Perception and practice of self-medication with over-the-counter analgesics among students of a tertiary institution

Background: Although over-the-counter (OTC) analgesics increase access to and ease of medication, they are a major contributor to irrational use of medicines worldwide.This study assessed perception and practice of self-medication with OTC analgesics among students of Federal College of Education,Zaria.Method: It was a cross-sectional study of 200 students. Data was collected using a self-administered questionnaire. Descriptive statistics were computed, and Chi-square test was used to test association between practice of self-medication and other categorical variables.Results: Seventy-six (38.8%) had good knowledge of OTC analgesics and 187 (95.4%) had good perception. Majority 151 (77.0%) had taken at least one OTC analgesic in the last three months.The most common reason for taking OTC analgesics was their easy availability 66 (43.7%),and the most common symptom treated was headache 80 (53.0%).Self-medication with OTC analgesics was significantly associated with age (p = 0.010) and level of study (p = 0.001),but not with sex (p = 0.866),ethnicity (p = 0.416) or marital status (p = 0.104).Conclusion: Knowledge of OTC analgesics was poor,perception was largely positive,while self-medication was a common practice. Major factors influencing self-medication were age and level of education. It is recommended that efforts to control excessive self-medication with OTC analgesics should focus on creating public awareness and restricting the sale of OTC analgesics to licensed dealers.Keywords: Self-Medication, Over-The-Counter, Analgesics,Student

Novel admixture for improvement of foundations on tropical expansive soils

: Black cotton soils have excessive shrinkage and swelling properties with respect to changes in the moisture conditions. Thus, construction on these soils may result in foundation problems. conventionally some approaches have been used to mitigate the problem by stabilization with lime or cement and which are relatively expensive for sustainability, an alternative stabilization was experimented with terrazzo waste. The polishing process of the terrazzo tiles produces a significant amount of waste slurry that it’s disposal could pose some environmental pollution threat. Laboratory experiments were conducted to determine the suitability of terrazzo waste as admixture in the stabilization of black cotton soil. Natural moisture content, atterberg limits, maximum dry density and optimum moisture content parameters were determined using 2, 4, 6, 8 and 10% proportion of terrazzo waste admixture. The results of the parameter analysis found the natural moisture content was 23.43%, liquid limit varied from 32.8 to 56.5%, Plasticity index varied from 4.71 to 13.52%, MDD varied from 1.61 to 1.67 (g/cm3) and OMC from 8.5 to 22.6%, the CBR value was indicates unsuitability for use as a base and sub-base material. The terrazzo waste admixture produced can be used for stabilization with the potential to minimize the cost of waste disposal as well as provide substitute to the use of conventional stabilizers for use in  places such as parks or pathways

Role of lauric acid against prenatal sleep deprivation-induced-stress rise in corticosterone and low birth weight in rat offspring

Prenatal stress is known to affect the offspring later in life. Lauric acid is a known antioxidant shown to play a protective role in experimental animals. This study examines the role of Lauric acid on sleep deprivation-induced stress on serum corticosterone level and birth weight in male rat pups. Pregnant dams were sleep-deprived using the modified multiple water platform for 20hrs daily from gestational day 9-19. Animals in groups 1 and 2 served as normal and stressed controls respectively, groups 3,4 and 5 received Lauric acid of doses 125mg/kg, 250mg/kg and 500mg/kg respectively while group 6 received Vitamin C 300mg/kg. Male offspring birth weight was recorded and at PND 28-36, were sacrificed and blood was collected for corticosterone assay. Serum corticosterone was significantly higher (p< 0.05) in the sleep-deprivation-induced stress group. Its level was also significantly lower (p<0.05) in the LA and vitamin C treated groups. Birth weight was significantly lower (p<0.05) in the stressed and vitamin C (300mg/kg) groups while being significantly higher (p< 0.05) in LA 125mg/kg group. This finding suggest that Lauric acid protect against rise in serum corticosterone level and improves birth weight in male offspring of dams subjected to sleep deprivation

Knowledge Assessment of Anti-snake Venom Among Healthcare Practitioners in Northern Nigeria

Introduction: Anti-snake venom (ASV) is the standard therapy for the management of snakebite envenoming (SBE). Therefore, the knowledge of ASV among healthcare practitioners (HCPs) is essential for achieving optimal clinical outcomes in snakebite management. This study aimed to assess knowledge of ASV among the HCPs in northern Nigeria. Methods: We conducted a cross-sectional study involving eligible HCPs from different healthcare settings in northern Nigeria. The participants were recruited into the study using a combination of online (via Google Form) and face-to-face paper-based survey methods. The ASV knowledge of the respondents was measured using a validated anti-snake venom knowledge assessment tool (AKAT). Inadequate overall knowledge of ASV was defined as scores of 0-69.9%, and 70-100% were considered adequate overall knowledge scores. The predictors of ASV knowledge were determined using multiple logistic regression. Results: Three hundred and thirty-one (331) eligible HCPs were included in the study analysis (310 from online and 21 from paper-based survey). Overall, an estimated 12.7% of the participants had adequate knowledge of ASV. Adequate ASV knowledge was higher among physicians compared with other HCPs (21.7%; X-2 =8.1; p=0.04). Those without previous training on ASV (adjusted odds ratio [a0R], 0.37; 95% confidence interval [CI], 0.18-0.73; p= 0.004) and who have not previously administered/dispensed ASV (aOR, 0.31; 95% CI, 0.15-0.63; p \u3c 0.001) were less likely to have adequate knowledge of ASV. Conclusion: The knowledge of ASV among healthcare practitioners in northern Nigeria is grossly inadequate. Experience with administering or dispensing ASV predicts ASV knowledge. Therefore, appropriate interventions are needed to improve ASV knowledge, particularly among the HCPs, for optimal healthcare outcomes

Seroprevalence and risk factors of Trypanosoma evansi infection in horses in Peninsular Malaysia

A cross-sectional study was designed to assess the seroprevalence and risk factors associated with Trypanosoma evansi infection among horses, using a total of 527 blood samples obtained from eight states in Peninsular Malaysia. A structured questionnaire was used to collect data on risk factors associated with T. evansi seroprevalence. The overall seroprevalence detected by card agglutination test for T. evansi (CATT/T. evansi) was 13.90% (73/527, CI: 11.2–17.1%). Female and exogenous horses showed a higher risk in association with the disease seroprevalence compared to other groups. The majority of the horse owners were not familiar with surra (85.30%). However, most of them were very cautious with the health of their animals. In conclusion, this study showed that T. evansi occurred in low frequency among horses in Peninsular Malaysia, and the good management system adopted by horse owners was probably responsible for the low T. evansi occurrence

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Availability and use of long-acting insulin analogues including their biosimilars across Africa; findings and implications

Background: Prevalence rates of diabetes mellitus are growing across Africa with an appreciable number likely to be on insulin to manage their condition. This has significant implications on future morbidity and mortality exacerbated by high complication rates. Complication rates in patients requiring insulins are enhanced by hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve patient compliance. However, they are typically appreciably more expensive than human and other insulins in Africa, and continuing controversies surrounding their benefits limits their listing on national essential medicine lists (EMLs). Biosimilars can reduce the prices long-acting insulin analogues. This needs assessing. Methods: Mixed methods approach including documentation of insulin utilisation patterns and prices among a range of African countries. In addition, input from senior level government, academic, and healthcare professionals from across Africa on the current situation with long-acting insulin analogues as well as potential changes needed to enhance future funding of long-acting analogue biosimilars. Results: There is variable listing of long-acting insulin analogues on national EMLs across Africa due to their high prices and issues of affordability. Even when listed, utilisation of long-acting insulin analogues is limited by similar issues including affordability. Appreciably lowering the prices of long-acting insulin analogues via biosimilars should enhance future listing on EMLs and use accompanied by educational and other initiatives. However, this will require increased competition to lower prices. Conclusion: There are concerns with value and funding of long-acting insulin analogues across Africa including biosimilars. A number of activities have been identified to improve future funding and listing on EMLs

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030