Aim: To evaluate in vitro the effectiveness of several anti-infective agents alone and in combination against Leishmania donovani. Method: A convenient stratified sampling method was used to obtain selected anti-infec...Aim: To evaluate in vitro the effectiveness of several anti-infective agents alone and in combination against Leishmania donovani. Method: A convenient stratified sampling method was used to obtain selected anti-infective agents. For individual drug samples, Half Maximal Inhibitory Concentrations (IC<sub>50</sub>) were obtained using the broth dilution method. The IC<sub>50’s</sub> of the drugs which were active against L. donovani were used as reference values to prepare drug combinations for the modified microdilution checkerboard method. Results: Five (5) out of the fifty-six (56) drugs used showed activity (inhibition of cell growth) against L. donovani cells. They include Quinine sulphate (IC<sub>50</sub> = 0.089 μg/ml), gentamicin (IC<sub>50</sub> = 8.1 μg/ml), amodiaquine (IC<sub>50</sub> = 138 μg/ml) and the two standard drugs: Amphotericin B (IC<sub>50</sub> = 6.3 μg/ml) and Pentamidine (IC<sub>50</sub> = 25 μg/ml). The remaining fifty-one (51) drugs did not show any inhibition within the range of concentrations used (1.25 - 160 μg/ml). The drug combinations of Pentamidine/Amodiaquine, Pentamidine/ Quinine sulphate, Pentamidine/Gentamicin, Amphotericin B/Quinine Sulphate, Amphotericin B/ Gentamicin, Amodiaquine/Quinine sulphate and Amodiaquine/Gentamicin showed synergistic effects against L. donovani whereas the Amphotericin B/Amodiaquine combination was antagonistic. Notable in the results obtained was the high effectiveness of quinine sulphate in inhibiting the growth of L. donovani. Quinine sulphate, though not indicated for leishmania treatment, was more effective than the two standard drugs and has a potential of playing a significant role in the treatment of leishmaniasis. Conclusion: This study has revealed five (5) anti-infective agents that by themselves or in combinations show activity against L. donovani. Some of the drug combinations which showed synergism should further be investigated. These results have to be confirmed by in vivo studies to define their roles in leishmaniasis treatment.展开更多
OBJECTIVE： Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary a...OBJECTIVE： Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine （TM-CAM） remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. METHODS： A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. RESULTS： Participants＇ knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes： the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. CONCLUSION： The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration practitioners＇ understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.展开更多
文摘Aim: To evaluate in vitro the effectiveness of several anti-infective agents alone and in combination against Leishmania donovani. Method: A convenient stratified sampling method was used to obtain selected anti-infective agents. For individual drug samples, Half Maximal Inhibitory Concentrations (IC<sub>50</sub>) were obtained using the broth dilution method. The IC<sub>50’s</sub> of the drugs which were active against L. donovani were used as reference values to prepare drug combinations for the modified microdilution checkerboard method. Results: Five (5) out of the fifty-six (56) drugs used showed activity (inhibition of cell growth) against L. donovani cells. They include Quinine sulphate (IC<sub>50</sub> = 0.089 μg/ml), gentamicin (IC<sub>50</sub> = 8.1 μg/ml), amodiaquine (IC<sub>50</sub> = 138 μg/ml) and the two standard drugs: Amphotericin B (IC<sub>50</sub> = 6.3 μg/ml) and Pentamidine (IC<sub>50</sub> = 25 μg/ml). The remaining fifty-one (51) drugs did not show any inhibition within the range of concentrations used (1.25 - 160 μg/ml). The drug combinations of Pentamidine/Amodiaquine, Pentamidine/ Quinine sulphate, Pentamidine/Gentamicin, Amphotericin B/Quinine Sulphate, Amphotericin B/ Gentamicin, Amodiaquine/Quinine sulphate and Amodiaquine/Gentamicin showed synergistic effects against L. donovani whereas the Amphotericin B/Amodiaquine combination was antagonistic. Notable in the results obtained was the high effectiveness of quinine sulphate in inhibiting the growth of L. donovani. Quinine sulphate, though not indicated for leishmania treatment, was more effective than the two standard drugs and has a potential of playing a significant role in the treatment of leishmaniasis. Conclusion: This study has revealed five (5) anti-infective agents that by themselves or in combinations show activity against L. donovani. Some of the drug combinations which showed synergism should further be investigated. These results have to be confirmed by in vivo studies to define their roles in leishmaniasis treatment.
文摘OBJECTIVE： Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine （TM-CAM） remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. METHODS： A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. RESULTS： Participants＇ knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes： the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. CONCLUSION： The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration practitioners＇ understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.
