Management of erectile dysfunction: perceptions and practices of Nigerian primary care clinicians

Erectile dysfunction (ED) is a prevalent health problem in many societies, but the diagnosis is seldom documented in primary care. The objective of this study was to investigate the perception and practices of clinicians regarding the management of ED in primary care settings in Nigeria. Methods A self-administered semi-structured questionnaire was applied to a purposive sample of clinicians attending conferences/workshops organised by the Society of Family Physicians of Nigeria and Update Courses of the Faculties of Family Medicine of the National Postgraduate Medical College of Nigeria and the West African College of Physicians. Information was obtained on their professional characteristics, experiences with the management of ED and possible barriers to the effective management of ED. Results A total of 187 completed questionnaires were analysed. Most (87.2%) of the respondents were general practitioners, while the rest were specialists in various fields (excluding sexual health) who worked at the primary care level. One hundred and forty-seven respondents (76%) reported that ED was common in their clinical practice. Over half (56.2%) of the respondents ascribed a high priority to ED management in their day-to-day clinical practice, while 33.2% and 10.6% of them ascribed medium and low priority to ED management respectively. Although 80.8% of the respondents agreed that ED patients could benefit from orthodox treatments, only 18% of them had ever prescribed any medication for affected patients; most (82%) of them either counselled or referred ED patients to secondary or tertiary care level for further management. Most of the clinicians (62%) would not take a sexual history unless the patient brought it up. The reported barriers to the management of ED include lack of a standardised protocol (64.2%), inadequate experience in ED management (85.6%), preference of patients for native medication (42.3%), and the high cost of modern medication (48.1%). Conclusion The clinicians acknowledged the high prevalence of ED in the primary care setting and recognised that they had a role to play in managing affected patients. The identified barriers to the management of the condition point to the need for education of both clinicians and patients, as well as the provision of guidelines for the management of ED in primary care settings.South African Family Practice Vol. 49 (9) 2007: pp. 1

Plasma and whole brain cholinesterase activities in three wild bird species in Mosul, IRAQ: In vitro inhibition by insecticides

Plasma and brain cholinesterase activities were determined in three wild bird species to assess their exposure to organophosphate and carbamate insecticides which are used in agriculture and public health. In the present study, we used an electrometric method for measurement of cholinesterase activities in the plasma and whole brain of three indigenous wild birds commonly found in northern Iraq. The birds used were apparently healthy adults of both sexes (8 birds/species, comprising 3–5 from each sex) of quail (Coturnix coturnix), collard dove (Streptopelia decaocto) and rock dove (Columba livia gaddi), which were captured in Mosul, Iraq. The mean respective cholinesterase activities (Δ pH/30 minutes) in the plasma and whole brain of the birds were as follows: quail (0.96 and 0.29), collard dove (0.97and 0.82) and rock dove (1.44 and 1.42). We examined the potential susceptibility of the plasma or whole brain cholinesterases to inhibition by selected insecticides. The technique of in vitro cholinesterase inhibition for 10 minutes by the organophosphate insecticides dichlorvos, malathion and monocrotophos (0.5 and 1.0 µM) and the carbamate insecticide carbaryl (5 and10 µM) in the enzyme reaction mixtures showed significant inhibition of plasma and whole brain cholinesterase activities to various extents. The data further support and add to the reported cholinesterase activities determined electrometrically in wild birds in northern Iraq. The plasma and whole brain cholinesterases of the birds are highly susceptible to inhibition by organophosphate and carbamate insecticides as determined by the described electrometric method, and the results further suggest the usefulness of the method in biomonitoring wild bird cholinesterases

The effect of nifedipine induced calcium antagonism on in vitro toxicity of lindane

The study of the effect of calcium antagonist (nifedipine) on isolated rabbit ileum poisoned with lindane was conducted. Rabbits of 1.2kg average body weight which was obtained from the Department of Pharmacology, Ahmadu Bello University, Zaria animal house were used for the current study. Each rat was sacrificed by a blow on the head, dislocation of the neck and exsanguinations. The abdomen was opened up and 4cm in length segment of the ileum obtained and mounted in an isolated organ bath containing Tyrodes solution. The preparation was maintained at 37oC aerated with air. (Kitchen, 1984; Dede, et al, 1991). 2 m g/ml lindane attenuated acetylcholine (1m g/ml) response, significantly different from acetylcholine response alone.

Knowledge, Use And Promotion Of Insecticide Treated Nets By Health Workers In A Suburban Town In South Western Nigeria

Background: Morbidity and mortality associated with malaria can be significantly reduced by widespread use of insecticide treated nets. Health workers can increase acceptability of ITN by promoting its use and serving as role model. Objective: To assess the knowledge, use and promotion of insecticide treated bed-net by health workers. Method: This descriptive, cross sectional study was carried out among health care workers in Sagamu (Ogun State) between November 2004 and January 2005. Data was collected from 263 health workers using a pre-tested, structured questionnaire. Result: Two hundred and forty six (93.5%) were aware of insecticide treated bednets (ITN) but many did not have adequate knowledge about it, only 52 (20.9%) knew that ITN should be retreated every 6 months. Sixty (22.8%) were currently using ITN. In the homes where they were currently using ITN, children were the main users (59%). The major reasons given for not using an ITN were that it had not occurred to them (23.2%), 13.3% were satisfied with the method they were using and 12.1% felt it was not convenient to use. Less than one-third (32.3%) indicated that ITN was available in their health facility. Fifty-seven percent (56.7%) had recommended it for patients before. The main reasons given by those who had not recommended it before were: lack of knowledge about it (52.5%), while 20% indicated that they were not familiar with it. Conclusion: Awareness about ITN is high among the health workers but the knowledge about it is inadequate. The major challenges to use and promotion of ITN by health workers are lack of conviction about the unique benefits of ITN, inadequate knowledge and poor access to the nets. Keywords: Use, Promotion, Insecticide Treated Nets, Health workersNigerian Journal of Clinical Practice Vol. 11 (2) 2008: pp. 149-15

Qualité de services prénatals de soin principal au Sud-ouest du Nigeria

A survey of 452 pregnant women accessing care at first level public health facilities in a local government area in southwest Nigeria was conducted to assess their perspectives on the quality of antenatal care received. Majority of the women expressed satisfaction with the level of expertise and basic technical competence of their careproviders. Less than 30% were pleased with the existing patients’ referral mechanisms. At least two-thirds received as much information as desired in salient aspects of antenatal health information needs. Frequency of antenatal visits was “about the same as expected” for 93.6% of the women. The mean reported waiting time before antenatal consultation was 131.1 minutes although 106 (43.3 %) women expected to be attended within 30 minutes of arrival. Approximately two-thirds of women were unhappy about their involvement in decision-making with respect to birth planning and postpartum contraception. Compared to other elements of quality, women were least pleased with constellation of services especially sanitary facilities and number of skilled healthcare providers. On the whole, respondents expressed a high level of overall satisfaction (81.4%) with the care received. The survey indicates that antenatal women may generally express satisfaction with the quality of services despite some inconsistencies between received care and their expectations of the facilities (Afr J Reprod Health 2008; 12[3]:71-92).Une étude de 452 femmes enceintes ayant accès au soin de premier niveau de santé publique dans une région publique du Sud-ouest du Nigeria a été faite afin de déterminer leurs vues sur la qualité de soin prénatal reçu. La majorité des femmes étaient satisfaites avec le niveau du savoir-faire et la compétence technique de base des dispensateurs de soins. Moins de 30% étaient contentes avec les mécanismes existant des recommandations des patients. Au moins deux tiers ont reçu autant de renseignements désirés dans des aspects marquants des renseignements des soins sanitaires prénatals. La fréquence des consultations prénatales étaient ‘presque la même exigée’ pour 93,6% des femmes. Le moyen du temps d’attente reporté avant la consultation prénatale étaient 131.1 minutes, pourtant, 106 (43,3%) des femmes qu’on devrait assister en moins de 30 minutes de leur arrivée. Approximativement deux tiers des femmes n’étaient pas heureuses concernant leur participation de prendre la décision en ce qui concerne le projet d’accouchement et le contraceptif postpartum. Par rapport aux autres éléments de qualité, les femmes sont moins heureuses avec la constellation de service surtout l’équipement sanitaire et le nombre de dispensateurs sanitaires qualifiées. Dans l’ensemble, des femmes interrogées ont exprimé une satisfaction complètement supérieure (81,4%) des soins reçus. L’étude indique que des futures mamans peuvent en général exprimer une satisfaction avec la qualité de service malgré les contradictions entre les soins reçus et leur espérance des installations (Afr J Reprod Health 2008; 12[3]:71-92)

Development of a countergradient parking system for gradient liquid chromatography with online biochemical detection of serine protease inhibitors

A gradient HPLC approach in combination with a countergradient system for online biochemical detection (BCD) to screen for inhibitors of serine proteases is described. For gradient separations, this novel countergradient system was developed to produce a biocompatible constant solvent composition in the BCD. The countergradient system is based on retaining complete gradients in an additional preparative HPLC column, followed by subsequent and reversible elution to the separation column effluent. Major advantages compared with existing countergradient systems are that no additional LC pumps are needed and enhanced stability. The developed countergradient system was systematically characterized applying different gradient programs. Inhibitors eluting in a post-column continuous flow analysis interfere with the enzymatic release of fluorescent 7-amino-4-methylcoumarin (AMC) from an AMC-labeled peptide. The inhibitory activity of eluting substances is sensitively detected as the degree of reduced fluorescence intensity. This biochemical detection system (BCD) for proteases was validated with three known inhibitors of the benzamidine type. Their I