High Concentrations of Pharmaceuticals in a Nigeria River Catchment

Pharmaceutical contamination of the environment is recognized as a global problem although most work has focused on Europe and North America to date and there remains a dearth of information for developing countries, including those in Africa. To address this data gap the occurrence of thirty‐seven pharmaceuticals belonging to nineteen therapeutic classes was monitored in surface water and effluents in Lagos State, Southwest Nigeria. Samples were collected quarterly between April 2017 and March 2018 from 22 sites, and 26 compounds were detected at least once, many in the microgram per litre range. Maximum concentrations for those compounds detected ranged from 75 to 129 µg L‐1 and even mean concentrations for thirteen compounds were in the order of µg L‐1. These values are amongst the highest ever measured globally. Sewage effluent was more important than drug manufacturing waste in polluting rivers although there are likely to be numerous unregulated sources of effluent being discharged to rivers which require further study, including urban waste collection areas and vacuum trucks which collect effluent. Seasonal trends in the data were complex with some compounds being found at higher concentrations in the dry season and, conversely, others being greater during the wet period, this variation potentially relating to the variety of pollution sources in the catchment. Pharmaceuticals are indispensable to human health although their usage and discharge into the aquatic environment may lead to ecological problems and antibiotic resistance. The data presented in this paper indicate that pharmaceutical pollution of freshwaters is a serious issue in Nigeria and management efforts are needed to improve this problem

Effective Mangement and Control of Malaria in Pregnancy

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Knowledge and Practice of Mentoring in Residency Training Programme in Family Medicine in Nigeria

Aim: To ascertain the level, sources of knowledge and practice of mentorship in family medicine residency training programme in Nigeria.Method: A cross sectional descriptive and inferential study at a national workshop in June 2011.Result: The mean age of respondents was (mean±SD) 34.35±4.5 years, while the mean ±SD year in residency programme was 3.14±1.655 years. The most frequent source of information about mentoring was personal reading (64 of 172 or 37.2%). Fewer respondents (46.5%) had knowledge of mentoring, which depended on years spent in residency (X2=24.605, df=6, p=0.000); older age (X2=44.680, df=9, p=0.000); working in public hospital (X2=15.662, df=3, p=0.001); having previous training in mentoring (X2=19.900, df=3, p=0.000); and personal experience in mentoring (X2=25.254, df=3, p=0.000). Choice of mentor was the most frequent constraint in the implementation of mentoring, which depended on age of subjects (X2=33.578, df=12, p = 0.001); previous training in mentoring (X2=30.074, df=4, p=0.000); and gender i.e. male (X2=13.337, df=4, p=0.010). In conclusion, the level of formal training and knowledge in mentoring among residents in family medicine was very low with a majority having no experience as mentees. Personal reading was the most frequent source of information of mentorship, while mentoring was perceived to improve performance. The single most frequently perceived constraints in the implementation of mentoring was the selection of mentor.Key Words: Mentoring, Knowledge, Constraints, Implementation, Residenc

Management of Pulmonary Tuberculosis- A Family Case Study

Background: Tuberculosis (TB) is a chronic, necrotizing infection which is caused by the Mycobacterium tuberculosis bacillus. It is spread primarily through an airborne route when an individual with pulmonary tuberculosis coughs, talks or sneezes. Close contacts are predisposed to contacting the disease. It is therefore important to trace and treat family members of all index cases because of the highly infectious nature of the disease.Patients, Methods and Results: The index patient was a 35 year old civil servant who had smear positive pulmonary tuberculosis. His immediate family was screened. His youngest child whom was known to be the closest to him was found to have active Pulmonary Tuberculosis (PTB). The older child had a positive tuberculin skin test but no other evidence of active infection. They were all treated according to the Nigerian national guideline for Tuberculosis management. Family medicine tools including the Family circle, Family life cycle, Home visits and Family counseling were used in the management of this case. This case emphasizes the need for a thorough contact tracing, family involvement in care, home visits and individualization in the management of pulmonary tuberculosis. It also emphasizes the practical application of family medicine tools in the family physician's evaluation of patients and families.Conclusion: Early identification and prompt treatment of all index cases of PTB together with a thorough search for close family contacts, family counseling and home visits by healthcare workers can help to reduce the scourge of PTB in Nigeria.Key Words: Pulmonary Tuberculosis , Family, Family Case Stud

Relationship between family support and quality of life of type-2 diabetes mellitus patients attending family medicine clinic, federal medical centre, Ido–Ekiti.

Background: Diabetes mellitus is a chronic disease with increase morbidity and mortality. It could be associated with significant adverse outcomes including poor quality of life. In Sub-Saharan Africa, Nigeria has a large share of the morbidity and mortality of DM. Several factors have been found to be associated with better quality of life among diabetes mellitus (DM) patients. There is a dearth of local research work on the relationship of family support and quality of life of this group of patients.Objective: This study sought to determine the relationship between family support and quality of life of type 2 diabetes mellitus patients attending family medicine clinic, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria.Materials and Methods: A cross-sectional study of 250 adult patients with type 2 diabetes mellitus was carried out over twenty (20) weeks. Respondents' family support was measured using Perceived Social Support – Family Scale {PSS- Fa}, while their quality of life was measured using the short version of the World Health Organization quality of life assessment tool (WHOQOL-BREF).Results: The level of family support was significantly associated with quality of life at p-value less than 0.001. Majority [n = 104 (59.8%)] of the respondents who reported having strong family support had fair quality of life. Also, a significant percentage (85.7%) of all respondents who had good quality of life were found to have strong family support. The converse was true of respondents with poor quality of life as only 5(10.4%) of them reported having strong family support. Also, majority [n = 33 (68.8%)] of respondents with poor quality of life reported having weak family support. Strong family support was an independent predictor of good quality of life among study participants. Respondents with strong family support were 14 times more likely to have good quality of life than those with no family support.Conclusion: Good family support positively correlated with better quality of life of respondents. Hence, Family Physicians should utilise this resource by advocating for an active involvement of family members in management plans of DM patients to enhance their quality of life

Chest X-Ray in Family Practice

No Abstract

Pattern of Family Support among HIV Patients in a Tertiary Health Center in Southwest Nigeria

Background: The impact of the HIV/AIDS pandemic on the social and economic development of Nigeria has been substantial. Adequate family support remains a critical factor for the achievement of optimal HIVcare. This study investigated the level and pattern of family support received by people living with HIV/AIDS (PLWHA).Method: A descriptive, cross-sectional study was carried out among PLWHAs receiving care within the family practice at the Federal Medical Centre, Ido-Ekiti, Nigeria. Respondents were selected using systematic random sampling technique. A structured, interviewer-administered questionnaire was used to collect data from the respondents. Data was analysed using SPSS version 16.0.Result: A total of one hundred (100) PLWHA were interviewed. Their mean age was 43.0 (SD12.0) years. Sixty-one per cent (61.0%) were females. A greater proportion of the subjects (81%) were married. Monogamous family structure was observed in 72% of all the subjects. Family support was strong amongst 85% and a significant positive association was found between family support and age (p=0.008), family structure (p=0.003) and marital status (p=0.000).Conclusion: Most PLWHA studied had strong family support. Middle age and being married in a monogamous family setup were significant factors for this support. Family involvement and support during initiation and continuation of their antiretroviral therapy is recommended.Keywords: Family Support; ART; HIV/AIDS; PLWHAs; Nigeri

Relationship between Perceived Spousal Social Support and Blood Pressure Control among Hypertensive Patients Attending General Outpatient Clinic in Federal Teaching Hospital, Ido-Ekiti, Nigeria

Background: Despite many approaches to control hypertension, a lot of people still experience challenges keeping their Blood Pressure (BP) under control, and because the condition requires life - long treatment, many patients will need additional effort from their spouses. The spouse shares intimacy with patient and is the chief source of social support that provides financial assistance, reminds and encourages medication use, shows concern and interest by discussing issues related to the disease. Therefore, exploring the relationship between Perceived Spousal Social Support (PSSS) and BP control will help the physician and other stakeholders harness the gains of this association to achieving BP control, prevent complications and death associated with hypertension.Objective: To identify the relationship between perceived spousal social support and blood pressure control among hypertensive patients attending General Outpatient Clinic (GOPC) in Federal Teaching Hospital, Ido-Ekiti, Nigeria.Materials and methods: This was a hospital - based cross - sectional study carried out between June and August 2016 among 298 hypertensive patients aged 18 and 65 years attending GOPC of the Federal Teaching Hospital, Ido Ekiti. Collection of data was done using pre-tested, semi-structured questionnaire on sociodemographic characteristics, blood pressure measurement and 4-point Likert Social Support questionnaire to measure the perceived spousal social support. Data was analysed using SPSS IBM version 17.0.Results: Mean age of respondents was 56.0 ± 8.5 years and seventy percent were females with male to female ratio of 1:2.3. Less than half of the respondents, 47.7% and about half of the respondents, 50.3% achieved BP control and demonstrated strong PSSS respectively. There was statistically significant relationship between PSSS and BP control (χ2 = 27.05, p &lt; 0.001).&nbsp;Conclusion: Social support perceived by participants positively influenced their BP control. Family Physicians and other health care providers should therefore determine and enhance the level of this support and encourage spouses to provide this support for their partners who have hypertension or those having difficulty controlling their BP despite the appropriate use their medications.</p

Modified solid lipid nanoparticles encapsulated with Amphotericin B and Paromomycin: an effective oral combination against experimental murine visceral leishmaniasis

Abstract The development of an effective oral therapeutics is an immediate need for the control and elimination of visceral leishmaniasis (VL). We exemplify the preparation and optimization of 2-hydroxypropyl-β-cyclodextrin (HPCD) modified solid lipid nanoparticles (SLNs) based oral combinational cargo system of Amphotericin B (AmB) and Paromomycin (PM) against murine VL. The emulsion solvent evaporation method was employed to prepare HPCD modified dual drug-loaded solid lipid nanoparticles (m-DDSLNs). The optimized formulations have a mean particle size of 141 ± 3.2 nm, a polydispersity index of 0.248 ± 0.11 and entrapment efficiency for AmB and PM was found to be 96% and 90% respectively. The morphology of m-DDSLNs was confirmed by scanning electron microscopy and transmission electron microscopy. The developed formulations revealed a sustained drug release profile upto 57% (AmB) and 21.5% (PM) within 72 h and were stable at both 4 °C and 25 °C during short term stability studies performed for 2 months. Confocal laser scanning microscopy confirmed complete cellular internalization of SLNs within 24 h of incubation. In vitro cytotoxicity study against J774A.1 macrophage cells confirmed the safety and biocompatibility of the developed formulations. Further, m-DDSLNs did not induce any hepatic/renal toxicities in Swiss albino mice. The in vitro simulated study was performed to check the stability in simulated gastric fluids and simulated intestinal fluids and the release was found almost negligible. The in vitro anti-leishmanial activity of m-DDSLNs (1 µg/ml) has shown a maximum percentage of inhibition (96.22%) on intra-cellular amastigote growth of L. donovani. m-DDSLNs (20 mg/kg × 5 days, p.o.) has significantly (P < 0.01) reduced the liver parasite burden as compared to miltefosine (3 mg/kg × 5 days, p.o.) in L. donovani-infected BALB/c mice. This work suggests that the superiority of as-prepared m-DDSLNs as a promising approach towards the oral delivery of anti-leishmanial drugs