed that the organic extracts of A. auriculata and H. crispum inhibited the growth of Mycobacterium smegmatis. The same extracts, together with the organic extracts of F. erigeroides, were active against Pseudomonas aeruginosa. Antifungal activities against Candida albicans were exhibited by the organic extracts of E. africanus, F. erigeroide^s and H. crispum. Organic extracts of A. auriculata and E. africanus, as well as the aqueous extract of the latter plant, were active against Staphylococcus aureus. Hereafter, the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum fungicidal concentration (MFC) and minimum mycobactericidal concentration (MMC) of the most active solvent extracts of selected organs of the four plants were done.Item The antimicrobial screening of four South African asteraceae species and the preliminary structural investigation of an antipseudomonal compound from Arctotts auriculata(University of the Western Cape, 1998) Salie, Fuad; Eagles, P.F.K.Infectious diseases represent one of the main causes of morbidity and mortality in developing countries, like South Africa. The indiscriminate use of antibiotics has also resulted in the emergence of a number of resistant bacterial strains. Four plants belonging to the Asteraceae (Daisy) Family, which forms part of the Fynbos Biome, were screened for their phytochemical composition and mantimicrobial activity. The plants investigated were: Helichrysum crispum, Felicia erigeroides, Eriocephalus africanzs and Arctotis auriculata. The plants were selected on the basis of their ethnobotanical use in various infectious diseases.Item An assessment of current practice patterns of TB/HIV at primary health care clinics in the Western Cape and a needs assessment for clinic-based training among final year pharmacy students(University of the Western Cape, 2010) Tokosi, Oluwatoyin Iyabode AbiolaTuberculosis and mv Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in the deaths of approximately 2 million people a year. South Africa (SA) has one ( of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depends exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics may be compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinic-based training programs that are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic the outcome of TB and HIV drug regimens could be closely monitored. XVll Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBIHIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. http://uwc.ac.za Objectives To achieve the primary aim the researcher; 1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to assess current TBIHIV practice among HCP's and co-infected patients, 2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB clinic (pre-intervention), 3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use by pharmacists at Delft South and Elsies River clinics (intervention phase), 4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South and Elsies River clinics (post-intervention phase). XVlll To achieve the secondary aim the researcher; 5. Introduced a clinic-based training for seven final year pharmacy students, 6. Designed and administered an assessment to both control and experimental students, 7. Assessed scores between students who received the training (experimental group) with those who did not receive the training (control group). Results and discussion Findings from the baseline study indicate the need for the involvement of a trained pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the patients preferred receiving their TB information from the clinic nurse, almost two-thirds (63.2%; 12) of the patients believed that pharmacists assisted with their treatment provision. Patient data obtained from the clinic record card showed that almost two-thirds of the patients reported that they had experienced side effects (64.4%); the therapy of more than one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %). Post-intervention, the data showed that patients' viewed the pharmacist's role more positively. Almost all responses (97.5%; 39) favored the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had scores in the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control students passed with marks within this range. Conclusion A trained pharmacist would be competent to work alongside nursing staff in optimizing care provision in the clinical management of TB and HIV in patients. The existing clinic-based TB/HIV program could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.Item An assessment of current practice patterns of TB/HIV at primary healthcare clinics in the Western Cape and a needs assessment for clinic-based training among final year pharmacy students(University of the Western Cape, 2010) Tokosi, Abiola Oluwatoyin Iyabode; Bheekie, AngeniTuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinic based training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBI/HIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. Objectives To achieve the primary aim the researcher; 1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to assess current TBIHIV practice among HCP's and co-infected patients, 2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB clinic (pre-intervention), 3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use by pharmacists at Delft South and Elsies River clinics (intervention phase), 4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South and Elsies River clinics (post-intervention phase). Results and discussion Findings from the baseline study indicate the need for involvement of a trained pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the patients preferred receiving their TB information from the clinic nurse, almost two-thirds (63.2%; 12) of the patients believed that pharmacists assisted with their treatment provision. Patient data obtained from the clinic record card showed that almost two-thirds of the patients reported that they had experienced side effects (64.4%); the therapy of more than one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %). Post-intervention, the data showed that patients' viewed the pharmacist's role more positively. Almost all responses (97.5%; 39) favoured the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study clearly underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had marks in the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control students passed with marks within this range. Conclusion A trained pharmacist would be competent to work alongside nursing staff in optimizing care provision in the clinical management of TB and HIV in patients. The existing clinic based TB/HIV programme could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.Item An assessment of current practice patterns of TB/HIV at primary healthcare clinics in the Western Cape and a needs assessment for clinic-based training among final year Pharmacy students(University of the Western Cape, 2010) Tokosi, Oluwatoyin Iyabode Abiola; Bheekie, Angeni; School of PharmacyTuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored.Item An assessment of three Carpobrotus species extracts as potential antimicrobial agents.(University of the Western Cape, 2001) Springfield, Evan; Amabeoku, George J.For centuries, indigenous people in South Africa have used a variety of medicinal herbs to treat chronic infections. This investigation focused on three Carpobrotus species, in an attempt to assess their potential antimicrobial activity. Extracts of varying polarities of the plants were prepared and tested against Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans and Mycobacterium smegmatis. For the disc diffusion method Ciprofloxacin (4Opg/disc) served as positive control for ^S. aureus, P. aeruginosa and M. smegmatis, whereas amphotericin B (25 pg/disc) was the control for C. albicans. A sample concentration of 10mg/ml was used. Minimum inhibitory concentrations (MIC) were determined by two-fold serial dilution. Phytochemical analysis was completed to test for the presence of flavanoids, hydrolysable tannins, phytosterols and aromatic acids. The ethyl acetate extracts {2lpl of 95mg/ml) were used for bio-autography, together with TLC analyses and HPLC fingerprinting. Carpobrotus mellei, Carpobrotus muirrii and Carpobrotus quidrifidus showed antimicrobial activity against S. aureus and M. smegmatis in the disc diffusion method and inhibition against S. aureus and M.smegmatis was observed by clear zones on the TLC plate. HPLC fingerprinting of the three species showed similarities with common peaks detected at 366 nmi, and providing a phytochemical map of potentially important natural bioactives. This investigation confirms that extracts of the three Carpobrotus species that are used as indigenous medicines, exhibits anti-bacterial activity. This scientific information can serye as an important platform, for the development of inexpensive, safe and effective natural anti-infective therapeutics.Item Attitudes and knowledge of cbd and non-medical cannabis amongst retail pharmacists in South Africa(Universty of the Western Cape, 2023) Naik, Yugeshnee; Ebrahim, NaushaadThe recent changes in South African legislation have led to the reclassification of cannabidiol (CBD) as Schedule 0 and the decriminalization of non-medical (recreational) cannabis. As a result, CBD and recreational cannabis have become more accessible to the general public. This increased interest in cannabis has prompted individuals to seek guidance from pharmacists regarding cannabis products and their usage. For pharmacists to provide accurate advice, it's crucial to assess their confidence and knowledge when dealing with these products. Interestingly, no previous research of this kind has been conducted in South Africa. This study's main objective was to assess the attitudes and knowledge of pharmacists concerning the recommendation and counselling of CBD and recreational cannabis to their patients. This goal was pursued by investigating pharmacists' clinical knowledge, experiences, attitudes, and practices regarding CBD products. Additionally, the study aimed to identify factors influencing pharmacists' inclination to endorse CBD products, as well as explore how pharmacists perceive and approach the topic of recreational cannabis.Item Bioassay guided fractionation of Angiotensin converting enzyme inhibitor compound from Hypericum perforatum(University of the Western Cape, 2019) Mokwelu, Onyinye Vivian; Obikeze, Kenechukwu; Beukes, Denzil R.Due to the contribution of hypertension to various cardiovascular diseases, many studies are currently focused on identifying efficient bioactive compounds with antihypertensive activity and thus reducing the levels of cardiovascular disease. ACE inhibitors are an important component of the therapeutic regimen for treating hypertension, but due to the increase in the prevalence of side effects of synthetic compounds, alternative and complementary medicines which may consist of pure bioactive compound or a combination of various compounds from natural sources are gaining importance in overcoming hypertension. Hypericum perforatum has been studied for various activities including anti-bacterial, anti-depressant, anti-oxidant properties, but studies on its cardiovascular effects specifically ACE inhibitory activity have not yet been explored. In this study, ACEI assay-guided fractionation of the ethanol extract of Hypericum perforatum was carried out other to isolate a compound with ACE inhibition. A compound – (3-hydroxy 4, 4 dimethyl-4-butyrolactone) was isolated from an active fraction of the plant extract and was tested for ACE inhibition and its chemical structure elucidated using 1HNMR and C13NMR spectrometry and further characterized using mass spectrometry and FTIR.Item Cardiovascular effects of aqueous leaf extract of Leonotis leonurus in Anesthetized rats(University of the Western Cape, 2008) Tshambuluka, Noxolo; Mugabo, PierreThe present study was designed to evaluate the hypotensive properties and the mechanisms of action of the aqueous leaf extract of Leonotis leonurus in anesthetized male Wistar rats, using computerized blood pressure recording system.Item Cardiovascular effects of Leonotis leonurus extracts in normotensive rats and in isolated perfused rat heart(University of the Western Cape, 2004) Obikeze, Kenechukwu; Dietrich, Danielle; Green, Ivan; Burger, Andreas; School of Pharmacy; Faculty of ScienceThis thesis discussed the cardiovascular effects of the aqueous leaf extract and a fraction of the methanol extract of Leonotis leonurus, a plant commonly used in traditional medicine in South Africa for the treatment of hypertension and other cardiac problems. The cardiovascular effects was tested on anaesthetized normotensive male Wistar rats and isolated perfused rat hearts.Item Cardiovascular effects, molecular docking and chemo informatics analysis of compounds isolated from leonotis leonurus(University of the Western Cape, 2015) Sasi, Abd-Alkarim Nour-Addin; Kenechukwu, Obikeze; Christoffels, AlanLeonotis leonurus (L. Leonurus) has relatively abundant diterpenes and has been used as a traditional herbal medicine for treating several ailments including influenza, muscular cramps, skin related diseases, menstrual, antilipidemic, hyperglycaemia and hypertension. In this study, diterpenoid compounds such as; Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9 were isolated from L. Leonurus plant. The cardiovascular effects of these isolated compounds were investigated in order to determine the response of anaesthetised normotensive Wistar rats (in-vivo) to the compounds. Also, the druglikeness of the isolated diterpenoid compounds and their binding interaction with β1 adrenoceptor (PDB: 2Y04), angiotensin II receptor (Ang II) (PDB: 3R8A), Angiotensin converting enzyme (ACE) (PDB: 4XX3), and renin receptor (PDB: 2X8Z) by using molecular docking methods and Chemoinformatics analysis was performed (in-silico). Important molecular descriptors and molecular docking were used in our Chemoinformatics (in-silico) analysis to study the druglikeness and the binding affinity for of each molecule (Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9). The molecular descriptors and the binding energy were calculated by using the molecular operating environment software (MOE 2013). The lowest energy and highest cluster conformations of the molecules were further analysed. All the five (5) diterpenoids were predicted to have good oral bioavailability after oral administration and passed the BloodBrain Barrier (BBB) rules. Also, the compounds were predicted to have high probability of being good Druglike candidates, except for DC9, which is predicted to have lower possibilities of being Druglike candidate than the other diterpenoids. Furthermore, these compounds (Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9) were shown to interact with β1 adrenoceptors in-silico, an interaction that was confirmed in-vivo by increases in Blood pressure (SP, DP and MAP) and Heart rate (HR). In anaesthetized normotensive male Wistar rats (in-vivo), Dubiin (0.5 40mg/kg; IV), SaponifiedDubiin (0.5 60mg/kg; IV) Hispanol (0.5 40mg/kg; IV), DC9 (0.5 40mg/kg; IV) and Marrubiin (0.5 40mg/kg; IV) produced dose dependent increase in Systolic pressure (SP), Diastolic pressure (DP), and Mean arterial pressure (MAP) at all doses. Also, the compounds produced dose dependent increase in Heart rate (HR). From the in-vivo and in-silico studies it can be concluded that all the five (5) isolated diterpenoid compounds showed cardiovascular effects on Blood pressure (BP) and Heart rate (HR) by acting as β1 adrenoceptor agonists. Also, these diterpenoids compounds could be responsible for the cardiovascular effect observed in the methanol extracts from previous studies. These cardioactive compounds are prototype or ''lead compounds'' for designing and developing new nontoxic and effective drugs for cardiovascular disease (CVD) treatment.Item Challenges facing researchers conducting clinical trials in HIV prevention in South Africa: a focus on adherence(University of the Western Cape, 2014) Suliman, Suraiya; O’Donoghue, Miriam; Eagles, PeterIn clinical trials, adherence of the participants to the dosing instructions is a major challenge. Many researchers have identified medication adherence as a topic to further explore in order to obtain good, usable and reproducible results. In order to gain an understanding of on-the-ground issues in clinical research a survey was conducted, isolating the issue of medication adherence among participants as a discussion point. The research was conducted specifically at clinical trial sites that are involved in HIV pre-exposure prophylaxis research. The survey was conducted at clinical trial sites across South Africa among health care workers in the clinical research sector. The principle issue to be identified was the perceptions of staff and researchers with regards to the current approach to adherence measurement and possible suggestions from them on future adherence interventions strategies. This research was conducted as a qualitative analysis from February to March 2014. Eighteen responses were received. Among the respondents were investigators, medical officers, nurses and pharmacists. The results of the survey suggest that healthcare workers have a strong understanding of the importance adherence monitoring and intervention. They have many ideas on which measurement tools work and which don’t, but most importantly feel that the self-report or interview techniques are the most useful. Researchers also feel that much more can be done in order to improve the perception of the clinical research institutes in the eyes of the community and that a more active role should be taken in the community in order to improve the acceptance of the participants to the use of the product.Item The chemical stability of betamethasone valerate and fluocinolone acetonide cream and ointment in cetomacrogol and emulsifying cream and ointment bases(University of the Western Cape, 2002) Titus, Michael John; Syce, James A.The corticosteroids are powerful anti-inflammatory molecules but their usage is hampered by adverse effects. To minimise their adverse reactions, proprietary brands of topical corticosteroids are commonly diluted with a variety of bases. Dilution may affect the stability of the corticosteroid molecule and may result in accelerated degradation. This degradation may vary depending on the diluent base used. Such dilutions are also made in the Western Cape Department of Health public health system where unique formulations of cetomacrogol and emulsifying preparations are used as diluents. Because of the uncertainty of how these diluents would affect the steroid molecules, no accurate expiry dates could be allocated to the diluted preparations. This study set out to determine the chemical stability of betamethasone valerate and fluocinolone acetonide creams and ointments when diluted with the bases used in the public hospital system and to assign shelf lives to them. Samples of the branded topical corticosteroid products used by the Western Cape Department of Health were diluted 1 :10 and 50:50 with cetomacrogol and emulsifying cream and ointment bases. The diluted preparations were stored protected from light, moisture and air at 25'C. Samples of the preparations were assayed at intervals for their corticosteroid content using reverse phase High Performance Liquid Chromatography. These concentrations of corticosteroid provided a degradation profile of each preparation from which degradation rate constants were determined and shelf lives calculated. The HPLC method used was sensitive, accurate and specific for the active ingredients studied. The retention times of betamethasone valerate and fluocinolone acetonide were 4,00 and 5,15 minutes respectively. Betamethasone valerate was significantly more stable in the cream dilutions than in the ointment dilutions (e g. 1 .10 dilution in cetomacrogol cream t* = 5,46 +- months vs 1 :10 dilution in cetomacrogol ointment tgo = 1 ,62 +- months P = 0,0181 ). Conversely, fluocinolone acetonide was more stable in the ointment dilutions than in the cream dilutions but not significantly so (e.9. 1:10 dilution in cetomacrogol ointment tgo = 12,69 +- months vs 1 :10 dilution in cetomacrogol cream tro = l,$! +- months P = 0,1938). ln general, both corticosteroids degraded more slowly when diluted with cetomacrogol cream (e.9. 1 :10 dilutions of betamethasone valerate cream tro = 5,46 +- months and fluocinolone acetonide cream teo= 2,63 +- months) than with emulsifying cream (e.g. 1 :10 dilutions of betamethasone valerate cream tno = 3,05 +- months but not significantly so P = 0,8280 and fluocinolone acetonide cream tro= 0,0111 +- months extremely significantly so P<0,0001) and more slowly when diluted with cetomacrogol ointment (e g. 1 :10 dilutions of betamethasone valerate ointment tso = 1 ,62 +- months and fluocinolone acetonide ointment tso = 12,69 +- months) than with emulsifying ointment (e.g. 1 :10 dilutions of betamethasone valerate ointment t* = 0,18 +- months and fluocinolone acetonide ointment 1 .10 t* = 9,81 +- months although not significantly so P = 0,6590). Also, generally, the more concentrated dilutions were more stable than the more dilute ones (e.g 50:50 dilution of betamethasone valerate in cetomacrogol ointment tro = 4,33 +- months vs 1:10 dilution tgo = 1,62 months significantly so P = 0,0140 and 50:50 dilution of fluocinolone acetonide in cetomacrogol ointment t* = 46,90 +- months vs 1:10 dilution tro = 12,69 +- months although not significantly so P = 0,6005). Due to the rapid breakdown of the molecules it is therefore recommended that 1 :10 dilutions of betamethasone valerate ointment not be made using emulsifying ointment nor should branded products of fluocinolone acetonide be diluted with emulsifying cream at all. The calculated shelf lives should be used as a guide when the various combinations of steroids and diluents are to be used.