EVALUATION OF DRUG THERAPY PROBLEMS IN ASTHMA PATIENTS RECEIVING CARE IN TWO HOSPITALS IN SOUTH-EASTERN NIGERIA

Objective: To evaluate drug therapy problems in asthma patients visiting a secondary and tertiary hospital in South-Eastern Nigeria.Methods: This study was a retrospective, cross-sectional analyses of the medical records of adult asthmatic patients receiving care in two hospitals in Enugu State, within a 15-year period. The Pharmaceutical Network Care Europe (PCNE) tool version 6.2 was used to assess drug therapy problems. The IBM Statistical Product for Services Solution (SPSS) version 20.0 was used for analysis. For all results, P ≤ 0.05 was considered statistically significant.Results: Majority of the patients were below 60 y old (81.2%); female (68.8%) and were on more than two drugs (95.3%). Majority of the identified drug therapy problems (DTPs) were adverse reactions (65.7%). The inappropriate drug combination was the major cause of DTPs (65.6%). Only about 23.4% of the intervention outcomes were known. University of Nigeria Teaching Hospital (UNTH) had more interventions (35.9%) than Medical Centre (8.0%) (χ2 = 6.323; df = 1; **P = 0.012); and more of the outcomes of their interventions known (38.5%) compared to Medical Centre (0.0%) (χ2 = 12.559; df = 1; **P ˂ 0.001).Conclusion: Adverse reactions and inappropriate drug selection were the major identified DTPs and major cause of DTPs, respectively. Most DTPs had no interventions. The documented interventions included stopping of the drugs, change of drugs or dosage, change of instructions for use and starting of new drugs. Most interventions had unknown outcomes. UNTH had more interventions with known outcomes than the University of Nigeria Medical Centre

Tide-generated Sedimentary Structures, Lithofacies and Particle Size Distribution: Proxies to the depositional setting of the Ajali Sandstone in the Anambra Basin, Southeastern Nigeria.

Herringbone cross stratification, mud draped foresets, reactivation surfaces, tidal bundles, flaser beddings, ripple and horizontal laminations were identified on the Ajali Sandstone studied. The biogenic structures occur as dominantly vertical to sub-vertical and u -tubed burrows of the Skolithos ichnofacies commonly Skolithos verticalis and Ophiomorpha nodosa. Occasional Thalassinoides and Teichichnus isp burrows of the Cruziana Ichnofacies also occur. Three lithofacies were identified and these include; the medium to coarse grained cross bedded sandstone lithofacies, Fine grained cross bedded sandstone lithofacies and the mudstone lithofacies. The paleocurrent pattern from cross bed azimuths shows a bimodal – bipolar pattern indicative of tidal process. The grain size frequency histograms indicate both unimodal and bimodal asymmetrical patterns with shifting modes. The cumulative frequency curves suggest traction, saltation and suspension as the mechanisms of the sediment transport. The bivariate plots of the discriminant functions (Y1, Y2 and Y3) for the sands suggest deposition in a shallow agitated marine environment. Intertidal to subtidal shallow marine depositional setting is proposed for the Ajali Sandstone. Key word: Tide, Sedimentary structures, Particle size, Lithofacies, Subtidal, Depositional settin

Exploring the evidence base for national and regional policy interventions to combat resistance

The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains—responsible use, surveillance, and infection prevention and control—and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions

Amelioration of high levels of serum kidney function biomarkers by Vernonia amygdalina in monosodium glutamate induced rats

Monosodium Glutamate (MSG), as a food seasoning agent, even at low doses, has been found to exert exceeding toxic effect on the body system when used for a prolonged time. This study was aimed at investigating the effect of varying doses of Vernonia amygdalina stem extract on MSG-induced alteration of some kidney function parameters in rats. Twenty (20) adult male Albino rats (weighing 90-180 g), divided into five groups of four rats each, were used for the study. Some kidney function parameters and histological examination of kidney tissues were determined according to standard methods. The mineral and vitamin contents of V. amygdalina stem were also determined. In rats administered with MSG (8 mg/kg), there were significant (P <0.05) increases in the serum urea and creatinine but decreased albumin concentrations compared to rats administered with normal saline. MSG co-administration with extract (400 mg/kg) significantly decreased serum urea and creatinine concentrations. Minerals such as zinc, sodium and iron and vitamins A, C and E were found to be present in the stem extract. Histological examination of the kidney tissues of MSG-administered groups showed signs of toxicity but were much lesser in MSG co-treatment with the extract. These findings suggest that V. amygdalina ameliorated MSG-induced toxicity on the kidney functionality and this could be attributed to the presence of the antioxidant vitamins and some minerals as well as other bio-compounds present in the plant’s stem extract

Hepatitis C Virus infection in apparentenly healthy individuals with family history of diabetes in Vom, Plateau State Nigeria

Hepatitis C virus (HCV) infection is an important public health problem worldwide. Its association with, and predisposing nature for diabetes mellitus (DM) has been long established. This research was carried out to determine the prevalence of Hepatitis C virus (HCV) amongst people with possible genetic predisposition to diabetes mellitus living in and around Vom, Plateau State, Nigeria. 188 subjects were screened after they filled a structured questionnaire to determine some of their demographic data, social habits and possible risk factors. 5 ml of blood was collected from each subject and sera separated out. Biotech's third generation ELISA Kit for HCV antibodies was used for the screening. Liver enzyme analysis was carried out on positive samples to determine their disease status. A prevalence of 14.36% was recorded with the highest seropositive group being those in the age bracket of 18 – 37 years. 13(13.40%) of males and 14(15.38%) of females were sero-positive. Liver enzyme analysis of sero-positive subjects showed increased levels which may imply early onset of liver damage. These result showed that these individuals could later suffer diabetes which may be triggered by their HCV infection if not treated. This is not over-looking the economic significance of their ill health, assuming they progress to cirrhotic HCV or develop hepatocelluar carcinoma due to HCV chronicity

Changing use of surgical antibiotic prophylaxis in Thika Hospital, Kenya: a quality improvement intervention with an interrupted time series design.

INTRODUCTION: In low-income countries, Surgical Site Infection (SSI) is a common form of hospital-acquired infection. Antibiotic prophylaxis is an effective method of preventing these infections, if given immediately before the start of surgery. Although several studies in Africa have compared pre-operative versus post-operative prophylaxis, there are no studies describing the implementation of policies to improve prescribing of surgical antibiotic prophylaxis in African hospitals. METHODS: We conducted SSI surveillance at a typical Government hospital in Kenya over a 16 month period between August 2010 and December 2011, using standard definitions of SSI and the extent of contamination of surgical wounds. As an intervention, we developed a hospital policy that advised pre-operative antibiotic prophylaxis and discouraged extended post-operative antibiotics use. We measured process, outcome and balancing effects of this intervention in using an interrupted time series design. RESULTS: From a starting point of near-exclusive post-operative antibiotic use, after policy introduction in February 2011 there was rapid adoption of the use of pre-operative antibiotic prophylaxis (60% of operations at 1 week; 98% at 6 weeks) and a substantial decrease in the use of post-operative antibiotics (40% of operations at 1 week; 10% at 6 weeks) in Clean and Clean-Contaminated surgery. There was no immediate step-change in risk of SSI, but overall, there appeared to be a moderate reduction in the risk of superficial SSI across all levels of wound contamination. There were marked reductions in the costs associated with antibiotic use, the number of intravenous injections performed and nursing time spent administering these. CONCLUSION: Implementation of a locally developed policy regarding surgical antibiotic prophylaxis is an achievable quality improvement target for hospitals in low-income countries, and can lead to substantial benefits for individual patients and the institution

Prediction of Self-Concept and Anxiety on the Tendency of Postgraduate Students with Learning Disabilities (LD) to Acquire Research Skills in Two Public Universities of Cross River State, Nigeria: Implications for Counseling

Background: Acquisition of research skills provide the forum for incorporating Nigerian graduate students with disabilities and university lecturers into the international scientific culture and the developing knowledge economy. Aim: This study investigated the prediction of self-concept and anxiety on the tendency of postgraduate students with Learning Disabilities (LD) to acquire research skills in two Public Universities of Cross River State, Nigeria: Implications for counseling. Two objectives of the study were stated to guide the study and to achieve the purpose of the study. Two research questions were formulated, which were converted to two statements of hypotheses. A literature review was carried out based on the variables under study. Method: The survey research design was considered most suitable for the study. A stratified random sampling technique was adopted in selecting the 49 respondents sampled for the study. A validated 20 items four-point modified Likert scale questionnaire was the instrument used for data collection. The face and content validity of the instrument was established by experts in Test and Measurement. The reliability estimates of 0.81 of the instruments were established using the Cronbach Alpha method. A simple Linear regression statistical tool was used to test the hypotheses formulated for the study. The hypotheses were tested at a 0.05 level of significance. Results: The results obtained from the data analysis revealed a significant prediction of self-concept and anxiety on the tendency of postgraduate students with Learning Disabilities (LD) to acquire research skills in the study area. Conclusion: Based on the findings of the study, it was therefore recommended, among others, that internal seminars and workshops should be organized by Graduate schools every quarter of the year, where each postgraduate student delivers a standard paper, and this should be made compulsory. This will encourage sharing knowledge and increase skills and zeal for using knowledge and more research publications