Prevalence of hyperhomocysteinaemia, selected determinants and relation to hypertension severity in Northern-Nigerian hypertensives: the ABU homocysteine survey

Background: This study aimed at evaluating the prevalence of hyperhomocysteinaemia in Northern-Nigerian hypertensives and its association with hypertension severity and some major determinants as data regarding these are lackingin sub-Saharan Africa. Method: A Community-based cross-sectional study done on 120 randomly-selected hypertensive patients who responded to an ABU radio frequency modulated invitation for free health-screening at the Ahmadu Bello University (ABU) Medical Centre from January 2016 to June 2016. The percentage of participants with high homocysteine levels, their anthropometric parameters and blood pressures were determined. Plasma homocysteine (hcy) was classified as normal (5-15), moderate (>15-30), intermediate (31-100) and severe (>100) μmol/L. Kruskal-Wallis test was applied and log-transformed homocysteine (Ln10Homocysteine) was correlated with systolic and diastolic blood pressures as well as age, body mass index, fasting blood glucose, glomerular filtration rate, hypertension duration and Ln10folate in males and females using the Pearson’s Correlation analysis. Results: There were 83(69.2%) females and 37(30.8%) males with Median homocysteine of 20.8 μmol/L and 22.0 μmol/L respectively (p=0.003). Hyperhomocysteinaemia was found in 118(98.3%) hypertensives while 2(1.7%) subjects had normo-homocysteinaemia. Moderate hyperhomocysteinaemia (Median, 20.8 μmol/L) was identified in 105(87.5%) and intermediate (Median, 40 μmol/L) in 13(10.8%) (p<0.001). No subject had severe hyperhomocysteinaemia.Homocysteine was higher (p=0.003) in subjects with Stage 2 systolic hypertension. Ln10Homocysteine was significantly (p<0.001) correlated with blood pressure (SBP: r=0.45; DBP: r=0.40) and age (r=0.33). Conclusion: The prevalence of hyperhomocysteinaemia in North-Western Nigerian hypertensives is high as against normal healthy controls. Plasma homocysteine is higher with severe systolic hypertension and positively associated with age. Keywords: Hypertension, Homocysteine, Blood pressure, Northern-Nigerians Funding: No specific grants but Micro Nova Pharmaceuticals Limited, Nigeria and Emzor Pharmaceutical Industries, Lagos, Nigeria supported with drugs

Patients’ Perspectives on Their Safety: A Qualitative Study in Two Public Health Facilities in Kaduna State, Nigeria

Background: Safe healthcare environments influence patients’ valuation of care received and impact on better health outcomes. It has been recognized that patients can contribute invaluably in improving the quality and safety of healthcare services they receive.Objective: To explore the perspectives of patients on their safety in healthcare.Methods: A qualitative study comprising of four (4) focus group discussions (FGDs) with six to eight participants was conducted in two public health facilities in Kaduna State, Nigeria. Patients admitted in medical wards (male and female) were recruited through a purposive sampling technique after obtaining their verbal informed consent to participate. A topic guide, containing open ended questions that explored patients’ opinions on their safety in healthcare was used for the discussions. All FGD sessions were recorded, transcribed and coded using thematic analysis.Results: The participants consisted of 15 females and 13 males in FGD sessions that lasted between 55 to 90 minutes. All participants were Hausa speaking, with varying levels of education. Six (6) themes were generated which the patients perceived to play a role in their safety in healthcare. These themes are: choice of hospital, patient satisfaction, patient experiences, patient engagement, communication openness and suggestions by patients for improvement.Conclusion: The findings of this study have highlighted both positive and negative perspectives of patients regarding their safety in healthcare. The patients provided some recommendations for areas where improvements are required for improved patient safety. These include infrastructural improvements, staffing, and availability of medicines, amongst others

Co-administeration of Ethanolic Leaf Extract of Moringa oleifera and Metformin Improves Glucose, Lipid and Protein Profiles of Diabetic Wistar rats

Herbs are often co-administered with orthodox drugs, raising the potential for herb-drug interactions. This study investigated the pharmacological interaction between ethanol extract of Moringa oleifera (MOE) leaves and metformin co administered to diabetic Wistar rats. Diabetes was induced in rats by administration of 150 mg alloxan/kg body weight intraperitoneally. A dose response study for MOE at doses of 100-2000 mg/kg body wt. was carried out. A plot of percentage glycaemic reduction at 4h post-treatment versus log dose was used to estimate the median effective dose (ED50). Nine (9) groups of rats were used for the interaction study. Groups I and II served as normoglycaemic and diabetic controls respectively and received 1ml Normal saline. Diabetic Groups III-V received 375, 750 and 1500 mg/kg MOE respectively. Groups VI-VIII also diabetic received the same doses of MOE respectively but co-administered with a fixed dose of metformin (150 mg/kg). Group IX received metformin (150 mg/kg) alone. Fasting blood sugar (FBS) was monitored weekly and blood samples collected on day 28 for protein and lipid profile assay. The MOE/metformin co administered groups showed greater antihyperglycaemic activity (p<0.001) than the MOE and metformin alone groups. Significant increases in serum levels of cholesterol, TG and LDLC with the decrease in HDLC levels in the alloxan induced diabetic rats were reversed in MOE (p<0.01) and MOE/metformin (p<0.001) administered groups. These findings indicate that MOE/Metformin co-administration produced additive anti-hyperglycaemic and hypolipidaemic effects compared to either MOE or Metformin alone and may be useful in the therapeutic management of diabetes mellitus that is associated with dyslipidaemia.Keywords: Diabetes, Hyperglycaemia, Pharmacological interaction, Moringa oleifera, Metformi

RANDOMISED DOUBLE-BLIND PLACEBO-CONTROLLED STUDY OF FOLIC ACID ADJUNCT FOR 8 WEEKS IN HYPERHOMOCYSTEINAEMIC HYPERTENSIVE PATIENTS IN ZARIA, NIGERIA

Objectives: This study was aimed at determining the effect of folic acid adjunct therapy on homocysteine (HCY) and blood pressure (BP) levels in hypertensive subjects. Method: The study was a double blind placebo-controlled trial on 100 hypertensive patients randomised into 50 folate and 50 placebo groups, where the folate group had 5 mg folic acid daily for 8 weeks. Fasting plasma homocysteine, folate and blood pressure levels were determined at baseline, at 4 and at 8 weeks. The Mixed Model Repeated Measures analysis of variance was applied for data analysis. Results: Hyperhomocysteinaemia was found at baseline in the folate (21.3 ± 5.7 µmol/L) and placebo (21.6 ± 4.9 µmol/L) groups which did not differ statistically (p > 0.05). Folic acid adjunct therapy, reduced homocysteine levels at 4 weeks by 2.0 µmol/L (9.2 %, p < 0.05) and at 8 weeks by 1.2 µmol/L (5.6 %, p < 0.05), with no significant (p > 0.05) systolic and diastolic blood pressure lowering effect. High base-line folate levels were found in both folate (113.8 ± 51.2 ng/ml) and placebo groups (109.5 ± 51.4 ng/ml) with no statistically significant difference (p > 0.05). Conclusion: Short-term daily folic acid supplementation over 8 weeks had a significant homocysteine reduction effect with no significant reduction in systolic and diastolic blood pressures of hypertensive subjects in Zaria, Nigeria. Hyperhomocysteinaemia could not be accounted for by suboptimal folate levels. Keywords: Hypertension, Homocysteine, Blood pressure, Folate, Placebo, Nigeria

Aqueous Methanol Extracts of Cochlospermum tinctorium (A. Rich) Possess Analgesic and Anti-inflammatory Activities

Cochlopermum tinctorium A. Rich. (Cochlospermaceae) is a commonly used medicinal plant in the West Africa sub-region for the management of various conditions including pain and inflammatory conditions. In the present study, we report the analgesic and anti-inflammatory activities of the aqueous methanol leaf (20–80 mg/kg), root (7.5–30 mg/kg), and root bark (20–80 mg/kg) extracts of the plant. The analgesic potentials of the extracts were studied using acetic acid induced writhing and hot plate tests in mice while the anti-inflammatory activity was investigated using carrageenan-induced paw edema in rats.The extracts significantly and dose dependently inhibited the acetic acid-induced writhing in mice. However, the highest protection against writhing was produced by aqueous methanol leaf extract at the dose of 80 mg/kg (96.65%) which even was greater than that of the standard agent, ketoprofen (82.30%). The extracts did not significantly increase mean latency of response in the hot plate test. However, aqueous methanol root bark extract at the dose of 20 mg/kg significantly (P < 0.05) increased the mean latency of pain response. While the extracts of the root and root bark extracts of the plant afforded non dose-dependent protection against carrageenan-induced edema, the aqueous methanol leaf extract significantly and dose-dependently inhibited carrageenan-induced hind paw edema at the end of the third hour.The present study suggests that the aqueous methanol leaf, root, and root bark extracts of Cochlopermum tinctorium possess analgesic and anti-inflammatory activities which lend some credence to the ethnomedical claim of the use of the plant in the management of pain and inflammatory conditions

Mapping Thermal Hotspots in Malé, Maldives : Assessing the Relationship Between Urban Heat Islands, Climate, and Heat Risk for Sustainable Urban Planning

This study aims to support climate-conscious urban development in greater Male’, Maldives, based on characterizations of the local microclimate. It explores intra-urban temperature variations, identifies heat risks and their factors in Male’ and Hulhumale’ phase 1 in order to support and inform climate-resilient urban strategies, driven by the absence of urban climate studies in Maldives. Measurements were primarily measured through mobile transects and fixed sensor data collection in March 2023, then analysed using Geographical Information systems. The findings indicate that intra-urban temperature patterns in the cities are influenced by, but not limited to, factors such as land use, cloud cover and wind. A noticeable urban heat island effect in the greater Male’ region became apparent as both Male’ and Hulhumale’ recorded higher nighttime temperatures compared to the nearby airport island Hulhule’. Urban heat islands are a phenomena which follows urbanization, where cities are generally warmer than their surroundings. Both cities also experienced an urban cool island effect in the early mornings, with maximum temperatures occurring later in the day compared to Hulhule’. Calmer nights were observed to be slightly cooler than windy nights, indicating a radiative cooling effect. Cloudy days and nights were observed with marginally higher daytime temperatures, suggesting a heat entrapment effect. Certain land use categories exhibited elevated temperatures compared to residential areas, highlighting the impact of land use on localized heat patterns. However, at night, impacts of land use on temperature variations appear to be low with minimal differences with consistent cooling across all types, suggesting that the influence of land use on temperature was more pronounced under solar loading. Heat Index values, a measure of perceived heat incorporating both relative humidity and air temperature, consistently indicated 'extreme caution' for both cities, underscoring an urgent need to address high outdoor humidity and its impact on human thermal comfort and well-being. Although addressing extremely high outdoor humidity presents a greater challenge than reducing air temperature, the study suggests interventions to integrate heat-resilient infrastructure and urban green infrastructure into national plans as effective approaches. Ultimately, to address the pressing question of where to best apply cooling interventions to maximize benefits in a warming climate, cities require an understanding of how the built environment impacts urban heat at a local level. Since there is no one-size-fits-all solution for urban heat mitigation, it might take a combination of customized strategies to achieve the desired result. Even with these interventions thermal discomfort may be inevitable, however the goal is to minimize risk and increase comfort as much as possible

Studies on Goldfleece and Diazole 60E brands of diazinon pesticide as a follow up to intoxications in cattle dipped with Goldfleece

No Abstract.Nigerian Veterinary Journal Vol. 29 (3) 2008: pp. 6-1

Antiplasmodial studies on the ethyl acetate fraction of the stem bark extract of Uapaca togoensis Pax. (Euphorbiaceae) in mice

No Abstrac

Effect of Pharmacist Intervention on Quality of Life of Patients with Major Depressive Disorder in Distressed North East Nigeria

Background: Quality of life is considered as an integral component and outcome indicator of mental illness and while pharmacist interventions have been proven to be effective in improving quality of life, no attention has been given to patients with depression in distressed North East Nigeria.Objectives: To explore the effect of pharmacist intervention on quality of life of patients with major depressive disorder.Materials and Methods: A longitudinal prospective randomized controlled trial approved by Ahmadu Bello University Ethics Committee on use of Human Subjects for Research (approval number: ABUCUHSR/2020/018) was conducted on 101 patients with major depressive disorder between April 2019 and March 2020 at a tertiary Neuro-Psychiatric Hospital in Maiduguri, Nigeria. Consenting patients were randomized into Usual Care or Intervention groups using a computer-generated list. The intervention consisted of pharmacist-delivered educational counseling sessions of between 15-30 minutes. Data were collected at baseline, 3 months and 6 months using the World Health Organization Quality of life Bref scale.Results: After the intervention, significant improvements (p &lt;0.001) in mean scores of participants in the intervention group were observed in all of the quality-of-life domains including; physical health [42.49 (SD=11.48) vs 72.25 (SD=15.82], psychological health [45.15 (SD=15.24) vs 85.57 (SD=12.95)], social relationship [40.47 (SD=21.24) vs 78.20 (SD=18.23)] and environment [40.94 (SD=14.09) vs 87.74 (SD=9.78)].Significant improvements (p &lt;0.001) were also observed in the general health [38.77 (SD=27.51) vs 86.53 (SD=21.27)] and overall quality of life [52.55 (SD=19.26) vs 76.92 (SD=25.16)] in the intervention group.Conclusion: Pharmacist’s intervention significantly improved quality of life in patients with major depressive disorder in this study

Concurrent use of orthodox and herbal antimalarials among science-based undergraduate students of Ahmadu Bello University, Nigeria

Many patients combine conventional and herbal drug for malaria treatment. The pattern and extent of such concurrent medication among medical and non-medical science based  undergraduate students of Ahmadu Bello University (ABU), Zaria was evaluated in this study. Three hundred and eighty (380) structured questionnaires were administered based on faculties of study to retrieve data. The study indicates that 60.1% of the students utilize hospitals for treatment, while self-medication and patronage of traditional medicine practitioners account for 30.4% and 9.5%, respectively. Majority (57.3%) use orthodox antimalarials alone, 7.6% utilize herbal antimalarials alone, while 35.1% use both concurrently. Non-medical science based students recorded highest incidence of concomitant orthodox–herbal drug usage (23.4%). Evaluation of perception on effectiveness revealed that 48.1% ranked concomitant medication as “relatively effective”, 28.7% regarded it as “considerably effective", and only 23.3% considered it as “not effective”. This study report that concurrent use of orthodox and herbal antimalarials among medical and non-medical science-based undergraduate students of ABU Zaria is not uncommon and that healthcare professionals are not always informed about concomitant drugs usage when visited by clients for treatment. Further studies should evaluate the clinical safety and efficacy of such concurrent use of the antimalarials and prescribers should always inquire and counsel potential parallel medications accordingly.Keywords: Conventional antimalarials; Herbal antimalarials; Concurrent medication; Malaria treatmen