Evaluation of hypoglycemic activities of hydroethanolic leaf extract of Nicotiana tabacum (Solanaceae)

The aim of this study was to evaluate the hypoglycemic activities of hydroethanolic leaf extract of Nicotiana tabacum. Acute toxicity was evaluated in Swiss albino mice using graded oral doses of the extract. Hypoglycemic properties of Nicotiana tabacum was assessed using oral glucose tolerance test and on normoglycemic rats that received single doses of the extract at 40 and 80 mg/kg body weight and blood glucose levels estimated at 2, 4 and 6 hours (single dose study). Phytochemical screening of the extract for the presence of secondary metabolites was performed with standard methods. Acute toxicity study revealed a median lethal dose (LD50) of 5.82g/Kg. the single-dose study showed that 40mg/Kg and 80mg/Kg body weight of the extract significantly (p<0.05) reduced blood glucose levels at 2h compared to control (27.35% and 28.37% respectively), while 80mg/kg body weight of the extract significantly (p<0.05) reduced blood glucose level at 6h compared to control (75.40%). The oral glucose tolerance test results also showed a significant reduction (p<0.05) in blood glucose levels. These findings suggest that the extract of Nicotiana tabacum has hypoglycemic properties which may be accounted for by the presence of secondary metabolites in the extracts -flavonoids, alkaloids, phenols and terpenoids.Key words: Nicotiana tabacum, Diabetes mellitus, Hypoglycemia, Oral glucose toleranc

Assessment of Rational Prescribing of Antihypertensive Drug combinations in Lagos University Teaching Hospital

Purpose: The study aimed to assess prescribing trends of antihypertensives and proportion of prescriptions containing irrational combinations of antihypertensives and co-prescribed drugs. Methods: Five hundred and fifty four prescriptions, containing antihypertensives, were collected prospectively over a period of twelve months, from the internal medicine clinic of the Lagos University Teaching Hospital, and evaluated. Results: The average number of drugs prescribed per encounter was 2.9. Encounters with injections were 0.5%. The percentage of drugs prescribed by generic name was 31.6%. All the drugs prescribed were from the National Essential Drugs List. Calcium antagonists were the most frequently used group of drugs (41.3%), followed by Diuretics (33.0%) and Angiotensin-Converting Enzyme inhibitors (ACEIs) (22.4%). Nifedipine (31.9%), Methyldopa (22.4%) and Propranolol (20.2%) were the most frequently used individual drugs. Beta-blockers with Calcium antagonists (13.3%), Methyldopa with Diuretics (10.6%), Calcium antagonists with ACEIs (10.3%) were the most frequently prescribed drug combinations. Irrational drug combinations with NSAIDs were observed in 21.8% of the prescriptions. Also beta-blockers were prescribed in 22% of prescriptions for hypertensive / diabetic patients. Conclusion: There is need to educate prescribers on appropriate therapeutic combinations that would provide optimal management of hypertension and associated clinical conditions. KEY WORDS: Antithypertensive, rational, drug combination. Nig. Jnl Health & Biomed. Sciences Vol.3(1) 2004: 8-1

The mutagenic testing of different brands of commonly used insecticides

Insecticides are chemical agents used to control insects, but humans are usually exposed to insecticides and this may have a long term toxicological effects on their health. Different brands of insecticides including BaygonR, MobileR, MorteinR and TotalR were subjected to Ames spot Forward Mutation Assay, using Escherichia coli. The assay was examined for the presence of revertant strains of the organism in the presence and absence of white albino rat liver metabolizing enzymes (S9). The results showed that these insecticides produced no mutant strain of the organism and no alteration in the phenotypic characteristics of the organism as compared with the standard mutagen (ethidium bromide), which produced revertant strains of the organism and altered the phenotypic characteristics of the organism. Finally, this result showed that these insecticides can be considered not mutagenic in bacteria and may not be mutagenic or carcinogenic in human

Off-label prescription for paediatric in-and outpatients at a tertiary hospital in Lagos, Nigeria

The licensing process of medicines aims at ensuring their safety, efficacy and quality. Although many medicines are not licenced for paediatric use, they are nevertheless prescribed for children outside the terms of their product license (off-label). Our main objective was to assess off-label prescribing and to document the level of this practice in paediatric patients attending a tertiary hospital in Lagos, Nigeria. Prescriptions received by children aged 16 years or less during a 24-month period (January 2010 to December 2011) were obtained from the case notes of randomly selected patients from a list of patients who had previously attended the Lagos University Teaching Hospital (LUTH). Data collected include demographic information, medicines prescribed and the nature of off-label medicine. A total of 1207 prescriptions were analysed from the case notes of 430 patients. Prevalence of Off-label prescription was 6.6% and commoner in males (62.5%) than females (37.5%). Young children, aged 1-5 years, (40.0%) and Infants, aged 1-12 months, (36.3%) were the two groups most commonly prescribed off-label medicines. Off-label prescription due to inappropriate dosage (38.7%) and unapproved age use (25%) were the two commonest categories observed in this study. Anti-infective (46.3%) and cardiovascular (38.7%) medicines were the two classes of off-label medicines most frequently prescribed. Off-label prescribing in paediatric patients is still prevalent however the magnitude is considerably lower than previously reported. Off-label prescribing should be evidence based and further studies should address the need for adequate dosing guidelines for such prescribed medicines.Keywords: off-label, unlicensed, medicine, children, hospital, Lagos Resume Le processus d'autorisation des médicaments vise à assurer leur sécurité, l'efficacité et la qualité. Bien que de nombreux médicaments ne sont pas autorisés pour un usage pédiatrique, ils sont cependant prescrits pour les enfants en dehors des conditions de leur licence de produit (hors AMM). Notre principal objectif étaitd'évaluer la prescription hors AMM et de documenter le niveau de cette pratique chez les enfants fréquentant un hôpital tertiaire à Lagos, au Nigeria. Prescriptions reçues par les enfants âgés de 16 ans ou moins au cours d'une période de 24 mois (Janvier de 2010 à Décembre 2011) ont été obtenus à partir des notes de cas depatients choisis au hasard parmi une liste de patients qui avaient déjà participé à l'hôpital universitaire de Lagos (LUTH). Les données recueillies comprennent des renseignements démographiques, les médicaments prescrits et la nature de la médecine off-label. Un total de 1207 prescriptions ont été analysées à partir desnotes de cas de 430 patients. Prévalence de Off-label prescription a été de 6,6% et plus fréquent chez les hommes (62,5%) que les femmes (37,5%). Les jeunes enfants, âgés de 1-5 ans, (40,0%) et les nourrissons âgés de 1-12 mois, (36,3%) sont les deux groupes les plus couramment prescrits des médicaments horsAMM. Off-label prescription due à une posologie inadéquate (38,7%) et l'utilisation de l'âge non approuvé (25%) ont été les deux catégories les plus courantes observées dans cette étude. Anti-infectieux (46,3%) et cardiovasculaires (38,7%) des médicaments sont les deux classes de médicaments hors AMM les plusfréquemment prescrits. Off-label prescrire chez les patients pédiatriques est encore répandu mais l'ampleur est considérablement plus faible que précédemment  rapporté. Off-label prescription devrait être une preuve fondée et d'autres études devrait répondre au besoin de directives de dosage adéquates pour ces  médicaments prescrits

Off-label prescribing for children with chronic diseases in Nigeria; findings and implications.

Prescribing medicines in an off-label manner for children with chronic conditions is sparsely documented, even more so among developing countries. This needs addressing. The objective of this research was to investigate the extent of off-label prescribing among children with epilepsy, asthma, and sickle cell anaemia in Nigeria.Prescriptions for children ≤16 years documented in their case files that attended paediatric clinics in Lagos, Nigeria, for these three conditions between January and October 2015, were reviewed retrospectively to extract data on the medicines prescribed. British National Formulary for children and American Hospital Formulary Service Drug information were used as references.477 patients received 1746 prescriptions. Off-label prescriptions were seen in 7.7% of prescriptions, related to dose (93; 68.9%), indication (22; 16.3%), and age (20; 14.8%). Nervous system (525; 30.1%) and anti-infective (441; 25.2%) medicines were the most prescribed but only 9.5% and 8.2% of the respective prescriptions were off-label. Children with epilepsy received the most number (94; 69.6%) of off-label prescriptions. The three chronic conditions did not associate significantly with the category of off-label medicine prescribed (p = 0.925).Off-label prescribing for children with epilepsy, asthma and sickle cell anaemia occurs. Encouragingly, the overall rate appears low in Nigeria

Client perception of radiotherapy services at the Lagos University Teaching Hospital, Lagos, Nigeria

Assessment of quality from the patient's perspective could be a method of aiding improvement of services to achieve total quality management. This study set out to determine the level of knowledge of radiotherapy among patients and assess their attitude to the radiotherapy services provided at the Oncology clinic of the Department of Radiotherapy, Lagos University Teaching Hospital Nigeria. Data collection was by self-administered questionnaires using a systematic random sampling technique of every second patient attending the clinic over a period of six months. Both old and new patients were included in the study. A total of 104 patients were interviewed. More than two-thirds of the respondents (70.2%) were females. Most (86.3%) of the female respondents were aged 30- 69yrs. A quarter (25.8%) of the male respondents were under 30 years. The majority of both males (62%) and females (58.9%) had at least senior secondary education. Majority of the respondents (males, 54.8% and females, 61.6%) were reassured in terms of the treatment modalities being received. About two-thirds (64.5%) of the males and three -quarters (74.0%) of the females felt they had improved chances of survival. Majority of the males (51.6%) and females (57.5%) felt that radiotherapy had its worth in the management of their conditions. Most (94.5%) of the clients who perceived radiotherapy to be of adequate worth felt there was an improvement in their condition. The study recommended the need for improved communication in doctor – patient relationships in chronic diseases such as cancer. Keywords: Client, perception, radiotherapy and services Nigerian Journal of Health and Biomedical Sciences Vol. 5 (2) 2006: 57-6

Knowledge, Attitude and Practice of Breast Cancer Screening among Nurses in Lagos University Teaching Hospital, Lagos Nigeria

No Abstract

Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature.

BACKGROUND: Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa. METHODS: We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings. RESULTS: We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory enforcement and practices of specialized drug shops. CONCLUSIONS: Evidence suggests that characteristics and practices of specialized drug shops differ across rural and urban locations, and that these providers are highly responsive to client demand. However, there is a dearth in knowledge on how regulatory enforcement influences their characteristics and practices, and what strategies can be employed to strengthen the governance of the retail pharmaceutical sector