Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia. Hospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data. Mean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in stock while only 19(63.3%) of key drugs had adequate labeling. On average, selected key drugs were out of stock for 30 days per year. All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline. Majority of WHO stated core drug use indicators were not met by the three hospitals included in the study.

Cellulose fibers (C₄₀ and C₈₀) were extracted from khat (Catha edulis) waste (KW) with chlorine-free process using 40% formic acid/40% acetic acid (C₄₀), and 80% formic acid/80% acetic acid (C₈₀) at the pretreatment stage, followed by further delignification and bleaching stages. Cellulose nanocrystals (CNCs₄₀ and CNCs₈₀) were then isolated from C₄₀ and C₈₀ with sulfuric acid hydrolysis, respectively. Thus, the current study aims to isolate cellulose fibers and CNCs from KW as alternative source. The KW, cellulose fibers, and CNCs were investigated for yield, chemical composition, functionality, crystallinity, morphology, and thermal stability. CNCs were also evaluated for colloidal stability, particle size, and their influence on in vitro diclofenac sodium release from gel formulations preliminarily. The FTIR spectra analysis showed the removal of most hemicellulose and lignin from the cellulose fibers. The XRD results indicated that chemical pretreatments and acid hydrolysis significantly increased the crystallinity of cellulose fibers and CNCs. The cellulose fibers and CNCs exhibited Cellulose I_β crystalline lattice. TEM analysis revealed formation of needle-shaped nanoscale rods (length: 101.55–162.96 nm; aspect ratio: 12.84–22.73). The hydrodynamic size, polydispersity index, and zeta potential of the CNC_S ranged from 222.8–362.8 nm; 0.297–0.461, and -45.7 to -75.3 mV, respectively. CNCs₄₀ exhibited superior properties to CNCs₈₀ in terms of aspect ratio, and colloidal and thermal stability. Gel formulations containing high proportion of CNCs sustained diclofenac sodium release (< 50%/cm²) over 12 h. This study suggests that cellulose fibers and nanocrystals can be successfully obtained from abundant and unexploited source, KW for value-added industrial applications.

Assessment of prescribing, dispensing, and patient use pattern of antihypertensive drugs for patients attending outpatient department of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia Fedila Shukrala,1 Tesfaye Gabriel2 1Dil Chora Referral Hospital, Dire Dawa, Ethiopia; 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Background: Hypertension is a global concern and is one of the key preventable risk factors for cardiovascular events, resulting in unnecessary morbidity and mortality. The aim of this study was to assess the prescribing, dispensing and patient use pattern of antihypertensive drugs among patients attending Hiwot Fana Specialized University Hospital outpatient department.Methods: A hospital-based cross-sectional study was conducted in Hiwot Fana Specialized University Hospital on assessment of the prescribing, dispensing, and patient use pattern of antihypertensive drugs among patients who were above the age of 18 years and attending outpatient department from April 1–May 31, 2013. Data collection was conducted by reviewing the record of patients and direct observation of the dispensing process of randomly selected patients to measure average dispensing time, and direct interview with the patients. Results: A total of 400 patients met the inclusion criteria; out of the 400 patients studied, 63.5% were females. Most of the patients had Stage 1 hypertension (69%), followed by Stage 2 hypertension (31%). Out of the total number of patients, 264 were with different comorbid conditions: diabetes mellitus (64.3%), followed by congestive heart failure (15.1%) and ischemic heart disease (2.3%). The most frequently prescribed class of antihypertensive drugs was diuretics, of which hydrochlorothiazide was the most frequently prescribed drug, both in single (55%), followed by enalapril (22.3%), methyl dopa (11.2%), atenolol (6.9%), and nifedipine (4.6%), and in combination with other antihypertensive drugs. The average dispensing time was 1.2 minutes, and 75% of the patients left the counter with inadequate information about the dosage.Conclusion: All antihypertensive drugs prescribed were in compliance with the Ethiopian Standard Treatment Guidelines. This study showed that most outpatients with hypertension in our hospital received monotherapy. Diuretics and angiotensin converting enzyme inhibitors were the most frequently prescribed classes of antihypertensive drugs in both monotherapy and combination therapy. Keywords: hypertension, antihypertensive drugs, monotherapy, combination therapy, fixed dose combination, compliance

This study aims to explore Cordia africana seeds as an alternative source of cellulose and MCC due to depletion of the major commercial sources such as wood pulp, and cotton. Cellulose was extracted from Cordia africana seeds employing a chlorine-free treatment approach, followed by partial depolymerization using acid hydrolysis to obtain microcrystalline cellulose (MCC). The untreated seeds, as-extracted cellulose, and MCC were investigated for yield, chemical composition, functionality, crystallinity, morphology, diameter, and thermal stability. The cellulose content increased from 30% (w/w) in the untreated seeds to 80.2% (w/w) in cellulose and 88.1% (w/w) in the MCC. The removal of non-cellulosic constituents was confirmed by the results obtained from Fourier-transform infrared spectroscopy, X-ray diffraction, Scanning electron microscopy, and Thermogravimetric analysis (TGA)/Derivative thermogravimetry (DTG). The crystallinity index of as-obtained cellulose and MCC increased from 32.38% (untreated seeds) to 68.28 (cellulose) and 73.19% (MCC) with chemical treatments. The extracted samples exhibited characteristic peaks of Cellulose I at around 15°, 16°, 22°, and 34°. Th e TGA/DTG results confirmed the cellulose and MCC had higher thermal stability than the untreated seeds. This study shows that cellulose and MCC can be obtained from unexploited source, Cordia africana seeds, for promising applications in various industries.