https://cyberleninka.org/article/n/195435.pdf

Hibiscus sabdariffa L. - A phytochemical and pharmacological review

Single-dose activated charcoal therapy involves the oral administration or instillation by nasogastric tube of an aqueous preparation of activated charcoal after the ingestion of a poison. Volunteer studies demonstrate that the effectiveness of activated charcoal decreases with time. Data using at least 50 g of activated charcoal, showed a mean reduction in absorption of 47.3%, 40.07%, 16.5% and 21.13%, when activated charcoal was administered at 30 minutes, 60 minutes, 120 minutes and 180 minutes, respectively, after dosing. There are no satisfactorily designed clinical studies assessing benefit from single-dose activated charcoal to guide the use of this therapy. Single-dose activated charcoal should not be administered routinely in the management of poisoned patients. Based on volunteer studies, the administration of activated charcoal may be considered if a patient has ingested a potentially toxic amount of a poison (which is known to be adsorbed to charcoal) up to one hour previously. Although volunteer studies demonstrate that the reduction of drug absorption decreases to values of questionable clinical importance when charcoal is administered at times greater than one hour, the potential for benefit after one hour cannot be excluded. There is no evidence that the administration of activated charcoal improves clinical outcome. Unless a patient has an intact or protected airway, the administration of charcoal is contraindicated. A review of the literature since the preparation of the 1997 Single-dose Activated Charcoal Position Statement revealed no new evidence that would require a revision of the conclusions of the Statement.

Position Paper: Single-Dose Activated Charcoal

Inadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. Thirty eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.

/pdf/hypertension-awareness-treatment-and-control-in-africa-a-4l06ps6liq.pdf

Hypertension awareness, treatment and control in Africa: a systematic review

To review studies on hypertension in Nigeria over the past five decades in terms of prevalence, awareness and treatment and complications. Following our search on Pubmed, African Journals Online and the World Health Organization Global cardiovascular infobase, 1060 related references were identified out of which 43 were found to be relevant for this review. The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population, type of measurement and cut-off value used for defining hypertension. The prevalence is similar in men and women (7.9%-50.2% vs 3.5%-68.8%, respectively) and in the urban (8.1%-42.0%) and rural setting (13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5% (2000-2011). Awareness, treatment and control of hypertension were generally low with attendant high burden of hypertension related complications. In order to improve outcomes of cardiovascular disease in Africans, public health education to improve awareness of hypertension is required. Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.

https://www.hedu-africa.org/uploads/files/Blood_pressure,_prevalence_of_hypertension_and_hypertension.pdf

Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review.

https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1208&context=eastafrica_fhs_sonam

Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Hypertension is a major public health problem. Due to paucity of data, the burden of hypertension in Nigeria might be underestimated. Estimating the prevalence of hypertension in populations of Nigeria would be useful in efforts to control hypertension and prevent its consequences. This survey aimed to assess the prevalence, detection, treatment and control of hypertension in Nsukka, a city located in South-Eastern Nigeria. Hypertension prevalence, awareness, treatment, and control (outcomes) were examined in 756 adult participants (364 men and 392 women) aged 18 years and above. Blood pressure (BP) of the participants was measured and they also answered a detailed questionnaire. Hypertension was defined as BP ≥ 140 for systolic BP and or ≥ 90 mm Hg for diastolic BP or being on antihypertensive therapy. Prevalence of hypertension was 21.1%. Men had higher prevalence of high BP compared to women. Systolic and diastolic BP increased with age in both men and women. Detection of high BP in participants with raised blood pressure was 40.3% and 24.7% for males and females respectively. Only 23.7% and 17.5% of males and females respectively with high BP were on antihypertensive treatment while 5.0% of males and 17.5% of females with hypertension were controlled. Prevalence of hypertension was comparable with other studies in Nigeria and Africa. The results showed a poor detection, treatment and control of hypertension. This underscores the need for comprehensive evaluation of the prevalence of hypertension and other cardiovascular diseases in Nigeria.

/pdf/prevalence-awareness-treatment-and-control-of-hypertension-2734gt8y6u.pdf

Prevalence, awareness, treatment and control of hypertension in a nigerian population

*Objective: The purpose of this study was to describe the attitude of University of Nigeria pharmacy students towards pharmaceutical care. Method: A survey of pharmacy students in their second to fifth year was conducted. A modified 13item standard Pharmaceutical Care Attitudes Survey (PCAS) was used for the study. Reliability and factorial validity of the modified instrument were assessed. Results: Modification of the instrument did not alter its validity. Students of the University of Nigeria had a positive attitude towards pharmaceutical care as attitude score of all the items were above the midpoint score of 2.5. The mean scale score of second and third year students were significantly lower than that of the fifth year’s (Oneway ANOVA, p<0.001). Females had a higher positive attitude score compared to male students (Students t-test, p=0.005). There was no significant difference in the mean scale score among those that had work experience and those without work experience. Marital status did not influence attitude score. Conclusion: University of Nigeria pharmacy students had a positive attitude towards pharmaceutical care. However, it is necessary to provide sites were students could acquire practice experience and these sites should be designed to enable students observe the integration of pharmaceutical care activities into pharmacy practice.

/pdf/assessment-of-attitudes-of-university-of-nigeria-pharmacy-2i50vchk8h.pdf

Assessment of attitudes of University of Nigeria pharmacy students toward pharmaceutical care

Perception, usage and knowledge of herbal medicines by students and academic staff of University of Nigeria: A survey

Many drugs are available for control of hypertension and its sequels in Nigeria but some are not affordable for majority of the populace. This serious pharmacoeconomic question has to be answered by the nation’s health economists. The objective of this study was to evaluate the cost-effectiveness of drugs from 4 classes of antihypertensive medications commonly used in Nigeria in management of hypertension without compelling indication to use a particular antihypertensive drug. The study employed decision analytic modeling. Interventions were obtained from a meta-analysis. The Markov process model calculated clinical outcomes and costs during a life cycle of 30 years of 1000 hypertensive patients stratified by 3 cardiovascular risk groups, under the alternative intervention scenarios. Quality adjusted life year (QALY) was used to quantify clinical outcome. The average cost of treatment for the 1000 patient was tracked over the Markov cycle model of the alternative interventions and results were presented in 2010 US Dollars. Probabilistic cost-effectiveness analysis was performed using Monte Carlo simulation, and results presented as cost-effectiveness acceptability frontiers. Expected value of perfect information (EVPI) and expected value of parameter perfect information (EVPPI) analyses were also conducted for the hypothetical population. Thiazide diuretic was the most cost-effective option across the 3 cardiovascular risk groups. Calcium channel blocker was the second best for Moderate risk and high risk with a willingness to pay of at least 2000$/QALY. The result was robust since it was insensitive to the parameters alteration. The result of this study showed that thiazide diuretic followed by calcium channel blocker could be a feasible strategy in order to ensure that patients in Nigeria with hypertension are better controlled.

/pdf/cost-utility-analysis-of-antihypertensive-medications-in-zswucrzr62.pdf

Cost-utility analysis of antihypertensive medications in Nigeria: a decision analysis.

A comparative in vitro dissolution efficiencies (DE) of six commercial brands of ciprofloxacin tablets were evaluated in acetic acid and phosphate buffer (pH 7.4) and results obtained were used in ranking of their probable in vivo bioavailability. The dissolution efficiencies (DE) of the six brands varied widely in the two media. This was attributed to differences in solubility of the drug in the two media. The dissolution efficiencies of five out of the six brands (Citrovenot, Ciproxin, Cipoxin, Ciproflox, and Quflox), in 0.1 N acetic acid fell within 60-75% at 30 minutes, and therefore, could be considered bioequivalent. The dissolution efficiency of a brand, Cipro, fell below 40% in the same medium and at the same sampling time and it was considered to be most likely less bioavailable in vivo. There was absence of correlation between the hardness and disintegration time of the brands with their dissolution efficiencies.

PO Udeogaranya

Papers

Prevalence, awareness, treatment and control of hypertension in a nigerian population

Assessment of attitudes of University of Nigeria pharmacy students toward pharmaceutical care

Perception, usage and knowledge of herbal medicines by students and academic staff of University of Nigeria: A survey

Cost-utility analysis of antihypertensive medications in Nigeria: a decision analysis.

Prediction of in vivo bioavailability of six brands of ciprofloxacin film coated tablets using the concept dissolution efficiency (DE).