Effect of educational intervention on knowledge about hypertension and factors predicting adherence to drug therapy

The present study was aimed at identifying the degree of knowledge of people with hypertension about the disease, identifying the factors predicting adherence to therapy and administering intervention. It was a quasi-experimental study involving 600 patients selected by multistage sampling technique. Adherence status was assessed using Morisky medication adherence scale8. Knowledge was measured using an eight-item instrument. Educational intervention in form of group discussions was administered. Values of p ≤ 0.05 were considered statistically significant. BP control was significantly higher in those that adhered to antihypertensive medication compared with non-adhering patients (χ2 = 14.526; df = 1; p-value = < 0.001). Comorbidity and number of antihypertensive drugs the patients were taking were found to be the predictors of adherence. After intervention, the percentage of respondents with good adherence increased from 41.3% to 48.3% (p = 0.369) in the intervention group. Furthermore educational intervention had a positive effect on knowledge of the respondents [from 64% to 66.3% (p= 0.623)] in the intervention group. The results revealed that the educational intervention had positive impact of knowledge of hypertension and its treatment. Additionally, Comorbidity and number of antihypertensive prescribed were found to be the predictors of adherence to medications.&nbsp

FEASIBILITY AND ACCEPTABILITY OF MY ELECTRONIC PERSONAL HEALTH RECORD MONITOR (MY-EPHRM)

Objectives: Smartphones could be used as a novel approach to improve medication adherence and patient's behaviour; due to constant accessibility, and the provision of a repository for health and medication information. This study aimed to assess the feasibility and acceptability of the use of My Electronic Personal Health Record Monitor (My-ePHRM), a newly-developed application (software) for personal health record monitoring as well as the factors that predict its acceptability.Methods: A cross-sectional study using structured questionnaire was conducted on 363 potential users. Statistical analyses were performed usingSPSS version 20.0. Description statistics and multiple logistic regression analysis were employed.Results: Majority of the participants were females (69.7%) with the mean age of 22 y (SD±1.7). Of the total number of the participants, 63.9% agreed that My-ePHRM was easy to operate and 50.7% thought that the language used was simple and easy to understand. Most of the participants found the features of My-ePHRM attractive (61.7%) and 52.1% would like to own it in the future. The majority agreed that My-ePHRM could increase health knowledge (57.0%), increase drug knowledge (54.0%) and could improve drug adherence (56.5%). Overall, (52.6%) believed that it was a good programme and (54.3%) would recommend it to others. Multiple logistic regression analysis revealed that ethnicity, gender and programme of the study participants did not predict My-ePHRM acceptance.Conclusion: My-ePHRM has been shown to be acceptable, simple and practical by its target users creating a huge potential in patients participation in documenting health-related activities.Â

THE APPLICATION OF COMMUNICATION TECHNOLOGY IN HOSPITAL AND COMMUNITY PHARMACIES: A BRIEF REVIEW

The use of communication technology has brought positive changes to the healthcare delivery system of today. Both healthcare professionals and patients have found a better option to access relevant health and drug information. The purpose of this review is to compile and evaluate all available investigations on the application of communication technology in hospital and community pharmacies. Pub Med, Medline and EBSCO host databases were searched using the key words: mobile phone, pharmacy and telecommunication, pharmacy and electronics, electronic record in pharmacy from the year 1994 until August 2014; whereby only full length English articles related to the review were included. Ten studies met all inclusion criteria comprising of 1124 respondents (age = 19-63, males=43%). Majority of the studies were cross-sectional in nature. Six utilized mobile phones as their means of communication of which majority (n=5) utilized text messages. Four utilized computer systems as their means of communication where they mostly work on drug-drug interaction software. Most of the reviewed studies demonstrated that incorporation of information technology in pharmaceutical care delivery and pharmacy training has improved patient satisfaction and produced better outcomes. However, several studies indicated that drug-drug interaction software had increased burden on the pharmacy staff and in some cases caused the distraction. Overall, there were positive reports on the use of communication technology which was found to help in improving pharmaceutical care

In Vitro Antilithiasis Activity of Melastoma malabathricum Linn

Urolithiasis is a painful disease that affects the human population in every part of the world and majority of cases of renal lithiasis have calcium oxalate. The present study was carried out to study effect of M. malabathricum on calcium oxalate crystals in vitro and to determine the relationship between total flavonoid content and anti-crystallization activity of different extract. Four different extract from different parts of M. malabathricum were studied to determine the part with higher activity against calcium oxalate crystallization.The leaf of M. malabathricum demonstrated the highest crystal growth inhibition activity compared to other parts of the plant. The leaf extract was further fractionated by column chromatography. The fractions were studied for total flavonoid content as well as crystal growth inhibition and Spearman correlation showed that there was a good correlation between TFC and antilithiasis activity with the F1 fraction having highest activity. The activity of the F1 fraction was confirmed by calcium oxalate aggregation assay and microscopic examination. The higher content of flavonoids and calcium oxalate antilithiasis activity of the leaves suggest further studies for development of newer effective drugs from this herb. Keywords: M. malabathricum, calcium oxalate, crystallization, lithiasis and total flavonoid content

Adherence to antihypertensive medications in patients attending public hospitals in Kano State, Nigeria

Hypertension is a chronic medical condition characterized by an elevated arterial blood pressure with increasing prevalence in developing countries including Nigeria. One of the integral elements in management of hypertension is adherence to medication and life-style modification. This study aimed to assess adherence level for anti-hypertensive medications among adult hypertensive patients attending public hospitals in Kano State, Nigeria. The study was a cross sectional prospective survey involving 600 patients from six public healthcare facilities selected by multistage sampling technique. Adherence status was assessed using Morisky medication adherence scale. Sociodemographic data and other factors that may influence adherence to hypertension medications were evaluated. Out of the 598 patients that participated in the study, only 178 (29.8%) have their BP controlled based on JNC8. Three hundred and thirty two (55.5%) out of 598 patients have good adherence, while 266 (45.5%) have poor adherence. Of the 178 patients who had good BP control, 120 (67.5%) have good adherence while 58 (32.5%) have poor adherence. BP control was significantly higher in those that adhered to antihypertensive medication compared with non-adhering patients (χ2 = 14.526; df = 1; p-value = < 0.001). Additionally, Chi-square test showed significant association between number of antihypertensives and blood pressure control. (χ2=37.556, df=3, p<0.001). The study established that 55.5% of the respondents have good adherence to their antihypertensive medication while 29.8% had their BP controlled. Adherence and number of antihypertensive medication a patient is taking were found to have significant relationship with BP control. Keywords: Medication, adherence, hypertension, antihypertensiv

Reasons for Integrated Library Systems (ILS) switching in Nigerian University Libraries

This study sought to determine the reasons for switching ILS among Nigerian university libraries. A qualitative research approach using multiple case study design was used to gain a better understanding of the problem; purposive sampling technique was used to select the participants. Interview was the instrument used for data collection, and the researcher conducted five interviews with five (5) participants from university libraries across the geo-political zones of Nigeria. Data were collected from June 2016 through July 2016. The analysis of data was done using themes derived from the objectives of the study. Findings revealed that delay in getting vendors support to fix ILS problems, some ILS have limited storage space to accommodate large data, crashing and data loss, and political considerations, were some of the reasons given by Nigerian  University Libraries for switching ILS. The study, therefore, recommended among others that Nigerian university libraries should conduct adequate and thorough feasibility study based on the peculiar needs of their libraries before selecting the appropriate library software, libraries should adoptand deploy open source ILS which are more cost effective and easier to maintain rather than buying proprietary ILS which were developed based on US and UK standards and which might not fit their needs. The study concluded that the switching over from one ILS to another by NUL studied is too frequent. The frequency of change is associated with lack of proper feasibility study and knowledge involved in determining the implications of frequent switching on the libraries. Keywords: Reasons, Integrated Library Systems (ILS), Switching, Nigerian University Librarie

Choice of delivery positions among multiparous women in Kano

Background: Confining women to hospital bed with limited power of movement and involvement of decision making during labor process and  restricting them to supine position in second stage of labor might contribute significantly to aversion to hospital delivery. Objective: To determine the different delivery positions women take during home delivery. Method: This was a cross sectional survey among 285 multiparous women who had vaginal delivery of life singleton babies. They were interviewed using questionnaire at Murtala Muhammad Specialist hospital Kano on choices of delivery position. Ethical approval was obtained from the ethical committee of the state. Data obtained were analyzed using SPSS Version 19. Qualitative data were summarized using frequencies and percentages. Chi (χ2) test was used for categorical data. A P value of ≤ 0.05 was considered statistically significant. Results: The mean age (±SD) of the respondents was 28.9 ± 7.12 years. Majority of the women that delivered at home assumed the squatting  position for delivery (60%) and were mainly assisted by traditional birth attendants (TBA) (41.3%). Over 50% of those that delivered at home were instructed to take the position they delivered in by their assistants at delivery while those that chose their position by themselves did that because they felt more comfortable in that position (85%). Over 80% of those that were instructed to take a position at delivery did not ask their assistant the reason for advising on that position. There was statistically significant association between educational level and right to decide in which positionto deliver the baby (χ²=28.517, P = 0.000). Conclusion: Squatting position was the most assumed position following home delivery. There was statistically significant association between educational level and right to decide in which position to deliver the baby. Key words: Choices; delivery position; multiparous women; Nigeria; vaginal birth

Comparison of Calculated Percentage Depth Doses at Extended Source-to-Surface Distance for 6 MV And 15 MV Photon Beam of a Linear Accelerator

Background: Research findings from percentage depth dose (PDD) are crucial in evaluating patient doses received in radiation therapy. Objective: To compare calculated percentage depth doses at an extended source-to-surface distance (SSD) for 6 MV and 15 MV photon beams of a linear accelerator. Methodology: Measured PDD values of the 100 cm source to surface distance (SSD) and calculated values at extended SSDs for 6 MV and 15 MV photon beams of an Elekta NHA SLi 1998 linear accelerator were analyzed. The PDD data was collected by placing ionization chamber inside water phantom for depths ranging from z = 0 - 30 cm in a water phantom and using a square field sizes of 10 x 10 cm2. Photon energies of 6 MV and 15 MV were used for the measurement, with both gantry and collimator angles fixed at zero degree. PDD was calculated at extended SSD of 110 cm, 120 cm, 130 cm, and 140 cm from the measured PDD values of 100 cm SSD for both 6 MV and 15 MV photon energies using Mayneord factor. Results:  The depth dose maximum (Dmax) for field size 10 x 10 cm2  for 6 MV and 15 MV photon energies were 1.62 cm and 2.65 cm, respectively and the PDD at 10 cm  (D10) were 67.9% and 75.9%, respectively. The mean deviation of the calculated PDD at extended SSDs was found to be between 0.2% and 1%. Conclusion: The calculated PDD values at extended SSDs are considered suitable for clinical use at all clinically relevant depths and field sizes. &nbsp

PREDICTION OF SOIL BEARING CAPACITY USING SOFT COMPUTING TECHNIQUES

The nature and manner in which structures are collapsing in Nigeria are alarming. It creates a room in which structural engineers, the building industry, government, estate developers, building consultants and other relevant stakeholders in the department building industry ask many questions about how and what is behind the sudden collapse of structures. Therefore, this research aimed to predict the ultimate bearing capacity of the square, strip and circular footing from shearing strength parameters using ANN and ANFIS. This paper, 200 data sets were used to develop the model; 75% were used for training and 25% for testing the model. ANN and ANFIS learning algorithms were employed in developing the models under various foundation types. Eventually, Various error measures, such as coefficient of determination (R2), root mean square error (RMSE), mean absolute error (MAE), and correlation coefficient (R), were employed to compare the efficiency of the models. The performance comparison findings indicated that the soft-computing system is an efficient instrument for risk reduction in soil engineering projects. The models were validated using external data and the correlation prediction capacity of the models where ANN-STRIP (89%), ANN-SQUARE (83%), ANN-CIRCULAR (89%), ANFIS-STRIP (86%), ANFIS-SQUARE (79%) and ANFIS-CIRCULAR (96%). All the models have shown a quite good and reliable prediction capacity, with ANFIS-CIRCULAR having 96% prediction accuracy of soil bearing capacity