Pharmaceutical care and the use of routine diagnostic tools by community pharmacists in Ibadan, Nigeria

Purpose: To evaluate the use of routine diagnostic tools among community  pharmacists in Ibadan, Nigeria.Methods: This is a cross-sectional study with pre-tested questionnaire  administered to 94 pharmacists in community pharmacies in Ibadan, southwestern Nigeria. Descriptive statistics was used to summarise data and categorical variables were compared with Chi-square at a significance level of p <0.05.Results: With a response rate of 94.7 %, the study showed that 78 (87.6 %) of the respondents use routine diagnostic tools, 48 (53.9 %) document results of routine diagnostic tests, 72 (80.9 %) make interventions on the results but only 37 (41.6 %) document the interventions made. Although all the respondents were aware of the concept of pharmaceutical care (PC), only 55.1 % of them had adequate knowledge of PC, while 93.3% were willing to undergo training to improve their knowledge on PC implementation.Conclusion: Most community pharmacists routinely use diagnostic tools in Ibadan. However, there is need for improvement on documentation practices.Keywords: Routine diagnostic tools, Community pharmacists, Pharmaceutical car

Missed medical appointment among hypertensive and diabetic outpatients in a tertiary healthcare facility in Ibadan, Nigeria

Purpose: To explore the reasons for missed medical appointment, patients’ awareness on its consequences; and to find strategies to reduce it among the study population.Methods: This was a descriptive cross-sectional survey among 300 hypertensive and 200 diabetic outpatients assessing care at the University College Hospital, Ibadan. Descriptive statistics was used to summarize data and categorical variables were compared with Chi-square at a level of significance set at p ≤ 0.05.Results: For hypertensive respondents, 16.7 % missed > 30 % of scheduled medical appointments while for diabetic respondents, it was 13.0 %; 59.7 % of the hypertensive respondents and 63.5 % of the diabetic respondents adhered to their medications. The reasons for missed medical appointments include forgetfulness, lack of funds for transport, conflicting commitments, etc. The level of awareness on the possible impact of missed medical appointments is low. Most of the respondents were of the opinion that those who missed appointments should be penalized, although a majority of them disagreed with the option of introducing financial penalties.Conclusion: The findings indicate that the reasons for missed medical appointment is mainly due to delay in attending to un-booked patients until all the scheduled patients are seen in order to reduce appointment non-adherence.Keywords: Missed medical appointments, Hypertensive, Diabetic outpatients, Medication adherence, Patient awarenes

Knowledge, attitude and perception on PharmD program among penultimate and final-year undergraduate pharmacy students in a Nigerian university – An intervention study

Purpose: To carry out an interventional study on the knowledge, attitude and perception of penultimate and final year undergraduate pharmacy students of the University of Ibadan on Doctor of Pharmacy (PharmD) program. Methods: A cross-sectional study was carried out among penultimate and final-year undergraduate students of the Faculty of Pharmacy, University of Ibadan using semi-structured questionnaire. A seminar was organized for the intervention group. The data were summarized using descriptive and inferential statistics. Results: Pre-intervention PharmD knowledge assessment of majority, 63 (94.0 %) control group and 63 (87.5 %) intervention group participants was below average. Post-intervention, 38 (52.8 %) intervention group participants had satisfactory scores, while 54 (80.6 %) of control group had below average scores. Generally, the participants had good PharmD attitude and perception. There was a significant difference (p < 0.001) between pre- and post-intervention PharmD knowledge assessment among the intervention group. A significant difference (p < 0.001) was observed between the post-intervention PharmD knowledge of the control group and the intervention group. Conclusion: Baseline below average PharmD knowledge of study participants improved significantly in the intervention group post-intervention. Generally, the participants had a good attitude and perception towards the PharmD program. Keywords: PharmD, Pre-post intervention, Undergraduate pharmacy students, Knowledge, Attitude, Perception, University of Ibada

Socio-psychological effects of acne among undergraduates of the University of Ibadan

Background: Acne is a skin disorder that is common among adolescents. The  various degrees of distortion of facial appearance could have some socio-psychological effects on sufferers.Objectives:The objectives of this research, within the study population  (undergraduates of the University of Ibadan), were: To determine the gender  prevalence of acne, to evaluate the socio- psychological effect of acne and to  evaluate socio-psychological effects of acne in relation to the severity of the  condition.Material and Methods: A cross-sectional study with pre-tested questionnaires administered to 100 undergraduate students of the University of Ibadan.  Descriptive statistics was used to summarize data and categorical variables were compared with Chi-square at a level of significance of p < 0.05.Results: The response rate was 100%. Gender prevalence showed that 70% of the students with acne are females with 30% being males. Twenty-seven (27%) of the respondents indicated high social effects, 8 (8%) indicated average score while 65 (65%) showed a high social effects. Fourteen (14%) of the respondent had low  emotional effects, 1 (1%) had average score while 85 (85%) had a high emotional effects. Twenty respondents (20%) had low psychological effects, 6 (6%) had an average response and 74 (74%) had high psychological effects.Conclusions: Acne is more prevalent in females than in males among undergraduate students of the University of Ibadan. The socio-psychological effect of acne was  found to be more in students with milder form of acne.Keywords: Socio-psychological, acne, Ibadan, undergraduat

Hypertensive heart disease in Africa

Hypertension has become an important public health problem in Africa. Currently an epidemiologic transition from infectious diseases is going on in the continent and the prevalence of chronic diseases like hypertension is increasing. The response of the heart to the stress/afterload imposed on the left ventricle by the progressively increasing arterial blood pressure is described as hypertensive heart disease. Hypertensive heart disease and failure are the commonest cardiovascular diseases of Africans. Since hypertension is a treatable cardiovascular risk factor, there is need to create more awareness about the disease and educate our patients concerning drug compliance. There is also a need for longitudinal multicentre study in Africa, in order to assess the severity and burden of the disease

Right ventricular systolic function in Nigerians with heart failure secondary to hypertensive heart disease

Background: Right ventricular (RV) dysfunction has been shown to be a major contributor to the adverse outcomes in subjects with heart failure. Few studies evaluating the right ventricle in heart failure subjectshave been carried out in Sub-Saharan Africa. This study was therefore designed to evaluate the right ventricular systolic function in subjects with heart failure secondary to hypertensive heart disease presenting to the University College Hospital, Ibadan Nigeria.Methodology: Seventy-six subjects with heart failure secondary to hypertension and 92 normal controls underwent clinical, electrocardiographic and echocardiographic evaluation. Indices of right ventricular systolic function that were measured include tricuspid annular plane systolic excursion (TAPSE), tissue Doppler derived tricuspid peak systolic lateral annulus velocity(S') and right ventricular fractional areachange(RVFAC).Results: Sixty-two (81.6%) heart failure subjects had right ventricular systolic dysfunction, 31(40.8%) had abnormal TAPSE, 42(55.5%) had abnormal S' while 49(64.5%) had abnormal RVFAC. Elevated pulmonary artery systolic pressure was found in 25(32.9%) of the subjects. There was no relationship between the indices of right ventricular systolic function and the estimated systolic pulmonary artery pressures. The independent predictor of right ventricular systolic dysfunction was the right atrial size.Conclusion: Right ventricular systolic function is impaired in patients with heart failure secondary to hypertensive heart disease. There is no relationship between the indices of right ventricular systolic function and systolic pulmonary artery pressure. Furtherstudies are needed to assess right ventricular systolic function in Nigerians.Keywords: Hypertension, Heart Failure, Right ventricular dysfunction, Nigeria, Sub- Saharan Africa

Multipurpose Energy Saving Manual Compressor for Artisans in African Countries

This Research work involves the design, fabrication and testing of a manually operated compressor for use of artisans and small scale vulcanizing activities. The developed machine consists of chain sprocket arrangement to a flywheel attached to a pulley which powers the compressor as well as a storage tank to receive air by foot pedaling. The article is an innovative product to meet the needs of rural African Artisans that uses air compressor for their daily activities . The design is such that the chain sprocket provides the compressor with a driving force in conjunction with the flywheel thereby replacing the prime mover. Prototype pilot test carried out on the developed manual air compressor could generates 10 Psi ie 0.69bar-volume of air in 60 seconds. A new design with better parameter of the machine was done to improve it’s proficiency after testing for broad application even for the handicap Artisans

Pitfalls in diagnosis of Hepatitis B Virus infection among adults Nigerians

Objective: Hepatitis B virus infection is common in Nigerians and its diagnosis is necessary for effective treatment and eradication. This study is aimed at highlighting the serological factors jeopardizing the diagnosis and treatment of the infection among Nigerians adults. Patients and Methods: Three studies were carried out. The first study involved 56 Nigerian adults and it compared the assay ofHBsAg byHaemagulationMethod (HMA)with Enzyme linked immunoassay (ELISA). The second study was a comparison of Glaxo Welcome HB rapid test(GWHB) with ELISA in sero-assay of HBsAg and HBeAg among 25 Nigerian subjects while the third study was on the assay of the sera of HBsAg positive patients forHBeAg and anti-HBe in forty twoNigerian patients byELISA. Results: The sero - prevalence rates of HBsAg were 41.8% and 61.8% by HM and ELISA respectively with false HBsAg sero-positives and sero-negatives by HM of 5.4% and 25.5% respectively. Similarly, there was sero-detection of HBsAg in 84% and 80% by ELISA and GWHB respectively in 25 Nigerian adults. In addition, 19% and 64% of the 42 patients with HBsAg sero-positivity were also positive for HBeAg and anti- HBe respectively,while 31%of the patientswere bothHBeAg and anti-HBe sero-negative. Conclusion: Sero-diagnosis of HBsAg and other serological markers of infectivity in patients with HBV should be carried out by ELISArather than HMAamong adult Nigerians. Furthermore, high infectivity of the virus abounds among Nigerians with HBV infection.  Keywords: Pitfalls, diagnosis, HBV, Adults Nigerians, ELISA.

Reflections on Gravettian firewood procurement near the Pavlov Hills, Czech Republic

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordThis paper draws attention to firewood as a natural resource that was gathered, processed and consumed on a daily basis by Palaeolithic groups. Using Gravettian occupation of the Pavlovsk� Hills as a case study (dated to around 30,000 years BP), we investigate firewood availability using archaeological, palaeoenvironmental and ecological data, including making inferences from charcoal in Pavlovian hearths. The collated evidence suggests that while dead wood was likely readily available in woodland areas where humans had not recently foraged, longer term occupations - or repeated occupation of the same area by different groups - would have quickly exhausted naturally occurring supplies. Once depleted, the deadwood pool may have taken several generations (~40-120 years) to recover enough to provide fuel for another base camp occupation. Such exhaustion of deadwood supplies is well attested ethnographically. Thus, we argue that Pavlovian groups likely managed firewood supplies using methods similar to those used by recent hunter-gatherers: through planned geographic mobility and by deliberately killing trees years in advance of when wood was required, so leaving time for the wood to dry out. Such management of fuel resources was, we argue, critical to human expansion into these cold, hitherto marginal, ecologies of the Upper Palaeolithic.AJEP is grateful to The Leverhulme Trust that funded this research, which was undertaken as part of the project Seasonality, Mobility and Storage in Palaeolithic hunting societies (RPG-2013-318)

Chronology and function of a new circular mammoth bone structure from Kostenki 11

This is the author accepted manuscript. The final version is available from Cambridge University Press via the DOI in this record.We report on assemblages of charcoal, burnt bone and microlithic debitage retrieved by flotation from a new circular mammoth bone feature discovered at Kostenki 11-Ia, Russian Federation, the first time a mammoth bone circle has ever been systematically sampled in this way. New radiocarbon dates are used to provide the first coherent chronology for the site, revealing it as one of the oldest such features on the Russian Plain and confirming occupation of this region during Greenland Stadial 3 at the onset of the last glacial maximum. Implications for human activity within and around the mammoth bone feature are discussed.Leverhulme Trus