Management of snakebite victims using low dose antisnake venom in a tertiary hospital in Southern Nigeria: A 5-year Retrospective study

Objective: Antisnake venom (ASV) is a specific antidote for the  management of snake bite envenomations. This study profiled the  treatment and outcome of adult snake bite victims managed using low dose antisnake venom.Methods: This was a 5-year retrospective study that involved all adult  patients who presented in University of Benin Teaching Hospital, Benin City, Nigeria, with a history of snake bite. Information obtained were  demographic characteristics, clinical features, and administered treatment per established. All patients with a diagnosis of snake bite envenomation were administered ASV.Results: Sixty patients were seen during the study period, 35(58.3%)  males, 25(41.7%) females with a mean age was 34.7±13.3. The mean time from bite to presentation was 14.67±14.05 hours with range of 1- 48 hours. Twenty patients (33.3%) had snake bite envenomations, of these eleven (57.9%) were managed and discharged after administration of 30 to 40 mls of polyvalent ASV. The mean dose of PASV used was 3.9 ± 2.0 vials. The most encountered clinical indication for ASV administration was  progressive painful swelling. No death was recorded throughout this period studied.Conclusion: Adoption of the low dose regimen in the management of snake bite envenomations may be as effective as the traditional high dose regimen.Key words: Snake bite, envenomation, polyvalent antisnake venom,  Nigeria

Proximate and Heavy Metals Compositions of Some Commercial Fish Feeds available in Keffi Metropolis, Nasarawa State

The nutrient balance of feed influences its utilization and growth in fish. Proximate and heavy metals examinations were carried out on three different fish feed samples obtained from commercially available fish feed shops in Keffi metropolis and were labeled A, B, and C. The sealed samples were taken to the laboratory, ground using a mortar and pestle and kept in an airtight container for subsequent chemical analysis. The results of the proximate analysis shows that the moisture content, ash content, crude protein, crude lipid, crude fibre and carbohydrate content range from, 3.17% - 7.50%, 9.39% - 11.61%, 37.85% - 48.90%, 5.00% - 13.33%, 2.53% - 6.00% and 21.31% - 30.78% respectively. The estimated levels of heavy metals analysed ranges from 0.35mg/kg - 0.61 mg/kg, 0.27mg/kg - 0.44 mg/kg, 1.15 mg/kg - 1.47 mg/kg, 0.02 mg/kg - 0.44 mg/kg, 3.15 mg/kg - 3.25 mg/kg and 0.40 mg/kg - 0.50 mg/kg for Cu, Cr, Co, Cd, Ni and Pb respectively. The concentrations of the heavy metals determined are in order of Ni > Co > Cu > Pb > Cr > Cd. The results of the proximate analysis obtained are in close argument with that obtained in the literature which ranges from 10.06% - 10.38%, 5.33% - 9.45%, 8.512% - 24.40%, 3.20% - 12.73%, 5.00% - 13.00% and 25.89% - 52.65% respectively. For the heavy metals, it ranges from 0.0579mg/kg - 0.0023mg/kg, 0.0002mg/kg - 0.0005mg/kg, 0.01mg/kg - 0.37mg/kg, 1.22mg/kg - 4.71mg/kg and 0.06mg/kg - 0.68mg/kg for Cu, Cr, Co, Cd, Ni and Pb respectively. It is therefore concluded that all the fish feed samples analysed contain the required nutrients in required proportions declared by the manufacturers and the regulatory guide lines. The heavy metals concentrations and proximate compositions obtained are within the certified limits as regulated by WHO, SON and FAO

Drug prescribing pattern in three levels of health care facilities in the north and central senatorial districts of Edo State, Nigeria

This retrospective cross- sectional survey critically assessed the drug prescribing pattern of doctors at the three levels of health care facilities (HFs) in the North and Central senatorial districts of Edo State, Nigeria, and compares the findings with a similar study done ten years ago in the same area. With a combination of random and systematic sampling techniques, 2,500 general outpatient prescriptions in the year 2007 were examined using standards described in the WHO Prescribing Indicators Manual. Thirty percent (30%) of hospitals was selected for the study. The data obtained were analyzed using the SPSS software (version 16). Tests of statistical significance were done using chi square contingency cross-tabulation and goodness of fit. Results showed that there is significant statistical differences in the number of drugs prescribed per patient encounter, percentage of encounter with an injection prescribed, in adherence to WHO prescribing guidelines; prescribing according to drug classes and generic names P<0.05. Poly-pharmacy and irrational prescribing appears to be the rule in GH and PH especially with continued prescribing of banned drugs and use of the injection route. The prescribing pattern in the three categories of hospitals fell short of WHO standards, especially in the GH and PH.Keywords: Drug use, prescribing pattern, Health facilities, prescribing indicator

Morbidty pattern amongst the adult population in three levels of health care in the north and central senatorial districts of Edo State, Nigeria

This retrospective cross- sectional survey assesses the morbidity pattern in the North and Central senatorial districts of Edo, State, Nigeria, using a combination of random and systematic sampling techniques. Diagnostic records in case notes of 2,500 general outpatients for the year 2007 were studied. The data collected was analyzed using SPSS statistical software (version 16) and the values expressed as mean ± standard deviation. Tests of statistical significance were also performed using the chi square and goodness of fit tools. Results showed that Malaria was the leading cause of morbidity followed by Hypertension, Musculoskeletal system (MSS) pathologies/trauma, Peptic Ulcer Disease (PUD), Sexually Transmitted Diseases (STD) and Skin diseases/infections (ranked lowest). Diseases comprising anaemias, helminthiasis, diabetes mellitus, HIV/AIDS, and Adverse Drug Reactions (ADR), as well as CNS, CVS, ENT, Eye diseases among others, were most common in ISTH. Overall, malaria, hypertension, MSS pathology and PUD were the commonest cause of morbidity, while skin diseases, UTI and disease of the GIT were the least. These findings could be a guide to provision of health services and allocation of resources by relevant agencies.Keywords: Morbidity pattern; Health care facilities, Disease

Clinical pharmacology of antiemetic agents A study on prochlorperazine and metoclopramide

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN006267 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Artemisinin-based antimalarial combination therapy amongst healthcare professionals in a tertiary facility in south-south Nigeria: preferences, tolerability, and cost considerations

Background: Nigeria adopted the Artemisinin-Based Combination Therapy (ACT) as the mainstay of treating uncomplicated malaria in February 2005. However, the individual preferences for the use of these medicines by health care professionals (HCP) as distinct from their observed prescribing practices is largely unknown. This study determined the preferences, tolerability and cost of the ACTs among HCPin Benin-City.Methods: This descriptive cross-sectional study was conducted in the University of Benin Teaching Hospital, Benin-City, Nigeria. Consenting HCPs were recruited consecutively for the study. Semistructured questionnaires were administered to doctors, nurses and pharmacists in the hospital. Information obtained included demographics, treatment of malaria in the previous year, antimalarial medication preferences and tolerability as well as cost of ACT.Results: A total of 556 HCPs, 295 doctors (54.1%), nurses 200 (36.0%), pharmacists 61(11.0%) completed the questionnaire. In the previous year, 224 (75.9%) doctors, 153 (79.1%) nurses, and 48 (70.5%) pharmacists had treatment for malaria and self-medication was highest among doctors (228, 77.3%). Artemether-Lumenfantrine was the most preferred antimalarial used, 294 (52.8%); however, 1.6% used chloroquine sulphate and ACTs were perceived to be ineffective by 25.4%. Adverse effects were experienced by 167 (29.1%) resulting in 50 (9.0%) discontinuing their medication. Between 500 and 1500 Naira (~US$1-4) was expended on ACT by 66.3% of the staff, while 21.4% were concerned about the high cost of medications.Conclusion: This study highlights the use and preferences, self-medication practices, perceived lack of effectiveness and high cost of ACTs from a HCP perspective. There is an urgent need to address these concerns in view of adverse consequences as well as the likely possibility of its the impact on prescribingpractices

The efficacy and tolerability of doxazosin in the management of mild to moderatery elevated blood pressure in black hypertensives

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A profile of gastriontestinal haemorrhage induced by aspirin and other nonsteriodal anti-inflammatory drugs

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