1 does not cause insulin release
2 may provoke lactic acidosis
3 requires monitoring of renal function
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Nigerian Doctors Successfully Separate Conjoined Twins in Abuja Hospital
A team of Nigerian doctors has successfully separated a set of conjoined twins at the University of Abuja Teaching Hospital Gwagwalada.
The doctors, led by Nuhu Kwajafa of the Global Peace Initiatives, confirmed the success of the operation that took them several hours on Tuesday in a post on his Instagram account @nuhukwaj.
“We wish to express our profound gratitude, as we say a massive thank you to Rt. Hon. Yakubu Dogara, for his kind hearted and extremely generous gesture to the successfully separated twins and their family…God bless you, Sir,” Mr Kwajafa posted.
The spokesman to the Speaker of the House of Representatives, Hassan Turaki, told the News Agency of Nigeria (NAN) on Wednesday that Mr Dogara was moved by the plight of the parents to settle the medical bill.
(NAN)
ALPs Tasks Incoming PSN President on Actualisation of Consultancy Cadre
– Expresses hope of emergence of ALPian PSN president in near future
Pharm. (Mrs) Victoria Ukwu is the newly elected national chairperson of the Association of Lady Pharmacists (ALPs). In this exclusive chat with Temitope Obayendo, Ukwu discloses the several roles the interest group of the Pharmaceutical Society of Nigeria (PSN) has played in empowering women and the girl child. She also expresses her dream for ALPs and Nigerian pharmacists in general.
Excerpts:
Congratulations on your new appointment as the new national chairperson of ALPs. How do you feel about this new role?
I feel a sense of responsibility for my fellow ALPians to have recognised my contributions to ALPs and had voted me to pilot the affairs of ALPs National.
Association of Lady Pharmacists is known for different health awareness programmes at state levels, but not much is heard of at the national level. Now that you have emerged, what is your vision for the association?
ALPs National has been involved in advocacy visits. We paid courtesy visits to the Minister of Health, Prof. Isaac Adewole in 2017 and the wife of the President, Hajia Aisha Buhari, on 15 May, 2018. Part of the outcome of the visit to the wife of the President was the appointment of Prof. Oluwatoyin Odeku, dean, Faculty of Pharmaceutical Services, University of Ibadan, as a member of the Presidential Advisory Committee on Elimination of Drug Abuse (PACEDA).
I agree that we have not done much publicity due to financial constraints and that’s why my vision is to publicise ALPs National, who we are and our activities both nationally and internationally.
Beyond advocacy, what is your plan to impact the society more with your outreaches?
To impact the society more with our outreaches, ALPs National plans to celebrate some of the world health days, carry out medical outreaches, organise workshops and trainings for women, organise radio talk shows to educate the public and so forth.
It is election year for PSN, what areas of the profession would you like the next PSN president to focus on?
ALPs would want the new PSN president to focus on better recognition of the pharmacy profession and subsequently the recognition of pharmacists, especially the consultant pharmacists; empowerment of pharmacists; creating conducive atmosphere for pharmacy practice; and partnering with ALPs to fulfil her goals, vision and projects.
Again, it has been observed that ALPs national and most branches, with the exception of Lagos, have not been active in the news and on social media. How do you hope to bridge this gap in communication?
ALPs is made up of national and state branches. ALPs has been involved in various activities in the different states with little or no publicity, I agree with you. I had a meeting with ALPs Lagos State and discussed on the issue of publicity and the conclusion is to set up a publicity committee. So, at our meeting during the PSN conference in Ibadan, the publicity committee will be constituted.
As an interest group of the PSN, are there some of your programmes tilted towards achieving Sustainable Development Goals (SDGs)?
Yes, some of our programmes are titled towards achieving the SDGs. The 27 goals of the SDGs were set by the UN and the deadline for achieving these targets is year 2030. Before the declaration of the SDGs, ALPs has been working actively on six major goals. The first is no poverty. ALPs has been involved in the empowerment of women, especially lady pharmacists, through the various branches of the ALPs Cooperative. Through the cooperative, our women have access to finance for various businesses. We also created opportunities for our ladies to showcase and sell products during conferences.
The second goal is zero hunger. In a bid to end hunger, achieve food security, improve nutrition and promote sustainable agriculture, ALPs, through her Project 91 (cultivation of medicinal plants), is encouraging the cultivation and consumption of local, natural and highly nutritious but neglected indigenous crops like the folio rice (Acha). These plants are not just highly nutritious, but they are readily available.
ALPs has been involved in food fairs, which enlightened people about availability of different agricultural products and how some can be cultivated and used as food. Project 91 also provided recipes on how best to use and maintain nutritional contents. The interesting thing is that there is an exchange of cultural values. Foods that were normally alien to some have become widely acceptable, providing more options for consumption and staying healthy.
The third goal is good health and well-being. ALPs has gone all out to ensure healthy lives and promote well-being at all ages. We are into the promotion of research and use of readily available/affordable herbal (alternative) medicines. We are also in the forefront of the campaign against drug and substance abuse by the youths through her awareness programmes. ALPs is also part of health campaigns against diseases in the society.
Our fourth area of focus is quality education. Through our visits to schools, ALPs has promoted and still promoting inclusive and quality education and lifelong learning opportunities for all, especially women.
This leads me to the next goal, which is gender equality. Being a gender-based association, all our programmes carry gender equality undertones and empowerment for women and the girl child. This explains why Benue and Lagos State ALPs are offering scholarships to the indigent girl child.
Last but not the least is clean water and sanitation. We organise enlightenment campaigns in public places and schools. We also donate sanitation items to schools and institutions, such as rehabilitation centres, old people’s homes and many of the like. In promoting clean water and sanitation, Rivers State ALPs is into production of water purifier and Sodium hypochlorite solution.
Where do you hope to see ALPs national in the next ten years?
For ALPs in the next ten years, I want to see a force to reckon with beyond the pharma family. I want to see highly empowered lady pharmacists. I want to see a very vibrant group that every member of the society will want to identify with; and finally, I want to see an ALPian as the PSN president in the nearest future.
Meet Pharm. Omatseye, Our November Personality
Pharm. (Mrs) Clare Omatseye is the president, Healthcare Federation of Nigeria (HFN) and founder/managing director of JNC International Limited (JNCI). She is a Pharmacy graduate of Ahmadu Bello University, Zaria. She also holds an MBA from Universidad De Navarra (IESE), Barcelona, Spain.
Omatseye started her career with an internship stint at Sterling Health (now GlaxoSmithkline). She later moved to May & Baker Nigeria, where she had a progressive career in several job roles – sales representative, product manager (Vaccines), business development manager (Pasteur Merieux Connaught) and national sales development manager.
Following her remarkable stint at May & Baker Nigeria, she became the executive director, Business Development, at Aventis Pasteur Nigeria (a French multinational pharmaceutical company) where she spent another two and a half years, before taking on a new frontier position as the country manager (Nigeria) for Huntleigh Healthcare UK Plc – a British multinational quoted on the NYSE.
Omatseye, who is currently vice president of the West Africa Healthcare Federation, founded JNCI in 2004, with the vision to make a difference in the medical infrastructure industry in Nigeria, through the delivery of innovative medical diagnostic and interventional technology solutions and after sales service.
Over the last two decades, she has grown JNCI into a mega enterprise, receiving several local and international recognitions and awards, including the renowned Frost & Sullivan Award for Quality in Customer Service.
The consummate entrepreneur has, over the years, developed the required capabilities to effectively monitor and oversee installations/turnkey projects from the budding phase through execution to commissioning and post commissioning. She is highly skilled in healthcare equipment consultancy, management of healthcare equipment installation and turnkey projects, project planning, management and integration, resource sourcing, healthcare solutions consulting and advisory.
An active advocate of affordable healthcare in Nigeria, Omatseye was recently elected pioneer president of the Healthcare Federation of Nigeria (HFN). She is also a member of several associations in the healthcare industry, such as the Pharmaceutical Society of Nigeria (PSN), the Society of Quality in Healthcare in Nigeria (SQHN), Society for Corporate Governance (SCG), Paediatric Association of Nigeria (PAN) and Women in Successful Careers (WISCAR).
She is also the founder and chairman, Vaccipharm Limited, a cold-chain vaccines & pharmaceutical distribution firm that she founded in 1999; She is the first female director, Society for Corporate Governance (SCG); and director, advisory board of the Entrepreneurial Development Centre (EDC) of the Lagos Business School.
A dedicated Rotarian and visiting facilitator at the EDC, Omatseye is married and blessed with children.
Nursing Practice in Nigeria: The Long Road to Recognition (3)
Internship for graduates of Nursing Science
Internship is a sine qua non to professional development, capacity building and professional competency for graduates of healthcare professions in general and nurses in particular. Our leadership was able to propose, defend and actualise the approval of the internship scheme for graduates of nursing sciences in our universities. It is noteworthy that our efforts at ensuring rightful placement of the nursing interns in the healthcare workforce came to fruition when the NCE in 2016 approved the inclusion of intern cadre in the unified schemes of service for nurses. The next challenge here involves striving for proper placement.
Harmonising education with practice
Historically, it was evident that nursing practice and nursing education were interwoven. We began in a collaborative mode, but we lost the tie that bound the two variables together.
Nursing was striving to be at par with other health professions. To promote this goal, nursing unguardedly created a wide gap between its education and practice, leading to educational and practice differences, as well as superiority and inferiority complexes among nursing personnel – based only on citadel of learning and training but not on professional qualifications, competencies, and adherence to ethical standard compliances.
Nurses engaged in in-fighting, running down each other and defacing and also debasing the profession. Painfully, there were nurses that empowered and collaborated with detractors other health professionals and administrators to render deadly blows to nursing professional developments.
It is only in nursing in Nigeria that you produce a product that you are not proud of, much less market to services consumers. England (1986) in Igbinlade (2010) once recognised the cause of the widened gap between nursing education and practice as that of “bad mentorship”. She noted that the art of mentorship had its beginning in early Greek times but has been utilised inconsistently in the nursing arena, adding categorically that: “nursing is a profession that has demonstrated serious lack of talented mentors.”
Schoor also supported this by referring to most mentors of nursing as “self-centered” and that lack of cohesion on the part of these mentors had greatly distorted the attainment of positive dividends that the transition of nursing education from diploma to degree might have ushered.
It is therefore pertinent that we, as nurses retrace our steps’, examine further and critically those factors responsible for the gap between nursing education and practice and if it was not so, institutionalise corrective steps for harmony. This trend has also compromised the image of nurses in the public glare and mostly among health administrators and the media practitioners.
Way forward
My suggestion is effective collaboration among the arms of nursing – that is, nursing practice and nursing education, administration, regulation and association. Gilson-Parkevich (1992) in Igbinlade (2015) stated it well that “we all possess talents, expertise and creativity within our individual selves to shape our collective destiny”.
Babajide (1996) in Igbinlade (2015) also likens the nursing profession to that of a baby dove who unfortunately had its egg hatched by a mother hen along with other chickens. The baby dove later continued to peck on the ground with its otherworldly designed “family” but every time it looked at the sky and watched other doves fly, it envied them and sang, “If I had the wings of a dove, I would fly high…”
Nursing profession is like that dove with all the characteristics required for it to fly high, but if care is not taken, a chicken will emerge instead. Appropriate and amiable developmental traits are inherent in Nursing; let us use them positively.
The regulatory body of the profession – the Nursing and Midwifery Council of Nigeria (NMCN) – must initiate and collaborate with relevant bodies and organisations. The National Association of Nigeria Nurses’ and Midwives’ (NANNM) as the only recognised association of nurses in the country must not relent in providing leadership in championing the task of professional struggle and extend the frontier of professional unionism beyond the regular public sector. This was corroborated by Prof. E. O. Ajao in his inaugural lecture in 2016.
Past and present service chiefs of nursing services must partake in the transformative agenda. The nurse scholars at the training institutions and universities must also be ready to use their position to pave way for development and increased access to education.
The effective collaboration of the aforementioned stakeholders will go a long way in making nursing education reform a transformational tool for improved healthcare delivery system.
By Comrade Nurse Abdrafiu Alani Adeniji
Enalapril is?
1 is an ACE inhibitor
2 is indicated for hypertension in diabetic patients
3 is used for long-term management of myocardial infarction
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
What do you know about Heparin ?
1 has a rapid onset of action
2 has a short duration of action
3 patient should be monitored for signs of haemorrhage
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Lagoon Hospitals Boss, Others, Decry Brain Drain among Nigerian Doctors
Eminent medical practitioners, including Dr Tagbo Azubike, managing director, Lagoon Hospitals, Ikoyi; Dr Titilayo Ogunlana, consultant paediatrician, Lagoon Hospitals, Ikeja; Hon. John Ajibayo Adeyeye, special adviser on health to the Ondo State Governor; Prof. Akin Osigbogun, member of the United Nations Funds for population activities,Dr Adeyinka Adeniran senior lecturer in the Department of community health and primary healthcare of the Lagos state university, college of Medicine and others have condemned the massive brain drain among medical practitioners in the country, while they called for urgent steps to stem the tide.
The medical professionals made this remark at the 2018 Public Health Week, organised by the Lagos State University Medical Students Association (LASUMA), held at the Lagos State University College of Medicine (LASUCOM) Lecture Theatre, on 22 October, 2018.
The 2018 Public Health Week, which was a national event, also hosted LASUMA’s 11th Annual Symposium themed, “ The Scourge of Brain Drain in Nigerian Health Sector and sub themed: Access to Adequate Healthcare: Barriers and Solutions”.
Speaking during a panel discussion, Dr Azuibike and other panelists emphasized and debated with the students on why they shouldn’t leave the country after their training, seeking for better offers from other countries.
Dr Ogunlana, who was the first speaker amongst the panelists, spoke at length on why Nigerian young doctors and undergraduates should stay back and improve Nigeria’s health sector and what has to be done to make Nigerian doctors to stay back in Nigeria. She also remarked that corruption is a systemic problem and has to be solved holistically.
Dr Adeyinka, on his own, stated that first of all, the problem has to be identified and knowing who is to be blamed, then we can start thinking of proffering valuable solutions that would last longer and improve the Nigerian health sector.
Furthermore, he explained that the government is supposed to provide leadership and governance, while the doctors render good services to the patients but reversed is the case here in Nigeria.
He went ahead to explain saying, “looking at our infant mortality statistics, we can see how many infants have been lost due to poor services”. As a confirmation to his claims, he made mention of the fact that here in Nigeria, we have 1 doctor to 6,000 patients per day, “ how then do we expect them to attend to all the patients properly knowingly full well that at the end of the month, they will get a peanut payment as salary”, he queried.
In his own contribution, Dr Osibogun, who was represented by Dr (Mrs) Okafor spoke on the barriers of accessing primary healthcare and maternity centres for pregnant women, lactating mothers and why people lose interest in going to healthcare centres for treatments.
She pointed out so many reasons why people do not like to go to health centres and some of the reasons- are the language barrier, limited cash flow, transportation, delay in hospitals, easy access to doctors, difficulties in navigating a hospital, stigma and lack of trust, among others.
Dr Azuibike, also spoke on how privatising the health sector, which may and may not be of help to the Nigerian health sector.
He went further to explain that in a private sector, you have to be accountable and the health sector in Nigeria seems very impossible because of the cost and expenses of running a private hospital adequately and not to now talk of several hospitals. Inefficiency is one of the major problems of Nigeria health sector and it has to be corrected, in as much as accountability is needed.
Coming up for the second time, Dr. Ogunlana enlightened the students on identifying their passions and specialty in medicine, which she described as not an easy task, while she urged them not to choose a specialty based on their present challenges, but they should stay on their area of interest, and advance on it gradually.
The high point of the symposium was the presentation of awards to some outstanding students, speakers, panelists and lecturers.
Speaking with Pharmanewsonline in an exclusive chat after the event, some of the students expressed their delight with the organization of the programme, saying it was apt at such crucial time as this, when they needed it most, because most of the topics and sub-topics treated were on point, especially for the finalists in their part 6.
They were really impressed with the symposium, because it has changed their orientation of joining the band wagon of medical practitioners who are seeking all means of leaving the country.
NANNM,UGONSA Flay FMC Owerri over Alleged Discrimination against Nurses
The National Association of Nigerian Nurses and Midwives (NANNM) and the University Graduates of Nursing Science Association (UGONSA) have condemned the alleged continuous discrimination against nurses and nurse interns by the management of Federal Medical Centre, Owerri, a situation they described as deliberate attempts to frustrate nurses in the institution.
The nursing groups have also called on the Director of Human Resources, Federal Ministry of Health, Dr Mohammed Lawal Yahuza, to use his good office in resolving the anomalies at the FMC Owerri, in order to ensure equity and fairness to all.
Reacting to the recent development, the NANNM National President, Comrade Abdurafiu Adeniji said the leadership of National Association of Nigerian Nurses and Midwives totally condemned the continuous relegation, non-recognition and unacceptable discrimination in terms of human resources development for health in our healthcare services and most importantly at the federal health institutions in Nigeria.
Comrade Adeniji, who spoke with Pharmanewsonline in an exclusive chat noted that “Nursing is the pivot upon which all other healthcare services professionals revolves around. Without due attention given to nurses and nursing care services providers, no appreciable development can be achieved. We totally condemn the criminal intent been demonstrated by chief executives of federal health institutions by not including nurses and nurse interns when vacancies are been declared and advertisement made and nurse interns and nursing cadres are intentionally left out of such advertisement.
“This is an attempt to marginalise nursing services in our health sector, whereas there is acute shortage of professionals in the nursing category that is already affecting the fundamental human right of quality healthcare services to the Nigerian populace”, he asserted
Speaking through a press statement, which was jointly signed by UGONSA National President, Chief (Hon) S.E.O. Egwuenu, and National Secretary, Nur. G.I. Nshi, UGONSA recalled a case where the management of Federal Medical Centre (FMC) Owerri on two consecutive instances, refused to include the position of nurse interns in their advert placement that listed internship positions of other healthcare disciplines, despite all the directives from the Federal Ministry of Health mandating them to do so.
“The latest of these discriminations against nurses was done via their advert placement for internship published by Daily Sun Newspaper of Monday 15th October, 2018 (page 20) that listed internship position for other healthcare disciplines except nursing.
“It will also be recalled that we approached your office for your kind intervention when this same management of FMC Owerri in October, 2017 excluded only the position of nurse intern from their advert placement for internship that listed interns of other healthcare disciplines just as they have done in the current dispensation.
“It was also on record that the ministry graciously intervened and directed that they implement the nurses’ internship and effect the proper placement of already employed graduate nurses vide several letters and circulars [e.g. Ref No. C2920/S.3/C.2/VOL1/116 dated 12th February, 2018 (specifically addressed to the MD FMC Owerri); Ref No. C.6093/T/16 dated February 20, 2018; Ref No.C6093/T/13 dated 19th June, 2017; Ref No. DHS/800/I/T/8 dated 3rd October, 2017]”, the statement reads in part.
According to the group, despite the fatherly intervention of the ministry to give a sense of belonging to all categories of healthcare workers , it became obvious that those at the helm of affairs in FMC Owerri, out of primordial sentiment against nurses are bent on treating nurses as outcasts in our health system.
It was on this note UGONSA urged Dr Yahuza, to prevail on the management of FMC Owerri to : Advertise the post of nurse interns as was done for the interns of other healthcare disciplines (as published by Daily Sun Newspaper on Monday 15th October, 2018); Upgrade existing nursing officers who were on CONHESS 07 before the release of the circular to the new base of CONHESS 08 effective from 8th September, 2016 (being the date of release of the circular REF No. HCSF/EIR/CND/S.100/ST/97 by the office of the head of civil service of the federation) as prescribed by the civil service circular, Ref No. B63279/S.7/II/T/273 dated 24th April, 2002 (please refer Annexure B).
The association also prayed for the commencement of employment of fresh graduate nurses on CONHESS 08 and upgrade the existing nursing officers who were wrongly employed on CONHESS 07 by FMC Owerri after 8th September, 2016 to CONHESS 08 effective from the date of their employment.
Get the Latest Volume of Pharmanews Series of Books- Treasures of Life
Treasures are valuable resources that help to add meaning, beauty and riches to whosoever discovers or possesses them. Life has many of such resources, but more importantly, God has deposited in each of us treasures that are meant to ensure that no individual lives on earth aimlessly or worthlessly.
Like many other valuable resources however, our inborn treasures are not always easily discerned. It sometimes takes a lot of introspection to discover them, and even greater effort to develop and harness them to achieve their fullest impact. This is why the author has chosen to dwell on the treasures of natural talents and gifts in this volume of Pharmanews series of books on life.
Everything in life revolves around our natural and spiritual endowments. It is in them that we find the essence of our existence, the direction that God intends for our destinies, as well as the key to our happiness and fulfillment in life. Many have passed through life without discovering or developing their God –given resources- much to their discontent and eventual frustration. But for as many as have explored and exploited their inner possibilities, the world has been blessed by their contributions, and God and His kingdom have been glorified.
The book, made up of ten chapters, and 98 pages, is very insightful, concisely written, and full of relevant qualitative images to drive home the subjects of discussion.
Indeed, you will prosper beyond your imagination if you pay careful attention to the principles contained in this volume.
A copy goes for N500.00. Order for your copies today!
Delivery within Lagos attracts additional N500, while delivery outside Lagos costs additional N1500.
For online payment: Click Here
For Direct Deposit or Bank Tranfer: Payment to be made in favour of Pharmanews Ltd., to Zenith Bank Plc. Account Number: 1010701673.
For further enquiries, contact: Chiazor (08134835525), Elizabeth: 08057235128
2nd Annual SK-Pharmanews Interactive Forum Holds in Oluyole, Ibadan
Pharmanews Ltd in collaboration with Mareek Image Concepts, cordially invites all our esteemed readers, revered advertisers, distinguished pharmacists and pharmaceutical companies, to an hour interaction with Sesan Kareem and other Pharmanews columnists, at the forthcoming 91st Annual PSN Conference, tagged, “Oluyole 2018”, Ibadan, Oyo State.
Feedbacks garnered from our readers have shown that stories on Pharmanewsonline.com and Pharmanews Journal, including those from our columnists, have impacted many lives. This one hour event is an opportunity to interact with our columnists and meet them one on one, to ask questions on any area of interest to them.
Pharmanews team will be fully available to share all our digital applications with participants at the venue, at no cost.
Date: Thursday, November 1, 2018.
Time: 4pm
Venue: International Conference Centre, Oluyole, Ibadan.
Target Audience: Pharmanews Readers, Advertisers, Columnists, Young Pharmacists.
PSN Launches Vision 2050, PharmiT and PSNPay Online Platforms
As a means of fulfilling his promise to uplift the Pharmaceutical Society of Nigeria (PSN) to an enviable height of professionalism and digitalisation of the system, the PSN President, Pharm. Ahmed I Yakasai, made good his pledge, at the triune event of the PSN, which unveiled the PSN Vision 2050 Strategy Document; PharmiT- Online platform for National Drug Distribution based on National Drug Distribution Guidelines; and launching of PSNPay – Online Platform for capitation and states dues.
The epoch-making occasion, held on 23 October, 2018, at the Sheraton Hotels, Ikeja, Lagos, had in attendance leaders of pharmaceutical groups in Nigeria, representatives of all technical groups of the Society, and Chams Plc staff members. They include: PSN President, Pharm. Ahmed I Yakasai; Prince Julius Adelusi-Adeluyi, president, NAPharm; Pharm. Lekan Asuni, chairman of PharmiT online platform committee; Pharm. Lere Baale, chairman of PSN Vision 2050 Strategy Document committee.
Others were: Pharm. Ibrahim Babashi, PCN representative; Immediate Past President of PSN, Pharm. Olumide Akintayo; ACPN National Chairman, Pharm. Samuel O. Adekola; AHAPN National Chairman, Pharm. Kingsley Amibor, BOF representative, Pharm. Rosemary Nikoro; Oluyole 2018 Conference Planning Committee Chairman, Pharm. Onyeka Onyeibor; Pharmanews Publisher, Sir Ifeanyi Atueyi; Alpha Pharmacy Managing Director, Sir Ike Onyechi; PSN National Secretary, Pharm. Emeka Duru; Dr Okey Akpa, PMGMAN chairman; Group Managing Director, Chams Pls, Mr Femi Williams, and several other leaders in the pharmaceutical industry.
Appreciating the huge sacrifices made by all members of the committees constituted to achieve the projects being unveiled, Pharm. Yakasai explained the motive behind the PSN Vision 2050 Strategy Document, noting that his administration discovered a need to develop a long term vision for the transformation of the Society, thus, they set up a committee, led by a very resourceful pharmacist, in the person of Pharm. Lere Baale.
The optimistic PSN President however stated that the launching of the strategy document is just the beginning of the journey, but the actualisation of the dream really lies in the implementation of the Vision 2050 Strategy Document, “which will go a long way in complimenting and supporting the profession, be it in education, training, practice, PSN structure and pharmaceutical sector in general”.
He further commented on the PharmiT Online Platform, as a Pharma Industry IT solution facilitated by the PSN under his leadership to compliment the implementation of the National Drug Distribution Guidelines (NDDG). Pharm. Yakasai, who noted the global Information Communication Technology revolution, explained that the Society must not be left out of movement, as the platform will serve as a central repository and interface for exchange of information for practitioners, the practice, and regulators.
And on the third agenda for the day, which was the introduction of the PSNPay Online Payment Platform, he said that PSN is transforming the existing manual process of PSN annual capitation and that of technical and interest groups of the PSN dues, for both states and national, to a digitalize payment platform powered by Chams switch.
Pharm. Yakasai explained the importance of the PSNPay, as an end-to-end automated payment/collection platform, that will ultimately improve operational efficiency of PSN and its technical and interest groups.
The chairman of the occasion, Prince Adelusi-Adeluyi, while addressing the participants at the event, remarked that with the plethora of achievements made by PSN at 91 years, it is obvious that pharmacy is not doing badly.
He therefore charged pharmacists saying “We tend to underestimate ourselves. I urge you as pharmacists to be bold-chested, because whatever a pharmacist does, he does well .We need to continually make ourselves available, dependable, and responsible as pharmacists”.
Pharm. Lekan Asuni, chairman of the PharmiT Platform explained to the audience what to expect from the platform, which he described as having three parental bodies- PSN, PCN, and NAFDAC.
He said the platform will provide access to needed information on the frontend, while the backend will be managed by Chams Plc. Also, he noted that mobile apps will be available for ordering of goods and pharmacists clearance, to allow them make payment.
The PharmiT platform chairman also disclosed that his team members made consultation across board in the profession, to engage NSCIP Abuja, APIN, PMGMAN,NAFDAC,PSN,Education committees, and others, to have a robust PharmiT platform.
On his own part, the Group Managing Director, Chams Pls, Mr Femi Williams, listed some of the benefits of the platform to include: Collaboration, trust, ease of discovery, safety, ease of doing business, quality assurance, and others.
Pharmanews Releases 2018/2019 Edition of the Nigerian Pharmaceutical Directory
Pharmanews Limited has just released the 2018/2019 Edition of the Nigerian Pharmaceutical Directory (NPD), with more precise health sector information for the use of policymakers and healthcare practitioners.
The Nigerian Pharmaceutical Directory (NPD) is a compilation of data on the Pharmaceutical Industry and health institutions. It is a very useful reference material for healthcare practitioners, governments, Small and Medium Scale Enterprises (SMEs), consultants, business administrators, investors and other major actors in the health sector.
The 2018/2019 Edition is a special one, with very rich content. It is not only a repository of facts and figures, but contains incisive reports such as the Nigeria Pharmaceutical Industry Investment Report; Nigerian Pharmaceutical Manufacturing Report; Report on Drug Regulatory Agencies Roles, Community Pharmacy Industry sub-sectors report; and many others.
Be assured of quality information for your money, as each copy goes for N3000.00. Order for your copy today!
For online payment Click Here
For Direct Deposit or Bank Tranfer: Payment to be made in favour of Pharmanews Ltd. to Zenith Bank Plc. Account Number: 1010701673.
For further enquiries, contact: Chiazor (08134835525), Elizabeth: 08057235128
You Need Skills with Talent
Your natural talents are inborn and programmed in your subconscious mind. You have to discover your area of natural talent and ability and then develop it. On the other hand, skills are learnable. They are not genetically determined. You learn a skill by practice and repetition.
Your skill can make you known, admired and valued. Think of persons who have come to the limelight in their fields and observe what made them prominent. Proverbs 22:29 (Amplified) says, “Do you see a man diligent and skillful in his business? He will stand before kings; he will not stand before obscure men.” You are at your best when your skills are in tandem with your talents. According to Larry Bird, “A winner is someone who recognises his God-given talents, works his tail off to develop them into skills to accomplish his goals.”
A skill may be defined as an ability and capacity acquired through deliberate systematic, and sustained effort to smoothly and adaptively carry out complex activities or job functions involving ideas (cognitive skills), things (technical skills) and /or people (interpersonal skills).
Skills are broadly divided into hard and soft skills. Hard skills are learnt in the classroom through books or training materials or on the job. Examples are machine operation, typing, playing games and proficiency in foreign language. These skill sets are easy to quantify.
Soft skills are subjective and much harder to quantify and are also known as “people skills” or “interpersonal skills”. Examples are communication, leadership, motivation, patience and teamwork.
Many skills are dependent on one another. Sometimes you need to learn a skill you do not enjoy but it is needed for you to use other skills. For example, in order for me to obtain admission to study Pharmacy in the university, I had to work hard on my Physics, which I did not enjoy. But I needed it to go along with Chemistry and Zoology for the required combination. If you want to become a good journalist, the skill of interviewing people must be learnt.
Improving your skill in a certain area can cause remarkable improvement of your productivity and income. If you are weak in a particular skill that you need to excel, you can determine to learn it instead of allowing it to hold back your progress.
One skill I learnt in my secondary school (Dennis Memorial Grammar School, Onitsha) in the fifties was photography. Students had a variety of hobbies like shoe-making, bookbinding, tailoring, carpentry, agriculture, music and so on. We were encouraged to get involved in one or two hobbies, depending on our areas of interest.
I chose photography and we were assigned to a professional photographer (Ugha’s Photos) to learn various aspects of photography, including focusing, snapping, developing and printing. That experience became very relevant when I got into pharmaceutical journalism in 1979. Taking good photographs became one of my greatest advantages.
Many current university graduates are not employable because they lack certain skills required by employers but which they could not acquire in the university. Even graduates of professional courses need to sharpen their skills after their university programmes because employers are concerned with performance and productivity.
Employers are now giving soft skills the desired consideration during employment interviews. As a matter of fact, you cannot be a successful physician if you do not relate well with your co-workers and patients. Your attitude can cause you to lose your patients. This is one of the reasons the interprofessional relationship in the healthcare system of the country has been unacceptable, resulting in poor health services.
In order to move to the top of your field and achieve excellence, there must be a price to pay. It is the price of success which involves mastering a difficult skill you need to be the best at what you do. If you desire to master a skill, you need to read, learn and practise it regularly. The more you practise what you learn, the faster you will become more competent and skilled in that area. The more you practise, the more confidence you will develop.
I have, on several occasions, tried to play the keyboard but never persisted in practising it steadily. After a long time of no practice, the little bit I learnt was forgotten. Then another session of learning was embarked upon. This is not a good way of acquiring a skill. There must be persistence and commitment to practise and improve in learning.
What do you know about Salmeterol?
1 is longer-acting than salbutamol
2 may be used in combination with beclomethasone
3 could replace salbutamol use
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Yakasai, Sanda Urge National Assembly to Review NHIS Act
– As AGPMPN decries marginalisation of private hospitals
Dr Umar Sanda, president, Healthcare Providers Association of Nigeria (HCPAN), has declared that delay in the passage of the current bill on the National Health Insurance Scheme (NHIS) Act at the National Assembly is having a negative effect on healthcare providers in the country.
Speaking at HCPAN’s Extraordinary General Meeting held recently at Lagos Chambers of Commerce and Industry (LCCI), Alausa, Lagos, Sanda disclosed that there was a nationwide lull in health insurance, which he described as quite worrisome.
According to him, “Nothing is moving positively in the nation’s health insurance. Even the HMOs have been inactive for some time and providers are feeling the pinch. That was why we called for this emergency general meeting to dissect the problem and come up with a solution.
“We are in a democracy where the rule of law applies. As long as this 8th National Assembly does not pass the new law on health insurance, we cannot move forward. That bill has been there for eight months and nobody is paying attention to it. We must get a legal backing for what we do to satisfy the HMOs, providers and relevant stakeholders.”
While noting that the bill had passed its second reading before being sidelined at the parliament, Sanda stressed that the new Act must make NHIS mandatory for people to access affordable healthcare across the country.
“After this meeting, the communique will be passed on to the relevant authorities – the presidency, the National Assembly and the state governments – to review,” Sanda said, adding that “universal health coverage can only be achieved when the NHIS is made compulsory. That is why I said passage of the bill is very important.”
In a related development, Dr Ugwu Iyke Odo, president, Association of General Private Medical Practitioners of Nigeria (AGPMPN) has taken a swipe at tertiary institutions’ dominance of the health insurance scheme.
Odo, who described the situation as an anormaly, repeatedly declared that teaching hospitals and, by extension, federal medical centres, had no business with a private sector-driven initiative like the NHIS, which is over 70 per cent about primary care.
“In primary care, we are talking about private hospitals mostly because we dominate over 70 per cent of these services. Essentially, over 70 per cent of the ill-health that bring people to the hospitals are covered by 70 per cent.
“Twenty per cent is secondary care and only about 10 per cent is required to be sent to the tertiary institutions like the teaching hospitals. That is the referral system,” he emphasised.
The AGPMPN boss further noted that even in the United Kingdom, the NHIS is an essentially private sector-driven programme and should therefore be designed to allow the right people to do their job.
“Sadly, the reverse is the case in Nigeria today. Teaching hospitals and the federal medical centres dominate here. They have almost 80 per cent of the enrollees.
“And where capitation is paid on health scheme, it always depends largely on the population of the patients. By our own scheme in Nigeria, we have recommended N750 capitation. The minimum number of patients a facility should have to break even is 5,000. Only teaching hospitals and FMCs have this number,” he said.
Speaking further, Odo remarked that over 90 per cent of private doctors cannot boast of the 5,000 mark, arguing that many have only 10, 50 or 100 patients at the most.
“In this case, the money is gone after treatment of the first two patients. For every other patient you treat, it means you are spending your own money. That is why doctors are poor.
“Until we meet universal coverage where every provider will be guaranteed that minimum critical number, we should revert to fee-for-service so that even if you have two patients, you can make 20 kobo to keep body and soul together,” he explained.
On his part, Pharm. Ahmed Yakasai, president, Pharmaceutical Society of Nigeria (PSN), wondered why Nigeria was still struggling with health insurance, long after its introduction.
“I agree that the NHIS Act needs to be reviewed. If countries like Ghana cover 70 per cent of their populations, and Rwanda that is just recovering from years of genocide covers over 90 per cent, what is the problem with Nigeria?” he quizzed.
Yakassai however expressed optimism in the strong representation of healthcare players under HCPAN, adding that the presence of professionals like medical lab scientists, physicians and pharmacists in its membership says a lot about the association’s collaborative stance.
“I believe synergy is a must and not an option. It should form the core of our larger society. In order for the Nigerian masses to have access to quality and affordable healthcare, NHIS has to be on its feet and rise up to the occasion,” he charged.
Glitz, Glamour at Jawa Pharmaceutical Boss’ 80th Birthday Celebration
No fewer than 100 people turned up for the 80th birthday celebration of Chief Varkey Verghese, chairman, Jawa Group and president of Indian Pharmaceutical Manufacturers and Importers Association of Nigeria (IPMIN).
The colourful event, which held at Hotel Smridus, Victoria Island, Lagos on 22 October, 2018 had Pharm. Ahmed I Yakasai, president, Pharmaceutical Society of Nigeria (PSN); Mazi Sam Ohuabunwa, former managing director, Neimeth International; Babatunde Ruwase, president, Lagos Chamber of Commerce and Industry (LCCI); H. S. Arora, managing director, Ranbaxy Nigeria Limited and Prof. Samson Adebaye, director of ports inspection, National Agency for Food and Drug Administration and Control (NAFDAC) in attendance.
Others were Ashwin Dayalani, vice president, IPMIN; J.T. Lalvani, chairman, Therapeutics Lab; Jasbir Singh, managing director, Pharma Ethics; Folusho Ajenifuja, superintendent pharmacist, Sagar Vitaceutical; Femi Taiwo, general manager, Finance, Jawa International and several members of IPMIN and the Indian Community in Lagos.
Congratulating the celebrant, Yakasai disclosed that he had to abort his trip to Kano when he heard that a get-together cocktail was being held in honour of his good friend (Verghese).
“We have known each other since 1993 when he started Jawa Pharmaceutical. Coincidentally, that was the same year I started my company – Pharmaplus Nigeria Limited. When Verghese was asked about his vision during the official commissioning of Jawa factory, I recalled him saying that he wanted to build world class pharmaceutical products.
“Today, Jawa is among the biggest pharma manufacturing companies in Nigeria. He is a strong Christian who has the fear of God and has touched so many lives. To show you his level of humility and compassion, he recently travelled all the way to Jigawa to drill a borehole for the benefit of the community in the state,” he declared.
On her part, Mrs Annie Verghese, wife of the celebrant announced that she has always supported her husband throughout their union.
“We have been joined together since 1968 as a young couple and we were already christians at that time. So many obstacles had come and gone, but we always come together to pray against such problems.
“My husband is a very humble man, even at home. Even when I was really sick, I used to see him several times on his own and by my bed praying for me. I wish him many more years ahead,” she enthused.
West Africa Countries Lose $7 Billion Dollars to Ebola – Official
The West African Health Organisation (WAHO) says there is urgent need for countries to prepare for emergencies to prevent economic, human and other losses, especially as the region lost 7 billion dollars in terms of cost during the 2014 Ebola epidemic.
Stanley Okolo, the Director-General of the organisation, disclosed this to the News Agency of Nigeria (NAN) during the Regional Disease Surveillance Systems Enhancement (REDISSE) sub-committee meeting in Lagos on Friday.
REDISSE project is a regional project funded by the World Bank, covering all the 15 ECOWAS countries and Mauritania in five-year phases from 2016 to 2023.
The first phase covers three countries, including Guinea, Senegal and Sierra Leone, the second phase covers four countries of Nigeria, Guinea-Bissau, Liberia and Togo.
Its implementation is in the third phase, covering four countries – Benin, Mali, Niger and Mauritania.
Mr Okolo said, “I am challenging the 15 countries in West Africa to be ahead of the curve because those involved in epidemic and emergencies know it has huge economic problems.
“We were involved in the 2014 Ebola epidemic and had nearly 7 billion dollars in terms of lost productivity, lost income, lost tourism and aid that came.
“This nearly 7 billion dollars is probably only in cost; we are not talking of the nearly 12,000 brothers, sisters, children and women that died, we must not have that again,’’ he said.
“So, a lot of work is going on but what I am really charging us to do is get ahead and challenge each other; and also to our leaders, that they imbibe and acquire the models and tools so as to be prepared and fight diseases.
“Our responsibility in our region is to make sure that countries are brought together, challenge them, give them support and promote the right things that will give us that epidemic preparedness.’’
Mr Okolo, a professor, added that: “It is important to say that the first 48 hours in outbreak of any epidemic is critical and what is done then is dependent on how prepared you are within that 48 hours.
“Epidemic responsibility is dependent on the easiness of preparedness and the system in each country; in other words, the preparedness in response depends on preparedness of each and every country.
“So, we are looking at how our countries, individually, are setting up their system, their people in terms of surveillance in getting information from all the districts, all the public health communities and how they are analysing those information.
“Also, how they have set up laboratories that will support the surveillance so that we can do the test to know when to suspect an illness.’’
The director-general said that the structure of REDISSE is important because “through it, the World Bank gives loan at zero or very low interest.
“It is trying to support our region so we don’t have the problem we had in 2014, for us to be prepared.
“Therefore, it is an opportunity for our region to get that preparedness in place’’. On the measures that have been put in place to checkmate future epidemic outbreaks in the region, Mr Okolo said: “The global community, physicians and everybody have learned the lessons from 2014.
“That is why in a lot of these projects, governments like that of Germany, are supporting us in terms of preparedness and finances.
“Also, in the region, we have set up super regional laboratories; 12 of them in West Africa for human reference analysis and another two is for veterinary.
“We have veterinary because we are looking at it that sometimes too some of these diseases and epidemics come through animals.
“We are also looking at how to train people, epidemiologists, to support the countries; we have 3,000 to support across West Africa.
“These are part of the things we are talking about in boosting capacity in terms of human resources.’’
Mr Okolo underscored the need to improve on the lessons learnt from the 2014 Ebola epidemic, including poor disease surveillance infrastructure as well as poor information sharing and collaboration.
According to him, poor emergency response, inadequate financing and leadership are also take outs to be learnt from the 2014 Ebola epidemic in the sub-region.
Also, John Paul Clark of the World Bank said: “This is our opportunity to discuss the challenges we face openly.
“From this meeting, we will map out strategies to utilise the resources that will help WAHO.
“We also seek to provide the technical support and assistance in more timely manner that will help the bank overcome some of the bureaucratic obstacles presently being encountered as well as streamline the procedures.’’
(NAN)
Prof. Olowokudejo Delivers UNILAG 14th Inaugural Lecture
As a way of fulfilling the global university requirement, which holds that every professor must deliver an inaugural lecture on his or her field of study, Professor James Dele Olowokudejo of the Department of Botany, Faculty of Science, University of Lagos (UNILAG), recently paid his academic debt, when he delivered the 14th Inaugural Lecture for the 2017/2018 academic session.
Presenting the lecture titled, ”The Enigmatic Kingdom of Plants: Their Power to Stimulate, Intoxicate, and Alter Consciousness; Their Power to Maim, Kill and Cure”, at the J. F. Ade-Ajayi Auditorium, UNILAG, Akoka, Lagos; Prof. Olowokudejo shed light on the subject of Botany, tracing its origin.
He elucidated on some of its sub-titles including recent advances and current trends and took the audience on a tour of the world of plants, letting them see how plants mould their bodies, faculties, perceptions, and tastes.
The erudite professor of Botany further submitted that the plant kingdom has an overwhelming influence on other forms of life, including humans and the environment, adding that it constitutes the foundation of all existence, including the society and civilization.
He continued: “The plant kingdom remains an enigma because the more we know about the diverse hierarchies of categories and groups, the more that remains to learn about the species and complexes”.
While calling for intensified co-operation among practitioners on the scientific field, and those in the pure sciences and social sciences, he stressed that the traditional subject compartment and categories can no longer remain in isolation from each other. Adding that all actors involved must work increasingly at the interface of discipline in order to address the complex problems of today’s world.
Affirming that education is the most effective means that society possesses to confront the challenges of the future, the erudite scholar called on government to allocate more resources to education at all levels, as well as prioritise, coordinate and intensify the conservation of plant diversity, adding that efforts should be redoubled towards the conservation of plants diversity and wise-use of all medicinal plants, so that our future benefits and knowledge are not put at risk.
In his speech after the lecture, the Vice Chancellor of the University, Professor Oluwatoyin T Ogundipe described the lecture titled “The Enigmatic Kingdom of Plants: Their Power to Stimulate, Intoxicate, and Alter Consciousness; Their Power to Maim, Kill and Cure” as apt, while assuring that the institution would continue to encourage research and innovations that could promote academic excellence.
He congratulated the 14th inaugural lecture presenter, Professor James Dele Olowokudejo for his commitment towards academic excellence, stressing that inaugural lectures are debts owed the university system.
The VC, who described inaugural lectures as one of the legacies of the global university system, however, said Olowokudejo has fulfilled his academic obligation to the university community, saying it is a challenge to others yet to deliver their inaugural lectures.
Presenting an over 120 pages lecture book, the plant expert urged the University authority to encourage the planting of trees on the campus, saying appropriate indigenous trees should be planted on both campuses, Akoka and Idi-Araba, to replace the old and aging ones, while the young actively growing trees should be trained by grooming.
Zamfara State PSN Chairman Becomes the Danmajen Bungudu
The Zamfara State PSN Chairman, Pharm. Sani Bello, has just added another feather to his cap, as he was recently decorated as the Danmajen Bungudu.
The Turbaning Ceremony of the newly installed Danmajen Bungudu was performed under the authority of His Royal Highness the Emir of Bungudu, Alh. Hassan Attahiru, in Zamfara State and was witnessed by several relations and friends of Pharm. Bello.
The management and staff of Pharmanews wish him the best in his new position.
When administering prednisolone ?
1 it should be taken after food
2 enteric-coated formulation is preferred
3 dose should be divided into twice daily administration
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Cefuroxime is?
1 also available for oral administration
2 active against Haemophilus influenzae
3 highly effective against Gram-negative bacteria
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Parameters that require monitoring in a patient who is admitted to the emergency department include?
1 urinary flow
2 blood gases
3 plasma-potassium concentration
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Zambia Set for Ebola:Trains Hundreds of Health Workers
Health workers in Zambia are training to deal with Ebola amid fears it will spread from the neighbouring Democratic Republic of the Congo.
More than 100 people in DRC have died from the contagious fever since the most recent outbreak began at the start of August.
Now Zambia, which borders the stricken country, is preparing in case it has to fight its own deadly epidemic.
Staffs are learning how to recognise signs of Ebola, how to treat patients and how to stop the infection spreading in case it is transmitted by travellers.
The government is focusing on regions of the country which are closest to DRC, where a now months-long outbreak has killed 106 people.
Ebola has killed almost two thirds (65 per cent) of the 162 people confirmed to have had it since the DRC’s epidemic began on August 1, SciDev.Net reported.
And fears surrounding the disease have been heightened since a devastating outbreak in western Africa in 2014 killed more than 11,000 people.
‘We do not want a repeat of the tragedy that hit the Western part of our continent in 2014,’ said Victor Mukonka, the director of the Zambia National Public Health Institute.
‘Having trained rapid response teams at all levels assures capacity for any community, and we encourage all states to take up this strategy.’
Some 216 health workers were trained in the country’s north-western provinces in September, with another 86 in the north in August.
Doctors, nurses, environmental and public health officers, pharmacists and laboratory staff have all been included in the education programme.
They are taught how to explain the infection to local people, how to collect and transport specimens for testing, and how to prevent the virus spreading.
The programme is designed to give workers the ability to set up a rapid response in the event of Ebola beginning to spread.
This could happen if the virus was brought into the country by a traveller or a refugee from military fighting in the DRC.
Around 50,000 people fleeing violence in the country are thought to have travelled to Zambia, according to the United Nations.
Both Zambia and the DRC should work together to monitor the virus and movement of people across the border, said Nathan Bakyaita, the World Health Organization representative for Zambia.
The public health institute’s Mr Mukonka told SciDev.Net: ‘It is important that Africa takes ownership and leads in addressing matters of health and other determinants affecting the continent’.
Daily Mailonline
Scientists Reveal How Posture and Movement Can Improve Cognitive Ability
Studies have shown over and over the effects of physical exercise on human brain, how it boosts memory capacity and prevents cognitive decline. However, much has not been written on the effects of posture- sitting, standing, and walking on the brain.
This informed the decision of three researchers from Ludwig‐Maximilians‐University Munich in Germany — Gordon Dodwell, Hermann J. Müller, and Thomas Töllner, to investigate into the impact of posture and movement on human memory.
Their findings, published in the British Journal of Psychology, validated previous findings that aerobic exercise protects the brain, and much more that sitting, standing, and walking each impact visual working memory, which is the brain’s ability to store visual information spontaneously, for use in a current task.
Another study published in Frontiers in public health on the effect of movement on cognitive performance also affirmed that movement can significantly improve memory performance in students.
The study titled: “The Effect of Movement on Cognitive Performance”, examined the relationship between walking, cognitive, and academic skills. The researchers required students from elementary, middle, high school, and college students to walk for 10 min prior to completing feature detection, Simon-type memory, and mathematical problem-solving tasks.
They found that ten minutes of walking had a significant positive effect on Simon-type memory and critical feature-detection tasks among all age groups. Separately, with mathematical problem-solving ability, higher performing high-school students demonstrated significant positive effects on mathematical reasoning tasks based on the Bloom Taxonomy.
The findings also revealed that poorly achieving high-school students performed significantly better than those with higher grades in mathematics on tests of mathematical problem-solving ability based on the Bloom’s Taxonomy.
According to the three Germane researchers “Acute aerobic exercise has been found to influence cognitive performance both subsequently and concurrently [during and after exercise].
“However, the influence on executive performance during acute exercise is less clear, with several accounts providing contradictory theory and evidence regarding the direction of effects,” the authors added
Using an electroencephalography (EEG) — a technique that allows researchers to monitor a person’s brain activity by recording electrical impulses — to see how people would perform on visual memory tasks while in a passive posture, or while physically active; the researchers selected 24 participants to be tested with this device.
The participants were made to undergo testing as they performed the memory task in different conditions: while seated on a stationary bicycle, while pedaling, while standing on a treadmill, and as they were walking on a treadmill.
According to the findings reported on Medical News Today, Lead author Thomas Töllner and colleagues found that the participants’ visual working memory seemed to work best when they were cycling or walking, rather than seated or simply standing.
Moreover, when it came to posture, the researchers observed that standing helped minimize mistakes as the participants performed their task.
The researchers stated : “Our behavioral results indicated that both acute aerobic exercise and upright posture expedited the overall speed of processing as compared to passive and seated conditions, while upright posture additionally served to reduce error rates”.
Jigawa Immunises 1.5 Million Children Against Polio
The Jigawa Primary Healthcare Development Agency (JSPHCDA) says over 1.5 million children were immunised against polio in the recently concluded immunisation in the state.
Kabiru Ibrahim, the executive secretary of the agency, said this on Monday in an interview with the News Agency of Nigeria (NAN) in Dutse.
He said the agency received enough Oral Polio Vaccines (OPVs) which led to the successful immunisation of the targeted children against the disease.
Mr Ibrahim also said adequate personnel were engaged to conduct the exercise simultaneously across the 27 Local Government Areas of the state.
The executive secretary commended traditional rulers and religious leaders as well as other stakeholders in the state for their support and cooperation in ensuring the smooth conduct of the exercise.
Mr Ibrahim further expressed satisfaction at the level of compliance by parents.
He said that such cooperation would facilitate quick response in combating the disease and address other emergency situations in the state.
(NAN)
World Food Day 2018: UN Tasks Governments on Strategies to Achieve Zero Hunger
With over 820 million people subjected to chronic malnutrition globally, the Food and Agriculture Organisation (FAO) of the United Nations have called on governments of member states to formulate policies that will encourage public and private partnership towards boosting agricultural produce of each nation.
While admitting that there came a short period of decline in global hunger level, the UN FAO, on the occasion of the 2018 World Food Day is lamenting a rise in world hunger level again, this necessitated the call on governments to encourage private investment in agriculture.
Of this global malnutrition burden, Nigeria has over 11 million stunted children, while the nation is also facing a crisis of malnutrition and ranks second behind India among all countries
The Federal Ministry of Health Report on malnutrition further revealed that up to 1 million Nigerian children under age 5 are affected by severe acute malnutrition each year, and these children have severely low weight for their height and are at risk of dying unless given urgent attention.
It also disclosed that nearly 4 out of 5 Nigerian children do not meet the World Health Organization’s recommendation for exclusive breastfeeding during the first 6 months of life, with about 70 percent of children ages 6 to 23 months not receiving adequate nutrition.
Thus, to achieve Zero Hunger by 2030, the UN statement reads in part:”Governments must create opportunities for greater private sector investments in agriculture, while boosting social protection programmes for the vulnerable and linking food producers with urban areas.
“Conflict, extreme weather events linked to climate change, economic slowdown and rapidly increasing overweight and obesity levels are reversing progress made in the fight against hunger and malnutrition.
“Now is the time to get back on track. The world can achieve Zero Hunger if we join forces across nations, continents, sectors and professions, and act on evidence. 70 percent of the world’s poor live in rural areas where people’s lives depend on agriculture, fisheries or forestry. That’s why Zero hunger calls for a transformation of rural economy.
“Smallholder farmers need to adopt new, sustainable agricultural methods to increase productivity and income. Ensuring the resilience of rural communities requires an approach that is mindful of the environment that leverages the power of technological innovation and creates stable and rewarding employment opportunities”.
Beyond governments, the officials of the Federal Ministry of Health believe there is a role for everyone in combating malnutrition. They said individuals can raise awareness about Nigeria’s silent crisis of malnutrition, reach out to colleagues in other sectors, such as health, agriculture, finance, education, women affairs; and work together to fight malnutrition.
Inflammatory mediators that are released in an asthmatic attack include?
1 histamine
2 leukotrienes
3 prostaglandins
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Regular Use of Aspirin May Reduce Liver Cancer Risk- Study Finds
A new study conducted by researchers at the Massachusetts General Hospital have found that regular aspirin use can reduce the risk of developing liver cancer.
The findings published in the journal JAMA Oncology, revealed how scientists reinvestigated aspirin and its impact on liver cancer.
The result of the study, reported on Medical News Today indicated that the use of aspirin on a regular basis can lower the risk of developing liver cancer, or hepatocellular carcinoma (HCC).The researchers defined their ‘regular use’, as taking two or more 325-milligram tablets per week for 5 years or more.
According to the lead author, Dr Tracey Simon, a research fellow from the Massachusetts General Hospital Division of Gastroenterology in Boston, :”Regular use of aspirin led to significantly lower risk of developing HCC, compared to infrequent or no aspirin use, and we also found that the risk declined progressively with increasing aspirin dose and duration of use”.
To arrive at their findings, the scientists reviewed some data, including health information on more than 170,000 people that were collected for over 3 decades.
Questionnaires were also administered to patients which asked questions like, whether they took aspirin, how often they took it, and for how long. Another part of the data included liver cancer diagnosis.
Analysis of the data collected from patients revealed that people who took two (or more) 325-milligram doses of aspirin each week had a 49 percent reduction in their risk of developing liver cancer. For those who took aspirin for 5 years (or more), that risk was reduced by 59 percent.
Also, the team saw that the risk reduction decreased if the participant stopped taking aspirin and disappeared entirely 8 years after they stopped taking aspirin. There was no decrease in risk of liver cancer when participants took acetaminophen or ibuprofen.
Having considered the findings on liver cancer, the research team realised it will be appropriate to state some key facts on the disease.
Liver cancer is not a particularly common type of cancer, but it has been on the rise over the past few decades. Someone’s risk of developing liver cancer is elevated if they already have liver disease, such as hepatitis B or hepatitis C.
If somebody has cirrhosis of the liver — which is when scar tissue replaces normal liver cells and prevents the liver from working as it should — their risk of liver cancer is also elevated.
Liver cancer is now the third leading cause of cancer deaths around the world. Some signs and symptoms include: a hard lump just below the rib cage on the right side, discomfort in that same are, a swollen abdomen, pain in the right shoulder blade or back, jaundice (a yellow discoloration of the skin and whites of the eyes), bruising or bleeding more easily, etc.
In an asthmatic attack the following condition(s) occur(s)
1 bronchospasm
2 increased airways resistance
3 inflammation
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Stakeholders Urge Nigerians to Stop Disease Spread Through Regular Handwashing
As Nigerians joined the rest of the world to celebrate the 2018 Global Handwashing Day, an annual event commemorated on 15 October, stakeholders have advised Nigerians to be involved in the process of stemming the tide in disease spread, by imbibing the practice of regular handwashing.
According to a statement released by Global Handwashing Day Partnership from Washington DC, hands are the leading carriers of germs that cause diarrhea and respiratory infections like pneumonia. Handwashing at critical times – such as before a meal or after using the toilet – stops the spread of disease-causing germs. Consistent handwashing with soap reduces the incidence of diarrheal by nearly half and respiratory infections by 25% among children under 5.
In view of the prevalence of infectious diseases in the country, which range from protozoal diarrhea,to hepatitis A and E, typhoid fever, leptospirosis and schistosomiasis, and others, regular handwashing, and access to portable water serve as protective shield from all these, experts asserted.
Disclosing this year’s Global Handwashing Day theme, “Clean Hands – a recipe for health,” the Global Handwashing Day Partnership document, emphasised the linkages between handwashing and food. “Handwashing is an important part of keeping food safe, preventing diseases, and helping children grow strong. Yet, handwashing is not practiced as consistently or as thoroughly as it should be. Diarrheal disease limits the body’s ability to absorb nutrition from food and is a major cause of death in low resource settings. Handwashing with soap is an effective way to prevent these losses”.
Celebrating the event in Nigeria, the Health Minister, Prof. Isaac Adewole, stressed the importance of regular handwashing in reducing disease burden, adding that the activities of other partners in the health industry to promote good hygiene have helped in reducing the burden on the Federal Government.
The minister, who was represented by the National Coordinator, Food Safety and Quality Programme, Mr. Fubara Chuku, at the exercise organised by Dettol as part of its school hygiene programme, in commemoration of the Global Hand-washing Day stated that government is making efforts to include the techniques of proper hand-washing in school curriculum to enable children learn it early in life
Critical food-related times for handwashing with soap include: before cooking or preparing food, before eating, and before feeding someone (including breastfeeding). The contamination of food can lead to a wide range of illnesses and outbreaks, many of which are particularly dangerous for young children and people with compromised immune systems.
Global Handwashing Day raises awareness of the importance of handwashing and encourages action to promote and sustain handwashing habits. Organizations and individuals can celebrate Global Handwashing Day by planning an event, participating in a digital campaign, or simply spreading the word about the importance of handwashing.
The Global Handwashing Partnership is an international coalition of organizations working to promote handwashing with soap.
PSN Decides 2018: Presidential Aspirants slug it out Ahead of Election
Ahead of the forthcoming presidential election of the Pharmaceutical Society of Nigeria (PSN), billed to hold at the 91st Annual National Conference of the PSN, tagged “Oluyole 2018”, in Ibadan, Oyo State, all the four presidential candidates have reeled out their manifestoes at the first ever PSN Presidential Debate organised by Pharmanews, in collaboration with PSN.
The debate, held on Friday, at the conference hall of the PSN Secretariat, Lagos, had in attendance all the candidates, including Pharm. (Mazi) Sam Ohuabunwa; Pharm. (Dr) Otakho Daniel Orumwense; Pharm. (Dr) Lolu Ojo, and Pharm. Anthony Bola Oyawole.
The debate moderator, Pharm. Shina Opanubi of PharmaAlliance asked the aspirants questions relating to the over-dependence of Nigeria on imported medicines, inadequate internship placement, open drug market and National Drug Distribution Guidelines (NDDG), the war on fake drug, interprofessional collaboration in the health sector and pharmacy education among others.
Delivering his opening statement on why he is contesting for the office of the PSN president, Pharm. (Dr) Lolu Ojo, who was a former national chairman, National Association of Industrial Pharmacists of Nigeria (NAIP), said his foremost agenda is to move the pharmacy profession from the height it is presently to the height it should be, adding that one of his agenda is to focus on the young pharmacists, by bridging the gap between training and practice.
While speaking, Pharm. (Dr) Daniel Orumwense, said part of his plans is to consolidate the gains of the past PSN leaderships, especially to build on the success of the outgoing PSN leadership, which he has been part of, saying he will reposition, re-engineer and rebrand pharmacy as PSN president.
On his own part, Pharm. Anthony Bola Oyawole, who has served the society in various capacities, including the Lagos State PSN chairmanship, member of Board of Trustees of PSN and ACPN, among others, said he is offering himself to serve the profession in order to revolutionise pharmacy with fresh ideas, while repositioning it for effective management and control.
Pharm. (Mazi) Sam Ohuabunwa, in his own submission, noted that his goal, which is the hallmark of his forty-two years in the practice, is to use his tremendous goodwill and connection to uplift the pharmacy profession in Nigeria. He added that pharmacy has to be rebuilt and reclaimed.
The debate, which was beamed live on social media, was watched live on- PSN Oluyole 2018 Facebook Page, Pharmanewsonline.com, and other social media platforms.
Stakeholders in attendance at the first ever PSN Presidential Debate include: The PSN President, Pharm. Ahmed I. Yakasai; Publisher, Pharmanews, Sir Ifeanyi Atueyi; National Secretary, PSN, Pharm. Emeka Duru; National Chairman, Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), Pharm. Kingsley Amibor; National Secretary, ACPN, Pharm. Bosede Idowu; Elder Ebenezer Adeleke; Dr John Nwaiwu; Chairman, Lagos PSN, Pharm. Bolanle Adeniran; Dr. Margret Obono; Chief (Mrs) Yetunde Morohundiya; and Pharm. (Mrs) Regina Ezenwa, among others.
Faces at 2018 NAPPSA Conference (PHOTOS)
The 2018 Annual Scientific Conference and Exposition of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA), held in North Carolina, United States, was recently concluded. Below are some of the photographs taken at the conference.
Photo credit: NABNTV
PSN Presidential Debate (VIDEO)
PSN Decides 2018 – Click on the video above to watch the full Presidential Debate.
WHO Vaccinates 377,000 People against Cholera in Adamawa
No fewer than 377,000 people have been vaccinated against cholera in Adamawa, the News Agency of Nigeria (NAN) reports.
This was contained in the World Health Organisation (WHO), Nigeria Health Emergencies Programme report, titled “Mid-Year Report 2018”, made available to journalists on Thursday in Yola.
The report indicated that WHO provided the technical and financial support for the immunisation in Mubi North, Mubi South, and Maiha Local Government Areas (LGAs) of the state.
It also said that the organisation established a cholera treatment centre during an outbreak of cholera in the state in May and engaged 35 health workers on ad-hoc arrangement to provide immediate response to the outbreak.
“As a result, we brought case fatality ratio from 17 per cent to 2.2 per cent within two weeks of managing the cholera treatment centre at Mubi General Hospital,” it added.
Other actions taken to contain the outbreak according to the report included the activation of an emergency operation centre for the coordination of rapid decision making of partners involved in the fight against the epidemic and provision of technical supervision for the chlorination of water sources.
“Supplied cholera response materials include ringers lactate, fluid giving sets, cannulas, ORS, antibiotics, and infection prevention and control materials,’’ the report said.
It added that WHO also deployed mobile health teams to disinfect household as well as engaged health workers to conduct geo-coordinate mapping which enabled focused intervention.
Meanwhile, WHO has commenced a two-day capacity strengthening workshop on health reporting during emergencies in Yola for some journalists selected from Adamawa, Borno and Yobe States.
(NAN)
Prof. Oluwatoyin Odeku is our Personality for October
Prof. Oluwatoyin Adepeju Odeku (Nee Adeyemo) is the dean, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria.
A distinguished professor of Pharmaceutics & Industrial Pharmacy, Odeku obtained her Bachelor of Pharmacy from Obafemi Awolowo University, Ile-Ife, in 1988, followed by a Master of Science in Pharmaceutics from University of Ibadan (UI) in 1992. Six years later, the UI dean upgraded her academic exploits with a Doctor of Philosophy in Pharmaceutics from the same institution in 1998.
In 2014, Odeku travelled overseas for a course at the prestigious University of Osnabruek, Germany, where she got a Certificate in Modern Higher Education Management and Leadership. In recognition of her contribution to the pharmacy profession, she was made a Fellow of the West African Postgraduate College of Pharmacists (WAPCP) in 2013.
Indeed, within the space of 16 years, Odeku has won scholarships, fellowships, grants and awards such as UNESCO/Israel co-sponsored Post-doctoral Fellowship (2000); John D. and Catherine MacArthur Foundation Staff Development Grant (2003); CAS-TWAS Visiting Scholar Fellowship (2004); George Foster Fellowship of the Alexander von Humboldt Foundation (2006); CSIR/ TWAS Postdoctoral Research Fellowship (2006); Alexander von Humboldt Foundation (AvH) Return Fellowship (2008); DAAD Visiting Scholar Fellowship (2009) and CV Raman International Fellowship for African Researchers (2012).
Others were NUC award for supervising the best thesis in Pharmacy for Year 2008 (2012); West African Research Association (WARA) Travel Grant (2012); AAU Staff Exchange Award (2015); TETFUND Conference Grant (2015) and Alexander von Humboldt Foundation (AvH) Re-visit Fellowship.
She is a member, Pharmaceutical Society of Nigeria (PSN); secretary, Faculty of Drug Production and Quality Assurance, West African Postgraduate College of Pharmacists (WAPCP) from 2017 to date; Fellow, West African Research Association (WARA); member, Africa Network for Internationalisation of Education (ANIE); member, West African Research and Innovation Management Association (WARIMA); member, Organisation for Women in Science in Developing World (OWSDW); member, Nigerian Association of Pharmacists in Academia (NAPA); and member, Association of Lady Pharmacists (ALPs).
Prof. Odeku is married, with children.
What is Rheumatoid arthritis ?
1 is a localised condition
2 occurs as a consequence of trauma
3 affects synovial joints
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Nursing Practice in Nigeria: The Long Road to Recognition (2)
It is pertinent to be reminded that Nursing did not start in Nigeria as a university-based programme; it began just like Medicine, which started at Yaba College, as well as Pharmacy and Physiotherapy. However, while these other fields of study responded swiftly and positively to societal needs, alongside technological and scientific advancement in healthcare delivery, nursing education and professional development became victims of conspiracies from within and outside the profession, leading to foot dragging. The reasons for this include:
Gender complacency and satisfaction with the minimum;
Territorial protection by nursing leaders with limited education (inferiority complex);
Nurse scholars “educated nurses” superiority complex;
Welfare-oriented professional association;
Government’s lack of will to formulate and implement policies on nursing education;
Propaganda by detractors to picture a situation of lack of confidence and proclamation of professional incompetence in the products of basic nursing education;
Lack of cooperation and professional internal cohesion that led to external aggression and infiltration into the professional autonomy.
Consequently, nursing education and practices were rendered sluggish in development. Multiples of sub-degree programmes emerged, promoting subservient and utility workers rather than thinkers; policy implementers, rather than decision-makers and reformers.
Actualisation of the new schemes of service
It has been a long-standing battle to convince employers of labour that the regulatory agency for the education and practice of the nursing profession in Nigeria, the Nursing and Midwifery Council of Nigeria (NMCN), does not train nor have a register for any cadre of nursing called “nursing superintendents” or “nursing assistants” but professionals who are officers in the public service.
The dichotomy created by the variance in nomenclatures, contrary to clarifications from NMCN, has meted out injustice and psychological trauma to members of the National Association of Nigeria Nurses and Midwives (NANNM), who have strived to acquire higher academic qualifications while still in service. Nurses have been made to revert back to lower grade levels in the name of conversion to the nursing officer’s cadre. However, the 39th National Council on Establishment (NCE) meeting which held in Minna July 2016 acceded to the prayers of NANNM, requesting the full implementation of the Industrial Arbitration Panel Award of 1981 that recognized the professional qualifying examination – with the award of Registered Nurse/Midwife (RN and RM) for nurses and midwives in Nigeria – as the pre-requisite for registration, certification and licensing for professional practice.
The approval ratified that all nurses in the country be recognised and regarded as “nursing officers”, irrespective of their training institutions and academic qualifications – either as graduates of schools of nursing and midwifery with an equivalent academic qualification of HND; or graduates of universities with bachelor’s degree in nursing sciences – provided that such graduates have sat and passed the same professional qualifying examination by the NMCN.
It was equally ratified that practising nurses who have possessed RN/RM and equally acquired a bachelor degree in nursing sciences should be converted laterally to enhance their career progression beyond grade level 14 in conformity with extant public service rules. This will ensure that not only will the discriminatory nomenclature of “nursing superintendent” be removed but that nurses who acquire additional qualification while still in service will enjoy seamless transition and continuity, without having to revert backwards on their grade levels to the pinnacle of their career.
By Comrade Nurse Abdrafiu Alani Adeniji
(National President, NANNM)
Sagamu agog, as PANS national convention kicks off in style
It was a carnival-like arena as pharmacy students from pharmacy schools across the country besieged the New Auditorium Hall, of the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State, for the 43rd Annual National Convention of the Pharmaceutical Association of Nigeria Students (PANS), which holds from 8 to 12, October 2019.
The enthusiastic students, who were brimming with smiles, were already seated with their writing materials as early as 10 am when the programme commenced.
The National Convention is an annual event of PANS national, which currently has its secretariat at the Olabisi Onabanjo University (OOU), Sagamu Campus, having produced the current president, Mr. Samuel Oluwaseyi Akanbi. This year convention has the theme “Sowing the Seeds of Professional Impact: Working to Transcend the Generations of Pharmacists to Come”, and the week would be featuring seminars, mentorship session, literary events, sports contests and some other social activities to foster interaction among the visiting pharmacy schools.
The national convention, which kicked off with the opening ceremony under the chairmanship of the managing director, Miral Flash Nigeria Limited, Pharm. Moses Oluwalade, also had in attendance several eminent guests, such as Pharm. (Dr) Lolu Ojo, PSN presidential hopeful and former national chairman, National Association of Industrial Pharmacists (NAIP); Pharm. Gbenga Falabi, the keynote speaker and the immediate past national chairman, (NAIP); Pharm. (Alh) Ahmed Yakasai, president, Pharmaceutical Society of Nigeria (PSN), who was represented by Pharm. Emeka Duru, national secretary, PSN; Dr Oluwayemisi Bamiro, dean, Faculty of Pharmacy, Olabisi Onabanjo University; Pharm. Daniel Orumwense, deputy president, PSN, represented by Pharm. Agbojo Olukemi, immediate past chairman, PSN, Ogun State; and Pharm. Abdul Hafeez, chairperson, IPSF, among others.
While delivering his speech, the managing director, Miral Flash Nigeria Limited, a leading pharmaceutical company in the country, Pharm. Moses Oluwalade, who was the chairman of the opening ceremony urged the students to embrace hard work and diligence, which, he said, were the hallmark of success.
According to him, leadership skills which he described as an essential component in positioning executives to make thoughtful decisions about their organization’s mission and goals, and properly allocate resources to achieve those directives are to excel in the pharmacy profession.
While describing the theme of the programme, “ Sowing the Seeds of Professional Impact: Working to Transcend the Generations of Pharmacists to Come”, as apt and timely, the Miral Flash boss, noted that leadership traits include honesty, confidence, commitment, and creativity, adding that the students should stop being egocentric, but begin to exhibit leadership skills that are vision driven.
“As pharmacists, you are practicing one of the foremost professionals in the World, so I am urging you today to raise your head and avoid intimidation that may come from any quarter as you are not supposed to be a second class citizen as far as healthcare family is concerned. I also want to urge you to be proactive, plan ahead, be courageous, be flexible and don’t do things haphazardly,” he advised.
In recognition of his immense support to PANS national activities, the national pharmacy students group, presented an Award of Appreciation to Sir Ifeanyi Atueyi, Pharmanews Publisher, who was represented at the convention by Mr Adebayo Oladejo.
The convention had in attendance fourteen schools of pharmacy across the country, including the host, Olabisi Onabanjo University (OOU), Ago Iwoye, Ogun State; University of Uyo; Nnamdi Azikiwe University; University of Nigeria, Nsukka; Delta State University; University of Ilorin, Kwara State; Obafemi Awolowo University, Ile Ife, Osun State; University of Ibadan, Oyo State; Uthman Dan Fodio University; Kogi State University; University of Maiduguri; University of Port Harcourt; Niger-Delta University.
What do you know about Perindopril?
1 may lead to deterioration of glucose tolerance
2 dose in GX should be reviewed due to under-dosing
3 treatment warrants routine renal function tests to be undertaken
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Habits of highly resilient leaders
Resilience is less about “positive thinking” and less about fearlessness; it is more about your perseverance and courage. Both challenging times and times of joy are important lessons of life. They are like mentors, placing the right circumstances at the right moments of our life. The hopes are that you will have learnt your lessons from the previous events of difficulty or joy, and now apply them to this new experience that you now face, and so on. Let us learn first from the lessons of challenging times. We will return in another piece, on lessons to be learnt from times of joy.
A crucial life-changing quality needed through any difficult situation — financial loss, loss of a job, divorce, relationship breakdown, death of someone close — is resilience. Emma Seppälä, in her very-worthy-to-read book ‘The Happiness Track’ describes resilience as:“…. The ability to quickly bounce back from the stressful situations you face every day ….”
An addition to this apt description of resilience would be one’s ability to remain centred on their purpose and persevere ahead. The power of purpose alone is a key driving force that maintains us at or close enough to, our centre, rather than lose hope and direction both of which are forces that spin us tangentially off our circle of life.
Anyone who has experienced a hurricane knows that the eye of the hurricane — its centre — is the calm around the storm. A wheel off-centred will cause one bumpy ride ahead. Being centred helps us to gracefully ride out the storms of life, and this centre is called resilience.
Resilience is underpinned by realistic thinking, not just positive thinking – and certainly not the kind of “positive thinking” that can be a mantra of affirmations, gravely detached from your very real suffering. Similarly, fearlessness, charging ahead, is rarely the answer. Without adequate self-care and working to transcend your fears — building courage — fearlessness will only lead to regret and possibly cynicism with one’s life. Hardened trees are often uprooted in storms; trees that sway in the heavy winds survive and grow stronger roots.
Winning strategies
So, what are key states of the mind which produce real positive outcomes that bring us out of our dark and difficult circumstances – bruised but standing in the light? Here are such key qualities that every challenge helps us build. If you appropriately learn the lessons of hardship we face, these qualities, internalised as habits, will see you through your dark storms and bring you to an illuminated path you will walk further on towards a fulfilling and memorable life. None of these qualities are easy to habitualise into our lives; but with intentional effort to embrace them, we will find their secrets in us whenever the need arises.
- Accepting what is
Difficult times teach us that nothing is perfect and challenges will come, but they will also go. After each difficulty, comes ease. Through each difficulty, one grows. A good way to accept what is, is by deferring to seek to know why it was so. Acceptance does not question, but understands the event, as it is well beyond our capacity to change results.
- Living in the present
Acceptance alone is not sufficient, because it can cast one’s mind constantly into the future to replay the events that hurt you, or into a future where there is supposedly no pain. The past that has already occurred can never be undone, and replaying it in your mind will cause you despair. The future that has not yet arrived can only be of any help if you embrace the present, and worrying about it will only cause you anxiety. By being resilient, you live the present. A resilient person learns from the lessons gradually; they do not expect to know now. They are mindful of their emotions and regulate them. They move from the fight-or-flight tension of the difficulty, to the rest-and-digest period of the moment.
- Avoiding the blame-game
Blaming others whilst putting on hold your momentum to move forward only robs you of precious time, not of those who may have perpetrated a wrong upon you. Blaming yourself forces you into a self-serving victim. And both — self-blame and blaming others — keep you enslaved to the past, not allowing you to move forward towards the good that awaits.
- Acknowledging the negative feelings
One of the causes of the blame-game is not accepting the very real negative, yucky, feeling you undergo when you have to face a challenging trial. We are also hardwired, believe it or not, to reinforce negative thoughts. And feeding such thoughts by succumbing to it only leads you to not accept the reality that faces you, and worse, a slippery slope into depression and despair. But denying them will only make the negative feeling stronger. It is a bit of a paradox, but there is a way out – acknowledgement.
The remedy is acknowledging the feeling, by paying due attention to it, working through it, and seeking to understand what the emotions inform us about ourselves. Speaking to a trusted person, prayer and meditation, as well as physical exercise help build resilience against the crumbling feelings of negative emotions, by having a refreshed mind that is able to acknowledge and deal with them constructively.
- Responding with virtue to others’ foulness
The toughest of acts in the midst of hurt and trial is to respond to others virtuously. Abusive language, for example, thrown at you will not resolve a conflict by firing back a similarly weighted expletive. Calling such behaviour out and then silence and even moving on will bring far better results. Roughness and anger will never bring the pleasant results you seek that gentleness will. Make no mistake: virtue is not gullibility or weakness, but it is a strength, particularly in the midst of perceived weakness.
- Replacing Over-thinking with self-care
Over-thinking about what has transpired hardly will give a better understanding of what has been. Seeking to understand, progressively, and which includes lessons for your own self, is much needed, but very different from over-thinking. Over-thinking leads to seeking to blame a perceived enemy, seeking a perfect solution which does not exist, and asking irrelevant questions that tie you into an emotional knot.
To build resilience, find ways to relax and care for your emotional and possibly spiritual injuries. From prayer and meditation, to physical exercise and meeting with good and trusted people all provide a nurturing ground for self-care.
- Undergoing healing
A crucial part of self-care, if not undertaken, can lead to self-victimisation and even selfish attitudes. Self-care must lead to appropriate and proper healing. And part of healing is to recognise that there is really no such thing as forgetting the past, but learning from that past. In addition, forgetting would entail a disregard of any wound that one may be left with, and if left unattended can fester into serious psychological sores.
Healing is about repairing with gentle care what has broken in you. Every injury leaves a scar, and therefore forgetting what caused it is nigh impossible, because all scars can be “felt”. What is possible is to repair the injury with elegance and a beauty that, upon healing, what emerges is a more beautiful, stronger and an evolved person. It is very similar to the wondrous Japanese art of Kintsugi. Gentle and elegant healing of ourselves is very similar to repairing precious broken pottery, with gold, except that what is seen is a refined and more attractive character when we heal ourselves properly.
- Avoiding toxic people
The last thing you will need around you through a challenging time, is toxic people, who flame your inquisitiveness to search for blame, criticism and gossip of others, and even creating unreal scenarios which never actually occurred.
Negative energy will breed twice that negative energy. Incidentally, good energy will breed exponentially more good energy. A simple rule to live by is to surround yourself with good, trustworthy people who are interested in positive ideas, aspiring hopes and meaningful actions. They speak of issues to see the good in others and all things, and to solve problems, rather than speak of people to complain, criticise and cause more problems.
It is better, always, to be with good people than toxic people; and it is better still to not fear being alone than with even one toxic person.
- Concentrating on one’s own matters
Resilience does not arise by fighting others’ wrongs, but by identifying our own weaknesses and shortcomings that are often silently highlighted to us by the very incident in difficult times. Once we know our shortcomings, we can put a plan into action to remedy them, thereby becoming a better and stronger person.
- Being grateful
Nothing increases you, mysteriously, than a true sense of gratitude. Why is this so? Being grateful immediately directs your focus on what you have rather than what you may not have or have lost. Losing a spouse in death, for example, is a painful experience; being grateful for your children or even your in-laws — your now gone spouse’s parents — and focusing on their wellbeing is a liberating experience. It whispers so many silent meanings that only the practitioner of gratitude can hear.
(Continues next edition)
Uche Amazigo:The consummate connoisseur of public health
With the burden of infectious diseases that sub-Saharan Africa has to grapple with, particularly the spread of tropical diseases such as malaria, tuberculosis and onchocerciasis (river blindness), there is so much for which to appreciate the efforts of public health professionals and researchers like Professor Uche Veronica Amazigo, who continuously work towards improving the quality of life of millions of Africans.
Prof. Amazigo is an internationally renowned public health administrator, biologist and professor of medical parasitology and public health. She is well recognised for her research on onchocerciasis and the introduction and application of the innovative, community-directed treatment mechanism in the control of neglected tropical diseases. She played a pivotal part in the success of onchocerciasis control by strengthening community health systems and helping to engage and empower 500,000 communities across 19 countries covered by the African Programme on Onchocerciasis (APOC) established by the World Health Organisation while she was director of the programme from 2005-2011.
Onchocerciasis is the world’s second leading infectious cause of blindness. As a public health problem, the disease is most closely associated with Africa, where it constitutes a serious obstacle to socio-economic development. Out of some 120 million people worldwide who are at risk of onchocerciasis, 96 per cent are in Africa. It thus becomes apparent why Amazigo’s efforts at taming the disease and others have gained widespread recognition and accolades.
Path to prominence
Uche Amazigo was born to the Onubogu family of Enugu State, Nigeria. She received her Ph.D in Biology and Medical Parasitology from the University of Vienna, Austria. She also holds a Diploma in Tropical Medicine and Parasitology from the Bernhard-Nocht Institute of Tropical Medicine in Hamburg, Germany, as well a Fellowship in International Health from the Harvard T.H. Chan School of Public Health.
Early in her career, Amazigo worked as a senior lecturer at the University of Nsukka, Enugu State, where she taught medical parasitology and public health. It was during this period that she began studying onchocerciasis (river blindness) after encountering a pregnant woman plagued by the disease’s itchy lesions and depigmentation during her travels around the area in 1991. She joined a rural women’s support group in order to better study the social effects that the disease had on rural communities. She then applied for and received a research grant from the United Nations’ Special Programme for Research and Training in Tropical Diseases (TPROF) in order to continue her research into river blindness.
Amazigo’s pioneering research on the social impact of river blindness in rural Nigeria revealed, for the first time, startling results about the social isolation, stigmatisation, suffering and disability caused by the disfigurement and unrelenting itching from the disease. This discovery brought international awareness on the morbidity due to river blindness and its social implications.
Amazigo worked for the TPR for several years, within which she developed a programme for training community workers to treat themselves and others, as well as keeping record books of the treatments. She brought her findings to the WHO, where her studies were replicated. The results from this replication resulted in the founding of the African Programme for Onchocerciasis Control (APOC) in 1995.
Exploits and influence
Amazigo joined the APOC as a scientist in 1996. Her work with the APOC was built upon her work with the TPROF programme, and resulted in the development of Community-Directed Treatment with Ivermectin (CDTI), with the use of Ivermectin as the sole drug for treating Onchocerciasis. It is estimated that her CDTI strategy has resulted in the treatment of over 112.4 million people for Onchocerciasis, 11 million people for malaria control, and 37 million people for the control of other diseases.
Amazigo spent four years as the Chief of the WHO’s sustainable drug distribution unit from 2001 to 2005. She served as the director of APOC from 2005 until 2011. During this period, she engaged 16 African governments, 14 international non-governmental organisations (NGOs), 20 bilateral and multi-lateral donors, and pharmaceutical companies.
In 2007, with her visionary leadership skills, she initiated and spearheaded the introduction of a curriculum and training module on community-directed interventions (CDI) in Faculties of Medicine and Health Sciences in more than 14 universities in Africa.
Amazigo also initiated the scientific evaluations which provided evidence of possible elimination of river blindness in some sites in APOC countries including Kaduna and Ebonyi States, Nigeria, and spearheaded the repositioning of WHO/APOC from a control to an elimination Programme. She has over 55 publications in international peer-reviewed journals.
After retiring from APOC, she founded the Pan-African Community Initiative on Education and Health (PACIEH) in 2013. She is a member of the Board of Trustees of Sightsavers and the TY Danjuma Foundation. She is also on the Advisory Board of Massachusetts General Hospital (MGH) Centre for Global Health and Merck’s Global Advisory Board on Maternal Mortality.
Awards and Recognitions
Amazigo valuable contributions in health policy development, research, public-private partnership and sustainable community-driven health interventions have earned her many awards and recognitions, which include the Prince Mahidol Award, under the patronage of the Thai Royal Family. She was awarded a Knight of the National Order of merit of Burkina Faso, She was also recognised by the US Agency for International Development and the National Medical Research Institute of Tanzania.
Amazigo received the Prof. Jean Mayer Global Citizenship Award from Tufts University, Boston Massachusetts, USA. While working as the Director of the WHO/APOC programme, she was awarded the 1 million Euro António Champalimaud Vision Award in 2011, which is the biggest global award for outstanding contributions to the prevention of visual impairment and blindness.
She is a Fellow of the Nigerian Academy of Science; Harvard T.H. Chan School of Public Health; and Parasitology and Public Health Society of Nigeria.
Disodium pamidronate is?
1 is used in corticosteroid-induced osteoporosis
2 is only available for parenteral administration
3 requires monitoring of serum electrolytes
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
Ude Aki, the Liquid Black Gold
Black palm kernel oil (BPKO), obtained from the edible seed (nut) inside the palm fruit from the palm tree (Elaies Guineensis), has been in existence for a long time without its benefits being appreciated. It is common in West African countries, especially Nigeria, where it is known locally as “ude aki” among the Igbos, “adi dudu” among the Yorubas, “mmayanya” in Efik and “manlade” among the Hausas. It is mostly seen in the rural areas and is very affordable.
Constituents
Black palm kernel oil is a highly saturated vegetable oil; it does not contain cholesterol which might be harmful to health. BPKO is loaded with antioxidants, unsaturated fats, vitamin K, zero trans-fat and vitamin A. It has a long shelf life.
Preparations
There are several methods of extracting palm kernel oil, but the traditional method is to heat the kernel (after removing the hard mesocarp) in a dry pot till the oil shows up. The oil extracted in this way is not normally used in cooking but for traditional medicine and lubrication. It is dark in colour, with a distinctively strong, nutty, roasted smell – resulting from of its method of extraction (roasting). Palm kernel oil can also be extracted by the cold press method to give a light yellow to clear oil.
Pharmacology and medicinal uses
Black PKO is one medicinal oil that is gradually disappearing from our shelves. It used to be an important home remedy for most life-threatening ailments in earlier years.
In children, BPKO is used to manage epilepsy, cold, and to strengthen the fontanel at 0-12 months old or even more. When a child is constipated, this “wonder oil” is applied to the anal region. It relaxes the muscles and results in easy bowel movement. BPKO is also used to treat children with high fever and convulsion, abdominal pain, as well as skin rashes.
The palm kernel oil is also reputed for helping the healing process of wounds and bruises. It prevents stretch marks when applied generously daily on the stomach during pregnancy. As the pregnancy advances, the palm kernel oil aids in the elasticity of the skin and prevents the cracks that usually lead to stretch marks.
As a good skin moisturizer, BPKO restores skin elasticity, thereby preventing wrinkles and protect the skin from harsh weather conditions. BPKO maximally accelerates hair growth, prevents excessive shedding, strengthens the roots of the hair, increases the softness and sheen of the hair, prevents hair breakages and treats the scalp.
BPKO is also applied on the surface of metal objects to prevent rust.
Economic value and prospects
Locally made BPKO in Eastern part of Nigeria costs about 1,000 naira per bottle. Indeed, the wonders of black palm kernel oil cannot be overemphasised. It is a raw material for the manufacture of soaps, washing powders, hair creams and other personal care products.
Increased use of PKO for domestic, medicinal and commercial purposes will go a long way to benefit Nigeria at individual, local and national levels.
By Ngozika Okoye, FPCPharm, MSc, MPH (Nigeria Natural Medicine Development Agency)
Miyetti Allah Pledges Support for Immunisation
The Miyetti Allah Cattle Breeders Association has pledged to support immunisation of child killer diseases in Makoda Local Government Area of Kano State.
The Chairman of the association in Makoda, Yahya Madawaki, made the pledge in an interview with the News Agency of Nigeria (NAN) on Sunday in Makoda town.
He said that the association had facilitated the immunisation of many nomadic children who came into the local government area from neighbouring states and countries.
According to him, “We have informants who are vigilant and inform us of any nomadic group coming into the local government and we immediately move to immunize their children.”
“If they refuse to allow for their children to receive immunization, we tell them to move elsewhere immediately as we don’t want get fresh virus in our community,” Mr Madawaki said.
The chairman, however, appealed to the nomadic groups to allow for the immunisation of their children in every community they found themselves as the immunisation is harmless.
He lauded the efforts of the local government council and other stakeholders for their tireless efforts in creating awareness in the border communities who were more prone to the diseases.
(NAN)
Tofade Harps on Incorporation of Interprofessional Education in US PharmD Curriculum
The Dean, Howard University College of Pharmacy, Washington DC, Professor Toyin Tofade, has highlighted the merits of incorporating Interprofessional Education (IPE) into the US PharmD Curriculum.
Prof. Tofade made the submission at the just conclude 2018 Annual Scientific Conference and Exposition of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA), held in North Carolina, United States, recently.
Delivering her keynote address titled: “Incorporation of Interprofessional Education (IPE) in the US PharmD”, she explained that this is key in bridging relationship gaps between pharmacists and other healthcare professionals, as well as grounding the knowledge of pharmacists in public health.
For better understanding of the topic, she cited the WHO definition of Interprofessional Education, as what “Occurs when two or more professions (students, residents and health workers) learn with, about, and from each other to enable effective collaboration and improve health outcomes.”
The Don, who noted that the merits of the process far outweighs the demerits, listed some of the advantages of incorporating Education (IPE) in the US PharmD to include: Improves health, creates support systems, using of different practice models, encourages learning together, enhances collaboration, reduces costs, engages communities, patients, families, trainees, health professionals and workers.
Her words :“The curriculum prepares all students to provide entry-level, patient-centered care in a variety of practice settings as a contributing member of an interprofessional team. In the aggregate, team exposure includes prescribers as well as other healthcare professionals.”
On how to incorporate IPE, she said the foundational courses will include: Pharmacology, Pharmacogenomic, Anatomy, Ethics, Conflict resolution, Communications, Emotional intelligence, Professionalism, Leadership, and Relationship building.
While students can take electives from: Public Health, Global health and Toxicology.
While reiterating the place of team work as pivotal in the whole process, she urged pharmacists to effectively use their leadership roles whenever the opportunity is given.
According to her, “when a pharmacist finds his/herself in a leadership role, it is an opportunity to do what you can where you are; Build relationships with physicians and health care providers in clinic and hospital settings; Grow our expertise by retooling and meeting needs; Apply knowledge by demonstrating stellar clinical service”.
Gratitude is the key to your next level
How often in your life do you sit down and count your blessings? How many times have you cast your mind to the past to recollect any of your family members, friends, course mates, colleagues, co-workers, family friends or even neighbours that have passed to the great beyond? If you can recall just one person who is close to you who has been lost to the cold hands of death in the past, then, it is enough to give thanks and praises to God who has kept you alive regardless of what is happening in your life right now.
Interestingly, some of our dear ones we hadlost in the past were those we never expected to be struck by death even in the next 20 to 30 years. Here we are, they’ve all gone. God’s plan is quite different from man’s plan. Also you should bear it in mind that God is not wicked and has full grasp of everything that happens in our lives. This truism emphasizes the importance of gratitude in daily life. Let’s always thank God as if we will not have another opportunity to praise and worship him anew. I strongly believe that the essence of our creation is worship and the best and most honourable form of worship in God’s sight is gratitude.
Gratitude is a forward drive for anyone who is keen on achieving success and living a fulfilled life. We must be grateful to God, our parents, our family, our friends and our loved ones for whatever “small” or “big” favours rendered to us.”
Henry Ward Beecher submitted, “The unthankful discovers no mercy, but the thankful heart will find in every hour, some heavenly blessings.” The more you thank, the more you will obtain. Gratitude gives you a sense of progress.
Gratitude allows us to think, thank and count our blessings. When you sit down and count those things you should be grateful for, you will always realise profit. If we get everything we want, we will soon want nothing to get. Stop complaining about what you do not have, be grateful for what you have. Focus on your blessing and feel grateful for them. The more you do this, the more you have reasons to be grateful. Roman philosopher, orator, politician and lawyer Cicero remarked, “A thankful heart is not only the greatest virtue, but the parents of all virtues.” The higher the altitude of your gratitude, the better your spiritual health will be.
Just like we need nutritious food for a healthy body, relevant information for a sharp mind, our souls need gratitude to blossom. Studies have shown that grateful people are more successful and innovative. Gratitude fuels happiness, happiness fuels success and success builds our confidence.
Whatever your condition and position in life, you must have cause to be grateful. There must be cause for, and a source of, happiness in your life. Let us always remember the words of Maxim Gorky: “Happiness always looks small while you hold it in your hands, but let it go, and you learn at once how big and precious it is.”
Be grateful for those things that bring you happiness. If you are stressed, frustrated, or depressed right now, you can effectively use gratitude to change your condition. Every morning for seven days, write down ten things you are grateful for and express heartfelt gratitude for those things. You can start by being grateful for the gift of life, sound mind, good health or someone who truly care for you.
If the only prayer coming out of your mouth is “Thank you,” it will suffice. We should imbibe the attitude of George Herbert, who remarked, “Thou o Lord has given so much to me, give me one more thing, a grateful heart.”
A poem to ponder on
Thank God for the morning
It has a tale to tell
While other folks don’t wake up
We wake up pretty well
With good health, peace and happiness
We shouldn’t want to be ungrateful
For this stack of evidence
God is wonderful to us.
The above poem really shows that as long as we live, we have cause to be grateful to God. Gratitude is your key to your next level.
ACTION PLAN
I consciously count my blessings and feel heartfelt gratitude for them. I focus on the good things in my life. I find the good reasons to be thankful at all times.
AFFIRMATION
I am grateful for every moment of my life. I am blessed and highly favoured.
Sesan Kareem helps organizations and their workforce improve their productivity, performance, sales, communication and profitability. He is a result-oriented coach.
Flood Disaster: WHO Steps up Disease Prevention Efforts in Nigeria
In a bid to prevent disastrous epidemics, the World Health Organisation (WHO) says it is stepping up efforts to provide life-saving assistance, especially basic medical care, to flood victims in Nigeria.
At least 826,000 Nigerians are severely affected by heavy flooding after the banks of the country’s two main rivers – the Niger and the Benue – busted following heavy rain, which began falling in August.
“The disaster is now affecting 12 out of 36 states according to the National Emergency Management Agency, with 176,300 people displaced, more than 150,000 hectares of farmland inundated, 17,800 houses washed away, and 321 roads and bridges destroyed.
“As of Monday, the floods had claimed about 200 lives. A state of national disaster has been declared in the four most-affected states: Kogi, Niger, Anambra and Delta,” WHO said.
The organisation said the United Nations and its partners were carrying out rapid assessments and scaling up support to the government’s emergency response agencies.
In particular, WHO said it has deployed experts to strengthen surveillance and early warning systems while also working to ensure that essential drugs were available in newly-created camps for displaced families.
Head of WHO in Nigeria, Wondimagegnehu Alemu, in a statement released on Thursday, said the flood has severely affected the health of the people.
“In addition to the immediate destructions and loss of lives, floods can severely affect the health of the affected population, even after the water levels have receded.
“Floods and their consequences – including a lack of drinkable water, shelter, and overflowing sanitation systems – can easily lead to the spread of communicable and water-borne diseases, such as cholera and malaria.
“In addition, access to healthcare and essential drugs can be difficult if health facilities are damaged.
“We can efficiently mitigate these risks if they are properly assessed and if disaster response measures are in place,” Mr Alemu explained.
To facilitate the mobilisation of resources for the response to the flooding, the International Federation of Red Cross and Red Crescent Societies launched an emergency appeal, seeking close to $5.5 million.
The funds are to support 300,000 of the most vulnerable flood-affected people for the next nine months, with shelter and basic household items; protection and livelihoods assistance, including through cash transfers; health care provision; water and sanitation supplies.
“The country’s Northeast zone is in the grip of one of the world’s worst humanitarian crises due to conflict, and already suffering various cholera outbreaks in the states of Borno, Adamawa and Yobe, making it crucial for humanitarian partners to effectively monitor and control the effects of the flooding in the rest of the country.
“In the coming days, the UN humanitarian chief, Mark Lowcock, and the head of the UN Development Programme, Achim Steiner, will visit the region, spending Friday and Saturday in Nigeria, and then moving on to neighbouring Chad,” the UN agency said.
(NAN)
WHO Commences Global Project to Treat Children with Cancer
Worried by the global burden of cancer, especially among children, with 300,000 new cases diagnosed annually from children aged 0-19 years, the World Health Organisation (WHO) has announced a new effort – the WHO Global Initiative for Childhood Cancer, with a goal of reaching at least a 60% survival rate for children with cancer by 2030, thereby saving an additional one million lives.
According to a release from the apex health institution, this new target represents a doubling of the global cure rate for children with cancer.
The fact remains that cancer is a leading cause of death among children, and to stem the mortality rate, the WHO report explained that it targets a twofold objective from the new initiative, which are increased prioritization of childhood cancer through awareness and expansion of national cancer care centres for optimum care.
“Too many children have their lives cut short by cancer, and survival rates in poor countries are scandalously lower than those in wealthy countries,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We hope our partnership with St. Jude will be a step towards redressing that injustice.”
The Initiative is announced on the heels of the Third Global High-Level Meeting on Noncommunicable Diseases, which convened dozens of heads of state and ministers from all countries to prompt more urgent action on noncommunicable diseases – among them cancer, diabetes, heart and lung diseases – which kill 41 million people each year.
The statement reads in part: “The aims of the Initiative are two-fold: to increase prioritization of childhood cancer through awareness raising at global and national levels and to expand the capacity of countries to deliver best practice in childhood cancer care. Concretely, WHO will support governments to assess current capacities in cancer diagnosis and treatment including the availability of medicines and technologies; set and cost priority cancer diagnosis and treatment programmes; and integrates childhood cancer into national strategies, health benefits packages and social insurance schemes.
“The WHO Global Initiative for Childhood Cancer, which involves development of a WHO technical package to help scale-up capacities within national health systems, will be achieved with support from a host of partners. Among them is St. Jude Children’s Research Hospital in the United States, the first WHO Collaborating Centre on childhood cancer, which has committed US$ 15,000,000 to supporting implementation of the initiative”.
It further noted that the event is a milestone in furthering achievement of the Sustainable Development Goals (SDGs) in particular SDG target 3.4 to reduce premature mortality from noncommunicable diseases by one third by 2030.
Onset of rheumatoid arthritis is?
1 is insidious
2 occurs symmetrically
3 is polyarticular
A 1, 2, 3
B 1, 2 only
C 2, 3 only
D 1 only
E 3 only
