Medication wastage and its impact on environment: evidence from Malaysia

The purpose of this study is to investigate the critical factors that have impact on environment causes of unused medication. The current study is a descriptive cross-sectional audit involving with patients based on a structured questionnaire format with answer sets. The data is analyzed using partial least square method. The results revealed that excess supplied, expired medicine, changed treatment and side effects have a significant impact on unused medication. In addition, overall unused medication has a significant relationship with environmental effect. In contrast, although excess supplied and side effects have not significant impact on environmental effect, but expired medicine and changed treatment have a significant impact on environmental effect. This survey results suggested; there are few factors which increased the volume of leftover medicine and it has led to an enhanced international awareness of the potential detrimental effects on the environment. More exertion is necessary to raise awareness of people in general as an initial step in promoting behavioral change in connection to medication wastage

Rainfall Trend Detection in Northern Nigeria over the Period of 1970-2012

This study examined the trends in variability and spatial distribution of annual rainfall over northern Nigeria during the period 1970-2012 with a view to understand the pattern of rainfall trend (significance and magnitude), by applying various statistical tools on the data obtained from 11 weather stations. The non-parametric Mann–Kendall test was used to determine the statistical signi?cance of trends while the magnitude of trends was derived from the Sen slope estimator of the linear trends using Kendall robust line ?tting. Map of rainfall trends was generated by applying a geo-statistical interpolation technique to visualize the detected tendencies. The findings revealed that a significant positive increase of 2.16mm in rainfall was recorded in the entire northern Nigeria within the period of 1970 to 2012. It further indicated that majority of the stations revealed an upward trend, with Bauchi, Borno, Kebbi and Sokoto stations showing significant positive trends of 8.13mm, 4.30mm, 4.76mm and 4.42mm respectively. It is concluded that there is high variability in rainfall in the northern Nigeria which signifies a clear evidence of climate change in the region. Keywords: Rainfall trend, Man-Kendall test, Northern Nigeria, Climate chang

Common Radiographic Findings in Patients with Low Back Pain a Major Nigerian Teaching Hospital

Objective: To identify common radiographic findings among patients presenting with low back pain.Methodology: A retrospective study was carried out on 160 patients with low back pain that underwent x-ray of the lumbosacral spine at ABUTH. The collected data was organized and classified into groups based on age, sex, radiographic findings, location on the lumbar spine and patients’ occupation. Mean, standard deviation and percentages were calculated and tabulated.Results: Findings show that, low back pain is mostly in patients between 41-50 years of age accounting 28.1%.Likewise, those engaged in more than one activity 71.3%. Abnormal radiographic findings were mostly seen on L4 vertebral body representing 26.5%, and lumbar spondylosis is the most frequent finding with 51.2%.Conclusion: The study has established various radiographic findings in patients with low back pain, and lumbar spondylosis is the most frequent in both males and females gender

Somalia’s medical education and regulation: a review of the health regulatory landscape

Background: Medical education and regulations are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability. Methods: This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted, along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the HRH maturity model framework. Results: This study identified 94 medical schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. However, only 25 of these schools are internationally accredited, raising concerns about the quality of medical education. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO's recommended threshold. Focus group discussions and surveys highlighted the employment challenges faced by young physicians and students' perceptions of their training and future employment opportunities. Conclusion: The proliferation of medical schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia's healthcare system. The establishment of the National Health Professionals' Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of medical schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia

Pharmacognostic and Acute Toxicity Study of Burkea Africana Root

Burkea africana is a plant that belongs to then family Fabaceae; it is widely spread in tropical Africa including Nigeria. It is of valuable in  ethnomedicine especially in the treatment of antidote for venomous stings and bites, cutaneous and sub cutaneous parasitic infection, convulsion and pulmonary troubles. Despite the fact that roots of Burkea africana have several medicinal properties, no standardization parameter has been  assessed. Due to lack of standard parameters, proper identification and ascertaining quality and purity in the events of adulteration has been thwarted. The objective of the study was to establish some important pharmacognostic profile and safety margin of Burkea africana root with the hope of assisting in its standardization for quality, purity and safety. Elemental analysis was carried out using acid digestion method and phytochemical composition of the plants was evaluated using standard method. Acute toxicity was achieved using Lorke method to determine the LD50. Chemomicroscopical evaluation revealed the presence of cellulose, tannins, starch, lignin, calcium oxalate, suberin, aleurone grain and mucilage with the exception of calcium carbonate. The average moisture contents, total ash, acid insoluble, water soluble ash, alcohol extractive value and water extractive values in the powdered plant material were 3.8%, 7.5%, 4.43%, 8.07%, 25.0% and 20.33% respectively. In addition, Fe, Mn, Ni, Pb, Cd and Cu were found to be within the safety limit. Phytochemicals which include alkaloids, flavonoids, saponins, tannins, carbohydrates and triterpenes were detected in both aqueous and methanolic extracts. The LD50 of Burkea africana was found to be greater than 5000 mg /kg and could be considered safe for consumption. Keywords: Elemental analysis, Burkea africana, Pharmacognostic, Phytochemica

Collection of broodstock and juveniles of Macrobrachium vollenhovenii from the wild

A total of 457 broodstock and 143,000 juveniles of Macrobrachium vollenhovenii were collected at Isheri Olofin area and Okunmanya River over a period of time. They were transported live to the shrimp hatchery of NIOMR in Lagos. Live transportation of the broodstock of M.vollenhovenii with body weight ranging from 71.0-264.5g in liter-capacity plastic containers half-filled with water, recorded 98-100% survival rate between 80-110 minutes transportation time. However, live transportation of the juvenile in 50 liters capacity plastic containers without water recorded survival rates ranging from 20-66% while those carried with water and aerated recorded 12.5-93.75%. An air conditioned vehicle was used during the live transportation. Higher mortality rate was recorded for the juvenile than the broodstocks due to large number transported in additoin to the small-size gear used for trapping the jiveniles. The study has developed a simple technology for the collection and transportation of live specimens of broodstock and juveniles of M. vollenhovenii. Efforts will be made to increase survival of the juveniles through the use of larger containers and gears

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Health Care Seeking Behavior of Pregnant Women in Gusau Metropolis of Zamfara State, Northern Nigeria

Purpose: The objectives of the study were to determine the health care seeking behavior and the barriers to hospital delivery of pregnant women in Gusau metropolis of Zamfara State, Northwest Nigeria. Also the study was to identify those factors that prevent women from delivering at the hospital and access care. Methods: The study used both survey and qualitative technique. In the survey a descriptive cross sectional survey involving with patients based on a structured questionnaire format with answer sets was used to ask about (N=826) pregnant women attending antenatal care at some clinics in Gusau metropolis about how, why, where and when they seek care and how they perceive certain illness during pregnancy. While about 6 focus group discussions (FGDs) were conducted at the health facilities targeting the pregnant women in order to understand their illness behavior and perception to facility delivery. During the FGDs notes were taken and answers recorded using a tape recorder and video. Results: 87.9%  of the respondents said they attend  Antenatal care clinics (ANC) regularly and  many of the respondents have some knowledge of complications during pregnancy, N=177 reported having headache, N=221 and N=227 reported having fever and swelling of legs respectively.87.1% of those attending ANC indicated that they will seek care at hospital or clinic. Though, responses in the FGDs, many of the respondents indicated that they seek care at health facility but will however not want to deliver at the hospital. Conclusion: There is a remarkable improvement in attendance of ANC by pregnant women but yet the hospital delivery is very low and not exciting as many women wished to deliver at home rather than in the hospital. Also many of the women’s perception about their health or illness during pregnancy are that they think it is normal to be sick and therefore not necessary to visit the clinic. There is still high preference for home delivery among the pregnant women in Zamfara State, with a consequent increased in maternal deaths unreported

Studies on Dermestes Maculatus Infestation of Smoked - Dried Fish at Uke Fish Market, Nasarawa State, Nigeria

Three smoke-dried fish, Clariasgariepinus, Oreochromisniloticus and Protopterusannectens were procured from Uke fish market to assess the effects of insect infestation. The fish samples were taken to the Department of Zoology Laboratory of Nasarawa State University Keffi. Percentage weights of the fishes were determined before and after insect pest infestations. The samples were stored in three different cartoons for a period of four weeks. Proximate analysis of the samples was carried out at the Animal Feed Analysis and Quality Control Laboratory Nyanya. The protein, moisture and fat contents for Clarias gariepinus before infestation were (73.40%, 9.70% and 15.70%), forOreochromisniloticus(72.30%, 10.40%, and 11.60%), for Protopterusannectens (63.50%, 12.60%,and 8.30%). After infestation, the protein, moisture and fat contents for Clarias gariepinus were (72.50%, 6.00%, and 12.80%). for Oreochromisniloticus(71.90%, 5.80%,and 11.60%), for Protopterusannectens(60.80%,10.30% and 7.70%). Itwas observed that insect pest infestation causes great loss and reduces the economic and market value of smoke -dried fish because it degrades and damaged the fish thereby reducing it protein, fat and moisture contents. The result of the study showed that Dermestesmaculatus infestation was higher in Clarias gariepinus compared to Oreochromis niloticus and Protopterusannectens with the highest infestation rate of 35%, 30% and 30% respectively in the three species. However, there was no significant difference between the number of insect pests found in the fish samples at (p>0.05), the proximate analysis shows that the data collected after insect infestation was significance at p=0.05 with p value 0.00005