<p>This study determined the affordability of medicines for diabetic patients attending the diabetic clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu. The Study was a cross-sectional time-delimited, descriptive study of affordability of Medicines for diabetic patients aged &gt / 18 years and who pay for medicines out of pocket. A structured questionnaire was used to collect sociodemographic information about patients and the prescription was assessed in terms of conformity with essential medicines list (EML), cost and ability to be completely filled by the patient. Data was analysed using EPI Info software.the results show that medicines prescribed for diabetes are unaffordable to the majority of patients who attend the UNTH diabetic clinic.</p>

<p>This study determined the affordability of medicines for diabetic patients attending the diabetic clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu. The Study was a cross-sectional time-delimited, descriptive study of affordability of Medicines for diabetic patients aged &gt / 18 years and who pay for medicines out of pocket. A structured questionnaire was used to collect sociodemographic information about patients and the prescription was assessed in terms of conformity with essential medicines list (EML), cost and ability to be completely filled by the patient. Data was analysed using EPI Info software.the results show that medicines prescribed for diabetes are unaffordable to the majority of patients who attend the UNTH diabetic clinic.</p>

Magister Public Health - MPH / This study determined the affordability of medicines for diabetic patients attending the diabetic clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu. The Study was a cross-sectional time-delimited, descriptive study of affordability of Medicines for diabetic patients aged >18 year s 18 years and who pay for medicines out of pocket. A structured questionnaire was used to collect sociodemographic information about patients and the prescription was assessed in terms of conformity with essential medicines list (EML), cost and ability to be completely filled by the patient. Data was analysed using EPI Info software.the results show that medicines prescribed for diabetes are unaffordable to the majority of patients who attend the UNTH diabetic clinic. / South Africa

Magister Legum - LLM

Introduction: Medication use by women of childbearing age is common. During pregnancy, medications should be used cautiously because some are teratogenic and/or feto-toxic, especially during the first trimester. Few studies have assessed exposure to contraindicated medications in developing countries. Aims and objectives: The overall aim was to assess the risk of exposure to contra-indicated medicines in early pregnancy (less than 13 weeks gestation) in Malawi. Specific objectives were to (i) determine the proportion of women inadvertently prescribed contraindicated medicines in the first trimester of pregnancy in a general outpatient clinic; (ii) explore women's beliefs, views and practices concerning medication use during pregnancy; (iii) determine the prevalence of congenital abnormalities by review of records at community and central hospital sites; (iv) to make appropriate recommendations for policy and practice in Malawi relating to medication use in pregnancy. Methods: A mixed methods approach was used. Survey data were collected at an outpatient clinic at Mitundu Community Hospital (MCH) between 1st February 2010 and 30th July 2010 to determine the range of medicines taken by potentially pregnant women. A pregnancy test established the pregnancy rate in this group. These data were summarised using descriptive and inferential statistics, and the proportions of exposed women who were pregnant were estimated. To understand women's beliefs, views and practices, semi-structured interviews were held with 21 pregnant women at their first visit to an antenatal clinic at MCH. The main themes were identified by Framework analysis. Retrospective data were abstracted from birth registers at MCH and Kamuzu Central Hospital (KCH) to estimate the prevalence of congenital abnormalities. Results: Of 1103 women prescribed contraindicated medicines in the outpatient clinic, 272 were potentially pregnant. Of the 63 (23.2%) confirmed pregnant (95% CI 18.3%-28.6%), 20 knew or thought they were pregnant, 22 were not sure and 21 did not think they were pregnant. Only 153 (55.9%) were asked about pregnancy by a medical officer before prescription. 3.2% of all pregnant women (95% CI 2.5%-4.1%) attending the clinic were estimated to have been prescribed contraindicated medicines. Eight pregnant women also self-prescribed unsuitable modern medications. Women accepted as safe any medications prescribed in the clinic. They also accepted potions given by traditional birth attendants to counter witchcraft, which they believed caused pregnancy loss. They did not associate use of these medicines with congenital abnormalities, the prevalence of which (6.58/1000 births at MCH, 14.55/1000 births at KCH) was similar to international figures. Conclusion: The study highlights areas of concern for practice, policy and research relevant to maternal health care in Malawi. Clinicians need to reduce the rate of exposure to potentially harmful medicines by paying attention to the possibility of pregnancy in women of childbearing age. There is also a need to facilitate public awareness especially among women about dangers of taking medicines.

Asthma is considered one of the most common respiratory complaints in the world today but a medical cure for this condition is currently not available. The use of herbal medicines to treat asthma has however been reported and Euphorbia hirtais one such herb. The alkaloids, flavonoids, glycosides, sterols, tannins and triterpenoids in E. hirta appear to exert the anti-asthma effects reported. In the first part of this study, the aqueous, acetone, dichloromethane and hexane extracts of E. hirta were evaluated for their effects on the lysosomal membrane integrity, cell viability and cell number of MRC-5 cell-line using the NR/MTT/CV assay. Hydrocortisone was used as a pharmaceutical control. The differences between the effects of the different extracts were investigated and the effects of the extracts were compared with hydrocortisone. Results obtained showed that hydrocortisone was relatively toxic to the MRC-5 cells whereas all four extracts studied showed very limited cytotoxic effects, with the aqueous extracts generally exhibiting the least effects. In the second part of this study, the effects of the aqueous E. hirta extract on the blood coagulation system and general airway wall microstructure and ultrastructure were investigated using the BALB/c mouse asthma model. Hydrocortisone was also used as a pharmaceutical control. Parameters studied included inflammatory cell population in peripheral blood and their migration into the lung parenchyma; platelet aggregation and fibrin fibre morphology; fibroblast and mucous cell proliferation; alveolar cell numbers, lamellar body formation as well as filopodia formation. The animal weights were continuously being monitored throughout the study. Results from the animal studies showed that the aqueous extract of E. hirta had limited effects on changes in the animal weights and did not cause fragility of blood fibrin fibres nor change the integrity and morphology of the platelets in the mice as seen in those treated with hydrocortisone. E. hirta extracts also significantly reduced the number of active inflammatory cells (especially neutrophils, eosinophils and basophils); restored the histological alterations observed in respiratory structures studied and had diverse, dose-dependent beneficial ultrastructural effects like reduction of smooth muscle hypertrophy, inhibition of macrophages into the airway parenchyma, among others. The final judgment and conclusion of this study was that the aqueous E. hirta extract did not show cytotoxic effects and could be used for the treatment of asthma in the BALB/c mice at doses ranging 25-62.5mg/kg. Further research leading to clinical trials is recommended after testing the potency of equivalent doses of this extract in other animal asthma models. / Thesis (PhD)--University of Pretoria, 2008. / Anatomy / PhD / Unrestricted

Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare but potentially life-threatening condition with high mortality. Diagnosis is challenging due to variable clinical presentation and a protracted latency period following initiation of the offending drug. DRESS is a complex interplay that starts by introduction of the offending drug, reactivation of viruses and activation of the immune system. Herpes virus reactivation is considered a diagnostic marker and indicator of illness severity. Prompt recognition and the removal of offending agent remain the key to successful treatment. In cases of severe organ involvement, corticosteroids, immunoglobulins, antiviral and specialist consultation may be helpful. Here we present a case of a 36-year-old African-American male who presented with symptoms mimicking sepsis with an associated skin eruption that was diagnosed as DRESS.

no / This paper reports 35 medicinal plants belonging to 25 families used in the treatment of malaria by the people inhabiting the forests located near to Bhubaneswar, the capital city of Orissa, a south-eastern state in India. The methods adopted for the preparation of plant parts are discussed along with their family and local name(s). The majority of the herbal preparations were made in the form of juices or by using water as the medium in the form of decoctions or infusions. Various plant parts, such as leaves, flowers, fruits, barks, stems, roots, and in some cases the whole plants are used to prepare these remedies each of which contains a single species.

Yes / Educational interventions by pharmacists for patients with cancer pain aim to improve pain management, but little is known about the different components of interventions and their effectiveness. Our aim was to assess the benefit of pharmacist delivered educational interventions for patients with cancer pain. A systematic review and meta‐analysis of experimental trials testing pharmacist delivered educational interventions for cancer pain was carried out to identify the components of interventions and effectiveness at improving pain‐related outcomes for patients with cancer. A literature review was conducted in EMBASE, MEDLINE, CINAHL, PsycINFO, ASSIA, Web of Science and CENTRAL from inception until January 2018 searching for educational interventions involving a pharmacist for patients with cancer pain. Four studies were included involving 944 patients. Meta‐analysis was carried out where possible. Meta‐analysis of three of the four studies found that mean pain intensity in the intervention group was reduced by 0.76 on a 0–10 scale (95% confidence interval), although only two of the studies used validated measures of pain. Improvements in knowledge, side effects and patient satisfaction were seen although with less reliable measures. Pharmacist educational interventions for patients with cancer pain have been found to show promise in reducing pain intensity. Studies were few and of varying quality. Further, good quality studies should be carried out in this area and these should be comprehensively reported. Trials measuring patient self‐efficacy and patient satisfaction are needed before the impact of the pharmacist delivered interventions on these outcomes can be established.

Yes / Abstract: Background: Medicines are often suboptimally managed for heart failure patients across the transition from hospital to home, potentially leading to poor patient outcomes. The Improving the Safety and Continuity Of Medicines management at Transitions of care programme included: understanding the problems faced by patients and healthcare professionals; developing and co-designing the Medicines at Transitions of care Intervention (MaTI); a cluster randomized controlled trial testing the effectiveness of a complex behavioural MaTI aimed at improving medicines management at the interface between hospitals discharge and community care for patients with heart failure; and a process evaluation. The MaTI included a patient-held My Medicines Toolkit; enhanced communication between the hospital and the patient's community pharmacist and increased engagement of the community pharmacist postdischarge. This paper reports on the patients' experiences of the MaTI and its implementation from the process evaluation. Design: Twenty one-to-one semi-structured patient interviews from six intervention sites were conducted between November 2018 and January 2020. Data were analysed using the Framework method, involving patients as co-analysts. Interview data were triangulated with routine trial data, the Consolidated Framework for Implementation Research and a logic model. Results: Within the hospital setting patients engaged with the toolkit according to whether staff raised awareness of the My Medicines Toolkit's importance and the time and place of its introduction. Patients' engagement with community pharmacy depended on their awareness of the community pharmacist's role, support sources and perceptions of involvement in medicines management. The toolkit's impact on patients' medicines management at home included reassurance during gaps in care, increased knowledge of medicines, enhanced ability to monitor health and seek support and supporting sharing medicines management between formal and informal care networks. Conclusion: Many patients perceived that the MaTI offered them support in their medicines management when transitioning from hospital into the community. Importantly, it can be incorporated into and built upon patients' lived experiences of heart failure. Key to its successful implementation is the quality of engagement of healthcare professionals in introducing the intervention. Patient or Public Contribution: Patients were involved in the study design, as qualitative data co-analysts and as co-authors. / Programme Grants for Applied Research. Grant Number: RP-PG-0514-20009