Pattern of morphine prescription by doctors in a Nigeria tertiary hospital

Background: Morphine was reintroduced into Nigeria after a long period of absence due to technical problems relating to stock accounting. With this reintroduction, prescriber education was commenced in many centers including the University of Ibadan. Aims and Objective: The aim of this study is to review the morphine prescription habits of the medical doctors practicing at the University College Hospital, Ibadan, and to assess the level of conformity with international guidelines. Materials and Methods: All the prescriptions on oral morphine in the hospital’s pharmacy records within a 6 months period were reviewed. Results: The results showed that more than half (51.7%) of all morphine prescriptions were from the Radiation Oncology Department, while the newly created Day Care Hospice Unit accounted for 31.8% of the prescriptions. No prescriptions were seen from the Labor ward. Only 1.1% of all the prescriptions conformed to international guideline as contained in the “Blue Book.” Conclusion: The results showed that there is a need for more education and advocacy programmes to increase awareness among doctors about morphine prescriptions.Keywords: Audit, doctors, morphine, Nigeria, prescriptionsNigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

Dose-response relationship between arsenic exposure and the serum enzymes for liver function tests in the individuals exposed to arsenic: a cross sectional study in Bangladesh

<p>Abstract</p> <p>Background</p> <p>Chronic arsenic exposure has been shown to cause liver damage. However, serum hepatic enzyme activity as recognized on liver function tests (LFTs) showing a dose-response relationship with arsenic exposure has not yet been clearly documented. The aim of our study was to investigate the dose-response relationship between arsenic exposure and major serum enzyme marker activity associated with LFTs in the population living in arsenic-endemic areas in Bangladesh.</p> <p>Methods</p> <p>A total of 200 residents living in arsenic-endemic areas in Bangladesh were selected as study subjects. Arsenic concentrations in the drinking water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The study subjects were stratified into quartile groups as follows, based on concentrations of arsenic in the drinking water, as well as in subjects' hair and nails: lowest, low, medium and high. The serum hepatic enzyme activities of alkaline phosphatase (ALP), aspartate transaminase (AST) and alanine transaminase (ALT) were then assayed.</p> <p>Results</p> <p>Arsenic concentrations in the subjects' hair and nails were positively correlated with arsenic levels in the drinking water. As regards the exposure-response relationship with arsenic in the drinking water, the respective activities of ALP, AST and ALT were found to be significantly increased in the high-exposure groups compared to the lowest-exposure groups before and after adjustments were made for different covariates. With internal exposure markers (arsenic in hair and nails), the ALP, AST and ALT activity profiles assumed a similar shape of dose-response relationship, with very few differences seen in the higher groups compared to the lowest group, most likely due to the temporalities of exposure metrics.</p> <p>Conclusions</p> <p>The present study demonstrated that arsenic concentrations in the drinking water were strongly correlated with arsenic concentrations in the subjects' hair and nails. Further, this study revealed a novel exposure- and dose- response relationship between arsenic exposure metrics and serum hepatic enzyme activity. Elevated serum hepatic enzyme activities in the higher exposure gradients provided new insights into arsenic-induced liver toxicity that might be helpful for the early prognosis of arsenic-induced liver diseases.</p

Histolopathological Patterns of Cervical Carcinoma Seen at A Radiotherapy Centre in Ibadan, Nigeria

Introduction: The treatment of cervical carcinoma is dependent on many factors including histological types and degree of differentiation. Degree of differentiation is an important consideration in determining the prognosticoutcome.Objective: The study is to describe the histological pattern of cervicer cancer seen in our practice with emphasis on tumour differentiationMethod: This retrospective study was carried out within Radiotherapy Department of University College Hospital, Ibadan. The records of patients diagnosed of cervical cancer seen between July 2008 and June 2010 wereanalysed. Data pulled out included age, disease stage at presentation, histological variant and degree of differentiation.Results: 206 patients were seen during the period of which 196 had complete data. Squamous cell carcinoma (SCC) was seen in 178 patients (i.e. 90.8%) while 14 patients (7.1%) had adenocarcinoma. One patient each had adenoid cystic carcinoma, adenosquamous carcinoma, clear cell carcinoma and mucinous carcinoma. Majority of the patients, 99 (50.5%) had poorly differentiated tumours, 64 (32.7%) had well differentiated tumours, while the rest 33 (16.8%) had moderately differentiated tumours. Of the SCC tumours, 95 (53.4%) were poorly differentiated, 58 (32.6%) well differentiated while the remaining 25 (14%) were moderately  differentiated. In comparison only 3 of the 14 adenocarcinoma cases (21.4%) were poorly differentiated, 5 cases (35.7%) were well  differentiated, while 6 (42.9%) were moderately differentiated. The difference in the degree of differentiation between squamous histology and adenocarcinoma was statistically significant (p value=0.002).Conclusion: Poorly differentiated squamous cell carcinoma remains the leading variants of cervical cancer seen in our environment.Keywords: Cervical cancer, histology, tumour gradin

Physicochemical Assessment of Drinking Water Qualities in Ogbomoso North and South Local Government Areas of Oyo State Nigeria

Water samples collected from twenty-four public groundwater facilities (22 boreholes and 2 wells) and twenty-six public treated water taps located in different quarters of Ogbomoso North and Ogbomoso South Local Government Areas, Oyo State, Nigeria were analysed for their physical and chemical characteristics between May and July 2006. Parameters determined to assess the level of wholesomeness of water from the water facilities included calcium hardness, magnesium hardness, Ca2+, Mg2+, Cl- and SO42- ions. Others were electrical conductivity, pH, colour, turbidity, alkalinity, acidity and dissolved solids. Heavy metal contents of the samples were also determined using standard procedures. Ranges of values obtained for groundwater were: Electrical Conductivity 16.88-1725 &micro;S/cm, PH 6.0 &ndash; 8.8, total hardness 20.0 &ndash; 264 mg/l, Sulphate 2.28 - 3.77 mg/l, chloride 20.0 &ndash; 205 mg/l, alkalinity 26.0&ndash;524 mg/l, DO ND - 8.5 mg/l. For tap water, the results were pH 5.72-8.4, total hardness 26-130 mg/l, Cl- 12-51.5 mg/l, residual chlorine 0.15-2.00 mg/l, turbidity 2.10-2.47 NTU. Some of the samples had appreciable amount of Pb2+ and Zn2+, but Cd2+ was not detected in any of the samples. Values obtained generally fell within the WHO&rsquo;s permissible limits. Keywords: Groundwater, boreholes, tap water, physicochemical, heavy metals, Nigeri

Memetic Algorithms for Business Analytics and Data Science: A Brief Survey

This chapter reviews applications of Memetic Algorithms in the areas of business analytics and data science. This approach originates from the need to address optimization problems that involve combinatorial search processes. Some of these problems were from the area of operations research, management science, artificial intelligence and machine learning. The methodology has developed considerably since its beginnings and now is being applied to a large number of problem domains. This work gives a historical timeline of events to explain the current developments and, as a survey, gives emphasis to the large number of applications in business and consumer analytics that were published between January 2014 and May 2018