1 has a longer half-life than the dinitrate salt
2 has poor bioavailability after oral administration
3 is used in hypertension
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Synonymous with its political meaning, which is protection from being judged or condemned by the law, immunity in medical terms is a way defence system that averts diseases. In any condition where our immune system fails or is dysfunctional, even the most ordinary activity, such as of brushing our teeth would introduce enough bacteria that would kill us.
The immune system can be compared to a group of soldiers dedicated to protecting the host (the human body) against invaders (bacteria and viruses) to maintain a balance (healthy living). Over time, this can become burdensome on these soldiers and cause their efficiency to weaken.

White blood cells in the body are responsible for providing this defence, as about between 4000 – 11000 cells is the normal value to maintain to ensure an optimum immune function.
Diseases can be cured using drugs, surgery, radiation, physiotherapy and quite a few others, but good health can only be achieved by maintaining a properly functional immune system. The aging process is known to be slowed down immensely in those with healthy immunity. A weakened immunity is an easy access to all sorts of illnesses. Some trigger signs that show this include:
Fatigue
Repeated infections
Inflammations
Allergic reactions
Slow wound healing
Chronic diarrhoea
Boosting the immune system
The immune system can only perform as it should, if cared for properly. This means getting all the right nutrients in recommended proportions (balanced diet) and providing the right environment for it to thrive. For example, exposure to toxic chemicals, household cleaners, pesticides and herbicides, or radiation greatly affects one’s immunity. Stress also affects immunity by producing more free radicals that cause harm.
Remedies for an improved immunity include:
Probiotics; Cultured organisms to increase the number of good bacteria in the digestive tract, including Sacchromyces bordadii, Lactobacillus acidophilus.
Vitamins – C, D and E.
Herbal supplements, such as Garlic, Echinacea, Astraguls and Kelp.
Mushroom extracts, such as Maitake extract, Reishi extract and Shitake extract.
Enzymes – CoQ10.
Minerals – Zinc + Copper, and Selenium.
Amino Acids – L-Arginine, L-Ornithine, L-methionine.
Cordyceps and Mushrooms.
Avoiding immunity killers
Stress, unhealthy diet and poor living conditions are the major contributors to a weakened immune system, to avert this, note the following:
Begin a diet of fresh fruits and vegetables (eat the rainbow).
Avoid processed animal food; also avoid sugar.
Follow through with a regular fasting regime to periodically get rid of toxins.
Get sufficient sleep (at least six hours daily).
Avoid overeating, practice portion control.
Do not smoke or consume alcohol or caffeine.
Go to your nearest registered pharmacy to get products and tips on ways to boost your immunity.
By Pharm. Ayodeji Oni
(Freelancing for Advantage Health Africa)
The 2018 edition of World Pharmacists Day, with the theme, “Pharmacists: Your Medicine Experts”, has once again highlighted the increasing need for pharmacists in Nigeria to be given the opportunity to make valuable contributions to optimum medicine management to improve patients’ care and healthcare delivery, as it is the trend globally.
Although the World Pharmacists Day was first celebrated in 2009, the annual event, which is marked every 25 September, has now become a veritable means of highlighting pharmacists’ expanding role in improving patients’care globally.

However, while the rest of the world seems to have begun to embrace the annual message of the World Pharmacists’ Day by giving pharmacists more responsibilities in medicine management, the case with Nigeria remains worrying, as pharmacists in the country are significantly restricted by the practice environment and failure of government to implement necessary polices that will make their impacts fully felt by the citizenry.
It is our view that safe, effective and rational use of medicines is a fundamental part of healthcare delivery and, in fact, without medicine, there can be no healthcare. Therefore, having pharmacists who are medicine experts as esteemed members of the healthcare team and utilising their skills and knowledge to get better healthcare outcomes for patients must form a key part of our healthcare policies, programmes and operations.
Apparently, a major reason this idea has not taken root in Nigeria can be traced to the perennial inter-professional rivalry in the health sector and the unfounded fear that pharmacists want to subvert the work of other healthcare professionals. This wrong notion should be discarded, as the multidisciplinary nature of healthcare now requires all health professionals to work together, deploying their knowledge and expertise to serve the patient.
To this end, there is an urgent need for more enlightenment of both the general public and all healthcare professionals on the global trend of healthcare and how pharmacists are helping patients and other members of the healthcare team to ensure that the right medicine is provided, in the most suitable formulation, at the right dose, and used in the right way. This laudable objective should not be sacrificed on the altar of petty rivalry, as the ultimate losers will be the patient and the healthcare system.
The Nigerian government must therefore be bold enough to approve the consultancy cadre for pharmacists, as it is the norm in other developed climes, to ensure that pharmacists, especially in hospitals, are professionally covered to make vital contributions to improve the outcomes of medicine management in the nation’s healthcare system.
This nation cannot continue to pay lip service to global best practice, especially when such practice is helping other nations to provide better care for patients. Nigeria must embrace pharmacists as medicine experts and encourage them to deploy their proficiencies as healthcare practitioners to move our healthcare delivery to the next level.
When this is done, citizens will learn to perceive and handle medicines more wisely, safely and effectively. This, ultimately, will help in combating the menace of drug abuse and misuse currently bedevilling the country.
There is need for diligence in your business or profession. God has promised to prosper and bless the work of your hands. But the business can suffer or even collapse for various reasons. Therefore, there must be continuous analysis of whatever business you do and projection of future possibilities.
Today, business and employment opportunities can change quickly and drastically. Businesses and jobs are usually lost as a result of consumer trends, stealing and fraud, economic depression, neglect and slothfulness, new technology, natural disasters and death of the owners, in particular.

God expects wisdom and diligence to be applied in our businesses. “Not slothful in business; fervent in spirit, serving the Lord” (Romans 12:11). Slothfulness is a sinful nature of man. Some successful businessmen have rested on their oars and watched their flourishing businesses decline and phase out. Are you operating your business to be better than the previous year?
“I went by the field of the slothful, and by the vineyard of the man void of understanding; and, lo, it was all grown over with thorns, and nestles had covered the face thereof, and the stone wall thereof was broken down. Then I saw, and considered it well: I looked upon it, and received instruction. Yet a little sleep, a little slumber, a little folding of the hands to sleep: So shall thy poverty come as one that travelleth; and thy want as an armed man” (Proverbs 24:30-34).
You are commanded to be diligent to know the state of your flocks, and look well to your herds (Proverbs 27:23). Knowing the condition of the flocks and herds directly applies to those in animal husbandry. Those who do the business of animals are expected to know those with diseases, as well as checking any losses from theft, wild animals or even death. They should provide adequate grazing areas and water and ensure the hired shepherds are committed to taking care of the animals.
Indolent shepherds may lose their jobs while the hardworking ones will be encouraged and rewarded. Herdsmen in Nigeria are notorious for consistently killing fellow humans and destroying their property and farmlands, ostensibly to acquire grazing fields for their animals. To them the lives of their animals are more valuable than those of people. Of course, this is not the type of diligence commanded by God, who created man in His own image.
You must know the condition of your business – your stock (liquid and solid) or fixed assets, banking and interest rates, human capital, machines and equipment, clients, consumers, competitors, impact of technology and Internet, changing lifestyles and fashions, government taxes and regulations, seasonal variations affecting demands and so on.
Do you know that the location of a business is a major factor to certain types of businesses? You need to know the present threats to your prosperity. Careful consideration of the statistics and information will enable you project into the future to manage growth and challenges. This is strategic planning.
As a worker, you will need further training to be up to date. Are you making deliberate efforts to make yourself more valuable and marketable? Can your employer do without your services? Are your present skills still in demand or do you need to sharpen them? How do you see yourself in the next five to ten years? You must continually check yourself to ensure you remain relevant and productive and, if possible, indispensable.
Diligence in business implies asking probing questions to intelligently forecast its future. What are its strengths, weaknesses, opportunities and threats? No person, even your business consultants, can tell you exactly what will happen in the future; but it is desirable to face the future with courage and hope and then trust the only One Who controls the future. He has the future in His hands and declares the end from the beginning (Isaiah 46:10a).
Therefore, make your plans for the future and commit them to the Lord. “Commit your works unto the Lord, and thy thoughts shall be established” (Proverbs 16:3). Without Him all the efforts to build your business may be in vain. “Except the Lord build the house, they labour in vain that build it: except the Lord keep a city, the watchmen waketh but in vain” (Psalm 127:1).
Do not overwork yourself and ruin your health. Rest, sleep and enjoy your life. “It is vain for you to rise up early, to sit up late, to eat the bread of sorrows: for so He giveth his beloved sleep” (Psalm 127:2).
In recent years, the fight against malaria has become much easier for primary healthcare providers in developing countries – unlike the days of old when lack of adequate diagnostic equipment (mainly due to financial constraints) was an agonising challenge. And you don’t need to look too far to know what has changed. It’s all in the Urine Malaria Test (UMT) kit, the ground-breaking device developed by Dr Eddy Agbo.
Agbo is a Nigerian-born biomedical scientist and the founder of Fyodor Biotechnologies, based in USA. His revolutionary medical device, which can be used to test if a patient has malaria within 25 minutes, has attracted both local and international attention because of the enormous impact it is making in healthcare systems around the world.

Background to breakthrough
Malaria, the most deadly parasitic disease in the world affects more than 40 per cent of the world’s total population, especially people living in areas where the parasite is endemic. According to the World Malaria Report, released by WHO, in 2017, 90 per cent of malaria cases in 2016 occurred in Sub-Saharan Africa. That same year, there was an estimated 216 million malaria cases and an estimated 445,000 of malaria deaths globally.
Aside from the high mortality rate, malaria has also had a devastating effect on productivity in Sub-Saharan Africa. The disease costs the region up to $12 billion in trade, foreign investment and tourism.
Early diagnosis and treatment of malaria reduces disease transmission and prevents deaths. The WHO recommends that all suspected malaria cases be confirmed, using either microscopy or rapid diagnostic test before treatment is administered. However, this recommendation remains unattainable in primary care facilities in rural areas in many developing countries where poor health infrastructures limit the use of the standard microscopy testing. In urban areas where adequate health facilities are available, many people are reluctant to go for testing because of the cost implication of going to the hospital and getting laboratory tests, or the inconvenience of waiting for many hours at public hospitals to get affordable care.
This is why the UMT device has proved to be a game-changer, as it enables people to easily, affordably and conveniently diagnose themselves at home before commencing treatment.
How it Works
The Fyodor UMT kit is a rapid diagnostic device that uses dipstick technology, just like the manual pregnancy test kit. It carries out an in vitro test of malaria parasite in a simple one-step procedure with no need for blood samples, reagents or complex equipment. The UMT detects proteins the malaria parasite sheds in the urine of a patient with Malaria fever.
Inventor’s profile
Dr Agbo grew up in a small village called Mbu in southeast Nigeria. He studied Veterinary Medicine at the University of Ibadan, where he obtained his Doctor of Veterinary Medicine degree. He holds a Master of Science in Biotechnology from Wageningen University and a PhD in Molecular Genetics from Utrecht University, both in the Netherlands. He also has a Graduate Certificate in “Leadership and Management in the Life Sciences” from Johns Hopkins University Business School, USA.
The erudite scientist has held university positions at Utrecht University, Wageningen University and Vrije Universiteit, Amsterdam, Netherlands, where he did biomedical research for many years. Agbo moved to the USA to work for the Johns Hopkins University. He was a Research Fellow at Johns Hopkins University School of Medicine. He left John Hopkins to work for Cangen Biotechnologies, a cancer therapeutics and diagnostics, in Baltimore. There he worked has a senior director for research and preclinical development and as a chief technical lead researcher.
Agbo is currently the Chairman/CEO of Fyodor Biotechnologies Corp USA and Fyodor Biotechnologies Nigeria Ltd., a firm he founded in 2008. Since its establishment, the firm has produced ground-breaking healthcare solutions, including the popular Urine Malaria Test kit.
Awards and recognitions
Dr Agbo has won numerous awards, including the “Outstanding Innovator of the Year” award from the US Corporate Council on Africa, and the “Innovation Award” from the Private Health Sector Alliance of Nigeria, among others. He has been a guest speaker at various forums, including the White House/US Department of State Bio-economy Conference, Washington DC; World Healthcare Congress; Corporate Council on Africa; US-Africa Private Sector Health Conference, Nigeria Business Summit, among others.
He served as a member of Maryland Life Sciences Advisory Board that oversees a $1.3B fund established by the state to advance biotechnology, appointed by Governor Martin O’Malley of the State of Maryland USA.
In 2015, the UMT kit won the inaugural Health Innovation Challenge Awards in Nigeria, backed by the Private Sector Health Alliance of Nigeria (PHN). The award comes with a grant of $100,000 and support from backers, including Bill Gates, Aliko Dangote, and former Nigerian president, Goodluck Jonathan.
Dr Agbo’s ingenuity and innovative solution is a major milestone in the war against malaria and has transformed the way healthcare systems in developing countries combat the disease. Indeed, the extraordinary impact of the UMT kit shows that Africans are in the best position to address their current and future challenges if they look inwards to develop innovative solutions to their problems.
Chief Oludolapo Ibukun Akinkugbe is a veteran pharmacist of high repute. A pioneer general secretary of the defunct Nigerian Union of Pharmacists (NUP) in the 1950s, the 90-year-old Chief Akinkugbe is the founding director of Palm Chemists.
In this video clip, Chief Akinkugbe talks about his foray into pharmacy practice, early challenges pioneer pharmacists faced, expectation of the society and areas that still crave attention in the profession. Enjoy it…
Getting enough rest can help you to effectively cope with stress. When we are burdened with thoughts and worry, they have adverse effects on our bodies. Taking time to absolutely do nothing and rest our minds can have wonderful health benefits. It is during this time of rest that we are free to recuperate, recharge, meditate and contemplate.
There is a story of a man who once challenged his friend to an all-day wood chopping contest. His friend accepted the challenge and the contest began. The challenger worked very hard, stopping only for a brief lunch break. His friend, on the other hand, had a leisurely lunch and took several breaks during the day.
At the end of the day, the challenger was surprised and annoyed to find that his friend had chopped substantially more wood than he had.
“I don’t get it,” he said. “Every time I checked, you were taking a rest, yet you chopped more wood than I did.”
“But you didn’t notice,” said the winning woodsman, “that I was sharpening my axe when I sat down to rest.”
The story highlights both the necessity and the significance of rest. Don’t feel guilty to take a rest any time you need it. If you need a rest, you deserve it.
Relaxation or engaging in a refreshing activity is a must, if you want to be productive in your work. God rested after the creation processes. Genesis 2:2 says, “And on the seventh day God ended his work which he had made, and he rested on the seventh day from all his work which he had made” (NKJV).
Rest is Universal
Do you know that God wants even animals and the land to rest, like human beings? Exodus 23:10-12 says, “Six years you shall sow your land and gather its produce, but the seventh year you shall let it rest and lie fallow… Six days you shall do your work, and on the seventh day you shall rest, that your ox and your donkey may rest…”
Every wise farmer understands the principle of crop rotation. It helps the soil to be replenished. From the above biblical injunction, it was discovered that the soil from the fields that were not left uncultivated every seventh year yielded less nutritional solids than the ones that were left fallow the seventh year.
In Mark 6:3031, Jesus demonstrated the principle of rest after work. After the disciples had narrated to Him the successful ministration they had, Jesus simply told them, “Let’s go off by ourselves to a quiet place and rest awhile.” Following this incident, I regard rest as a reward for accomplishing a task. For example, whenever I complete writing an article as planned, I congratulate and reward myself with a good refreshing break. I get out of my office, stretch my body, take some water, walk around the premises, talk to people and breathe fresh air.
Rest is Healthy
This principle of rest after an activity is an important one for our health. Rest is crucial to the health of the body. Sleep is an absolute and undeniable necessity of life. As our energy level goes down and wastes accumulate, we experience fatigue and a desire for rest. During rest, energy is restored, and the waste buildup is diminished.
Rest and sleep are dependent on our ability to relax. The person who is tense is not relaxing, and therefore cannot really rest. Fatigue is protective, in that it serves to make us aware of our need for rest. As fatigue increases, efficiency and performance decrease. Other factors like overeating, lack of exercise, stress, stale air, and not drinking enough water can produce fatigue.
Rest or relaxation slows the heart rate, reduces blood pressure, and slows the rate of breathing, which reduces the need for oxygen, increases blood flow to the muscles and decreases muscle tension. Rest or relaxation results in more energy, better sleep, increased concentration, greater efficiency, better problem-solving abilities, less headaches and pain.
We all need a rest or break from the routine of our major activities. When you are sick or diseased, your body is giving signs that it is time to rest from work. It is also trying to tell you to rest from foods that are difficult to digest. Stop drinking coffee and eating foods that are high in sugar and caffeine, which may help you to keep on working. Coffee, kola nuts and cigarettes provide artificial stimulation, but without recuperation. The underlying fatigue persists.
Rest is Inescapable
Serious fatigue can manifest as general breakdown of the body. Some time ago, a friend returned from Vienna, Austria, for the burial of his mother and had a very hectic time with his people, whom he had not seen for about fifteen years. Throughout the period at home, he was involved in one activity or another, and did not have enough rest or sleep. He fed poorly and even had bouts of malaria attack.
By the time he returned to Lagos, on his way back to Vienna, he had lost some weight and looked haggard. He took a night flight, to resume work the following morning. Two days after, he phoned me from a hospital, where he was on admission. Diagnosis: excessive fatigue.
Rest is so important to life that the vital organs are designed with built-in rest periods. The heart rests between each beat, and the lungs between each breath. The stomach rests between meals. The central nervous system is recharged during sleep.
Rest Means Quality Sleep
Rest and relaxation cannot take the place of sleep. Human beings are designed to be awake during the day and asleep at night. Wakefulness and sleepiness are normally controlled by enzymes and hormone systems within the body.
The “internal clocks” can be adjusted forward or backward. They may be also be ignored, but not without negative consequences. Besides giving us the night for regular sleep, the Creator programmed human beings and animals to rest completely every seventh day.
Studies have shown that we need seven to nine hours of sleep per night, to maintain good health. Going to bed early (before 10.00 pm) is conducive to health. It has been found out that one hour of sleep before midnight is worth two after midnight.
Getting enough rest can help you to effectively cope with stress. When we are burdened with thoughs and worry, they have adverse effects on our bodies. Taking time to absolutely do nothing and rest our minds can have wonderful health benefits. It is during this time of rest that we are free to recuperate, recharge, meditate and contemplate.
There are many things that cause us to lose our rest – anxieties, troubles, insecurity, businesses, greed, covetousness, fear of the unknown etc. This is why Jesus says, “Come unto me, all ye that labour and heavy laden, and I will give you rest” (Matthew 11:28).
A new report by the Socio-Economic Rights and Accountability Project (SERAP) has revealed the “humanitarian crisis, manifestations of corruption and mismanagement at the Lagos University Teaching Hospital, (LUTH) Idi Araba and how unhygienic conditions, severe shortages of medicines and medical supplies in the hospital and two other federal government owned hospitals in Lagos make it extremely difficult for many Nigerians to obtain essential medical care.”
Apart from LUTH, the other two hospitals covered in the report “are the National Orthopaedic Hospital, Igbobi (NOHIL), and the Federal Medical Centre, Ebute Metta (FMC).”
The report shows “a sharp deterioration in the quality and safety of care in these hospitals. LUTH, NOHIL and FMC do not have enough cancer treatment machines. Linear accelerator (LINAC), magnetic resonance imaging (MRI) and CT scan machines are not working optimally due to erratic electricity even as the hospitals do not have back-up plans.”

According to the report, “A LINAC costs about US$5 million and the six that the federal government procured for six teaching hospitals have packed up. The dialysis machine at LUTH is outdated and its functionality at the time of study was zilch. LUTH recently lost its accreditation to teach dentistry because all its five dental chairs had packed up and there is no functional dental engine available.”
The 53 pages report recently launched at the CITI-HEIGHT Hotels, Lagos is titled: Failing Healthcare: How Federal Hospitals are letting Down the Poor and Making Healthcare a Privilege rather than a Right.
The report, presented to the media by a professor Dejo Olowu, Dean, School of Law, American University of Nigeria discloses that “vital medical supplies such as oxygen, diagnostic machines, dental chairs, sterilising units, burns apparatuses, were in pronounced shortage. Overcrowded waiting rooms and wards were noticeable.”
The report was part of the highlights of the public hearing held by SERAP to provide forum for people to provide testimonies and submit complaints/petitions on allegations of corruption they encounter while accessing public services particularly in the health, education and water sectors.
The research for the report was conducted between April and June 2018 using semi-structured in-depth interviews as the primary instrument for data collection.
The public hearing was attended by among others the representatives of the Acting Chairman of the Independent Corrupt Practices And Other Related Offences Commission (ICPC), Economic and Financial Crimes Commission (EFCC), the Special Adviser to President Muhammadu Buhari on corruption, civil society, lawyers, the media, Freedom of Information Unit of the Federal Ministry of Justice, Nigeria Union of Petroleum and Natural Gas Workers (NUPENG) and the public in general.
The report reads in part: “Our researchers observed that some wards have no mosquito nets. And there is no waiting area for mothers with sick babies. There is the Gynaecology ward, at which entrance a small bench that could seat about four persons, was placed. The bench was occupied by patients’ relatives, presumably. At the end of the corridor where the neonatal ward is, there is a similar four-seater bench, fully occupied. The bench, having been occupied, a group of people were standing. At the neonatal ward, it was the same case. A waiting room for mothers whose babies are on admission was not part of the hospital’s plan. The mothers have improvised.”
“A woman lay on the bare pavement under the staircase, taking a rest. Nearby was an area where waiting mothers had carved out as waiting area. A number of women, whose babies were on admission, were seen sitting or lying down on a mat or on the pavement. With the laid mats, sacks of clothes, plates, buckets etc stacked against the wall and a woman washing clothes, it was clear that many a mother stay for days in this state.”
“Another nurse told SERAP, ‘The infant incubator or neonatal incubator is a rigid box-like enclosure in which an infant can be kept in a controlled environment for observation and care. Some of the incubators in LUTH are not working. It is either the heater is bad, or the monitoring mechanisms are not working. The incubators available in LUTH have been in use for over 15 years.’”
“A nurse, who has worked for four years in LUTH spoke to our researchers: ‘Some beds in different wards are too old to still be in use, but LUTH knows how to manage. Some of the available beds have become dilapidated. Some beds can cause accidents. They have beds from which patients can fall. It has really happened, and I’ve seen it happen. But they keep managing.’”
“Another medical staff said, ‘Even bed sheets are in short supply. Patients use their wrapper for bed sheets sometimes. And when they use LUTH bed sheets, they are usually old and torn most of the time. Toilets in LUTH are centres of disease distribution. You can be sure to get urinary tract infections and the like. I am referring to the toilets in different wards.’”
“According to a senior doctor who spoke to SERAP, ‘There is poor water supply in LUTH and water is supposed to be an essential commodity, especially in a hospital. It’s deplorable to the extent that water does not run in the taps. You are seeing LUTH’s flowers and wall paints, but it is rotten inside. I will be right to say things are not working optimally in LUTH.’”
“At all the three study sites, derelict and obsolete equipment were commonplace. Most wheelchairs in LUTH are stiff and old. They are not in optimal condition. There is a poor maintenance culture. Not even the lifts are working well. One can easily get stuck in an elevator; so it is better to use the staircases. The lift in E Block is bad to the extent that they got a man to manually operate the lift when people enter and are in transit. It doesn’t even have doors anymore.”
“LUTH has its own laboratories but the doctors there prefer to refer patients to the private laboratory because private labs are considered to be more efficient and delivered results quicker.”
“16-year-old Ngozi Eze (not the real name), who was diagnosed with stomach obstruction and was referred to LUTH for an urgent surgery to avoid complications, shared his experience with us: ‘When we got to LUTH, we were told there was no bed in the general ward. We were referred to the VIP section and they said I would have to wait for about three weeks before the surgery could be done, because such surgeries are pre-booked; this was despite that my condition was critical. At the end of the day, we had no choice but to return to a private hospital where the surgery was eventually done.’”
“Another nurse at LUTH said, ‘The facilities are overstretched. To see a specialist on clinic days you have to leave your home by 4am or 5am to be at LUTH by 6.30am to join the queue early. Even at that, there are no guarantees you will be attended to.’”
“Nurses are forced to pick and choose patients to attend to. The ideal World Health Organisation (WHO) standard is five nurses to one patient. In LUTH it’s two nurses to 30 patients. In each ward, there are about 30 patients, and there are only about four nurses for each shift. In the afternoon, there’ll be two nurses, and in the night, there’ll be two nurses.”
“People are dying in service, they are not being replaced; people are resigning, they are not being replaced; people are retiring, they are not being replaced; people are leaving for greener pasture outside Nigeria, they are not being replaced. So, it has cut down the number of professionals that ought to be rendering health care service. And this has also made the management of this hospital (LUTH) to be employing professionals on a casual basis, which is actually against the provisions of the law.”
“Another senior medical officer at LUTH said, ‘LUTH is like a dumping ground for health care in Lagos. It’s usually the extreme cases that are brought to LUTH after treatment elsewhere has failed. Even if you’re rushed in as an emergency case, it’s not guaranteed that you’ll be attended to. Sometimes they’ll tell you there are no available beds unless you can afford the VIP section. LUTH is supposed to be the last hope of the common man in terms of health care. Once you come here, you’re expected to get answers. Sometimes you get answers. But there are a whole lot of challenges. Government is not paying attention to the health sector.’”
“Another nurse said, ‘There are patients that need to be bathed in the morning with hot water because they cannot help themselves. But there will be no hot water; so, we use cold water to bath them. Is it not when there is electricity that the heater will work? That is if there is heat. And you have to bathe the patient because you’re closing for the day. So, what do you do? The generators are not working.’ Sometimes, in the night, there is no light in the wards. Nurses sometimes use torchlight to attend to patients. LUTH electricity just recently improved, still electricity supply is epileptic. It’s still bad but it was worse. Before, there was no electricity at all day and night.’”
Other testimonies gathered for the report read in part: “This is a machine designed to move breathable air into and out of the lungs, to provide breathing for a patient who is physically unable to breathe or breathing insufficiently. When a patient cannot breathe anymore because the lungs are not functioning, the ventilator is used to aid artificial breathing. It’s only available in a few hospitals. As big as LUTH is, there is none. The state of health care in LUTH is deplorable.”
“At Igbobi, no money, no treatment. Admission at Igbobi’s casualty ward is N5,000 per day. After the preliminary examination, tests and eventual diagnosis, patients must pay before they could be admitted into the appropriate ward for their conditions.”
“Patients get their syringes and needles, gloves, without it the doctor will not touch the patient. If they ask you for it and you don’t have it, they just walk away, they don’t have time. Privatization of laboratories is another ill that the National Orthopaedic Hospital, Igbobi, has in common with LUTH.”
“We don’t have a therapeutic swimming pool at Igbobi. We used to have long time ago, but it is now filled up; you won’t even recognize the site of the swimming pool now when you get there. And these are the basic simple tools that increase output. No matter how skillful you are, when you don’t have tools to work with, you cannot optimize your output.”
“This study sought to analyse evidence-based information on the causes of the failure in healthcare service delivery in Nigeria, using three of the frontline institutions of public healthcare delivery, namely, LUTH, NOHIL and FMC, all located in Lagos State, the most populous state in Nigeria and its commercial nucleus. The study solely focuses on healthcare service delivery systems at LUTH, NOHIL and FMC as representative of the experiences in their counterparts across the country.”
“Increase the transparency in the execution of the budget planning process by publishing income and expenditure reports, ensuring the release of assigned budgets to the health sector and projects implemented. Information on funded projects, on renovation and reconstruction will be vital to regaining the confidence of health workers and the public.”
“The leadership in each of the hospitals need to back up their commitment to enable data collection as well as performance tracking and reporting. The board of these hospitals should live up to their responsibility by monitoring standard operating procedures and compliance in day-to-day management, administration and the delivery of services. Where there are established cases of operational failures as we found in the course of this study, there should be appropriate responses to ensure accountability.”
“The study adopted the descriptive method and content analysis to arrive at the conclusion that poor implementation of healthcare policies and programmes is the major constraint to the achievement of desired goals in public healthcare provision in Nigeria.”
“It also adopted an exploratory qualitative case study design based on analytical methods originating from both public health, legal and social science research to understand the extent to which the questions of governance, dominance, hierarchy, competencies, dichotomies, communication, interaction, resources, and dysfunction impact on the management of the Federal Government-owned hospitals in the Lagos axis.”
“Our choice of strategy was informed by the fact that case studies are in-depth investigations of a single instance of a phenomenon in its broader, real-life context. The localisation of the investigations notwithstanding, the study implicates a wide range of systemic issues affecting the whole spectrum of public health institutions in Nigeria.”
“In order to reverse this situation, therefore, the study recommends among other things that the Federal Government of Nigeria should allocate adequate resources for improving the quality of equipment and human resources in the public hospitals under its patronage.”
“Some of the core recommendations made towards improving the public healthcare sector included the following: improved procurement practices, stronger political commitment to health, increased funding, effective accountability across the board as well as elimination of corruption and bureaucratic bottlenecks in public healthcare delivery in Nigeria.”
“Show a people as one thing, only one thing, over and over again, and that is what they become.” – Chimamanda Adichie

The salesman is like a business empire
You are like a business empire that has the powers to determine its structure. You are the only one who has the right to design your vision and mission. You are in charge of the decisions about this personal enterprise. You decide who to hire or fire. Your business strategies and the ways to achieve them are in your hands. You know your strengths and weaknesses. You know the type of brand identity you want to develop and how to go about it.
You are a brand and only you have the complete information required to tell your story. Only you can tell your story the way you want it. Only you can form yourself the way you want to look. No man can design you, except with your approval. Only you can write your script the way you want it to be.
Self-discovery is key
In the journey of life, you are expected to first discover yourself. This self-discovery answers questions like: Why am I here; what is the actual purpose of my creation? Who really am I? And where do I go from here? It is only when you are able to answer these questions that you will truly know where you are going and how to get there.
You might be a very busy person working day and night, seven days in a week; but without self-discovery, your effort might be likened to the proverbial pouring of water into a basket. Self-discovery enables you to know your purpose, to know what is expected of you and to know how to achieve it.
It is this self-discovery that will make you perform better as a salesman. Sales job is a job that requires the best from the salesman. It takes your best to convince an individual who is your prospect or customer to buy your products or services. It takes your best to attract and sustain customers’ patronage.
You cannot give what you don’t have. You cannot give out the best when you have not discovered where the best comes from. You cannot give the best when you have not discovered the source of your best performance. The best is inside you, you carry the best in your uniqueness if only you believe it. Your best is driven basically by your mind and the deposit you have inside you.
In sales, your mind is a great tool
The human mind accommodates everything that will be. The mind works like a computer. It receives our thoughts, processes them and gives out action. Therefore, the mind will give you what you put in it. The way you think is the way it will become. The things you accommodate within become your world; what you believe with all your mind becomes your reality.
What you think all the time becomes your possibility. Salespeople don’t fail in real sense, salesmen only think the wrong way – which makes them to believe the wrong way, and subsequently act the wrong way. Your thoughts matter. There is a thin line between success and failure. The thin line lies in how you think, believe and act. These three make the difference.
If you believe that everything is possible, then everything becomes possible for you. If you think that everything is impossible, then it becomes that way too. If you can fix mindset, you can fix everything!
Connect with the inner you
To attain prominence in life, always go into dialogue with your mind to extract the priceless resources deposited there by your Creator. What goes on in your mind determines what you will be. The personality you carry inside has a lot to do with your performance; the more positive you are, the greater your results.
The Scripture says, ‘‘Guard your heart with all diligence for out of it are the issues of life.’’ All the things we need to get to the top are deposited in the inside of us. Nothing in life happens by accident; most things we achieve or fail to achieve are products of our conscious or subconscious designs.
It is an age-long adage that you can’t give what you don’t have. The best salespeople are those who have discovered themselves. They know where they are, the place they are going and how to get there. They are not controlled by vagaries of the market; rather, they are driven by their inner-wheel to overcome their environment. It is in their character to imagine success even before going to the field.
Peter Drucker says, ‘‘The best way to predict the future is to create it.’’ Successful salespeople create the future they want to see by going after their big dreams. Step out today and believe you will conquer because everything begins with you.
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The forthcoming 2018 World Heart Day, slated for 29 September, presents a golden opportunity for the Nigerian government and other stakeholders in the health sector to galvanise proactive national action towards stemmming the worrisome incidence of cardiovascular disorders and its attendant catastrophes on the populace.

Cardiovascular diseases (CVDs), which are disorders of the heart and blood vessels, have, in recent years, been subtly but steadily spreading among Nigerians and, except some prompt and pragmatic steps, are taken to address the trend, the nation may soon be plunged into a devastating CVDs epidemic.
As it stands, it will be difficult to find any Nigerian who does not know someone who is hypertensive or has had a stroke or a heart attack. The stark implication is that millions of Nigerians are battling with these conditions. It needs to be pointed out though that the challenge posed by CVDs is not peculiar to Nigeria. As the latest figures from the World Health Organisation show, heart-related conditions are responsible for the death of 17.7 million people every year which is 31 per cent of all global deaths.
What makes the Nigerian situation particularly alarming, however, is that, with the absence of reliable national data and the fact that cardiovascular diseases were previously viewed as more of an issue in developed countries, the Nigerian government does not appear to be giving the issue the attention it deserves. The nation is concentrating so much on infectious disease control while neglecting CVDs. This is a primary reason, aside from dietary and lifestyle issues, why heart conditions continue to be a major cause of mortality in Nigeria.
A recent study conducted by WHO revealed that 46 per cent of adults in the African region countries are hypertensive. In the breakdown of the statistics, Nigeria, with its huge population, has the highest number of hypertensive adults, followed by Ghana, Seychelles, Sao Tome and Principe, and Cabo Verde. Indeed, the study specifically cites over 35 per cent adult Nigerians as battling with hypertension.
While the above report may not be conclusive, what is not in doubt is that the mortality rate from stroke, which usually occurs as a result of untreated or poorly managed hypertension, is very high. Very few people survive incidents of stroke in this clime. In fact, the Minister of Health, Prof. Isaac Adewole revealed last year that 150,000 Nigerians die annually as a result of heart-related diseases like hypertension and warned that the figure was likely to increase to 23 million by 2030, if adequate measures were not taken.
The WHO is worried about the CVD challenge – and so should the Nigerian government and other relevant stakeholders. The global health body in 2016 launched “Global Hearts”, a new initiative to beat the global threat of cardiovascular diseases, including heart attacks and strokes. The initiative is to protect people from CVDs and help them recover following a heart attack or stroke.
The Nigeria nation must embrace this initiative which is supporting governments to heighten efforts on CVDs prevention and control through three technical packages: tobacco control, salt reduction and strengthening of CVD management in primary health care. The initiative also aims to train health workers to better deliver tested and affordable measures to protect people from CVDs.
However, beyond this global initiative is the need to scale sup enlightenment campaigns on heart diseases, especially on the importance of lifestyle change, healthy living, regular checkups and management of the heart. Ocassions, such as World Heart Day, offer good opportunities and platforms to execute such campaigns.
The theme of the 2018 World Heart Day: “My Heart, Your Heart” is a call to a collective action by all and sundry to take heart-related issues seriously. All Nigerians must embrace this slogan and its message.
Dr (Pharm) Albert Kelong Alkali is the immediate past national chairman of the Association of Community Pharmacists of Nigeria (ACPN), an umbrella body of all community pharmacists in Nigeria. In this exciting interview, shortly before the handover ceremony, Alkali in an emotion-laden voice recalls the highs and lows of his tenure. Excerpts:

You recently handed over as ACPN national chairman, after serving for the last three years. How many of the objectives that you set for yourself and your team were achieved?
To the glory of God, I believe we were able to achieve at least 90 per cent of the objectives we set for ourselves at the beginning of my tenure. We put together a four-point agenda and we were able to achieve it.
One of the objectives I set for my tenure was the fact that I was going to engage the media, and for the past three years I did that actively and robustly. I also stated that I would be taking care of the issue of the secretariat and we have moved to a brand new secretariat, with trained staff that are on pension schemes. Our Drug Information Centre (DIC) now has a new pharmacist, while the new secretariat has given us a good image and brand as an association.
I also stated that I would engage the regulatory agencies and we have done that. Over the last three years, we have been able to engage the NAFDAC meaningfully and we are getting results. We have a technical working group that raises issues and resolves them when they arise and the relationship between ACPN and NAFDAC is quite good.
I believe that it’s been a wonderful time and we’ve done our best for the association and we are hoping that those that have taken over will build on this and do more.
What were your greatest challenges and achievements while you were in office?
My greatest challenge is the fact that we were not able to get the Council to sanitise the practice area as we would have loved. PCN has said that this is due to the fact that they need to amend the laws; this issue however still poses a big challenge. Most of our members are worried and unhappy about the situation as the practice environment is still overrun with so many patent medicine vendors, unregistered premises and the open drug market. This situation in itself does not give room for professional practice and that is the biggest challenge I had.
Another challenge we faced is the economic situation. When we were coming in as executives, we came in under the shroud of economic depression; so it limited our projects and the input that many community pharmacists were able to give to the association. We wanted to get a land in Abuja but we were unable to, due to the financial constraints and I hope the new executives will look into that. But I am happy now that we have a befitting secretariat.
Another great achievement for me is the formation of the non-profit company called CP Nexus because it has the potential to maximise our practice and increase the income of the average community pharmacist, as well as enabling them to source for grants and carry out IT infrastructure and other things.
We were also able to operationalise COPA (Community Pharmacy Action), which had been lying fallow over the years and all efforts made to implement it had yielded no fruits; but we came on board and we were able to operationalise it. Presently, we have 17 pharmacies that are called COPA pharmacies; 15 of them are at COPA 1 status, while the remaining two are at COPA 3 status.
Is there a pending project that you would have loved to carry out before leaving as the national chairman?
One of the biggest things I wanted to do involves the NHIS – National Health Insurance Scheme. The NHIS, as far as I am concerned, has the greatest potential to change community practice in Nigeria and also has the greatest potential to deliver and ensure that patients get professional care from community pharmacists.
The scheme is such that prescription comes from health facilities to community pharmacies to be refilled and then community pharmacists get to carry out other pharmaceutical services. However, this scheme has not been carrying community pharmacists along and we are in the process of forming a proposal so that we can engage the top management of the scheme in dialogue and the PSN is also interested in this.
I had begun writing and putting certain data together for the proposal to be taken for discussion, involve more of our members in it and make the scheme successful. As the scheme is right now, we cannot say that it is succeeding because the coverage is not up to ten per cent. So, that is one thing I would have loved to do but was unable to. I urge the next executive to take it serious.
Many are of the opinion that, a fellow northerner, Pharm. Ahmed Yakasai, being at the helm of affairs of the PSN, contributed greatly to the success of your tenure. What are your thoughts on this sir?
Well, what I believe is that what we have seen over the years are massive collaborations and I don’t think it is because Pharm. Yakasai is from the north. I believe that we must be able to engage the president of PSN. Pharm Olumide was there and we never had any friction, Pharm Yakasai came in and we’ve had a good relationship. If they say that we have a very good working relationship, I agree. In fact, he calls me his pharmaceutical son and I respect him very much.
We have a very good understanding of each other. He gives me advice and I take it and I make demands from him that will complement my efforts and he does it. I do not think it is because we are both from the north. We have people that are from the same area and they fight all day and achieve nothing.
What are your thoughts on the recently held ACPN elections?
The ACPN I must say is the most democratic arm of the PSN, as far as democracy is concerned. Our annual general meeting is quite open and interactive. Our National Executive Council is also quite open. We raise issues and discuss them and in situations where you see people come unopposed for a position, it is because there is an understanding. When people see that you are competent to do a job, there is no need for them to go through unnecessary hassles to oppose you; after all, we are going in for service.
We tried as much as we could to make the process as transparent and just as possible to all candidates so that, at the end of the day, the people’s choice would emerge for the association.
What is your advice to the new national chairman of the association?
I urge the new national chairman to be focused. He should pay attention and listen to advice from people. He should study the handover notes that will be given to him carefully and come up with his own programmes. There is so much to be done and we have tried our best to lay a solid foundation, so that the new chairman can take the association soaring to greater heights.
I will be there, as the immediate past chairman, to give all necessary support and make sure he succeeds. If he remains focused and is able to do what he ought to do, then we can be sure that we will see three times more than what I was able to achieve.
Red palm oil is derived from the fruit of the oil palm tree, Elaeis guineensis (Fam: Arecaceae). It is a vegetable oil extracted mainly from the pulp of the palm trees fruit.
Constituents
Palm oil is packed full with powerful phytonutrients, like beta carotenes (which account for its dark red colour), lycopene and tocotrienols. This oil contains about 17 times the amount of carotene in carrots.

Similarly, the abundant tocotrienol (a form of Vitamin E) found in red palm oil is about 40 to 60 times more potent than tocopherol (another form of Vitamin E) in terms of antioxidant properties.
Uses
Palm oil is used as a cooking oil, for frying different types of cuisines, as a tasty ingredient for different cuisines, dietary supplement, as well as making personal care and household products.
Injuries like bruises, sunburn and cuts heal faster when palm oil is applied.
Some palm species in sub-Saharan Africa are used in various ritual practices. Palms are added as a support to other powerful ingredients. For example, palm oil is used as a medium to blend and make coherent the healing mixture.
Pharmacological action/medicinal uses
Palm oil was regarded as a sacred healing oil by the ancient Egyptians because of its tremendous health benefits.
The phytonutrients in palm oil have been shown to offer considerable protection for major body organs like the brain, heart and blood vessels.
Numerous studies, like one funded by the National Institute of Health, revealed that the risk reduction of stroke associated with red palm oil was found to be as high as 50 per cent.
Tocotrienol in red palm oil fights against cancers of the breast, pancreas, liver, skin, stomach, colon and prostate by blocking and mopping up harmful free radicals and initiating apoptosis (a process that leads to a programmed death of mutated cancerous cells in the body).
Red palm oil enhances the absorption of fat-soluble vitamin in the intestines. Some studies have linked red palm oil to a decrease in the incidence of cataracts and macular degeneration, which are the leading global causes of blindness.
Individuals who have adequate regular intake of red palm oil are less likely to suffer cognitive impairments than others.
Red palm oil in the diet can help to maintain a healthy, supple skin. (tocotrienols shield the skin) from harmful ultraviolet rays. This may also explain why red palm oil has been linked to reduced risk of cancers of the skin.
Adverse effects
Consumption of large amounts may cause yellowing of the skin; topical application can cause skin to turn yellowish orange. Palm oil stains on clothes is challenging to wash off.
Economic value and potentials
Palm oil trade has been going on for thousands of years. The official cultivation of palm oil started in Africa and Asia. The origin of extracting oil from the palm plant originated in Africa and is considered to be one of the earliest traded commodities.
Palm oil is a raw material for many manufacturing activities; it helped to set up the soap, lubricant, and the edible oil industries.
Potentials
Palm oil is used in a very high proportion of household products. There is strong demand for palm oil right here in Nigeria. Small-scale farmers across the region sell their products locally.
Packaged products in any supermarket contains palm oil, so the chances are high that you have a lot of palm oil products in your house.
Since there is a strong demand for palm oil right here, small-scale farmers across the region sell their products locally.
(Nigeria Natural Medicine Development Agency)