Inflammation and pain are devastating conditions characterizing many diseases. Their manifestation ranges from mild body discomfort, to a debilitating experience, which may culminate in organ failure or death. In conventional medicine, corticosteroids, nonsteroidal anti‐inflammatory drugs, opioids, and adjuvants are utilized to manage symptoms related to pain and inflammation. Despite their reported successes, these agents are only palliative, debatably inaccessible, unaffordable, and cause many undesirable side effects. As a result, the search for alternative and complementary therapies is warranted. Medicinal plants have been intensively utilized by humans for a long time to treat various ailments. In spite of their reported efficacies, empirical scientific data supporting their healing claims is scanty. P. thonningii (Schumach.) has been used in African traditional medicine, especially by traditional herbalists in Nigeria and Kenya, to treat conditions associated with inflammation. Even though analgesic, anti‐inflammatory, and toxicity studies have been performed on leaf extracts, and some of their isolated compounds in Nigeria, there is scanty data supporting the use of stem bark extracts, which are commonly utilized in Kenya for pain, and inflammation management. Moreover, scientific data regarding safety and toxicity of the stem bark extracts of P. thonningii utilized in Kenya by traditional herbalists are inadequate. Based on this background, acute oral toxicity evaluation of the aqueous and methanolic stem bark extracts of P. thonningii, in Swiss albino mice, was performed according to the OECD/OCDE (2008) guidelines. Anti‐inflammatory activities were investigated using the xylene‐induced ear oedema in mice, whereas analgesic activities were examined following the acetic acid‐induced writhing technique. The acute oral toxicity data was analyzed, and interpreted according to the OECDE (2008) guidelines. Anti‐inflammatory and analgesic activities data were tabulated on MS Excel, and exported to GraphPad Prism (v8.3). Descriptive statistics were computed, and expressed as mean ± SEM. Thereafter, One‐Way ANOVA followed by Tukey’s test was performed. p < 0.05 was considered statistically significant. All the studied plant extracts had LD₅₀ values > 2000 mg/kg bw, and were hence deemed to be nontoxic according to OECD/OCDE document no. 425. The results showed that the acetic acid‐induced writhing frequency in mice administered the aqueous stem bark extract of P. thonningii, at a dose of 500 mg/kg bw, was not significantly different from that recorded for mice which received the reference drug (acetylsalicylic acid 75 mg) (p > 0.05). Additionally, at all the studied extract doses, significantly lower acetic acid‐induced writhing frequencies were recorded in mice that received the aqueous stem bark extract of P. thonningii, compared with the writhing frequencies in mice that received the methanolic extract of the same plant (p < 0.05). On the other hand, the aqueous stem bark extract of P. thonningii, at doses of 100 mg/kg bw and 500 mg/kg bw, and the methanolic stem bark extract of the same plant, at a dose level of 500 mg/kg bw, exhibited significantly higher percentage inhibitions of xylene‐induced oedema than the percentage inhibitions shown by the reference drug (dexamethasone 1 mg/kg bw) (p < 0.05). Generally, the aqueous stem bark extract of P. thonningii, at all the studied dose levels, caused significantly higher inhibitions of xylene‐induced ear oedema in mice, compared with the percentage inhibitions shown by methanolic stem bark (p < 0.05). Therefore, the aqueous, and methanolic stem bark extracts of P. thonningii, grown in Kenya, possess peripheral analgesic and anti‐inflammatory activities in Swiss albino mice. Hence, they have a potential of offering safe analgesic, and anti‐inflammatory compounds. Further studies aimed at isolating, elucidating, and characterizing bioactive components from the studied extracts are recommended. Moreover, specific mode(s) through which these extracts exert the reported bioactivities should be established. Further toxicological investigations involving the studied plant extracts are encouraged to fully establish their safety.

Cognitive impairment (CI) is among the leading causes of disability in humans. It is estimated that over 35.6 million people are suffering from Alzheimer’s disease- (AD-) associated cognitive deficits globally with these statistics projected to rise over 115.4 million by the year 2050. There is no specific etiology for this cognitive impairment; however, various contributing factors including advancing age (>60 years old), oxidative stress, cerebral injuries, infections, neurologic disorders, and cancer have been implicated. Despite various attempts to manage CI, no curative medicines are yet available. The current drugs used to manage symptoms of AD-associated CI including Donepezil and Rivastigmine among others are only palliative rather than therapeutic. Furthermore, these agents have been associated with undesirable side effects. This calls for alternative and complementary approaches aimed at either preventing or reverting AD-related CI in a curative way without causing adverse events. It is estimated that over 80% of the world’s population utilize herbal medicines for basic healthcare as it is considered safe, affordable, and easily accessible as opposed to conventional healthcare. Various parts ofP. thonningiiare used in traditional medicine to manage various conditions including CI. However, empirical and scientific data to validate these uses is lacking. In this study, the Morris water maze (MWM) experiment was adopted to evaluate the cognitive-enhancing effects of the studied plant extracts. The malondialdehyde (MDA) profiles in the brains of experimental mice were determined using the thiobarbituric acid reactive substances (TBARS) test. Moreover, qualitative phytochemical profiling of the studied plant extracts was performed using standard procedures. The results showed remarkable cognitive-enhancing activities which were reflected in significantly shorter transfer latencies, navigation distances, longer time spent in platform quadrant, and lower MDA levels compared with those recorded for the negative control mice (p<0.05). Phytochemical screening of the studied plant extracts revealed the presence of antioxidant phytocompounds, which may have played key roles in the extracts’ potency. Based on the findings herein,P. thonningiiextracts, especially the aqueous ones have a promising potential for the management of AD-associated CI. Further studies aimed at isolating and characterizing specific active compounds for CI fromP. thonningiiare recommended. Additionally, specific mode(s) of action of active principles should be elucidated. Moreover, toxicity studies should be done on the studied plant extracts to ascertain their safety.

Oxidative stress has been recognized as a key driver of many ailments affecting humankind. Free radicals attack biologically important biomolecules, impairing their functioning, thereby initiating and exacerbating diseases. As a comeback, antioxidant therapies have been proposed as novel approaches to ameliorating oxidative stress–associated diseases including chronic ones. Antioxidants are thought to employ multifaceted and multitargeted mechanisms that either restore oxidative homeostasis or prevent free radical buildup in the body, which overwhelm the endogenous defenses. Plants have been used for many ages across time to manage human diseases, and have a host of antioxidant phytocompounds. Piliostigma thonningii is traditionally used for the management of inflammation, malaria fever, rheumatism, and insanity, among other diseases caused by a disturbed redox state in the body. In this study, in vitro antioxidant activities of the methanolic and aqueous stem bark extracts of P. thonningii were evaluated using the in vitro antilipid peroxidation, the 1,1-diphenyl-2-picryhydrazyl (DPPH) free radical scavenging, and the ferric reducing antioxidant power assay methods. The obtained results revealed remarkable antioxidant activities of the studied plant extracts as evidenced by the low IC₅₀ and EC₅₀ values. These antioxidant activities could be due to the presence of antioxidant phytochemicals like flavonoids, carotenoids, tannins, and phenols, among others. Therefore, the therapeutic potency of this plant could be due to its antioxidant properties. This study recommends in vivo antioxidant efficacy testing of the studied plant extracts, as well as isolation and characterization of bioactive antioxidant compounds that are potent against oxidative stress.

Oxidative stress causes and drives many agonising inflammatory conditions, which cause disability, financial burden, and emotional stress. The current anti-inflammatory, analgesic, and antioxidant agents are associated with adverse effects, inaccessibility, high costs, and low efficacies, thereby warranting the need for alternatives, especially from natural sources. Lonchocarpus eriocalyx plant is traditionally used in Kenyan communities to treat various inflammatory and oxidative stress-associated diseases; however, its pharmacologic efficacy and safety have not been empirically validated, hence this study. The in vivo antiinflamatory and antinociceptive efficacy of the aqueous and methanolic stem bark extracts of L. eriocalyx were determined using the xylene-induced ear oedema, and the acetic acid-induced writhing techniques, respectively, in experimental mice. Also, in vitro antioxidant activities of the studied plant extracts were investigated using the Thiobarbituric acid test for lipid peroxidation, 1, 1-diphenyl -2-picrylhydrazyl (DPPH), and Ferric reducing antioxidant power standard assay methods. Moreover, the studied extracts' acute oral toxicity effects were investigated according to the Organisation for Economic Corporation and Development (OECD) guidelines. The studied plant extracts showed significant dose-dependent inhibitions of oedema and writhing, depicting their anti-inflammatory and antinociceptive efficacy. Besides, the extracts revealed significant inhibitions of in vitro lipid peroxidation in varying degrees. Notably, the extracts demonstrated very strong DPPH radical scavenging and ferric-reducing antioxidant efficacies. Furthermore, the two studied plant extracts did not elicit acute oral toxicity, with LD50 values of >2000 mg/kg BW, hence were considered safe. The anti-inflammatory, antinociceptive, and in vitro antioxidant efficacies of these extracts were attributed to antioxidant phytocompounds with diverse pharmacologic effects, especially through the amelioration of oxidative stress. Further studies on the anti-inflammatory, antinociceptive and antioxidant mechanism(s) and isolation and characterisation of responsible compounds are encouraged to spur the development of affordable, accessible, safe, and efficacious drugs.

Malaria is a deadly disease caused by a protozoan parasite whose mode of transmission is through a female Anopheles mosquito. It affects persons of all ages; however, pregnant mothers, young children, and the elderly suffer the most due to their dwindled immune state. The currently prescribed antimalarial drugs have been associated with adverse side effects ranging from intolerance to toxicity. Furthermore, the costs associated with conventional approach of managing malaria are arguably high especially for persons living in low-income countries, hence the need for alternative and complementary approaches. Medicinal plants offer a viable alternative because of their few associated side effects, are arguably cheaper, and are easily accessible. Based on the fact that studies involving antimalarial medicinal plants as potential sources of efficacious and cost-effective pharmacotherapies are far between, this research was designed to investigate antiplasmodial and cytotoxic activities of organic and aqueous extracts of selected plants used by Embu traditional medicine practitioners to treat malaria. The studied plants included Erythrina abyssinica (stem bark), Schkuhria pinnata (whole plant), Sterculia africana (stem bark), Terminalia brownii (leaves), Zanthoxylum chalybeum (leaves), Leonotis mollissima (leaves), Carissa edulis (leaves), Tithonia diversifolia (leaves and flowers), and Senna didymobotrya (leaves and pods). In vitro antiplasmodial activity studies of organic and water extracts were carried out against chloroquine-sensitive (D6) and chloroquine-resistance (W2) strains of Plasmodium falciparum. In vivo antiplasmodial studies were done by Peter’s four-day suppression test to test for their in vivo antimalarial activity against P. berghei. Finally, cytotoxic effects and safety of the studied plant extracts were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) rapid calorimetric assay technique. The water and methanolic extracts of T. brownii and S. africana and dichloromethane extracts of E. abyssinica, S. pinnata, and T. diversifolia leaves revealed high in vitro antiplasmodial activities (IC50≤10μg/ml). Further, moderate in vivo antimalarial activities were observed for water and methanolic extracts of L. mollissima and S. africana and for dichloromethane extracts of E. abyssinica and T. diversifolia leaves. In this study, aqueous extracts of T. brownii and S. africana demonstrated high antiplasmodial activity and high selectivity indices values (SI≥10) and were found to be safe. It was concluded that T. brownii and S. africana aqueous extracts were potent antiplasmodial agents. Further focused studies geared towards isolation of active constituents and determination of in vivo toxicities to ascertain their safety are warranted.

Background. The emergence of antimicrobial resistance (AMR) and multidrug resistance (MDR) among Escherichia coli and Klebsiella pneumoniae, especially through the production of extended spectrum β‐lactamases (ESBLs), limits therapeutic options and poses a significant public health threat. Objective. The aim of this study was to assess the phenotypic and genetic determinants of antimicrobial resistance of ESBL‐producing Escherichia coli and Klebsiella pneumoniae isolates from patient samples in two Kenyan Hospitals. Methods. We collected 138 E. coli and 127 K. pneumoniae isolates from various clinical specimens at the two health facilities from January 2020 to February 2021. The isolates’ ESBL production and antibiotic susceptibility were phenotypically confirmed using a standard procedure. Molecular analysis was done through conventional polymerase chain reaction (PCR) with appropriate primers for gadA, rpoB, bla_TEM, bla_SHV, bla_OXA, bla_{CTX-M-group-1}, bla_{CTX-M-group-2}, bla_{CTX-M-group-9}, and bla_{CTX-M-group-8/25} genes, sequencing and BLASTn analysis. Results. Most E. coli (82.6%) and K. pneumoniae (92.9%) isolates were ESBL producers, with the highest resistance was against ceftriaxone (69.6% among E. coli and 91.3% among K. pneumoniae) and amoxicillin/clavulanic acid (70.9% among K. pneumoniae). The frequency of MDR was 39.9% among E. coli and 13.4% among K. pneumoniae isolates. The commonest MDR phenotypes among the E. coli isolates were CRO‐FEP‐AZM‐LVX and CRO‐AZM‐LVX, while the FOX‐CRO‐AMC‐MI‐TGC‐FM, FOX‐CRO‐FEP‐AMC‐TZP‐AZM‐LVX‐MI and CRO‐AMC‐TZP‐AZM‐MI were the most frequent among K. pneumoniae isolates. Notably, the FOX‐CRO‐FEP‐AMC‐TZP‐AZM‐LVX‐MI phenotype was observed in ESBL‐positive and ESBL‐negative K. pneumoniae isolates. The most frequent ESBL genes were bla_TEM (42%), bla_SHV (40.6%), and bla_OXA (36.2%) among E. coli, and bla_TEM (89%), bla_SHV (82.7%), bla_OXA (76.4%), and bla_{CTX-M-group-1} (72.5%) were most frequent ESBL genes among K. pneumoniae isolates. The bla_SHV and bla_OXA and bla_TEM genotypes were predominantly associated with FOX‐CRO‐FEP‐MEM and CRO‐FEP multidrug resistance (MDR) and CRO antimicrobial resistance (AMR) phenotypes, among E. coli isolates from Embu Level V (16.7%) and Kenyatta National Hospital (7.0%), respectively. Conclusions. The high proportion of ESBL‐producing E. coli and K. pneumoniae isolates increases the utilization of last‐resort antibiotics, jeopardizing antimicrobial chemotherapy. Furthermore, the antimicrobial resistance patterns exhibited towards extended‐spectrum cephalosporins, beta‐lactam/beta‐lactamase inhibitor combinations, fluoroquinolones, and macrolides show the risk of co‐resistance associated with ESBL‐producing isolates responsible for MDR. Hence, there is a need for regular surveillance and implementation of infection prevention and control strategies and antimicrobial stewardship programs.