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Homemade Remedies for your allergies

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The pharmaceutical industry seems to have devised a drug for every condition from allergies to weight loss. However, people are becoming increasingly aware of the many side effects of prescription drugs. As a result, they have turned to natural remedies.

For those of you struggling with allergies and have symptoms that include constant sneezing, watery eyes, runny nose, coughing, and nasal congestion amongst many others, we show you some natural and homemade remedies that you can use to treat common allergies.

  1. Raw Honey

Did you know that all the pollen carried by bees go into the honey they make? Therefore, when you eat locally produced honey, you give your immune system a natural allergy shot that helps you build up resistance and tolerance to those allergens over time.

Hay fever and related pollen allergies may be minimized by taking honey a month before pollen season starts. Start by taking one tablespoonful of honey after each meal. To further reduce the allergy symptoms, chew a small piece of waxy honeycomb once a day. Honey also has many antibacterial properties which are important in fighting infections.

  1. Apple Cider Vinegar (ACV)

This is one of the best natural treatments available for allergies and with zero side effects.

Apple cider vinegar has both antibiotic and antihistamine powers, both extremely useful for sufferers of various allergies.

Apple cider vinegar works by blocking the production and release of histamines and efficiently suppress the allergy symptoms. It works best when it is combined with 1 tablespoon of honey and lemon juice.

Take 3 times a day for your body to build up its defense to fight various allergies. Apple cider vinegar also strengthens the lungs, immune system, improves blood circulation and provides the necessary acids which help in digestion of food.

  1. Turmeric

Turmeric is a bright yellow herb with an active ingredient called curcumin which has anti-inflammatory, antiseptic, anti-oxidative and anti-tumor properties. Tumeric also serves as a first line of defense where it works by stabilizing mast cells which mostly line the trachea and intestinal tract

Turmeric also contains cortisone which is a bioflavonoid that strengthens mast cells when consumed frequently. Healthy mast cells have a barrier that keeps foreign materials such as pollen, protein and bacteria out of the blood stream, thus providing resistance to allergens.

  1. Saline Solution

Saline solution helps to clear sinus problems or if you are having a runny nose. To create your own home-based saline solution, follow these steps:

  • Mix a quarter teaspoon of sea salt with a cup of lukewarm water
  • Slightly tilt your head and lean over the sink
  • Use a teaspoon to pour the saline solution into one of your nose and allow to drain
  • Continue pouring until half of the content is used
  • Repeat the process with the other nostril
  • To clear the nostril, gently blow each nostril on a clean handkerchief
  1. Lemons

Lemons are packed with vitamin C which functions by breaking down histamines once it starts circulating in the blood.

Lemons also work by preventing histamine from being released through the stabilization of mast cell membranes. Mast cells are the storage unit of histamine and when they rupture, they release histamines which cause the allergic reactions.

Vitamin C in lemons also aid in reduction of inflammation.

  1. Nettle Leaf

Nettle is the go-to herb for allergies. This herb is believed to have an anti-inflamatory effect where it helps in drying out sinus problems. It works by blocking the production of histamines. A typical dosage to treat allergies is 300mg of freeze dried nettle extract, one to three times a day.

  1. Quercetin

This is a compound found naturally in vegetables such as onions, berries, red wine and grape fruit.

People with allergies benefit immensely from taking products containing high amount of quercetin because it inhibits the release of histamine. It also reduces inflammation and works by stabilizing cell membranes such that they become less reactive to allergens.

Quercetin should be taken a month before allergy season, in between meals with a recommended dosage of 1000mg.

  1. Omega 3 Fatty Acids

People with allergies or asthma need to increase their intake of omega 3 or omega 9 fatty acids, and limit the consumption of omega 6 fatty acids. Foods rich in omega three include nuts, flaxseed oil, fish and olive oil. These foods help prevent and treat chronic allergic reactions by strengthening the immune system, thus making it less prone to suffer from allergic reactions.

  1. Garlic

Garlic has antibacterial properties that are beneficial in healing allergy symptoms such as runny nose. Raw garlic eaten daily has the abilty to boost immunity to combat allergens effectively.

  1. Butterbur

Butterbur is scientifically known as Petasites Hybrids. It contains petasin and isopetasin as the active ingredients, both of which have anti-inflammatory effects.

These active compounds work by blocking the formation of leukotrienes which cause sneezing, itchy nose, swelling and congestion. They inhibit histamine synthesis thus resulting in mast cell degranulation.

Butterbur is extracted from the roots and leaves of the butterbur shrub, and can also be used to treat symptoms of asthma and migraines.

  1. Peppermint

Peppermint helps to enlarge pores and increase perspiration, in the process eliminating toxins from our body that is causing allergy reactions.

  1. Acupuncture

Many people suffering from allergies are turning to acupuncture to release allergy symptoms. Research done by researchers in Germany in 2013: Annals of Internal Medicine showed that when people with allergic reactions were treated with acupuncture, they ended up experiencing less seasonal allergy symptoms and use of antihistamine.

Acupuncture treatment also strengthens the immune system. Other functions of acupuncture include improving mental clarity, treating insomnia, back pain, migraines, weight loss, digestive problems and muscle aches.

  1. Probiotic

Probiotics are helpers of the immune system where they reduce incidences of allergies and calms allergic reaction inflammations.

Foods rich in probiotics include pickles, kimchi, yoghurt, kefir, Sauerkraut and tempeh.

Probiotics have also been known to prevent and treat asthma and eczema in children. They also help in the breakdown and absorption of food including making vitamins required by the body such as vitamin K.

Geneith introduces non-blood malaria test kit

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Admin
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GeneithIn what has been described as a landmark achievement in the Nigerian pharmaceutical industry, the partnership between Geneith Pharmaceuticals, a leading pharmaceutical company in Nigeria and Fyodor Biotechnologies, has birthed the launch of the first ever non-blood malaria test kit in Nigeria.

Explaining the development in an interview with Pharmanews, during his visit to the company in Lagos, Geneith’s Deputy General Manager, Mr Emeka Nwachukwu said that the special test kit that detects malaria from a tiny quantity of urine had begun to gain wide acceptance in the Nigerian market.

According to him, the new test kit will help Nigerians to tell whether they have malaria by sticking a test strip in a tiny capful of urine, adding that after twenty minutes, the appearance of two indicating lines on the strip would confirm that the patient has malaria, while the appearance of just one line would mean that the patient is free from the condition.

Nwachukwu, who announced that the test kit had earlier been launched in Abuja on 11 November 2015, said that it took seven years of painstaking research by a Nigerian-born scientist in America, Dr Eddy Agbo, to come up with the innovation.

The Geneith boss was however quick to add that the test kit was not meant to encourage self-medication but to help individuals detect and diagnose malaria early, and thus reduce blind treatment, in which people take anti-malarial drugs for any kind of fever.

In his words, “The greatest advantage of this product, and the reason Geneith Pharmaceuticals Limited has taken the gauntlet of ensuring its availability in every Nigerian home is that the Urine Malaria Test kit (UMT), does not require blood. It is one step and not complicated to do. Results are obtained quickly and accurately. It is affordable and much less expensive than the current test that is done in the pharmacies or hospitals. So, doctors are able to deliver the UMT to patients cheaper than the current method of blood test.”

On how to ensure only the genuine product gets to patients, Nwachukwu  said, “each of the test pack has a product code, so one can Scratch off the code and text the code to the number 1393, and you get a message back whether it is valid or not.”

Dr Agbo, who invented the Urine Malaria Test kit, is the chief executive officer of Fyodor Biotechnologies, and a Research Fellow at Johns Hopkins University School of Medicine, United States. He worked on diagnostic and therapeutic biomarker discovery and has over 15 years of biomedical research and direct product development experience in university and industry settings.

Agbo founded Fyodor Biotechnologies in 2008, and his company won a minority-owned business achievement award from the Greater Baltimore Committee. He is working on other patents such as a genotyping and diagnostic biomarker patents as well as another urine test kit that will detect both malaria and typhoid, in a single test.

 

Do you feel inadequate?

By
Ifeanyi Atueyi
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Sir Ifeanyi Atueyi

Feeling inadequate is a natural phenomenon, which arises mainly out of fear. Many people have demonstrated it in their lives at one time or the other. You feel inadequate to do something because you think you cannot do it. There is the fear of failure and what people will say about you.  At such a time, you forget God’s promises to be with you always and that He makes all things possible. All that occupies your mind is that your self-image will be dented if you fail and that people will lose confidence in you. This feeling of inadequacy can result in failure to take advantage of an opportunity. It can even cause you to miss God’s guidance and blessing.

Often, God turns our areas of inadequacy around for His glory and purpose. He demonstrates that without Him, we can do nothing. There are many things we cannot do in our own strength but we can do all things through Christ who gives us the strength. This is why He takes our areas of inadequacy and turns them into strength and the glory becomes His. I Cor. 1:27 says, “God has chosen the foolish things of the world to confound the wise; and God hath chosen the weak things to confound the things which are mighty.”

You need to trust and obey God, and walk in His strength when you are called to serve. It is foolishness to reject God’s call because of the feeling of inadequacy. Rejection of the call is disobedience which takes you away from God’s plan for your life. Whatever your feelings or concerns are, believe God and He will transform your weakness into strength.

When God called Moses to lead the children of Israel out of slavery in Egypt, he felt grossly inadequate. He demanded assurance from God that the Israelites would believe that He had sent him. God obliged him with three miraculous signs. Despite these miracles, he still presented his slowness of speech and tongue as an excuse to decline his assignment. Even when God assured him of helping and teaching him what to say, he said, “O Lord, please send someone else to do it.” At this stage God became angry with him and quickly assigned his brother, Aaron, to him. He promised to help them with what to say and instructed that Aaron should speak to the people. In addition, he equipped him with a staff for performing miracles.

Can you imagine what might have happened if Moses had eventually turned down God’s directive? First of all, his purpose in life would have been thwarted. His destiny would have remained unfulfilled. Right from birth, God had preserved his life for this purpose and guided him through various stages of life in preparation for the leadership of the Israelites out of bondage in Egypt. However, if he had failed, God’s plan of deliverance would still have come to pass.

The attitude of Moses was not an isolated case. What of young Jeremiah when he was called to be a prophet? He presented his age as an area of weakness.   What of Gideon when he was called to save the Israelites from the Midianites? He offered excuses of poverty of his family in Manasseh, and of being the youngest in his family. Despite God’s assurances of being with him, he demanded some signs.

The attitude of these men who later became mightily used of God is not peculiar. Some of us still behave in a similar way today when we are called to serve. We feel inadequate and give hundreds of excuses why we cannot do it.

At the annual conference of the Pharmaceutical Society of Nigeria (PSN) held in Kano in 1974, I had an encounter with my friend, Prince Julius Adelusi-Adeluyi, who was the outgoing national secretary. There was a vacant position for the editor-in-chief of the Society’s journal and a suitable person was being searched for the position. Juli (as he is popularly called) approached me at the bar of Lake Bagauda Hotel, venue of the conference. “Atus”, he said, patting me on the shoulder, “you have to do something for the PSN now.”  “Sure, if I can do it,” I replied.

Then he released the bombshell. “I want to submit your name as the editor-in-chief of our journal and I want you to accept the nomination because I am sure you will perform well.”  I reacted sharply and negatively. “You know I cannot do it. I have never done it before. Don’t expose my ignorance and inadequacy. Please find another person”. Juli listened to me and assured me that two of us would be working together and it was a service to our Society. Eventually, with the assurance of his working closely with me, I accepted to serve. From that moment, I determined to do the work so well as to be the best editor.

I did not realise that God was preparing me for a career in pharmaceutical journalism with the acceptance to serve the Society. From November 1974 to date, I have edited pharmaceutical periodicals. It is likely that if out of feeling of inadequacy, I had rejected the offer to serve, I might have missed God’s purpose for my life.

Computer-aided drug design and development: Emerging approach in drug discovery

By
Solomon Ojigbo
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Drug discovery is the process by which new medications are discovered. Historically, drugs were discovered after screening by identifying the active ingredient from herbal remedies or crude extracts from plants or microorganisms suspected to have potential biological activity without the knowledge of their biological target. Only after the active principle has been identified was an effort made to identify the biological target. This approach to drug discovery is known as classical pharmacology.

It is understood that individual chemicals are required for the biological activ­ity of a drug. This is based on the premise that drugs mediate their effect in the human body by specific interactions of the drug molecule with its target – biological macromolecules, such as proteins or nucleic acids in most cases. A drug target is the naturally existing cellular or molecular structure involved in the physiological/pathological pathway of interest that the drug-in-development is meant to act on.

Modern approach to drug discovery is based on the understanding of the aforementioned principle of drug action, employing the use of High Throughput Screening (HTS) of large chemical libraries of synthetic small molecules, natural products or extracts against isolated biological targets to identify a compound that is capable of eliciting the desirable therapeutic effect in a process known as reverse pharmacology. The method is the most fre­quently used approach today and has the advantage of requiring minimal compound design or prior knowledge. Although traditional HTS often results in multiple hit compounds, some of which are capable of being modified into a lead and later a novel therapeutic, the hit rate for HTS is often extremely low.

It is generally recognised that this approach to drug discovery and development (the use of HTS) is a time and resource consuming process. As noted by Anson et al (2009) despite advances in technology and understanding of biological systems, current approach to drug discovery is still a lengthy “expensive, difficult, and inefficient process” with low rate of new therapeutic discovery. Estimates of time and cost of currently bringing a new drug to market vary, but 7–12 years and $ 1.2 billion are often cited. In 2010, it was estimated that the cost of research and development of new molecular entities (NME) was US$1.8 billion. Thus, it is evident that pharmaceutical industry needs to find means of improving efficiency and effectiveness of drug discovery and development in order to sustain itself.

New approach

An emerging approach to drug discovery, involving the use of computing power to streamline drug discovery and development process, is rapidly gaining popularity and shows some promise in reducing time and cost in drug discovery process. Various terms are being applied to describe this approach, including Computer-Aided Drug Design (CADD), Computational Drug Design, Computer-Aided Molecular Design (CAMD), Computer-Aided Molecular Modelling (CAMM), Rational Drug Design, In Silico Drug Design, and Computer-Aided Rational Drug Design.

This approach leverages on chemical and biological information about ligands and/or biological targets to identify and optimise new drugs. This has been made possible by increase identification of molecular targets, elucidation of the 3D structures by X- ray crystallography and nuclear magnetic resonance (NMR), availability of commercial, private or public data bases (of biological targets and ligands) and availability of computer-aided drug design softwares.

CADD employs the use of in silico filters to identify hits (active drug candidates), eliminate compounds with undesirable properties (poor activity and/or poor Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET), selects the most promising candidates for further evaluation, and optimises these leads i.e. transform biologically active compounds into suitable drugs by improving their physicochemical, pharmaceutical, ADMET/PK (pharmacokinetic) properties.

A successful CADD campaign will allow identification of multiple lead compounds. Lead identification is often followed by several cycles of lead optimisation and subsequent lead identification, using CADD. Lead compounds are tested in vivo to identify drug candidates.

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 How it works

The process of drug discovery, using CADD approach begins with the identification of a therapeutic target against which a drug has to be developed. Depending on the availability of structural information, a structure-based approach or a ligand-based approach is used. Structure-based computer aided drug design depends on the information of the target protein structure obtained from X-ray crystallography, NMR or homology modelling to calculate interaction energies for all tested compounds. This approach involves “docking” a process of ligand binding to its receptor or target protein, to identify and optimise drug candidates by examining and modelling molecular interactions between ligands and target macromolecules.

Ligand-based computer-aided drug design approach, on the other hand, is used when 3D structural information of the target is not available and involves the analysis of compounds known to interact with a target of interest. This method relies on the Similar Property Principle, published by Maggiora and Shanmugasundaram (2011). It states that molecules that are structurally similar are likely to have similar properties. Structural properties considered in this approach include molecular weight, surface areas, ring content, atom types, electro-negativities, atom distribution, interatomic distances, bond distances, planar and non-planar systems, rotatable bonds, symmetry,   functional group composition, aromaticity, solvation properties, and many others.

The overall goal is to characterise compounds in such a way that the physicochemical properties most needed for their desired interactions are retained, whereas unnecessary information not relevant to the interactions is discarded. It is considered an indirect approach to drug discovery in that it does not necessitate knowledge of the structure of the target of interest.

Advantages

According to Kapetanovic (2008) computational drug design expedites and facilitates the process of drug discovery from target identification, hit identification, hit to lead selection and lead optimisation. It increases the effectiveness and efficiency of drug discovery at a lower price, compared to the conventional drug discovery and decreases the use of animals in the process of lead identification and optimization.

Another benefit of in CADD is application in the screening of virtual compound libraries, also known as virtual High Throughput Screening (vHTS). This allows researchers to focus resources on testing compounds likely to have the activity of interest. In this way, a researcher can identify an equal number of hits while screening significantly less compounds, because compounds predicted to be inactive with high confidence may be skipped.

Avoiding a large population of inactive compounds saves money, time and resources, just as the pharma mantra goes, “fail fast, fail early”.

References

  • Anson D, Ma J, He J-Q (May 2009). “Identifying Cardiotoxic Compounds”. Genetic Engineering & Biotechnology News. TechNote 29 (9) (Mary Ann Liebert). pp. 34–35. ISSN 1935-472X. OCLC 77706455. Archived from the original on 25 July 2009. Retrieved 25 July 2009
  • Kapetanovic I.M. (2008) Computer-Aided Drug Discovery and Development (CADDD): In Silico-Chemico-Biological Approach. Chem Biol Interact. 2008 January 30; 171(2): 165–176. doi:10.1016/j.cbi.2006.12.006.
  •  Paul SM, Mytelka DS, Dunwiddie CT, Persinger CC, Munos BH, Lindborg SR, Schacht AL (Mar 2010). “How to improve R&D productivity: the pharmaceutical industry’s grand challenge”. Nature Reviews. Drug Discovery 9 (3): 203–14. doi:10.1038/nrd3078. PMID 20168317.
  • Sliwoski G, Kothiwale S, Meiler J, and. Lowe E. W. (2014) Computational Methods in Drug Discovery. Pharmacological Reviews. 66:334–395.
  • Wikipedia: Drug Discovery

ACPN chairman expresses fears over chain pharmacy

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Pharm. (Dr) Albert Kelong Alkali is the national chairman of the Association of Community Pharmacists of Nigeria (ACPN). In this exclusive interview with Pharmanews, the soft-spoken pharmacist speaks on the experiences of community pharmacists in the country, as well as the efforts put in place by his administration to render necessary support. He also expresses his fears regarding the introduction of retail chain pharmacy practice into the Nigerian drug market. Excerpts:

Could you tell us some of your achievements and challenges since you took over the mantle of leadership of ACPN?

Since we took over, we have been able to redesign the association’s website and it is still being upgraded to meet the information needs of our members and the general public. We have paid advocacy visits to some pharmaceutical companies like Worldwide Commercial Ventures (WWCV), GSK, Biofem, Greenlife and there are still more to be visited. We have also visited the registrar and management staff of the Pharmacists Council of Nigeria (PCN), the executive secretary of the National Health Insurance Scheme (NHIS), as well as the director general and the head of Pharmacovigillance of NAFDAC.

We have also visited and are still visiting some elders to seek their cooperation and support. We have secured some BNF to be distributed to states to enhance drug information and counselling by members. We are currently drafting a proposal with the Bank of Industry (BOI), other health care providers and commercial banks to the federal government for a Health Sector Intervention Fund.

The major challenge I faced immediately I took over was the issue of National Drug Distribution Guidelines and the unacceptable retail chain concept. These challenges are being handled and I have confidence that we will come out strong at the end of the day.

You have been a community pharmacist for years, at what point did you decide to go for ACPN chairmanship and what prompted the decision?

I have been an active participant in ACPN and PSN activities in the FCT and at the national level for years now. I was once ACPN Abuja vice chairman and later chairman; and I was also chairman of PSN Abuja Pharmacy week 2012 Planning Committee.

I was elected national vice chairman, ACPN in 2012 and national chairman in 2015. What prompted me to aspire for all these leadership roles was the need to make my modest contributions to the development of ACPN and the pharmacy profession.

What is your assessment of community pharmacy practice in this country?

My assessment of community pharmacy practice in this country is that we have a long way to go. Community pharmacy practice thrives in a highly regulated and sanitised environment; but in Nigeria we still need more from our regulatory agencies, although I must appreciate some laudable actions of the registrar of the PCN. Still there is more to be done, as there are still many illegal premises and people selling pharmaceuticals on the roads and buses.

What would you say are the greatest challenges facing community pharmacists in Nigeria at the moment?

The greatest challenges facing community pharmacists in Nigeria presently are the poor practice environment, chaotic drug distribution and lack of government’s appreciation and recognition for the health services being rendered by community pharmacy practitioners in Nigeria. In Australia, the government in a year spends more than $600 million as part of the budget for community pharmacy practitioners to improve access to pharmaceutical services by its citizens.

The chain-pharmacy concept is becoming more popular and common. As the ACPN national chairman, how do you see this development?

My take on chain pharmacy is that the practice should dwell more on encouraging good pharmacy practice (GMP) as stipulated by the World Health Organisation (WHO), rather than being seen as ordinary trading with the sole aim of making money.

Also, in line with our existing status, community pharmacy practice has a lot to give to the  improvement of our health services because we do a lot of health promotions, prevention (which could come in form of immunisations, counselling, medication reviews , monitoring and treatment of minors for important diseases like malaria, Flu, diarrhoea, just to mention a few).

However, chain pharmacy concept that has to do with mainly trading by foreign concerns, who are only interested in changing our laws to turn the practice to trading of imported commodities, is definitely not in the interest of the Nigerians. I will therefore use this opportunity to call on the government to increase the involvement of community pharmacy practitioners in programmes, policy formulations and in achieving the Sustainable Development Goals (SDGs).

What grey areas in the profession do you think stakeholders should address urgently?           

The grey areas that I will like stakeholders to address are  areas like the participation of the pharmacists in the health sector as regards policy formulations, our practice environment, National Health Insurance Scheme, and the full integration of clinical pharmacy practitioners in our health institutions because some institutions do not allow pharmacists access to case notes.

What is your general view of the current state of the health care sector?

The current state of the health care sector in the country is not encouraging enough. A situation where there is rivalry among the health care providers leaves the patient in a helpless situation. No wonder a lot of people seek help outside the shores of our country. Government must as a matter of urgent importance address this issue, if we are to have a health care sector that will take care of the health needs of Nigerians.

You were at the FIP in Luxembourg, Germany. What would you say is the contribution of the programme to the development of pharmacy profession in Nigeria?

The contribution of FIP conferences to the development of Pharmacy profession in Nigeria is quite enormous. A very good example was the recently concluded one in Luxembourg, Germany, as there were many plenaries sessions that had to do with pharmacy practice and regulations; as well as the sharing of experiences of the practitioners from various countries.

Some examples of what we learnt at the plenaries were: evidence-based practice skills, Pharmacogenomics,   patient-centered pharmacy practice (rather than mere buying and selling), medicine optimisation and interprofessional and transformative pharmacy.

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Admin
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Pharmacist Nnamdi Nathan Okafor is the managing director of May & Baker Nigeria Plc. Born on 11 May, 1961, in the northern city of Kano, where he started his early education, the pharmacist relocated to the eastern part of the country to continue his studies, following the outbreak of the civil war in 1967.

In August 1978, he obtained admission to study Pharmacy at the University of Ife (now Obafemi Awolowo University) and graduated in 1983 with a second class honours (upper division) degree.

Okafor went on to bag a Master of Business Administration (MBA) degree in Marketing from the Enugu State University of Technology in 1998. Two years later, he was amomg the year 2000 AMP 10 graduating class of the prestigious Lagos Business School.

Okafor commenced his pharmaceutical career in October 1985, as a medical representative at May & Baker Nigeria Plc. This was immediately after having completing his National Youth Service and internship programmes at the National Sports Commission Clinic, Surulere, and Railway Health Centre, Ebute Metta, in 1983 and 1984 respectively.

The pharmacist demonstrated such superlative performance in his early years that he became the youngest staff ever to be promoted to an area manager position after just two years as a representative. Continuing with his sterling performance, he won several awards and rose rapidly in the management hierarchy.

On 11 June, 2003, he was appointed to the board of May & Baker Nigeria Plc as executive director (Sales & Marketing). In this capacity, he restructured the local pharma business into what remains today the biggest contributor to the company’s revenue and profit achievements so far.

Again, in January 2006, he was appointed chief operating officer of the company, with the responsibility of championing its diversification into the food business. He was the man behind the “Boom Sha Sha” jingle that thrilled many young Nigerians, following a successful launch of Mimee Instant Noodles into the Nigerian market.

To cap his long and meritorious contributions to the success of the company, Mr Okafor was on 1 February, 2011 named its managing director/chief executive. He has led the company to achieve several distinguishing feats, including the attainment of the World Health Organisation (WHO) current Good Manufacturing Certificate (cGMP) in 2014.

Mr. Okafor is an active member of the National Association of Industrial Pharmacists where he has played many key roles. In recognition of his numerous contributions to the association, he was honoured with the Eminent Persons Award in 2007. He has also been a staunch supporter of the Pharmaceutical Society of Nigeria (PSN)’s activities, both at national and state levels. He has served the Society in different capacities, and in recognition of his contributions he was in November, 2006 decorated as a Fellow of the Society, the highest honour in his profession. In 2015, he was further honoured with the Fellowship of the Nigeria Academy of Pharmacy.

Pharm. Okafor is happily married with children.

Pharmanews-White Tulip trains PharmacyPlus sales team

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Admin
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It is believed that employees with access to training and development programmes often excel above their counterparts without such access. This perhaps explains why PharmacyPlus Limited recently engaged Pharmanews-White Tulip’s training team to train its sales team and regional managers.

Pharmanews White-Tulip
Group photograph of participants at the training workshop. (Seated) L-R: Pharm. Tunde Oyeniran, training consultant/facilitator, Pharmanews-White Tulip Training; Pharm. Chukwuemeka Obi, Chief Operating Officer, PharmacyPlus Ltd; Pharm. Jude Elue, and; Mr Paul Ibeanuka. (Standing) L-R: Mr Joseph James, National Sales Manager, PharmacyPlus Ltd; Mr Adekola Adediran, and Mr Cyril Mbata, both of Pharmanews-White Tulip Training.

The one-week training programme which was held during the company’s 2016 National Sales Conference at Ibis Hotel, Airport Road, Lagos from 24 to 28 January, had over 20 participants in attendance.

Highlighting the importance of such training which had the theme “Thinking Possibilities”, Pharm. Joseph James remarked that the event was set up to achieve two things.

“First, the occasion was the company’s annual business meeting. Secondly, we felt the need to also use the opportunity to hold performance improvement training for our sales and marketing team including the regional managers.

“Of course, we are hoping that after this training, the sales team can go out there and be top class customers’ delights. Whichever way we look at it, it is a win-win situation,” he said.

Pharm. Yemi Ilori, PharmacyPlus regional sales manager, seems to share the same optimism as he stressed that the lessons obtained at the one-week training would go a long way in benefitting the company.

Among other highlights, the participants were trained on new techniques to achieve exceptional results and self-leadership. They were also exposed to new trends on account management, proper understanding of the pharmaceutical industry and what was expected of each sales representative.

Industrial pharmacists seek FG’s intervention

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Manufacturers under the aegis of the National Association of Industrial Pharmacists (NAIP) have made a clarion call to the federal government to declare a state of emergency in the manufacturing sector.

L-R: Pharm Moses Oluwalade, managing director of Miraflash Pharmaceuticals; Prof. Ayo Arije, consultant physician at University College Hospital (UCH), Ibadan; and Dr Lolu Ojo, NAIP’s national former chairman, during the official commissioning of Miraflash’s factory in Magboro, Ogun State recently
L-R: Pharm Moses Oluwalade, managing director of Miraflash Pharmaceuticals; Prof. Ayo Arije, consultant physician at University College Hospital (UCH), Ibadan; and Dr Lolu Ojo, NAIP’s national former chairman, during the official commissioning of Miraflash’s factory in Magboro, Ogun State recently

In a recent interview with Pharmanews, Pharm. Moses Oluwalade, managing director of Miraflash Nigeria Limited, an indigenous pharmaceutical manufacturing company, explained that, given the right attention and support, the manufacturing sector had the potential to yield billions of dollars in annual revenue.

“There should be a deliberate effort to encourage manufacturers by creating an enabling environment for them and opening up channels for loans at affordable lending rates. We are advocating for a special fund that local manufacturers can access,” he said.

Oluwalade noted that the main reason many big companies were folding up was because of unfavourable operating environment.

While expressing firm confidence that the local manufacturing holds the key to Nigeria’s future, the pharmacist canvassed that certain drastic measure must be put in place to promote the sector to rapidly develop the economy.

“We want the present administration to declare a state of emergency in the manufacturing sector and provide an enabling environment so that more companies can come up,” he said. “Instead of providing jobs in other countries, we can actually create jobs here in Nigeria for our populace.”

Shedding more light on his position regarding the Nigerian business landscape, Oluwalade said: “There are several businesses that have closed down due to hostile environment. When I say hostile, I mean no light, no water and no good road. If these problems are properly addressed, more businesses will thrive. At the current rate of lending in commercial banks, no manufacturer will survive. The interest rates have to be reasonable for manufacturers to survive.”

It would be recalled that Miraflash was one of the two local pharmaceutical companies selected by Standford Seed Innovation Programme (West Africa) in March 2015 for transformation of developing economies through the scaling of medium to large companies by intensive training and development of manpower and structural capacity.

Concurring with him, Dr Lolu Ojo, immediate past chairman of the association in Lagos, argued that the manufacturing arm of the pharmaceutical sector was long due for such considerations.

Ojo noted that local manufacturing was quite a difficult terrain, particularly given the many hurdles that must be surmounted in the Nigerian environment.

The managing director of Merit Healthcare Limited observed that it was quite easy to import products and make quick profit, but strictly warned that this should not be the focus of an economy aspiring for growth.

“We cannot continue to live on commerce to the neglect of industry,” Ojo cautioned. “Whether we like it or not, we must have factories like Miraflash that can produce locally. Even if it is intermediate production, once it is mastered, we can start primary production, using available locally sourced raw materials,” he said.

Ojo futher said that he agreed with the notion that the time was ripe for Nigeria to consider declaring a pharmaceutical village where local pharmaceutical production would be stimulated.

“All these monies being used or not being used to buy arms could be used to set up a pharmaceutical village. Let it be divided into industrial plots, encourage people to come, provide amenities and loan out money at five or six per cent, the sector would develop massively,” he said.

The ex-NAIP boss also emphasised the importance of government patronage of locally-manufactured products, noting for example that if the Ogun State government decided to buy pharmaceuticals from companies in the state, there would be more than enough of multivitamins, ampiclox, ampicillin, among others that are used in the state.

“That, to me, is how to make manufacturing attractive and I believe this development will make more people to come on board,” he said.

How civil war almost truncated my B.Pharm dream – Pharm. Okonkwo

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Pharm. Okonkwo

Pharm. Eugene Chibuzo Okonkwo was born at Nise in Awka South Local Government Area of Anambra State. The first of five surviving children, he is the managing director of Chixie Pharmacy in Aguda area of Lagos. In this exciting interview with Adebayo Folorunsho-Francis, Okonkwo recounts some of the challenges faced by early pharmacists in the country and how the civil war almost compelled him to give up his pharmacy study.

Tell us about your younger days.

At age five, I started my early education at St Bartholomew’s Primary School, Enugu, capital of the Eastern Region of Nigeria. After primary five, I was transferred to St Paul’s Practising School, Awka, to complete my primary six. It was in that great school that I gained admission into the prestigious Government College, Umuahia. While there, I was among the first batch of students who were selected to write the West African School Certificate Examination (WASCE) in four years instead of the normal five years. My best friend, Prof. Bona Obiorah, was then my classmate at Government College, Umuahia.

After passing my WAEC examination in grade one, Prof. Obiorah and I got admitted into the Nigerian College of Arts, Science and Technology, Enugu, for a two-year pre-pharmacy course which included Physics, Chemistry and Botany. At the end of the course, we both passed the three subjects in the London GCE A-Level Examination. From there, we moved to the University of Ife to start our course in Pharmacy.

How did you decide to study Pharmacy?

Honestly, my decision to study Pharmacy was by chance. While at Government College, my decision was to study Medicine, while Prof. Obiorah was considering Agriculture. We were lucky to have wonderful masters in Chemistry and Biology, namely Edmund Wilson (Briton) and W. E. Allagoa (Nigerian). Because we were well grounded in these subjects, we were sure that we would scale through our chosen courses.

However, just before we started WAEC Examination, we heard about the Nigerian College of Arts, Science and Technology for the first tme. We were told that if we passed the written examination into this institution, we would get automatic East Regional Government scholarship to pursue a five-year course in Pharmacy and this would remove the burden of school fees from our parents. Additionally, we were told that at the Nigerian College, we would have a room to ourselves in a hostel and that we could wear trousers instead of the Khaki shorts we wore at Umuahia. We were also told that we could wear suits, attend dances and that our hostel rooms would be cleaned and our dresses washed by washerman. That was it. We decided it was Pharmacy or nothing!

Looking back, was it a good decision?

Yes, indeed it was a very good decision to study Pharmacy. Pharmacy, as a profession, has broadened my perspective of life. I started out as a hospital pharmacist at the Enugu General Hospital and later at Arochukwu General Hospital for one year in each station. This exposed me to make friends with doctors, nurses and patients.

In 1971, I joined Glaxo Nigeria Limited as a medical representative based in Aba. I covered the present Abia, Anambra, Imo, Ebonyi, Cross River, Akwa Ibom, Enugu and Benue States. As a medical representative, I lived a glamorous life, staying in good hotels and meeting and discussing with prominent doctors and pharmacists in my area of operation.

In 1974, I was promoted and transferred to Lagos as a product manager. I later to move up to become the western branch manager, marketing services manager, general manager and, eventually, marketing manager, before my retirement in 1987. These positions enabled me to be familiar with all the states in Nigeria.

If not Pharmacy, what other interests would you have followed?

If I had not studied Pharmacy, I would have studied Medicine because I was very good at science subjects.

As one of the second set of B.Pharm graduates of Ife in 1967, can you tell us some of your memorable experiences?

After passing my London A-Level GCE Examination, Prof Bona Obiorah, Pharm. Dennis Okolo, Pharm. Pius Ogwueleka and I were given admission to pursue a degree in Pharmacy at the University of Ife. On the resumption date, we and other students started our lectures in the Pharmacy block of the University. A couple of weeks after we started receiving lectures, a young, handsome man was ushered into the Pharmacognosy lab by Dr J. D. Kulkani and was given a seat at the back of the class. We thought he was a new lecturer in Pharmacognosy and wondered how such a young man could have become a lecturer at such a tender age. He had neither a paper nor a pen and his poise resembled that of a teaching staff member. It was a few days later that we discovered that the young man was just a fellow student like us. That chap is Pharm. (Sir) Ifeanyi Atueyi, publisher of Pharmanews.

And then, in our second year, we started hearing speculations that the university was not certified to offer the B.Pharm degree after three years and that we would end up with Diploma in Pharmacy. All hell was let loose. Some of our classmates such as Nath Ozobia, Augustine Oronsanye and Bayo Owoseni quickly applied to the Lagos University Teaching University (LUTH) to study Medicine and were offered admission. They formed the foundation students of the College Medicine. Prof. Bona Obiorah and I also applied to the German Embassy in Lagos to study Medicine in Germany. Luckily, we were offered a scholarship to study at the University of Heidelberg. I believe Pharm. Atueyi also got admission to study in either Germany or elsewhere. We were all totally disillusioned and disconsolate.

However, as time went on, we became more rational and changed our minds to complete the three-year Diploma in Pharmacy at the University of Ife. We decided that instead of starting another six-year course in Germany, we should complete the diploma course, own our cars and become senior civil servants, even though our salaries would be £408 per annum compared to other graduates who earned £720 per annum.

Just before we left Pharmacy school, one of the lecturers, Dr Vernon Walters, gave us assurance that an opportunity would be given to us in future to come and complete our B.Pharm degree.

Was that prediction fulfilled?

Yes, just as Dr Walters had predicted, we were invited to the university in 1966 to do a one-year course to complete our B.Pharm. degree. You can imagine the elation we had as our dreams came through! However, little did we know that unforeseen circumstances would threaten our dreams.

As the session was beginning, the killing of Easterners in the North had begun to escalate. Most of my classmates then were Pharm. Moses Azuike, Pharm. (Sir) Ifeanyi Atueyi, Prof. Bona Obiorah, Pharm. Dennis Okolo, Pharm. Pius Ogwueleka and Pharm. Bola Olaniyi. Those of us from the Eastern Region were really afraid. There was tension in the country and Lt. Col. Odumegwu-Ojukwu, the then military governor of the Eastern Region, asked all Easterners to return to the East. We stayed back to continue our studies, until two days to our final examination when Ojukwu declared the Independent State of Biafra. With that announcement, we, the students from the Eastern part of Nigeria, felt that our lives were in danger. We sent a delegation to the amiable vice chancellor, Prof. Hezekiah Oluwasanmi, to request for a means of transporting students from the Eastern Region to Asaba. He sympathised with us and provided us with the university’s buses; while some of us who had personal vehicles assisted others and we all left the campus for Asaba with mobile police escort provided by the vice chancellor.

Did you make it to East?

In the evening of that day, we arrived at Asaba. Just then, it dawned on us that we had been hasty in dumping our academics for safety. So, we decided that all the final year students should return to Ibadan that night in order to write their exams the following morning. Instantly, the few of us involved hired a 404-station wagon and started heading back to Ibadan. These included Atueyi, Obiorah, Ogwueleka, Azuike, Okolo and I.

We arrived at the Pharmacy block of the university 30 minutes after Pharmaceutical Chemistry paper had started at 9.00am the following day. As unkempt as we were, we barged into the office of the head of department, Dr Rowland Hardman, and told him that we had returned to write our examination. He declined our request, and this prompted us to march to the vice chancellor’s office in protest. Prof. Oluwasanmi (of blessed memory) was so kind as to instruct our head of department to allow us to write the examination and to give us extra time to do so.

By the time we finished the examination and were on our way back to the East, the Biafran government had blown the Onitsha end of the Niger Bridge and we had to cross over by canoe from Asaba. We were among those returnees who were labelled “saboteurs” by Biafran soldiers and could have been shot, if not for divine intervention and the assistance of some soldiers who recognised us.

How would you compare today’s pharmacy practice with your time?

As at the time I qualified as a pharmacist, I think that the number of pharmacists in Nigeria must be in the hundreds, certainly not up to one thousand. Many of those pharmacists were trained at Yaba Higher College, the Nigerian College of Arts, Science and Technology, Ibadan, and later on, at the University of Ife. The highest qualification then was Diploma in Pharmacy.

The majority of pharmacists worked in government hospitals, while a few ran retail pharmacies or worked for the few multinational companies as medical representatives. The hospital pharmacists, through their union, Nigerian Union of Pharmacists (NUP), were always engaging the government over their poor salary which was £408 per annum, compared with other graduates who earned much higher. Those who ran chemist shops were doing well because there were few patent medicine shops to compete with them.

What was the catalyst that changed the trend?

Between the late 50s and early 60s, the first set of graduate pharmacists started to return to Nigeria from the United Kingdom and the image of pharmacists started to soar. They included the late Emmanuel Igwueze (who later became the chief pharmacist of the Eastern Region after the last had expatriate left), Pius Alu, D. N. Akuneme and Mrs. A. Pepple. Those pharmacists were referred to as pharmaceutical officers and were placed on a salary of £1,020 per annum. The arrival of these graduate pharmacists opened a new vista for the image of pharmacists in Nigeria.

After this first set of pharmacists came the second set which included Dr Philip Emafo, Prof. Gabriel Osuide, Prof. Paul Akubue and Dr George Iketubosin, who went straight to academia. I was among the second set of graduate pharmacists from the University of Ife in 1967.

Today, virtually all universities in Nigeria churn out graduate pharmacists every year. With this massive increase in the number of graduates, it is getting more difficult to find gainful employment. It is therefore no surprise that some misguided graduates team up with patent medicine dealers to engage in unethical practices. During my time in Glaxo, pharmaceutical companies had three tiers of prices for their products: distributors’ price, hospital price and retail price. Retail price had a mark-up of 33.3 per cent on the distributors’ price so that any ethical product sold by a retail pharmacist attracted a 33.3 per cent automatic profit while OTCs had a mark-up of 25 per cent. This price regime was strictly adhered to and retail pharmacy boomed. Now, with the deluge of young pharmacists in competition with the patent medicine dealers, price cutting has become the order of the day, especially now that one cannot guarantee the quality of products in circulation in the country.

What is your view about pharmacists in politics?

My view about pharmacists in politics is premised on the saying, “Different strokes for different folks.” I have no problem with pharmacists who have the genetic make-up to jump into the shark-infested, murky waters of Nigerian politics.

I recall some people who, while in the university, showed signs of going into politics. First among them was Prince Julius Adelusi-Adeluyi, who was the president of All Nigeria United Nations Students and Youth Association (ANUNSA), PAX ROMANA (Latin for “Roman Peace”), Pharmaceutical Association of Nigeria Students (PANS) and secretary of National the Union of Nigeria Students (NUN), as well as a host of other associations. He was later to become the minister of health in Nigeria.

I also recall people like Chief Lambert Eradiri, Late Sir Samuel Agboifo, Late Chief Tony Ekoh, Pharm. Tony Chukwumerije and others. I wish to use this medium to congratulate Pharm. Jimi Agbaje who mustered the courage to contest in the last governorship election in Lagos State. I look forward to a time when more pharmacists will be in the corridors of power in Nigeria to help us in controlling some ills affecting the pharmacy profession.

Can you recall some of your colleagues and lecturers who had touched your life in unforgettable ways?

The most prominent personality at Ife in my time was Prince Julius Adelusi-Adeluyi. I just could not fathom how he was able to cope with the tedium of being a pharmacy student and at the same time acting as secretary of NUNS, president of ANUNSA, PAX ROMANA, PANS, and being a newscaster at the Western Nigerian Broadcasting Corporation (WNBC).

I also remember Chief G. L. Eradiri, who was a vibrant student politician and president of PANS. I remember an instance when Eradiri went to our Pharmaceutical Chemistry lecturer, Dr George Iketubosin, to ask whether he could be admitted to pursue postgraduate studies. Dr Iketubosin told him that he was known as a student politician and that he should go home and take up chieftaincy titles.

I also recall the Late Sir Samuel Agboifo who was president of the Students Union and PANS. Samuel was a quintessential gentleman who eventually became president of the Pharmaceutical Society of Nigeria (PSN).

As for my lecturers, I recall Dr Vernon Walters, who was our Pharmaceutics lecturer and who promised to give us the opportunity to take our B.Pharm degree after our Diploma course. Walters was a polished gentleman who loved his subject and the students. I also remember Dr Iketubosin who took us in Pharmaceutical Chemistry but died before we finished our course. He was replaced by Dr (Mrs) Pamela Ghergis.

We had other lecturers like Stella Rivers, Jennifer Heathcote, Dr. J. D. Kulkarni and M.B. Patel. Others were Maxwell Foy, Dr Parrat, Dr Rowland Hardman (HOD), Prof. Ayo Tella and Prof. Lanre Ogunlana. Looking back, I just remember how Dr Stella Rivers nicknamed Pharm Moses Azuike as “The Moses of the Bible.”

What is your advice to pharmacy students and today’s young pharmacists?

I advise pharmacy students and young pharmacists alike to always remember the history of the profession from the apothecary to dispensers to chemists and druggists. We have come a long way to where we are now. With the introduction of clinical pharmacy to the curriculum, pharmacists have moved from being dispensing pharmacists to being clinical advisors. Pharmacists have now become indispensable partners with other health care workers in health workers in health care delivery. So the young ones must work hard to add value to whatever standards we have handed over to them.

 

Why we enlisted Artequick for MAS – Artepharm boss

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Jeremy Hu
Jeremy Hu

China-based pharmaceutical company, Artepharm, has explained why the company recently signed up the Artequick antimalarial drug for the Mobile Authentication Service (MAS).

Speaking with Pharmanews, Jeremy Hu, marketing director of the company, said that the move was necessary to ensure that only genuine products got to the end users without hitches.

Hu said that Nigeria had a huge market where several antimalarial drugs were always jostling for attention, adding that this had led to counterfeiting of such products in some quarters.

He stated that Artepharm’s subscription to MAS was a further demonstration of its commitment to the well-being and speedy recovery of patients, noting that the move became even more necessary when the company discovered that a faceless pharmaceutical outfit in the country was faking its product.

“It took the intervention of a court injunction to stop the act. This is why we encouraged patients and physicians alike to ensure that they scratch and authenticate the pin on each product before use,” he admonished.

The Chinese businessman observed that many consumers don’t bother scratching to authenticate the genuineness of the drug they procure, adding that this behaviour encourages imitators and fake drug peddlers to thrive.

Describing Artequick, the Chinese expert described the drug as a quick action, preventive, highly efficacious and low toxicity medication, with a side effect of less than three per cent.

“Artequick is a 4-tablet 2-day anti-malarial treatment. It is a new line generation of ACT combining Artemisinin and Piperaquine as its potent ingredients. Unlike most complex anti-malarial products in town, it is a short regimen drug (specifically a four-tablet dosage),” he said.

On the long term goal of Artepharm, the marketing director noted that arrangement was being concluded by the management to build a local factory in Nigeria within the next two to three years.

“Aside production of Artequick, which is marketed in Nigeria by Trusted Pharmacy and Chemist (West Africa), we are hoping to start reproducing other wide range of brands like antibiotics, hypertensive, diabetics, Azithromycin, Meropenem, Ceftriaxone, and Amoxicillin which are currently gaining ground in the market,” Hu revealed.

The Artepharm boss further said, “When compared with local production, I have observed that most pharmaceutical products here in Nigeria are mainly from India, China and Malaysia. I recall that China once experienced a similar situation in the 1980s.”

Going down memory lane, Mr Hu recalled that his countrymen had to deal with several issues when local pharmaceutical manufacturing companies were just blossoming in the 1980s.

“In the 1980s when China local medicines had not attained international status, the bulk of the drugs you saw around were from the West. Since the global brands that took over the Asian markets, such as GSK, Novartis, and Pfizer, were more or less using our resources, the need for joint ventures became paramount.

“Their presence were felt everywhere in the major cities. With such ventures came the needed experience and expertise for many Chinese entrepreneurs who ventured into full time pharma manufacturing,” he remarked.

The marketing director believes that Nigeria can equally benefit by encouraging global brands and foreign investors to build factories open up channel of local production and run joint ventures. He expressed optimism that with government’s backing, local pharma manufacturing would reach its peak.

For a self-acclaimed introvert, the Artepharm director who has been operating in Nigeria since 2009, was quick to acknowledge Nigerians as very hospitable, creative and hardworking people.

“I have travelled through the six geo-political zones of Nigeria. What I find remarkable is the fact that the huge population of market consumers gives a level playing field for new and existing companies to carve a niche for themselves and compete favourably. That, to me, is a plus for any developing nation,” he observed.

On why he thinks any company would want to risk introducing an anti-malarial drug into Nigeria when it is almost saturated with different innovator products and generics, Mr Hu declared that Artequick is different from the bulk of brands in the market.

According to him, Artepharm has come to realise that non-compliance, as a result of taking too many tablets for a length of time, is a challenge in eradicating malaria in Nigeria.

PSN cautions young pharmacists against quick gratification

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Temitope Obayendo
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The Lagos State branch of the Pharmaceutical Society of Nigeria (PSN) has kicked against the get-rich-quick trend among young pharmacists, noting that such orientation would prevent them from making a meaningful impact on their profession and the society at large.

The timely counsel was given by elders of the profession at the induction ceremony of over 70 new pharmacists, who were posted to the state for their internship.

The veterans took turns to emphasise the supremacy of commitment to service over greedy tendencies.

L-R: Pharm. Gafar Madehin , Secretary, Lagos PSN; Pharm. Gbenga Olubowale, chairman, Lagos PSN and Pharm. Harry Ikechukwu Nnoli, keynote speaker, during the induction ceremony of new pharmacists held in Lagos recently
L-R: Pharm. Gafar Madehin , Secretary, Lagos PSN; Pharm. Gbenga Olubowale, chairman, Lagos PSN and Pharm. Harry Ikechukwu Nnoli, keynote speaker, during the induction ceremony of new pharmacists held in Lagos recently

The keynote speaker, Pharm. Harry Ikechukwu Nnoli, who spoke on the topic: “Enter the future”, made it clear to the inductees that their future would be shaped by their preoccupations, urging them to maximise their time on productive activities, rather than cutting corners to get to the top.

Nnoli, who cautioned the pharmacists against sharp practices, highlighted the qualities of a great professional to include integrity and personal development, adding that greatness in a chosen career is determined by the ability to get relevant knowledge, as well as the right application of such knowledge to the practice.

He further added that the ultimate difference that they would make would be determined by their relationship with God, encouraging them to embrace God and let Him guide them in all that they do.

“The God factor must not be forgotten, because except the Lord builds the house, they labour in vain that build it.”

Continuing, he said, “People must be humble to know that the journey of a thousand miles begins with a step, it doesn’t start with hundred steps. For as long as they are honest with themselves, and conscious of being relevant to the society, not trying to enrich their purses, they will be able to avoid the pitfall of corruption.

“History has shown that most of those who engaged in fraudulent acts, often ended up miserably. Thus, young pharmacists should know that their call to service is not about stealing money, because no one remembers the money you stole, but the impact made on the lives of people. So as pharmacists, my advice to you is to make a difference in the lives of poor Nigerians, and in the society at large. In the process of impacting others positively, your own lives will also be transformed”, he counselled.

Also speaking at the occasion, Pharm. Gbenga Olubowale, chairman of Lagos PSN, explained the essence of the induction ceremony, stating that it was a way of integrating the new pharmacists into the culture of the PSN.

“We use that avenue to talk to them, as some of our senior colleague offer advice and share experiences”, he said.

The chairman noted that it had come to the notice of the PSN that most of the new pharmacists on the field are not well versed in what the profession is all about, saying that some of them graduate from school with wrong notions, which easily makes them get conscripted into wrong practices – “register and go”, get-rich-quick syndrome, and so on.

He also mentioned the importance of mentoring, which he said is prerequisite for making real impact on the field.

Fielding questions from the inductees on how best to resolve the recurrent bottlenecks in getting internship placement, Pharm. Augustine Ezeugwu , PCN Lagos zonal coordinator, said the PCN was working on the expansion and accreditation of community pharmacies in the state, urging the young pharmacists to also be prepared to work in the community , as not all pharmacists would have the privilege of serving with federal government institutions.

NAFDAC canvasses property seizure, life jail for drug counterfeiters

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In continuation of its zero tolerance campaign against counterfeiting in the country, the National Agency for Food and Drugs Administration and Control (NAFDAC) has called for a review of existing laws on spurious, substandard and falsified drugs to include life imprisonment and confiscation of offenders’ assets.

Dr Paul Orhii, NAFDAC’s director general (now former); Dr Monica Hemben-Eimunjeze, director of registration and regulatory affairs and Pharm. (Mrs) Elizabeth Awagu, special assistant to NAFDAC DG
L-R: Dr Paul Orhii, NAFDAC’s director general (now former); Dr Monica Hemben-Eimunjeze, director of registration and regulatory affairs and Pharm. (Mrs) Elizabeth Awagu, special assistant to NAFDAC DG, during the summit

Dr Paul Orhii, NAFDAC’s director general (now former) vowed that the agency would never compromise on its decision to penalise any manufacturer involved in production of counterfeit drugs and food at the expense of the Nigerian people.

Speaking on the theme, “Exceeding Industry Baseline”, at the opening ceremony of the annual NAFDAC SummEx (Summit & Exhibition) which held recently at Muson Centre, Onikan, Lagos, Orhii explained that drug counterfeiting had become a major concern in Africa.

Enumerating reasons certain importers of fake products seem to target Nigeria, the NAFDAC boss said that only 30 per cent of the drugs used in Nigeria are manufactured locally, thereby creating a 70 per cent vacuum which the importers take advantage of.

Among other things, Orhii cited Nigeria’s huge population and porous land borders as the main reasons counterfeiters still focus on Nigeria.

“This is why we are advocating life jail term without an option of fine, confiscation of assets, and reward for individuals who expose those involved in the crime, in line with what is obtainable in India and China,” he said.

While explaining that counterfeiting was not restricted to Nigeria, Orhii remarked that NAFDAC had succeeded in convincing the Chinese and Indian governments to introduce death and life jail sentences for offenders.

According to him, such move was necessary as most of the counterfeited, unwholesome and substandard products finding their ways into Nigeria had their origin from those countries.

“Unfortunately, Nigeria which is at the receiving end has the most lenient law which imposes 5-15 years jail term or an option of a N500,000 fine for those convicted of the crime,” he lamented.

Dr. Paul Orhii however said that Nigeria had a cause to rejoice, following the World Health Organisation (WHO)’s declaration that counterfeiting of antimalarial drugs had reduced drastically from 20 per cent in 2008 to an all-time 3.6 per cent in 2015.

“This is made possible with the aid of two globally recognised innovations – Truscan and Mobile Authentication Service (MAS) technology- which were put in place by NAFDAC to check counterfeiting.

“Health is an index of development. I congratulate all the staff for making this possible. The nation should be grateful to you for this achievement,” he stressed.

Dr. Orhii was also quick to add that the agency now has “Small Business Support Desk” to assist upcoming entrepreneurs.

“One does not need to have a big outfit in order to meet NAFDAC’s specifications. Depending on what one is manufacturing, you can have one room that meets NAFDAC’S requirements.

“We give discounts and sometimes full discounts for registration and inspection if we see that the product is good but that the producer is financially incapacitated,” he explained.

Earlier in her welcome address, Ms Christiana Obiazikwor, the agency’s public relations officer, remarked that the three-day exhibition and summit is an annual platform that offers a forum for effective and sustained engagement by stakeholders in the food, drugs and allied sectors.

“It serves as convergence for all stakeholders to learn, share and showcase innovations, ideas and experiences, as well as review policies and set an agenda for the future,” she said.

In attendance at the occasion were Pharm. Regina Ezenwa, a Fellow of the PSN; Mr Chris Ejiofor, a legal luminary; Eugene Olewuenyi, corporate planning and development manager of M&B Nig. Plc; Pharm. (Mrs) Elizabeth Awagu, special assistant to NAFDAC director general and Dr. Monica Hemben-Eimunjeze, NAFDAC’s director of registration and regulatory affairs.

 

 

Specialisation will boost relevance of pharmacists – PANS-OAU president

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Funmbi Okoya is president of the Pharmaceutical Association of Nigeria Students (PANS), Obafemi Awolowo University (OAU) chapter. In this exclusive interview with Pharmanews, the 500 level pharmacy student discusses the achievements of his administration, while also suggesting ways to improve pharmacy education in Nigeria. Excerpts:

How would you assess pharmacy profession in Nigeria?

Pharmacy profession is one that is indispensable anywhere in the world due to the important roles pharmacists play in the health sector. In Nigeria, the profession is advancing, though a lot of work still has to be done to ensure that the profession reaches the heights expected of it. I believe this can be achieved through the unity of all for the betterment of the profession.

 Can you tell us some of your plans for the association within the next one year as PANS-OAU president?

Knowing that my tenure will soon be over, only a few important programmes and projects are yet to be executed. So far, PANS-OAU has been able to make giant strides, which will redefine and enhance the growth of the association. First of all, the association has successfully launched its official website – www.pansoau.org – which will further expose us to the world at large, while serving several other functions.

Secondly, PANS-OAU was represented at the just concluded PANS National Convention at the University of Nigeria, Nsukka (UNN), by 41 delegates, which is the highest in recent years by a great margin. In addition to that, PANS-OAU now has two additional PANS national executives, who are the IPSF contact person, Mustapha Abdul-Afeez and the Deputy Editor-In-Chief, Zone A, Gloria Agboola.

Also of great importance is the fact that the constitution of the association is currently under review, and plans are in place for the reviewed version to be published as a handbook, for the first time in the 43 years of existence of PANS-OAU. It must however be said that the shortening of the semesters in this session has been a thorn in the flesh, as it has forced us to review our plans and programmes to ensure that we don’t overload the session and that our academics remain our primary focus.

How have you been coping with funding?

Yes, I agree that funds are essential in the execution of programmes and projects, and as such must be available when needed. Aside from membership dues, individual donations and corporate sponsorship have been at the core of our fund-raising activities over the years. Also, PANS-OAU annual publication, “PHARMATEL” and our website, www.pansoau.org, are both available for adverts placement.

However, it would have been better if PANS-OAU had a steady means of generating funds. To address this, it is my vision to set up a fixed account with a substantial amount, the interest of which will be available to each administration for years to come.

 What grey areas in the pharmacy profession do you think the Pharmaceutical Society of Nigeria (PSN) and stakeholders in the profession need to address urgently?’

As a profession of high repute and relevance, the profession has to get popular among the general public, not just within the health sector. People have to understand the roles of pharmacists and consider them distinct from other health care professionals. The younger ones also have to be well-informed about the profession as early as possible, so that the bright minds in the country will continue to be interested in the profession. This will help secure the future of the profession for years to come.

 What, in your own opinion, are the major challenges facing pharmacy education in Nigeria?

First is the curriculum for pharmacists-in-training. I personally think Industrial Training should be a part of every curriculum as it is vital for the students to gain the necessary practical experience outside the classroom. This is why I’m in full support of the Pharm.D programme that is more clinically-oriented. However, it is yet to be fully implemented and recognised.

Secondly, the issue of insufficient internship placements is a growing concern. Quite a number of recent graduates have had delays due to inadequate internship placements. If an internship of one year is to be made compulsory for all graduates of pharmacy school, which I believe is good for the profession, then these placements have to be available for these persons.

Also, I believe continuing education through specialisation will improve the relevance of pharmacists, particularly in the hospital setting. Specialisation in the pharmacy profession will further enforce our position as drug experts as pharmacists would be unequalled in the knowledge of drugs in specific areas.

 What are those things you think government can do to improve the standard of pharmacy education in Nigeria?

I think the most important resource needed for quality education is qualified tutors which we do not lack in Nigeria. However, our tutors still need to have facilities at their disposal, which is fundamental in giving quality education. These facilities need to be provided and maintained by the government.

The government will also do well to better remunerate lecturers and teachers, not just pharmacists, who give their all in ensuring that the standard doesn’t fall. It is saddening that their efforts are not recognized, as they should, and this has resulted in a lack of motivation.

Where do you see PANS by the time you will be handing over?

PANS OAU is already at a higher level than it was before my tenure, and I know that with the plans we have in place, PANS OAU is going to ascend even greater heights.

 What is your message to pharmacy students across the country?

I’d like to encourage my colleagues in pharmacy schools that the profession has a very bright future and so we should have a lot in confidence in it. Our chosen profession is a noble one, and as such, we should strive to represent the profession in the best way possible.

The effect of a unilateral mistake in Law

By
Dozie David
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Asokoro Medical Laboratories acquires some new equipment in Lagos and wishes to transport them to its headquarters in Abuja. Mr Johnson, a member of staff of the company, takes the equipment to the Cargo Division of City Link Transport Services in Jibowu, Lagos.

The weight of the cargo is determined to be 500kg. An invoice is issued by the staff of City Link and Mr Johnson is directed to the accountant to make the required payment. The freight rate written on the invoice is N8 per kilo and so, the sum of N4,000 is paid for the conveyance of the equipment.

Later in the day, Asokoro Medical Laboratories receives a call from the cargo manager of City Link Transport Services in Lagos. They are informed that an error must have been made in the transaction, earlier that day. The official freight rate for goods conveyed from Lagos to Abuja is N80 per kilo and not N8, as written in the invoice. This would bring the amount due to N40,000 for the conveyance of 500kg and not N4,000, which was paid by Mr Johnson. The cargo manager refuses to convey the equipment to Abuja until the required sum is duly paid.

From the foregoing, what is the legal position of the parties concerning the mistake made in the transaction?

As already established, there are three classes of mistake in law: a) Common Mistake b) Mutual Mistake c) Unilateral Mistake. The subject of the above scenario is unilateral mistake. The factor that distinguishes unilateral mistake from the other two types is that, in this case, only one party is entering the contract under a mistake and the other party either knows or is presumed to know that the first party is indeed labouring under a mistake.

The legal issues to be considered in this situation are:

  1. What constitutes a unilateral mistake in law?
  2. The effect of a unilateral mistake in a transaction.

The rule governing unilateral mistake, as applied in the case of Hartlog v. Colin Shields, is that where it is established that one party is mistaken, or is presumed to be mistaken, the contract is rendered void. With regard to the person making the mistake, the test of mistake is subjective. What the law takes into consideration is his actual belief and intention, not what a reasonable man in his position would have thought or believed.

However, concerning the other party, where he himself did not induce the mistake of the first party, he is nevertheless presumed to be aware of the mistake, if it would have been obvious to a reasonable man in the circumstances.

On the matter of the transaction for the conveyance of equipment belonging to Asokoro Medical Laboratories by City Link Transport Services, the goods to be transported were weighed, an invoice was issued and payment was made. However, there is a dispute regarding the amount paid, which apparently is the result of an error on the part of City Link Transport Services.

In determining the existence of a unilateral mistake, a subjective test will have to be taken. In this case, the actual intention of the party making the mistake (City Link Transport Services) is what will be considered. The Cargo Manager of City Link has expressed that the figures indicated in the invoice issued to Mr Johnson were written in error. Indeed, the official rates are ten times those presented and so, the amount paid was only 10 per cent of that which was due.

In the case of Abdul Yususf v. Nigerian Tobacco Company, the defendants engaged several lorry owners, including the plaintiff, to haul tobacco from various parts of Western Nigeria to their cigarette manufacturing factory at Ibadan. The freight rate typed in the agreements was half penny per lb per mile. The plaintiff commenced the carriage of tobacco and continued for sixteen days, until they were stopped by the defendants.

The defendants claimed that the normal freight rate for the carriage of their tobacco was half penny per 100 lb per mile and not half penny per 1 lb per mile, and that the latter figure appeared on the agreement as a result of a typing error. They then invited the plaintiff and the other transporters to bring in their agreements for necessary rectification to read half penny per 100 lb. Whilst others agreed, the plaintiff refused and consequently, the defendants cancelled their contract with him. The plaintiff then sued the defendants for breach of contract, claiming damages, based on the freight he would have received if he had been paid at the rate of half penny per lb.

In an appeal by the defendants at the Western Court of Appeal, it was held that this was a clear case of unilateral mistake. From the circumstances, the plaintiff must have known that the defendants made a mistake in their offer. Any “reasonable fair-minded person” would have been put on his enquiry as to the correctness or otherwise of the freight rate.

In view of this, the application of the subjective rule (which goes to the intention of the mistaken party) will result in the determination of a unilateral mistake. The contract between Asokoro Medical Laboratories and City Link Transport Services for the conveyance of equipment from Lagos to Abuja will therefore be rendered void.

Principles and cases are from Sagay: Nigerian Law of Contract

This mission is still possible

By
Lolu Ojo
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Nigerians are apprehensive about the country’s state of affairs. Multiple questions are being raised about the performance of the Buhari administration and concerns are growing about the ability of the government to deliver promises made when it was inaugurated with so much fanfare last year. Hope, it seems, is rapidly giving way to dismay. Have we made another mistake? That’s the key question Nigerians are asking themselves.

True, President Mohammed Buhari was a symbol of hope to many in the country. Nigerians expected the new president to ‘hit the ground running’ and swiftly turn things around. Everyone admitted the president had inherited a mess but many hoped also that the man with a magic wand had finally taken over. The problems were certainly many, so the expectations for change were similarly huge. The president and his party helped fuel our expectations that things were about to change dramatically.

General Buhari pressed on us the message of “change” as he travelled across the country. It wasn’t too difficult to agree with him that the country needed to move in a different direction. It was like a starved child waiting for the mother to bring food. Nigerians were similarly waiting for Buhari to perform multiple wonders. The list of things we expected from him is almost endless. Here are a few:

  •    End the Boko Haram nightmare
  •    Fix dilapidated roads
  •    Ensure uninterrupted electricity supply
  •    Strengthen the Nigerian Naira
  •    Create jobs
  •    Institute social allowance payments for the unemployed
  •    Clear all the rots in our educational system
  •    Put a permanent stop to the activities of armed robbers, hired assassins and kidnappers
  •    Completely eliminate corruption in the system … and so many more.

Delayed manifestations

Those were our expectations. However, the reality has not matched the expectations. Nigerians have seen deeper and further hardships: The fuel queues are back; petrol, when available, sells well above the official price; electricity supply has worsened; companies are in distress due to multiple problems; the threat of job losses loom large; our roads appear to be in worse conditions; and the security situation has not improved with armed gangs prowling our streets, robbing and kidnapping.

But that’s not all. The national currency is in freefall. The naira’s slide against major international currencies began before President Buhari took office but it seems to have only worsened. Acute scarcity of foreign currencies has crippled importers and businesses dependent on foreign machineries and other supplies. Our letters of credit for overseas facilities are derided by foreign business partners. They are not worth the papers they are printed upon. Suffice it to say that in this environment, it is getting increasingly difficult to remain in business.

Nigerians can be forgiven therefore for asking if we have made a mistake in electing Buhari and the APC into power. Wouldn’t it have been better to return Jonathan to office? many wonder. As John the Baptist demanded of Jesus, people are asking President Buhari: “Are you that cometh or look we ye for another?” Those who did not support Buhari are hammering those who did, saying they had placed their trust in the wrong leader and party.

Dissecting the dilemma

The criticisms are valid but we all need to take a step back. Things haven’t changed as much as expected since Buhari assumed the position of president but I believe we are headed in the right direction. Nigeria needs a complete and exhaustive makeover and not cosmetic, surface-deep change. We must put competent and committed people in positions of authority and create systems, policies and structure that can deliver good results on a consistent basis. President Buhari’s steps may be slow but this measured pace is necessary to ensure we avoid the mistakes of the past.

Furthermore, we knew that things were very bad when the current administration took over but no one could have imagined the depth of the rot. The ongoing probes have already shown that the last administration was reckless, ineffective and clearly corrupt. Clearing the rot will take quite some time and subsequent corrective action will require a gestation period.

Recent external developments have also been unfavourable to the government. The price of crude oil has fallen precipitously. Even the current 2016 budget benchmark of $38 per barrel is already proving to be a failure as the International Monetary Fund has predicted a further decline to $20 per barrel. A further shortfall in funds available to the government can be expected. Since our economy is heavily dependent upon oil receipts, the negative impact of lower oil prices will be onerous.

Where will the Buhari administration secure the money to IMMEDIATELY implement the planned programmes? The expected diversification of the economy with adequate attention being given to other sources of income like agriculture, solid minerals, tourism, etc., will take time to materialise. There are fears that President Buhari’s N6 trillion budget will lead to more hardship for businesses as about N1 trillion naira is expected from taxes. This fear may be true but I think that better tax collection will alleviate this challenge and make it unnecessary to raise taxes as many currently fear.

Doing the needful

Our revenue collecting agencies are corrupt. They have been for a long time. This implies that once leakages are blocked, government revenue will increase sharply. The ongoing fight to reduce overall government corruption will help and must be supported by every Nigerian. Complaints that the efforts to tackle corruption have been selective do not make sense; anyone who violated the trust reposed in them and stole from our common purse should not only repay the looted funds but must also receive adequate punishment to deter others.

A Yoruba story about the legendary tortoise is instructive here. The tortoise fell into a pit toilet but his neighbours found out only three days later. As they made arrangements to pull him out, however, Mr Tortoise began complaining. “Hurry up. This place is very smelly!”

Like the tortoise, Nigerians have been in this mess for quite a while. We need to give our rescuers enough time to do a good job of pulling us out safely. We must be vigilant and ensure the government is accountable at all times. The ‘smell’ is indeed suffocating and the government must quicken its pace. However, we don’t need another superficial effort.

Our country has many ailments. The healing process will take time. President Buhari is up to the task but only with the nation behind him. The president requires our cooperation, support, dedication and patience.

The process has only just started. It’s too early to say the president has failed. It took decades to create the mess. The clean-up will not happen overnight, either. I believe, most convincingly, that the mission to make Nigeria a great, wealthy and peaceful nation is still possible under the care of President Mohammed Buhari.

God bless Nigeria!

Pregnancy sleep guide – tips for sleeping better when pregnant By Lisa Martin

By
Admin
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We all need a good quantity and quality of sleep – it is when we are asleep that the body carries out some of the most vital processes, such as growth, repair and recovery. If you don’t get enough sleep, you can soon find yourself not only tired, but also irritable, stressed and more prone to illness. It stands to reason then, that when you are pregnant, you need your sleep even more since there are bodies to look after!

Despite this need for sleep, many women find it difficult to get a good night’s sleep when pregnant, particularly during the latter stages of pregnancy when your baby is getting big and restless! This article provides some useful tips that will help women to sleep better when pregnant.

Take care of your diet

Pregnant or not, you can take steps to getting a good night’s sleep by ensuring that you eat properly. Processed foods full of artificial additives and caffeinated drinks, especially consumed within an hour or two of bedtime, can stimulate your body and mind and keep you awake rather than allowing you to settle and relax. Eat plenty of fresh fruits and vegetables, try not to eat too close to bedtime, and reduce your caffeine intake, particularly in the evenings. Herbal teas like chamomile may help to relax you.

Sleep on your side

Sleeping on your back won’t harm your baby, but as you get bigger you may find it uncomfortable. Many women find that sleeping on their side is the most conducive to sleep, and propping up your bump with pillows may help to make you feel more comfortable. Alternatively, sleeping in a more upright position, again with pillows for support, may help – and can help to reduce pregnancy-related heartburn too.

Take gentle exercise

Pregnancy makes you feel tired even without doing anything strenuous, but if you are finding it hard to sleep then taking some active exercise can help to tire your muscles and promote sleep. Gentle, low impact exercise such as yoga or walking is best – try not to exercise too close to bedtime as this can have the effect of stimulating you rather than helping you to relax.

Take a bath

The soothing properties of a nice warm bath are renowned for helping you to relax before bedtime. Add a lavender-scented bubble bath to the water, light some candles, listen to some relaxing music, and take time out before bed to calm your mind. The water will also take pressure off your bump and make you feel lighter.

Take naps

If you find it hard to get enough sleep at night, it’s OK to nap during the day! You need enough sleep during pregnancy more than ever, so don’t feel guilty about sleeping during the day time – even if it’s only a half-hour catnap, you will feel much better for it than if you deprive yourself of sleep.

Dana donates van to Ogun HMB

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L-R: Pharm. G.O. Fafiolu, director of pharmaceutical services, Ogun State Hospital Management Board (OSHMB); Pharm. Fred Ohwavborua, Dana Drugs’ business development manager; and Pharm. Gerald Oputa, Dana’s assistant vice-president (Sales and Marketing), presenting the key of a brand new delivery van to Ogun State Commissioner for Health, Dr Babatunde Ipaye, on behalf of OSHMB

 Foremost drug manufacturing company in Nigeria, Dana Drugs Limited, with branches across all geo-political zones of the federation, has donated a brand new state-of-the-art delivery van to the Ogun State Hospital Management Board (OSHMB).

The donation, which held on 21January, at the Ogun State Ministry of Health Secretariat premises, Oke-Mosan, Abeokuta, had Pharm. Gerald Oputa, Dana’s assistant vice-president (Sales and Marketing), Pharm. Fred Ohwavborua, Dana’s business development manager, and officials of OSHMB in attendance.

Presenting the delivery van, Oputa said, “We believe this delivery van will assist in the re-distribution of drugs and consumables from the Central Medical Stores to the various hospital units across Ogun State. We appreciate the State government and Ministry of Health for the support given us.”

He added that the donation was part of Dana’s Corporate Social Responsibility (CSR) initiative.

Receiving the delivery van, the Ogun State Honourable Commissioner for Health, Dr Babatunde Ipaye, thanked Dana Drugs for the gesture, while assuring that the vehicle would beused for the purpose for which it was donated.

Dana, which manufactures the Paradana brand of Paracetamol, has previously made similarly helpful gestures to support government establishments, NGOs, hospitals, flood victims and Benue victims of bomb blasts.

It is presently involved in a nation-wide de-worming exercise for school children.

Preventing Zika virus outbreak in Nigeria

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Admin
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Zika virusThe World Health Organisation (WHO) recently declared Zika virus infection a global public health emergency, stating that the virus, which is now spreading rapidly in South America, is not just a threat to countries in South America or Europe but to the whole world. An official of WHO, Bruce Aylard, while speaking on the condition, noted that Zika virus, which has a short cycle of less than a week, with symptoms such as joint pain, fever, rash and conjunctivitis (red eyes), is a “much more insidious, cunning and evil” condition than Ebola virus because most people who contract the virus have no idea they have it.

According to the WHO, more than 1.5 million Brazilians have been infected with Zika virus since early 2015, while the country recorded its third Zika-related death on 11 February, 2016. Zika is also biting hard in Colombia with WHO statistics indicating that there have been 31,555 cases of the condition in the country, 5,013 of those being pregnant women. The WHO also reported that the virus has spread to Mexico, the Caribbean, the Pacific Islands and Cape Verde; while over 50 Americans overseas have been infected.

What these grim statistics signify is that the whole world is at risk of this viral infection, which was first identified in monkeys in 1947 and humans in 1952 in Uganda and Tanzania. Even more alarming is that while the WHO has admitted that not all the effects of Zika virus is known yet, it has also categorically emphasised that there is neither a vaccine to prevent the condition, which is spread primarily through the bite of an infected Aedes specie mosquito, nor is there a medicine for its treatment.

The implication of this for a country as populous and mosquito-ridden as Nigeria is that, while the world earnestly awaits the production of preventive vaccines and curative medicines for the virus, the government and the entire citizenry must do all that is necessary to ensure there is no outbreak of this condition in our nation. It was apparently in light of this that Nigeria’s Minister of Health, Prof. Isaac Adewole, recently urged Nigerians to protect themselves from mosquitoes carrying the Zika virus by using mosquito nets.

Adewole, who made the call while speaking with the press in Abuja on prevention of Zika outbreak in the country, disclosed that the mosquitoes with Zika virus have always been in Nigeria, adding that Nigerian scientists discovered the virus in western Nigeria in 1954. Cheeringly, however, according to him, further studies between 1975 and 1979 revealed that 40 per cent of Nigerian adults and 25 per cent of Nigerian children had antibodies that made them to be immune to the Zika virus.

The health minister nevertheless urged Nigerians, especially pregnant women, to protect themselves from mosquito bites. He advised against travelling to countries affected by the virus in this period; while also appealing for calm, vigilance and the need to report any suspected case of acute febrile illness especially in pregnant women to hospital.

While we commend the health minister for the above precautionary suggestions, it is, however, our view that the government should go a step further by actually putting concrete machineries in place to prevent an outbreak. To begin with, the government must embark on massive sensitisation of Nigerians on this condition, as there is presently widespread misconception about it. Considering the success of the media campaign that tremendously helped Nigeria to overcome the dreaded Ebola disease outbreak of 2014, the media should be engaged to educate Nigerians on this condition.

Also, while it seems reassuring that the minister has provided information that suggests that some Nigerians may have immunity against Zika virus, the fact that the studies referred to were done way back in the 1950s and the 1970s is an indictment on us as a nation. For such outdated reports to still be considered a valid reference point at the national level shows that we are incapable providing up-to-date information and statistics on national health developments and challenges. Is there any surprise then that our approach to health emergencies is often belated and haphazard?

Indeed, in this particular instance, one would have expected the minister to know, as most of the scientific world seems to do, that viruses mutate over time, and relying on dated research while dealing with them is not only inappropriate but absurd. We therefore call on the Nigerian government to see that the National Centre for Disease Control, like its counterparts in developed countries, is properly funded, so that the agency can consistently provide latest data on health conditions like Zika virus disease for better prevention and management.

In the meantime, researchers in the country should be engaged to do a fresh study to validate the Zika virus immunity claim, so that response to preventive measures against the disease will not continue to be lethargic, as it presently seems to be.

World Cancer Day 2016: Reducing Nigeria’s cancer burden

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Admin
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cancer day

Poised to reduce the global burden of cancer, which kills about thrice the number of people who die of tuberculosis, HIV and malaria combined, the Union for International Cancer Control (UICC), established the World Cancer Day (WCD), on 4 February, 2008, to raise awareness and generate support for people living with the disease. From then on, WCD has been commemorated annually. However, the impact of the celebration seems quite limited, as the prevalence of the terminal disease continues to rise from year to year, and from border to border, claiming multitudes of lives all along.

One major issue that has been generally identified as a setback in the fight against cancer, especially in Nigeria, is inadequate medical facilities for the screening and treatment of the condition, as well as late presentation of patients to care centres.

This is why the theme for this year’s edition of WCD – “We can. I can” – is centred on deliberate actions by the government, corporate bodies and individuals, in reducing the disease burden in the country. The theme, which will last through 2018, implies that everyone can do something to inspire action, take action, prevent cancer, challenge perceptions, create healthy environments, improve access to cancer care, build a quality cancer workforce, mobilise networks to drive progress, shape policy change, make the case for investing in cancer control, and work together for increased impact.

This deliberate concerted effort is imperative because, according to the World Health Organisation (WHO), more than 70 per cent of cancer deaths occur in low- and middle-income countries. Although the risk of developing or dying from it is still higher in the developed world, early detection and prompt medical attention are key in its management.

According to the Medical Director, Pfizer Pharmaceutical Company, Dr Kodjo Soroh, cancer is on the rise, not only in Nigeria, but worldwide. As a result, doctors are still researching into its cure.

“The unfortunate aspect of cancer situation in Nigeria is not that doctors cannot treat it, but the cost of treatment and availability of medical equipment is grossly inadequate. Nigeria is not prepared for the Tsunami that is about to break in cancer. I did a little survey in the northwest of the country some two years ago. It was recorded in a teaching hospital that 30 new cases are reported every day. Cancer is killing Nigerians every day. The rate at which cancer is killing Nigerians is alarming. It is more than cases of deaths caused by malaria AIDS and Tuberculosis.

“The best way to get an idea on the prevalence is to go by the WHO statistics on cancer situation in Nigeria. The statistics is alarming. It says that per hour 30 Nigerians are dying of cancer. I say Nigeria is not prepared because, if you look at our National Health Insurance Scheme (NHIS) cancer is not covered. So, if you develop cancer now, you are on your own. How many radiotherapy units do you have in Nigeria and the specialists, how many oncologists? Early detection and diagnosis are important. Once these are delayed, it spreads and causes more damage. If you have money to go out, then the cost is on your head.”

He continued: “The best option anybody has is to prevent it. Government should invest more on the infrastructure and health personnel. Early screening and detection are important in cancer management or its prevention. Let us create more awareness by telling our women to do self breast examination, screen for cervical cancer that is even preventable by getting vaccinated.

“Let people disabuse their minds on a misconception that if they get female teenagers immunised against cervical cancer – that they are indirectly being prepared for promiscuity. Nigerians should move on. Get our women vaccinated against cervical cancer. There are some women who have been known to keep only a man and still come down with cervical cancer because pappiloma virus is the cause of that type of cancer. The statistics even have it that more married women may have cervical cancer than the unmarried.”

Explaining the development of cancer, the Medical Director, Triumph Medical Centre, Dr Deji Morenikeji, said cancer is the abnormal growth of body tissues in the cells and can affect any part of the body. “When a person is said to have developed cancer, it simply means the cells that are normal are fast growing into abnormal cells and distorting them. There is increase of awareness on cancer now. Government is actually playing a major role in cancer detection. It has a unit in the Ministry of Health dedicated to that.

“Unfortunately, in this part of the world people go late to the hospital. The treatment is not encouraging. If cancer is detected early, depending on the type of cancer, there is a five-year survival rate, and the rate is higher and impressive. Cancer drugs and treatments are expensive worldwide. Government is trying its best to contain the development of the disease, all things being equal, including not having its hereditary trait, and then its prevention, that is, its development is more individualistic.

On prevention, he said: “People should be mindful of their lifestyle. They should watch what they eat as what they consume plays important role on their well-being. They should exercise more and do away with sedentary lifestyle. They should do more health assessments, routine medical examinations.”

Statistics show that there are six most common cancers in Nigeria. They include:

  • — Breast cancer
  • — Cervix cancer
  • — Prostate cancer
  • — colorectal cancer
  • — liver cancer and
  • — NHL

 Breast cancer

Breast cancer is the commonest female cancer and studies have indicated increase in the relative frequency ratio; moving from number two or three to the number one cancer in both sexes..This increase has been attributed to increase awareness and presentation for screening. Majority of breast cancers occur in pre-menopausal women with the peak age in the 5th decade…

About 80-85 per cent still present in advance stage III with attendant poor outcome. In Nigerian studies, only 25-50 per cent of the tumours are reported to be oestrogen/progesterone receptor positive, which is the basis for hormonal treatment.

 Causes of breast cancer

When you’re told that you have breast cancer, it’s natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesn’t, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cell’s DNA.

Risk factors for breast cancer

  • — Female gender
  • — increasing age
  • — Maternal relative with breast cancer
  • — Abnormal genes (BRCA 1, BRCA2 genes)
  • — Nulliparity
  • — Late age at first pregnancy and longer reproductive span (early menarche<12yrs, late menopause>50yrs).

Others are

  • obesity
  • — Increased dietary fat & alcohol intake
  • — Cigarette smoking
  • — Previous breast lesion with atypical changes
  • — Previous breast cancer.

Male breast cancer

In Nigeria, this represents 3.7-8.6 per cent of all breast cancers. This is higher than the 1 per cent recorded from other parts of the world. The higher figures in Nigeria may be due to small sample size, since the data are mainly-hospital based. The peak age incidence is 40-49 years, similar to that of female cancer. Majority are invasive ductal carcinoma. It is characterised by late presentation at advanced stage with attendant poor prognosis.

Diagnosis of breast cancer

Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms. This is why getting the recommended screening tests before any symptoms develop is so important.

If you think you have any signs or symptoms that might mean breast cancer, be sure to see your doctor as soon as possible. Your doctor will ask you questions about your symptoms, any other health problems, and possible risk factors for benign breast conditions or breast cancer.

If breast symptoms and/or the results of your physical exam suggest breast cancer might be present, more tests will probably be done. These might include imaging tests, looking at samples of nipple discharge, or doing biopsies of suspicious areas.

 Mammograms

A mammogram is an x-ray of the breast. Screening mammograms are used to look for breast disease in women who have no signs or symptoms of a breast problem. Screening mammograms usually take 2 views (x-ray pictures taken from different angles) of each breast.

For a mammogram, the breast is pressed between two plates to flatten and spread the tissue. This may be uncomfortable for a moment, but it is necessary to produce a good, readable mammogram. The compression only lasts a few seconds. If your diagnostic mammogram shows that the abnormal area is more suspicious for cancer, a biopsy will be needed to tell if it is cancer.

Even if the mammograms show no tumour, if you or your doctor can feel a lump, a biopsy is usually needed to make sure it isn’t cancer. One exception would be if an ultrasound exam finds that the lump is a simple cyst (a fluid-filled sac), which is very unlikely to be cancerous.

Magnetic resonance imaging (MRI)

MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into a very detailed image. For breast MRI to look for cancer, a contrast liquid called gadolinium is injected into a vein before or during the scan to show details better.

MRI scans can take a long time “ often up to an hour. For a breast MRI, you have to lie inside a narrow tube, face down on a platform specially designed for the procedure. The platform has openings for each breast that allow them to be imaged without compression. The platform contains the sensors needed to capture the MRI image. It is important to remain very still throughout the exam.

 Prevention of breast cancer

The following tips are essential in preventing breast cancer

  • Regular breast examination
  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicine to treat a precancerous condition or to keep cancer from starting.

 Cervical cancer

Cervical cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it’s found early. It is usually found at a very early stage through a Pap test.

Cervical cancer is the second most common cancer in Nigerian women and the most common female genital cancer constituting a major cause of mortality among Nigerian females in their most productive years. It was the commonest cancer reported from Ibadan, Eruwa, Zaria, Jos, Benin and Calabar and in the early years, second to breast in Enugu and Ife-Ijesha , as indicated by a study conducted by Professor Fatimah Abdulkareem of the College of Medicine, University of Lagos.

Recent data shows that it has however been overtaken by breast cancer – except in Kano where it was reported as the most common cancer in both sexes. In Jos, it is the most common female cancer.

Human papillomavirus (HPV) is a necessary cause of cervical cancer being present in 99.9 per cent of cases. In a study of 233 cases of cervical cancer from Lagos, HPV 16 and 18 were present in 65.2 per cent.. This supports data that effective vaccination against these two types will reduce the cervical burden in Nigeria.

You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.

 Symptoms of cervical cancer may include:

  • Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.
  • Pain in the lower belly or pelvis.
  • Pain during sex.
  • Vaginal discharge that isn’t normal.

The treatment for most stages of cervical cancer includes:

  • Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.
  • Chemotherapy.
  • Radiation therapy.

 Prevention of cervical cancer

The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It’s important to follow up with your doctor after any abnormal Pap test result so you can treat abnormal cell changes. This may help prevent cervical cancer.

If you are age 26 or younger, you can get the HPV vaccine, which protects against two types of HPV that cause most cases of cervical cancer.

Prostate cancer

The prostate is a gland that is a part of the male reproductive system that wraps around the male urethra at its exit from the bladder. Common problems are BPH (Benign Prostatic Hyperplasia), acute and chronic bacterial prostatitis and chronic prostatitis (non-bacterial)

Prostate cancer is common in men over 50, especially those who eat fatty food and/or have a father or brother with prostate cancer. It is the most common cancer in Nigerian males, having overtaken liver cancer. It accounts for 6.1-19.5 per cent of all cancers and the incidence is increasing.. Current data from most parts of the country show it to be the 3rd most common cancer, except in Calabar where a very high figure was recorded for prostate cancer as the most common in both sexes accounting for 34.7 per cent of all cancers.

Compared to African-American men, Nigerian men are 10 times more likely to have prostate cancer and 3.5 times more likely to die from it. Environmental and most importantly, genetic factors have been incriminated as the reason for the geographic differences in incidence.

Risk factors for prostate cancer include:

  • — race
  • — age above 40years
  • — positive family history
  • — high fat diet and
  • — high serum androgens levels; the latter being most consistent.

 Symptoms of prostate cancer

Symptoms of prostate problems (and prostate cancer) include urinary problems (little or no urine output, difficulty starting (straining) or stopping the urine stream, frequent urination, dribbling, pain or burning during urination), erectile dysfunction, painful ejaculation, blood in urine or semen and/or deep back, hip, pelvic or abdominal pain. Other symptoms may include weight loss, bone pain and lower extremity swelling.

Prostate cancer is definitively diagnosed by tissue biopsy. Initial studies may include a rectal exam, ultrasound and PSA (prostate-specific antigen) levels.

Treatments for prostate cancer may include surveillance, surgery, radiation therapy, and hormone therapy. PSA testing is considered to be yearly PSA tests; not all agree this should be done.

Identifying prostate problems early is a way to reduce future prostate problems.

 Diagnosis of prostate cancer

The diagnosis of prostate cancer mostly involves a combination of three tests:

  • Digital rectal examination: As part of a physical examination, your doctor inserts a gloved and lubricated finger into your rectum and feels toward the front of your body. The prostate gland is a walnut or larger-sized gland immediately in front of the rectum, and beneath your bladder. The back portion of prostate gland can be felt in this manner. Findings on this exam are compared to notes about the patient’s prior digital rectal examinations.

The exam is usually brief, and most find it uncomfortable due to the pressure used to adequately examine the prostate gland. Findings such as abnormal size, lumps, or nodules, may indicate prostate cancer.

This examination should be part of an annual physical in all men over 50 years of age to note changes in the prostate. In men with a family history of prostate cancer, or in African American men exams should begin at 40 years of age.

  • Prostate specific antigen (PSA) blood test: The PSA blood test measures the level of a protein found in the blood that is produced by the prostate gland and helps keep semen in liquid form. The PSA test can indicate an increased likelihood of prostate cancer if the PSA is at an increased or elevated level, but it does not provide a definitive diagnosis. Prostate cancer can be found in patients with a low PSA level but this occurs less than 20 per cent of the time.

If the PSA level is elevated (levels can depend upon your age, on the size of your prostate gland on examination, certain medications you may be taking, or recent sexual activity), further testing may be needed to rule out prostate cancer. PSA measurements are often tracked over time to look for evidence of a change. The amount of time it takes for the PSA level to increase is referred to as PSA velocity. A PSA doubling time can be also tracked in this fashion. PSA velocity and PSA doubling time can help your doctor determine whether prostate cancer may be present.

The presence of an abnormal result on digital rectal examination, or a new or progressive abnormality in a PSA test may lead to a referral to a surgeon who specialises in diseases of the urinary system (a urologist) who may perform further testing, such as a biopsy of the prostate gland.

 

  • Prostate biopsy: A biopsy refers to a procedure which involves taking of a sample from a tissue in the body. Prostate cancer is only definitively diagnosed by finding cancer cells on a biopsy sample taken from the prostate gland. The urologist may have you stop medications such as blood thinners before the biopsy.

On the day of the biopsy, the doctor will apply a local anaesthetic by injection or topically as a gel inside the rectum over the area of the prostate gland. An ultrasound probe is then placed in the rectum. This device uses sound waves to take a picture of the prostate gland and helps guide the biopsy device. The device used is a spring-loaded needle that allows the urologist to extract cores from the prostate gland. Usually 12 cores are obtained, six from each side. Two cores are taken from the upper, middle, and lower portions of the prostate gland. The cores are submitted for analysis to a pathologist (a doctor who specializes in examining tissues to make a diagnosis). Results may take several days.

A biopsy procedure is usually uncomplicated, with just some numbness, pain, or tenderness in the area for a short time afterwards. Occasionally, a patient has some bleeding in the urine after the procedure. Rarely, the patient may develop an infection after a biopsy procedure, or be unable to urinate. The patient will be advised to call and consult a doctor if such problems occur.

 Prostate cancer biopsy results

The result of the pathologist’s analysis of the biopsy cores under the microscope is the only way to diagnose prostate cancer.

Treatment of prostate cancer

Treatment options for prostate cancer are many, and while this is an advantage in that prostate cancer is such a common disease in men, it can also be a cause of great confusion. The following overview presents some information about these options, but it is not a complete explanation of any of these.

 Surgery

The removal of the entire prostate gland and the attached seminal vesicles is referred to as a radical prostatectomy. This is usually done through an incision or incisions made over the front of the lower abdominal wall, with the procedure taking place behind the pubic bones at the front of the pelvis (a retropubic approach). Today the main choice is between a standard open radical prostatectomy and the use of a robotic system for performance of the procedure through smaller incisions. The former allows the surgeon to feel the tissues and make the cuts themselves. The latter uses an operating system robot, which the surgeon guides. The former takes longer to recover from, and has more risk of blood loss associated with it. The latter results in a more rapid recovery and less blood loss generally.

Intact pelvic nerve bundles on either side of the prostate in the pelvis are essential for a man to be able to have an erection. Impotence – or the inability to have and sustain an erection of a quality sufficient for successful intercourse – can occur after this operation. The likelihood of impotence is primarily dependent on whether or not the necessary nerves can be preserved during surgery, AND the patient’s true preoperative ability to still have an erection. Nerve-sparing surgical technique is desirable and the surgeon should plan to do this, if possible. These important pelvic nerve bundles may need to be sacrificed if they are too close to or are involved with the cancer. The objective of the surgery is to cure the patient of the prostate cancer with the least number of problems afterward as possible, but the performance of a potentially curative procedure must remain the primary objective of the surgeon.

The radical prostatectomy involves the removal of a portion of the urethra. The urethra is the tube that runs from the bladder to the outside through the penis. It runs through the prostate gland. The procedure can disrupt the sphincter or valve, which controls urine flow from the bladder. The surgeon reconnects the urethra to the bladder after the prostate is out. The more careful and experienced the surgeon, the less the risk of long-term inability to control the flow of urine (incontinence).

The risks of an operation lasting several hours also remains substantial and include heart problems, blood loss, as well as a risk of infection, blood clots, and rarely, death. Such operations are appropriate for patients whose cancer appears to be confined to the prostate gland.

 Radiation therapy

Radiation therapy involves potentially curative treatment using machines that generate and administer controlled, invisible beams of energy known as radiation. This is called external beam radiation therapy (EBRT). It also can be done using radioactive sources, or seeds, implanted permanently, or higher energy sources placed temporarily into the body. This technique is called brachytherapy.

An X-ray machine uses a low energy radiation beam to take a picture of a portion of the body. Radiation therapy machines put out high energy beams that can be focused very precisely to deliver treatment to a site. The radiation does not “burn out” the cancer, but damages the cells’ DNA, which causes the cancer cells to die. This process can take some time to occur after the radiation treatments have been given.

The radiation passes directly through the tissues in EBRT. Radiation treatment used today delivers very little energy to normal tissues. It just passes through. Most of the energy is able to be focused and delivered directly to the area of the prostate gland containing cancer. This process minimises damage to healthy tissue.

Radiation therapy to the prostate gland by external beam technique may cause fatigue and bladder and/or rectal irritation. These effects are usually temporary but may recur or persist long after treatments are finished. Radiation damage to adjacent tissues can cause skin irritation, and local hair loss. Delayed onset of impotence can occur after radiation therapy due to its effect on normal tissues including nerves adjacent to the prostate. Radiation therapy may be given alone or in combination with hormonal therapy which can also shrink up the prostate gland thereby reducing the size of the radiation area or field that needs to be treated.

A recently popular technique of EBRT is called proton beam radiation, which can theoretically more closely focus on the area being treated. Proton beam radiation therapy is more expensive. Its side effects presently appear similar to those discussed for standard radiation therapy. Studies comparing the effectiveness and overall results of conventional radiation therapy versus proton beam therapy have not been completed yet.

EBRT is appropriate for men who are candidates for radical prostatectomy but do not wish to undergo the surgery. It is also used to shrink tumours and reduce pain in areas where metastatic prostate cancer is damaging bone, or is pressing on important structures including the spinal cord.

Note that radiation therapy can be performed after radical prostatectomy if prostate cancer recurs in the region where the prostate was, and can potentially cure a locally recurrent prostate cancer if it has not spread beyond the area, after radiation therapy has been given. If radiation fails to control the cancer, surgery is difficult – if not impossible – to perform due to scar tissue which develops in the area.

Colorectal cancer

Most colorectal cancers arise from adenomatous polyps. Such polyps are comprised of excess numbers of both normal and abnormal appearing cells in the glands covering the inner wall of the colon. Over time, these abnormal growths enlarge and ultimately degenerate to become adenocarcinomas.

People with certain genetic abnormalities develop what are known as familial adenomatous polyposis syndromes. Such people have a greater-than-normal risk of colorectal cancer. In these conditions, numerous adenomatous polyps develop in the colon, ultimately leading to colon cancer.

Colorectal carcinoma is the commonest malignancy of the gastrointestinal tract worldwide. Previous studies had shown it to be a rare disease in Nigeria representing 3-6 per cent of all malignant tumours in most studies. .It accounts for 10-50 per cd of all GIT malignancies in Nigeria. Peak incidence is 60-70 years; mean age in Lagos is 50.7yrs..When it occurs in the young, associated with polyposis syndrome or ulcerative colitis should be suspected.

Contrary to previous report which showed it to be rare, recent report shows the incidence to be increasing. An 81 per cent increase over a period of two decades was reported from Ibadan. .A recent study from Lagos & Sagamu showed similar trend with an increase in annual frequency of this cancer from 14 cases per annum to 32.3 cases per annum. .The low incidence in Nigerians was attributed to fibre rich diet which is common practice and rarity of the familial polyposis syndrome and IBD.

Recent urbanisation/civilisation has resulted in upsurge of confectionary food outlets in major cities resulting in many Nigerians changing their dietary habit from a fibre rich diet, which was common practice to a highly refined carbohydrate and fat diet.

 Colon cancer symptoms

Cancer of the colon and rectum can exhibit itself in several ways. If you have any of these symptoms, seek immediate medical help. You may notice bleeding from your rectum or blood mixed with your stool.

  • People commonly attribute all rectal bleeding to haemorrhoids, thus preventing early diagnosis owing to lack of concern over “bleeding haemorrhoids.” New onset of bright red blood in the stool always deserves an evaluation. Blood in the stool may be less evident, and is sometimes invisible, or causes a black or tarry stool.
  • Rectal bleeding may be hidden and chronic and may only show up as an iron deficiency.
  • It may be associated with fatigue and pale skin due to the anaemia.
  • It usually, but not always, can be detected through a fecal occult (hidden) blood test, in which samples of stool are submitted to a lab for detection of blood.
  • If the tumour gets large enough, it may completely or partially block your colon. You may notice the following symptoms of bowel obstruction:
  • Abdominal distension: Your belly sticks out more than it did before without weight gain.
  • Abdominal pain: This is rare in colon cancer. One cause is tearing (perforation) of the bowel. Leaking of bowel contents into the pelvis can cause inflammation (peritonitis) and infection.
  • Unexplained, persistent nausea or vomiting
  • Unexplained weight loss
  • Change in frequency or character of stool (bowel movements)
  • Small-calibre (narrow) or ribbon-like stools
  • Sensation of incomplete evacuation after a bowel movement
  • Rectal pain: Pain rarely occurs with colon cancer and usually indicates a bulky tumour in the rectum that may invade surrounding tissue.

Other factors that may affect your risk of developing a colon cancer:

  • Diet: Whether diet plays a role in developing colon cancer remains under debate. The belief that a high-fibre, low-fat diet could help prevent colon cancer has been questioned. Studies do indicate that exercise and a diet rich in fruits and vegetables can help prevent colon cancer.
  • Obesity: Obesity has been identified as a risk factor for colon cancer.
  • Smoking: Cigarette smoking has been definitely linked to a higher risk for colon cancer.
  • Drug effects: Recent studies have suggested postmenopausal hormone, oestrogen replacement therapy may reduce colorectal cancer risk by one third. Patients with a certain gene which codes for high levels of a hormone called 15-PGDH may have their risk of colorectal cancer reduced by one half with the use of aspirin

Also at high risk for developing colon cancers are people with any of the following:

  • Ulcerative colitis or Crohn’s colitis (Crohn’s disease)
  • Breast, uterine, or ovarian cancer now or in the past
  • A family history of colon cancer

The risk of colon cancer increases two to three times for people with a first-degree relative (parent or sibling) with colon cancer. The risk increases further if you have more than one affected family member, especially if the cancer was diagnosed at a young age.

Exams and tests

You may have a test called a colonoscopy. This is a test that allows a specialist in digestive diseases (a gastroenterologist) to look at the inside of your colon. This test looks for polyps, tumours, or other abnormalities.

Colonoscopy is an endoscopic test. This means that a thin, flexible plastic tube with a tiny camera on the end will be inserted into your colon via your anus. As the tube is advanced further into your colon, the camera sends images of the inside of your colon to a video monitor.

Colonoscopy is usually done with sedation and is not an uncomfortable test for most people. You will first be given a laxative solution to drink that will clear most of the faecal matter from your bowel. You will be allowed nothing to eat for a short period before the test and a liquid diet only for a day before the test.

Flexible sigmoidoscopy is similar to colonoscopy but does not go as far into the colon. It uses a shorter endoscope to examine the rectum, sigmoid (lower) colon, and most of the left colon.

CT colonography is another way to examine the colon. Again, the stool must be cleared from the colon before the examination. Colonoscopy allows sample to be taken (biopsies) if an abnormality is found. Colonography does not allow that, as there is no direct visualisation of the interior of the colon.

This test highlights tumours and certain other abnormalities in the colon and rectum.

Other types of contrast enemas are available.

Air-contrast barium enema frequently detects malignant tumours, but it is not as effective in detecting small tumours or those far up in your colon.

If a tumour is identified in the colon or rectum by a biopsy performed during a sigmoid or colonoscopy, you will

Medical treatment

The primary treatment of colon cancer is to surgically remove part of your colon. Suggestive polyps, if few in number, may be removed during colonoscopy. Chemotherapy after surgery can improve your likelihood of being cured if your colon cancer has spread to nearby lymph nodes.

Radiation treatment after surgery does not improve cure rates in people with colon cancer, but it is important for people with rectal cancer. Given before surgery, radiation may reduce tumour size. This can improve the chances that the tumour will be removed successfully. Radiation before surgery also appears to reduce the risk of the cancer coming back after treatment.

Radiation plus chemotherapy before or after surgery for rectal cancer can improve the likelihood that the treatment will be curative

 

Liver cancer

Primary liver cancer is a condition that happens when normal cells in the liver become abnormal in appearance and behaviour. The cancer cells can then become destructive to adjacent normal tissues, and can spread both to other areas of the liver and to organs outside the liver.

Malignant or cancerous cells that develop in the normal cells of the liver (hepatocytes) are called hepatocellular carcinoma. A cancer that arises in the ducts of the liver is called cholangiocarcinoma.

What is metastatic liver cancer?

Metastatic cancer is cancer that has spread from the place where it first started (the primary site) to another place in the body (secondary site). Metastatic cancer in the liver is a condition in which cancer from other organs has spread through the bloodstream to the liver. Here the liver cells are not what have become cancerous. The liver has become the site to which the cancer that started elsewhere has spread.

Metastatic cancer has the same name and same type of cancer cells as the original cancer. The most common cancers that spread to the liver are breast, colon, bladder, kidney, ovary, pancreas, stomach, uterus, breast, and lungs.

Metastatic liver cancer is a rare condition that occurs when cancer originates in the liver (primary) and spreads to other organs (secondary) in the body.

Some people with metastatic tumours do not have symptoms. Their metastases are found by x-rays or other tests. Enlargement of the liver or jaundice (yellowing of the skin) can indicate cancer has spread to the liver.

Liver cancer is the most common cause of cancer death in Nigeria and the most common liver malignancy in Nigeria is hepatocellular carcinoma (HCC). Data from various parts of Nigeria show that it accounts for between 1.6 per cent – 7.2 per cent of all cancers in both sexes and represent the 2nd or 3rd most common cancer in males.

HCC was earlier reported to be the most common male cancer until recently when it was overtaken by prostate cancer.   It is the most common cause of liver disease in Nigeria accounting for between 29.3 per cent – 64 per cent of all liver biopsies in several studies. The peak age incidence has been found to be a decade earlier than for liver cirrhosis and hepatitis. A significant number of cases occur in association with liver cirrhosis.

Most people who get liver cancer get it in the setting of chronic liver disease (long-term liver damage called cirrhosis), which scars the liver and increases the risk for liver cancer. Conditions that cause cirrhosis are alcohol use/abuse, hepatitis B, and hepatitis C.

The causes of liver cancer may be linked to environmental, dietary, or lifestyle factors. For example, in November 2014, researchers at the University of California, San Diego School of Medicine, found that long-term exposure to triclosan, a common ingredient in soaps and detergents, causes liver fibrosis and cancer in laboratory mice. Although triclosan has not been proven to cause human liver cancer, it is currently under scrutiny by the FDA to determine whether it has negative health impacts.

According to the American Cancer Society, “The stage of cancer is a description of how widespread it is. The stage of a liver cancer is one of the most important factors in considering treatment options. A staging system is a standard way for the cancer care team to sum up information about how far a cancer has spread. Doctors use staging systems to get an idea about a patient’s prognosis (outlook) and to help determine the most appropriate treatment. There are several staging systems for liver cancer, and not all doctors use the same system.”

Liver biopsy as well as imaging studies help in classifying liver cancer stages as per the American Joint Committee on Cancer (AJCC) TNM system, the Barcelona Clinic Liver Cancer (BCLC) staging system, the Cancer of the Liver Italian Programme (CLIP) system, or the Okuda system.

Treatment of liver cancer

The treatment chosen depends upon how much the cancer has spread and the general health of the liver. For example, the extent of cirrhosis (scarring) of the liver can determine the treatment options for the cancer. Similarly, the spread and extent of spread of cancer beyond the liver tissue plays an important part in the types of treatment options that may be most effective.

  • Surgery: Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. Surgical options are reserved for smaller sizes of cancer tumors. Complications from surgery may include bleeding (which can be severe), infection, pneumonia, or side effects of anaesthesia.
  • Liver transplant: The doctor replaces the cancerous liver with a healthy liver from another person. It is usually used in very small unresectable (not able to be removed) liver tumours in patients with advanced cirrhosis. Liver transplant surgery may have the same complications as noted above for surgery. Also, complications from medications related to a liver transplant may include possible rejection of the liver transplant, infection due to suppression of the immune system, high blood pressure, high cholesterol, diabetes, weakening of the kidneys and bones, and an increase in body hair.
  • Ablation therapy: This is a procedure that can kill cancer cells in the liver without any surgery. The doctor can kill cancer cells using heat, laser, or by injecting a special alcohol or acid directly into the cancer. This technique may be used in palliative care when the cancer is unresectable.
  • Embolisation: Blocking the blood supply to the cancer can be done using a procedure called embolisation. This technique uses a catheter to inject particles or beads that can block blood vessels that feed the cancer. Starving the cancer of the blood supply prevents the growth of the cancer. This technique is usually used on patients with large liver cancer for palliation. Complications of embolisation include fever, abdominal pain, nausea, and vomiting.
  • Radiation therapy: Radiation uses high-energy rays directed to the cancer to kill cancer cells. Normal liver cells are also very sensitive to radiation. Complications of radiation therapy include skin irritation near the treatment site, fatigue, nausea, and vomiting.
  • Chemotherapy: Chemotherapy uses a medicine that kills cancer cells. The medicine can be given by mouth or by injecting it into a vein or artery feeding the liver. People can have a variety of side effects from chemotherapy, depending on the medications used and the patient’s individual response. Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhoea, and mouth sores. These side effects are usually temporary.

 Prognosis of liver cancer

The prognosis for liver cancer depends on multiple factors such as the size of the cancer, the number of lesions, the presence of spread beyond the liver, the health of the surrounding liver tissue, and the general health of the patient. Life expectancy depends on many factors that determines whether a cancer is curable.

The American Cancer Society states that the overall 5-year survival rate for all stages of liver cancer is 15 per cent. One of the reasons for this low survival rate is that many people with liver cancer also have other underlying medical conditions such as cirrhosis. However, the 5-year survival rate can vary, depending on how much the liver cancer has spread.

If the cancer is localised (confined to the liver), the 5-year survival rate is 28 per cent; if it is regional (has grown into nearby organs), the 5-year survival rate is 7 per cent. Once the cancer is distant (spread to distant organs or tissues), the survival time is as low as 2 years.

Survival rate can also be affected by the available treatments. Liver cancers that can be surgically removed have an improved 5-year survival rate of over 50 per cent. If caught in the earliest stages, and the liver is transplanted, the 5-year survival rate can be as high as 70 per cent.

 References:

Report compiled by Temitope Obayendo, with additional information from Professor’s Fatimah Abdulkareem’s work on: “Epidemiology & Incidence of Common Cancers in Nigeria”; American Cancer Society; WHO; National cancer institute; thenationonlineng; and emedicinehealth

 

Rural areas are a goldmine for community pharmacy – Pharm. Aremu

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Pharm. Babatunde Samuel Aremu is a Merit Award Winner of the Pharmaceutical Society of Nigeria (PSN) and chairman, Association of Community Pharmacists of Nigeria (ACPN), Kwara State Chapter. A dedicated pharmacist, Pharm. Babatunde has served as the secretary for ACPN and PSN, Kwara State respectively. He is the MD/CEO of Babsam Pharmacy Limited, Ilorin, Kwara State, a community pharmacy established in 2003.

In this exclusive interview with Pharmanews, the Kwara State born pharmacist argues that as long as open drug markets exist, the country’s battle against drug counterfeiting will remain a mirage . He also speaks on how community practice can be very lucrative, as well as why he considers the much publicised chain-pharmacy concept dicey. Excerpts:

Tell us about your pharmacy and how it was at the beginning.

Immediately after my Youth Service programme at the Ebonyi State University Teaching Hospital in 2002, I worked as a superintendent pharmacist for a few years in some pharmacies in Kwara state in order to gain relevant experience in community pharmacy, my dream practice area. In October 2003, having worked for one year, I opened a small retail outlet called Babsam Pharmacy in a then grossly underserved area. The outlet was basically run in the evenings after returning from my primary assignment. This combination was not an easy thing to do but all the same, with youthful vigor, I managed to do this for a few years until I finally got it registered.

The registration was predicated upon the discovery that with increased presence of a pharmacist in the premises, better patronage and, of course, better sales and profits were assured and also because I wanted to get all the perceived and real benefits that other registered outfits in Kwara State were getting.  And I can tell you that ever since the registration, I have had no regret for leaving my former employers and, by God’s grace, Babsam Pharmacy has become a household name in my community and beyond, having rendered a decade-long of dedicated and selfless pharmaceutical services to the community.

One of the key tools that really helped me at the beginning was the introduction of a counselling area in a section of my small premises and ensuring virtually every client coming in got appropriate and adequate counselling on their purchased or prescribed medications as against the over- the -counter transactions other drug stores were practising. Before long, these satisfied customers themselves became my mouthpiece in the community and that really assisted in the rapid growth of the outlet.

You have been a community pharmacist for over ten years, at what point did you decide to go for ACPN chairmanship in Kwara State and what prompted the decision?

Ever since my internship and national service, I have been a community pharmacist and I am still proud today to be one.  I am so passionate about this area of pharmacy practice basically because of the joy inherent in being involved in the well-being of members of my immediate community. Also, with community practice, you stand a better chance of putting into use virtually all you were taught in your undergraduate days as a pharmacist. With this passion and love, I soon became a regular attendee of ACPN meetings in my state branch and was dutifully discharging the various assignments given to me by the various executives.

My colleagues probably saw a thing or two that God helped me to do right in these assignments. This prompted my being called upon to serve the association in a higher capacity. So, my decision to serve as ACPN chairman was actually a positive response to the call of my colleagues and also because I saw it as an avenue to use my wealth of experience to improve on the good works established so far by my predecessors. This call came earlier in 2011 but was unheeded due to another equally important assignment of serving as the state PSN secretary.

What is your assessment of community pharmacy practice in this part of the country?

Overall and by virtue of my interaction with some of my counterparts in other states, my assessment of community pharmacy practice in this part of the country may not differ much from what obtains in other states. The practice here is obviously not where it ought to be but certainly we’re not doing badly. Given a better practice environment, the potential to attain the so-called global best practice is high.

Present with us now though are diverse challenges, including inadequate number of pharmacies to serve the ever-increasing population, especially in the rural areas; limited supply and sometimes complete absence of logistic supports for inspectoral activities from the various relevant organs of government; poor orientation/education of members of our various communities on who a community pharmacist really is and the increasingly huge benefits they stand to benefit from patronising one; prescriptions caged within the four walls of hospitals and not getting to our members premises (the private hospitals being the chief culprits) as most of them now have a mini pharmacy without necessarily employing a pharmacist to man such. This last observation is a dangerous trend and one that always proves counterproductive to both the owners of such establishments and, of course, their patients due to that essential missing link – the pharmacist factor.

We can go on and on but the current leaderships of both the PSN and the ACPN are working round the clock to reverse some of these issues especially those that lie within our borders at the least.

How lucrative is community pharmacy practice business in this state?

Community practice essentially is supposed to be a service-oriented one. In days gone by, emphasis tilted in favour of service. However, Nigeria being what it is today, the emphasis is shifting to monetary gains and even most professionals in the health care sector are not spared from this trend. Having said this, I would like to bring it to the fore that the lucrativeness of any business in any part of the country, including Kwara State, is a function of so many factors, including: the location of that business, the quality and sometimes quantity of the human resources running the business (especially the quality of the staff in terms of their approach to customers), the stock size and stock varieties available,  availability of the pharmacist-in-charge alongside his/her wealth of experience in handling diverse cases, just to mention a few. With the right blend of these factors and others not listed, any community pharmacy will always get good returns on investment.

However, and generally speaking, community pharmacy business is still a lucrative one here in Kwara ahead of many other business choices. Many places are yet to be covered, even in the urban parts of the state. The rural areas remain a mine gold  for potential investors who are able to able to look away from some little inconveniences.

The chain-pharmacy concept is becoming more popular. How do you see the development?

It is indeed a development that needs to be watched more closely. We all need to tread with caution on this. The pros and the cons need to be put on the balances. Personally, I don’t really buy into it. I would rather support the recently talked-about satellite pharmacy concept which, as we speak, is at an advanced stage of planning. 

You had some objectives set for yourself at the beginning of your tenure, how many of these have you achieved so far?

Of course, I had my objectives which I built around our slogan “Empowering Pharmacists, Protecting the People”. I actually wanted to see my members being truly empowered in every sense of the word. I wanted to see communities around us benefiting immensely and maximally health-wise from our day-to-day interventions. Consequently, all our programmes so far have been deployed in this direction and they are not likely to change in the months ahead.

We actually wanted to see a community pharmacy practice that was more vibrant and dynamic. We wanted to raise the bar in terms of members welfare; we wanted better publicity for community pharmacists; we wanted to involve ourselves in world health days celebrations, a practice that was hitherto strange to us as an association in Kwara; we wanted to organise and or participate in more trainings/workshops to build our members’ capacity; we wanted to create a way or two that would impact positively on our members finances and many more.

Ten months on, I would say without any fear of contradiction, that the current executives have vigorously pursued these objectives to the best of our abilities. We leave the assessment of our overall performance so far in the hands of our people who gave us the mandate in the first instance. We celebrated, for the first time in our annals, both the World Malaria Day and the World Diabetes Day in 2015, and both exercises were highly successful and widely reported in the print and electronic media. We voted an unprecedented sum of money on welfare. Training/seminars on current trends in malaria management, in partnership with Novartis, as well as a special workshop where our members were sensitised to the relevance of conducting certain simple test procedures in their various outlets were all staged at various times and were all well-attended. Still, work is on-going as we are not there yet. We plan to build on this good foundation to take the practice to a new high level this year, God helping us.

What is your assessment of the health care sector in the year 2015?

The sector witnessed a lot of challenges in 2015. Painfully though, some of these were clearly avoidable ones. The NMA-JOHESU case readily comes to mind with all its attendant strikes, which inflicted untold pain, sorrow and tears upon thousands of Nigerians.  A closer look at the demands of JOHESU then and now still show that most are not out of place. It is hoped that in this current era of CHANGE, adequate justice, equity and sincerity of purpose would override sentiments in all ramifications and every component of our health care team as it were will be accorded due respect and remuneration

 A major challenge facing pharmacy profession in Nigeria is the problem of fake drugs. How can this challenge be surmounted?

As long as we allow open drug markets to continue, we will continue to battle with this menace for many years to come, as an alarming percentage of fakery originates from these markets. This is no longer news; it is a fact that we must face and deal with without further delay. We have dwelled so long at this harbour but it is a highly dangerous place. It is high time we moved on with other developed countries in eradicating these marts.  Knowing the cause of a disease, they say, is half the cure. What else are we waiting for?

The NAFDAC-introduced Truscan machines initially appeared promising in the fight against fakery. Over the years, however, the initiative has been fraught with some ills especially on its accessibility and cost – which has raised questions about its suitability for this fight. Perhaps, with government coming in to subsidise this testing equipment, its availability, even at the level of community pharmacies, would be guaranteed.

The effectiveness of MAS (Mobile Authentication Service) in this fight has also been blown out of proportion and in recent times has brought many unnecessary embarrassments to our members rather than achieving its original purpose. I recommend that NAFDAC in conjunction with pharmaceutical industries and importers take urgent steps in amending the observed lapses in that system if they are bent on its continuity.

The new drug distribution guidelines even as recently amended will certainly go a long way in curbing the menace of this hydra-headed monster of drug counterfeiting. I therefore use this platform to call on the Federal Government of Nigeria to implement this programme without further delay.

NMA seeks review of national health budget

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The Nigerian Medical Association (NMA) has called on both the federal government and the National Assembly to look into why only a paltry sum of N221.7 billion was allocated to the health ministry in the 2016 Appropriation Bill.

In a statement signed by its president, Dr Kayode Obembe, and its secretary general, Dr Adewunmi Alayaki, the umbrella body of doctors and physicians in the country, said that it observed, with great dismay, the drastic departure from the consensus reached at the meeting of African Heads of States and Government in 2001, in which it was prescribed that 15 per cent of the national budget should be allocated to the health sector.

According to the NMA, the deviation poses a huge moral burden for the country in going against its avowed commitment, despite rising health challenges and the resultant burgeoning demands from the sector.

“Though not ignorant of the current realities of dwindling oil revenue and contracting fiscal space – a situation which the country has most unfortunately found itself – the NMA is of the view that the markedly diminished allocation of 3.65 per cent in the 2016 budget will never encourage the advancement of universal health coverage.

“This is because universal health coverage is the only panacea towards improving availability, access quality and efficiency of health services to reduce the disparaging health indices which continue to malign the image of our country in the comity of nations,” it said.

Additionally, the association lamented that the N60 billion (equivalent of at least one per cent of the Consolidate Revenue Fund) envisaged to accrue as the Basic Health Provision fund, as enshrined in the National Health Act 2014, was conspicuously absent from the budget proposal as presented.

The NMA secretary declared that such developments, coming during the much vaunted era of change was unbecoming, adding that Nigeria should begin to show a good example to other African countries, rather than lagging behind since 2001 when it hosted the Heads of State summit.

“Facts from available evidence show that whereas 33 per cent of countries have allocated at least 10 per cent of their national budgets to health, with only Tanzania, Rwanda, Swaziland, Ethiopia, Malawi and Central African Republic attaining 15 per cent, Nigeria has been revolving between 3 per cent and 6 per cent,” he said.

Alayaki further revealed that contrary to the recommendation of the World Health Organisation (WHO) that national budgets should be allocated an equivalent of N6,908.00 per head (General Government Health Expenditures (GGHE) per capital), the association was dismayed to hear that the World Bank’s reports show that the 2016 federal budget only provided for N1,448.00 ($7.55 at $1=N197), representing a retrogression from N1,546.00 in 2015 and N1653.00 in 2014.

“This presents a precarious situation, as all other contributions from state and local governments, donor agencies and other sources cannot bridge the deficit of N5,460.00 in this regard.

“It is on this premise that we call on the National Assembly as the only organ that can mitigate this looming disaster in the health care delivery sector in 2016. They must look dispassionately without any partisan sentiments at what should be done to substantially Increase the allocation to the health ministry in order to deliver better health care to the Nigerian People” he said.

The NMA, in the communiqué, promised to assist government in budget tracking, to ensure that budgeted and released funds are used for the purposes for which they were appropriated.

While equally calling on state and local governments to allocate substantial resources to the health care delivery sector, the association restated its continual commitment and readiness to partner with government to deliver prompt and efficient health care to Nigerians.

Jigawa Govt shuts 3 health facilities

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The Jigawa State Government has closed three private health facilities in the state for violating operational rules. Confirming this development to NAN, the Public Relations Officer in the state’s Ministry of Health, Malam Musa Aliyu,on Thursday in Dutse, said the private institutions were faulty of operational rules.

Aliyu, who explained reasons behind the closure,  said the directives came from the state Commissioner for Health, Dr Abba Zakari, who had inspected the facilities earlier on Feb. 16.

The spokesman listed the affected facilities as City Clinic in Hadejia; Taimakon Allah Scan in Jahun town and Ema Chini of Zago village in Kafin Hausa.

He said the facilities were found to violate rules and regulations governing operation of private health practice in the state.

Aliyu quoted the commissioner as saying that the ministry will continue with such unscheduled inspection of private health facilities operating in the state.

According to him, the policy is to ensure they comply with the rules and regulations governing private health facilities for safe and proper healthcare delivery system. (NAN)

Zika Vaccine on its way- WHO

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ZikaThe World Health Organization says possible Zika vaccines are at least 18 months away from large-scale trials, the Associated Press reports.

WHO assistant director-general for health systems and innovation Marie-Paule Kieny says the U.N. health agency’s response is “proceeding very quickly” and 15 companies or groups have been identified as possible participants in the hunt for vaccines.

She told reporters in Geneva at the weekend that WHO also believes the link between the mosquito-borne virus and abnormally small heads in some newborn children is “more and more probable.”

The Zika outbreak is spreading rapidly across Latin America.

 

Michel L. Pettigrew President of Ferring Prescribed drugs – BioAsia 2016

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Michel L. Pettigrew President of Ferring Prescribed drugs – BioAsia 2016 – hybiz.television
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Lars Peter Brunse Sr Vice President of Ferring Prescribed drugs – BioAsia 2016

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Lars Peter Brunse Sr Vice President of Ferring Prescribed drugs – BioAsia 2016 – hybiz.television
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How to whiten your teeth with proven natural remedies

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The benefits of having great looking teeth cannot be over estimated. Good, white teeth can help boost your self esteem, make a positive first impression and also increase your overall image. Yet, studies have shown that an estimated 18 percent of all people attempt to conceal their teeth. While the reasons vary, commonly this is because of stained, yellow teeth that just won’t whiten, no matter how much brushing is done. Nobody should have to conceal his teeth for this reason. And while there are plenty of cosmetic procedures that can help make teeth look whiter, you can also take measures into your own hands at home. Here’s a look at easy, natural ways to whiten your teeth:

Apple Cider Vinegar:

Brushing with Apple Cider Vinegar, is one proven teeth-whitening method, although those who administered  it say that it takes about a month of regular brushing with the substance to notice a real difference. Specifically, this method shines in terms of removing the likes of coffee and nicotine stains from the teeth. One thing to note is that it is an acid, so following the administration of Apple Cider Vinegar, you should either brush thoroughly with a standard toothpaste or wash your mouth out well. If acid is left to dwell inside the mouth, it could end up eating away at the tooth enamel.

Coconut Oil Pulling:

Although one of the newer discoveries in natural teeth-whitening, many are praising the results from coconut oil pulling. The best way to use this as a teeth whitener is to place a spoonful in your mouth and swish it around like mouthwash, add drops of it to your toothbrush and brush your teeth with it or dab it with a wash cloth and apply it to the teeth that way.

Eat Cheese

Eating cheese can also help promote a healthy smile. That’s because cheese contains the milk protein casein, which works to make enamel stronger. Essentially, by eating cheese, you’re helping to keep your tooth enamel healthy.

Eat Your Veggies

Yes, simply eating crunchy vegetables, such as celery and carrots (as well as fruits like apples and pears) can help keep your teeth whiter. How? It’s because these veggies are abrasive and can help remove stains from the surface of the teeth. They also help produce saliva, which also helps to minimize staining.

Baking Soda and Hydrogen Peroxide

As far as natural teeth whitening goes, this is a proven, effective method. Just mix minimal amounts of baking soda and hydrogen peroxide into a paste and use it to brush your teeth. The hydrogen peroxide kills germs and keeps the mouth clean, while the baking soda works to scrub any staining off of the teeth.

Change Your Toothbrush Every 3 Months

Most people only change their toothbrush out when they get a new one from their dentist at their six-month cleaning. This is a mistake – toothbrushes should be swapped out at least once every three months. Why? Because this is normally about the time that bristles bend and wear down. Once that happens, your teeth aren’t being cleaned like they should.

Brush, Brush, Brush

Although this might be a tad inconvenient, one of the best ways to ensure that your teeth stay white is to brush them after every meal. Drinks like coffee, tea and red wine can stain the teeth, and foods that are high in sugar can also do damage to their appearance, however regular brushing can help offset some of these issues.

Activated Charcoal

Activated charcoal is commonly used to absorb toxins that have been ingested by the body – but it also works to remove toxins from the mouth and get rid of stains. So while this method may sound a little strange, and while it will surely turn your mouth black until you rinse, brushing with activated charcoal provides highly satisfying results.

Zika Virus: Nigerians express fear over a possible outbreak

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antenatalWorried by the Zika virus outbreak in the North and South America, which has damaged the brain development of several babies, Nigerians have called on the Federal Government to develop effective and adequate protection for its citizens, in the event of a possible outbreak in the country.

According to Pharmanews investigation, the citizens bared their minds out on the state of things in the country, explaining why the government should prepare herself against the spread of the virus, in order to avert an addition to the already existing burden of Lassa fever at hand.

The pregnant women at the Oak Hospital Antenatal Clinic, Wednesday, who formed the majority of our vox pop, said although the government has issued a precautionary measure on travelling to affected countries, as well as prevention of mosquito bites, insisted that by now, there should have been provisions in form of vaccine or other drugs, to treat infected pregnant women and babies.

Mrs Titilayo Aina, a-7-month pregnant woman, noted how she has not been at rest ever since the WHO declared that the virus is a global public emergency, which could spread to any part of the world, Nigeria inclusive.

“As for me, I cannot risk my unborn baby’s life, due to government’s negligence. That is the more reason we are crying and pleading with President Mohammed Buhari, to allocate special fund to researchers to develop vaccine for the treatment of this disease, in order to be sure we are safe”, Mrs Ugo Kalu stated.

According to a WHO fact sheet, Zika virus infection, which is caused by the bite of an infected Aedes mosquito, usually causing mild fever, rash, conjunctivitis, muscle pain and headache, has already been found in 21 countries in the Caribbean, North and South America.

The virus has also been linked to thousands of babies being born with underdeveloped brains following which some countries have advised women not to get pregnant.

There are also indications that  Nigeria is in danger of dengue fever outbreak, another deadly fever in the class of Ebola Virus Disease, transmitted by Aedes aegypti mosquito (yellow fever mosquitoes) and Aedes albopictusis (tiger mosquitoes) that are now common in the country mostly in and around homes.

 

 

 

CET-10

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CET-10  (contains Cetirizine 10 mg)

Cetirizine is used in the treatment of urticaria; allergic rhinitis and belongs to the drug class antihistamines. There is no proven risk in humans during pregnancy. Cetirizine 10 mg is not a controlled substance under the Controlled Substance Act (CSA).

International Epilepsy Day 2016: Taking proper charge of your seizures

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Epilepsy is a group of related disorders characterized by a tendency for recurrent seizures. There are different types of epilepsy and seizures. Epilepsy drugs are prescribed to control seizures, and rarely surgery is necessary if medications are ineffective.

While many types of repetitive behavior may represent a neurological problem, a doctor needs to establish whether or not they are seizures.

Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures.

  • The person experiencing such a seizure may cry out or make some sound, stiffen for several seconds to a minute and then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping.
  • Eyes are generally open.
  • The person may appear to not be breathing and actually turn blue. This may be followed by a period of deep, noisy breathes.
  • The return to consciousness is gradual and the person may be confused for quite some time — minutes to hours.
  • Loss of urine is common.
  • The person will frequently be confused after a generalized seizure.

Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary.

  • If the part of the brain controlling movement of the hand is involved, then only the hand may show rhythmic or jerky movements.
  • If other areas of the brain are involved, symptoms might include strange sensations like a full feeling in the stomach or small repetitive movements such as picking at one’s clothes or smacking of the lips.
  • Sometimes the person with a partial seizure appears dazed or confused. This may represent a complex partial seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious.
  • Absence or petit mal seizures: These are most common in childhood.
  • Impairment of consciousness is present with the person often staring blankly.
  • Repetitive blinking or other small movements may be present.
  • Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day

Prevalence of Epilepsy in Nigeria

Epilepsy is a problem in Nigeria but prevalence data is lacking.

The epilepsy prevalence for a rural community was 20.8/1000

The epilepsy prevalence for a semi-urban community was 4.7/1000

What Are the Treatments for Epilepsy?

The majority of epileptic seizures are controlled by medication, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors, including the frequency and severity of the seizures and the person’s age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment.

  1. Drug Therapy

Many drugs are available to treat epilepsy. Although generic drugs are safely used for most medications, anticonvulsants are one category where doctors proceed with caution. Most doctors prefer to use brand-name anticonvulsants, but realize that many insurance companies will not cover the cost. As a result, it is acceptable to start taking a generic anticonvulsant medication, but if the desired control is not achieved, the patient should be switched to the brand-name drug.

The choice of drug is most often based on factors like the patient’s tolerance of side effects, other illnesses he or she might have, and the medication’s delivery method.

Although the different types of epilepsy vary greatly, in general, medications can control seizures in about 70% of patients.

Side Effects of Epilepsy Drugs

As is true of all drugs, the drugs used to treat epilepsy have side effects. The occurrence of side effects depends on the dose, type of medication, and length of treatment. The side effects are usually more common with higher doses, but tend to be less severe with time as the body adjusts to the medication. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier. One of the best rules in medicine is to ”go low and go slow.”

There are three types of side effects:

Common or predictable side effects. These are common, nonspecific, and dose-related side effects which occur with any epilepsy drug, which affects the central nervous system. These side effects include blurry or double vision, fatigue, sleepiness, unsteadiness, and stomach upset.

Idiosyncratic side effects. These are rare and unpredictable reactions which are not dose-related. Most often, these side effects are skin rashes, low blood cell counts, and liver problems.

Unique side effects. These are those that are not shared by other drugs in the same class. For example, Dilantin and phenytoin (Phenytek) can cause the gums to swell and valproate (Depakene) can cause hair loss and weight gain. Your doctor will discuss any unique side effects before prescribing the medication.

  1. Ketogenic Diet

This is one of the oldest treatments for epilepsy, and helps lessen seizures.

  1. Alternative Treatments

Biofeedback, melatonin, and large vitamin doses can help.

  1. Vagus Nerve Stimulation

There is no cure for epilepsy, but medications may help keep symptoms under control.

  1. New Epilepsy Treatments

Treatments for epilepsy have come a long way in the last decade. Doctors have more than twice as many epilepsy medications to choose from than they did 10 years ago.

  1. Epilepsy Drugs for Children

There are a wide number of medications available for treating epilepsy in children, and advances in the past years have made a difference.

  1. Multiple Subpial Transection (MST)

Sometimes, brain seizures begin in a vital area of the brain — for example, in areas that control movement, feeling, language, or memory.

  1. Temporal Lobe Resection

A temporal lobe resection is a surgery performed on the brain to control seizures. In this procedure, brain tissue in the temporal lobe is resected, or cut away, to remove the seizure focus.

  1. Lesionectomy

Lesionectomy may be an option for people whose epilepsy is linked to a defined lesion and whose seizures are not controlled by medication.

  1. Functional Hemispherectomy

This procedure generally is used only for people with epilepsy who do not experience improvement in their condition after taking many different medications and who have severe, uncontrollable seizures.

  1. Corpus Callosotomy

A corpus callosotomy, sometimes called split-brain surgery, may be performed in people with the most extreme and uncontrollable forms of epilepsy, when frequent seizures affect both sides of the brain.

  1. Extratemporal Cortical Resection

An extratemporal cortical resection is an operation to resect, or cut away, brain tissue that contains a seizure focus.

Drug Treatments for Essential Tremor

With the use of medication, people with essential tremor may see improvement in their ability to control their tremor and improvement in activities such as drinking from a cup or using food utensils.

 

World Cancer Day 2016: How to reduce cancer burden in Nigeria

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Poised to reduce the global burden of cancer, which kills about thrice the number of people who die of tuberculosis, HIV and malaria combined, the Union for International Cancer Control (UICC), founded World Cancer Day (WCD), on February 4 , 2008, to raise awareness and as well as generate support for people living with the disease.

Consequently, WCD has been commemorated worldwide on February 4, but the impact of this celebration is yet to be felt as the prevalence of the terminal disease swells from year to year, and from border to border, as it keeps claiming the lives of  its victims, both rich and poor alike.

One major issue that has been generally identified as a setback in the fight against cancer is inadequate medical facilities for the screening and treatment of the condition, in the country, as well as late presentation of patients to the hospitals.

This is why this year’s theme is centred on deliberate actions on the part of government, corporate bodies and individuals, in reducing the disease burden in the country. The theme for this year’s WCD: “We can. I can.”—will last from 2016 through to 2018.

This implies that we can:  inspire action; take action; prevent cancer; challenge perceptions; create healthy environments; improve access to cancer care; build a quality cancer workforce; mobilize our networks to drive progress; shape policy change; make the case for investing in cancer control; and work together for increased impact.

This deliberate concerted effort is imperative because, according to the World Health Organisation (WHO), more than 70 per cent of cancer deaths occur in low- and middle-income countries. Although the risk of developing or dying from it is still higher in the developed world, still, early detection and prompt medical attention are key in its management.

According to the Medical Director, Pfizer Pharmaceutical Company, Dr Kodjo Soroh, cancer is on the rise, not only in Nigeria, but worldwide. As a result, doctors are still researching into its cure.

“The unfortunate aspect of cancer situation in Nigeria is not that doctors cannot treat it, but the cost of treatment and availability of medical equipment is grossly inadequate. Nigeria is not prepared for the Tsunami that is about to break in cancer. I did a little survey in the northwest of the country some two years ago. It was recorded in a teaching hospital that 30 new cases are reported every day. Cancer is killing Nigerians everyday. The rate at which cancer is killing Nigerians is alarming. It is more than cases of deaths caused by malaria AIDS and Tuberculosis.

“The best way to get an idea on the prevalence is to go by the WHO statistics on cancer situation in Nigeria. The statistics is alarming. It says per hour, 30 Nigerians are dying of cancer. I say Nigeria is not prepared because, if you look at our National Health Insurance Scheme (NHIS) cancer is not covered. So, if you develop cancer now, you are on your own. How many radiotherapy units do you have in Nigeria and the specialists, how many oncologists? Early detection and diagnosis are important. Once these are delayed, it spreads and causes more damage. If you have money to go out, then the cost is on your head.”

He continued: “The best option anybody has is to prevent it. Government should invest more on the infrastructure and health personnel. Early screening and detection are important in cancer management or its prevention. Let us create more awareness by telling our women to do self breast examination, screen for cervical cancer that is even preventable by getting vaccinated.

“Let people disabuse their minds on a misconception that if they get female teenagers immunised against cervical cancer; that they are indirectly being prepared for promiscuity. Nigerians should move on. Get our women vaccinated against cervical cancer. There are some women who have been known to keep only a man and still come down with cervical cancer because pappiloma virus is the cause of that type of cancer. The statistics even have it that more married women may have cervical cancer than the unmarried.”

Explaining the development of cancer, the Medical Director, Triumph Medical Centre, Dr Deji Morenikeji, said cancer is the abnormal growth of body tissues in the cells and can affect any part of the body. “When a person is said to have developed cancer, it simply means the cells that are normal are fast growing into abnormal cells and distorting them. There is increase of awareness on cancer now. Government is actually playing a major role in cancer detection. It has a unit in the Ministry of Health dedicated to that.

“Unfortunately, in this part of the world people go late to the hospital. The treatment is not encouraging. If cancer is detected early, depending on the type of cancer, there is a five-year survival rate, and the rate is higher and impressive. Cancer drugs and treatments are expensive worldwide. Government is trying its best to contain the development of the disease, all things being equal including not having its hereditary trait, and then its prevention, that is, its development is more individualistic.

On prevention, he said: “People should be mindful of their lifestyle. They should watch what they eat as what they consume plays important role on their well-being. They should exercise more and do away with sedentary lifestyle. They should do more health assessments, routine medical examinations.”

Statistics show that there are six most common cancers in Nigeria. They include:

  • Breast cancer
  • Cervix cancer
  • Prostate cancer
  • colorectal cancer
  • liver cancer and
  • NHL

Breast Cancer

Breast cancer is the commonest female cancer and studies have indicated increase in the relative frequency ratio; moving from number 2 or 3 to the number one cancer in both sexes..This increase has been attributed to increase awareness and presentation for screening. Majority of breast cancers occur in pre-menopausal women with the peak age in the 5th decade.

About 80-85% still present in advance stage III with attendant poor outcome.In Nigerian studies, only 25-50% of the tumours are reported to be oestrogen/progesterone receptor positive, which is the basis for hormonal treatment.

Causes of Breast Cancer

When you’re told that you have breast cancer, it’s natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesn’t, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cell’s DNA.

The risk factors for breast cancer

  • Female gender
  • increasing age
  • Maternal relative with breast cancer
  • Abnormal genes (BRCA 1, BRCA2 genes)
  • Nulliparity
  • Late age at first pregnancy and longer reproductive span(early menarche<12yrs, late menopause>50yrs).
  • Others are obesity,
  • Increased dietary fat & alcohol intake,
  • Cigarette smoking,
  • Previous breast lesion with atypical changes,
  • Previous breast cancer.

Male breast cancer

In Nigeria, it represents 3.7 -8.6% of all breast cancers .This is higher than the 1% recorded from other parts of the world. The higher figures in Nigeria may be due to small sample size, since the data are mainly hospital based. The peak age incidence is 40-49years; similar to that of female cancer.Majority are invasive ductal carcinoma. It is characterized by late presentation at advanced stage with attendant poor prognosis.

A tumor is a mass of abnormal tissue. There are two types of breast cancer tumors: those that are non-cancerous, or ‘benign’, and those that are cancerous, which are ‘malignant’.

 Diagnosis of Breast cancer

Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms. This is why getting the recommended screening tests before any symptoms develop is so important.

Medical history and physical exam

If you think you have any signs or symptoms that might mean breast cancer, be sure to see your doctor as soon as possible. Your doctor will ask you questions about your symptoms, any other health problems, and possible risk factors for benign breast conditions or breast cancer.

Your breasts will be thoroughly examined for any lumps or suspicious areas and to feel their texture, size, and relationship to the skin and chest muscles. Any changes in the nipples or the skin of your breasts will be noted. The lymph nodes in your armpit and above your collarbones may be palpated (felt), because enlargement or firmness of these lymph nodes might indicate spread of breast cancer. Your doctor will also do a complete physical exam to judge your general health and whether there is any evidence of cancer that may have spread.

If breast symptoms and/or the results of your physical exam suggest breast cancer might be present, more tests will probably be done. These might include imaging tests, looking at samples of nipple discharge, or doing biopsies of suspicious areas.

Mammograms

A mammogram is an x-ray of the breast. Screening mammograms are used to look for breast disease in women who have no signs or symptoms of a breast problem. Screening mammograms usually take 2 views (x-ray pictures taken from different angles) of each breast.

For a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. This may be uncomfortable for a moment, but it is necessary to produce a good, readable mammogram. The compression only lasts a few seconds.

If your diagnostic mammogram shows that the abnormal area is more suspicious for cancer, a biopsy will be is needed to tell if it is cancer.

Even if the mammograms show no tumor, if you or your doctor can feel a lump, a biopsy is usually needed to make sure it isn’t cancer. One exception would be if an ultrasound exam finds that the lump is a simple cyst (a fluid-filled sac), which is very unlikely to be cancerous.

Magnetic resonance imaging (MRI) of the breast

MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into a very detailed image. For breast MRI to look for cancer, a contrast liquid called gadolinium is injected into a vein before or during the scan to show details better.

MRI scans can take a long time − often up to an hour. For a breast MRI, you have to lie inside a narrow tube, face down on a platform specially designed for the procedure. The platform has openings for each breast that allow them to be imaged without compression. The platform contains the sensors needed to capture the MRI image. It is important to remain very still throughout the exam.

Prevention of Breast Cancer

The following tips are essential in preventing breast cancer

  • Regular breast examination
  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicine to treat a precancerous condition or to keep cancer from starting.

Cervical Cancer

Cervical cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it’s found early. It is usually found at a very early stage through a Pap test.

It is the second most common cancer in Nigerian women and the most common female genital cancer constituting a major cause of mortality among Nigerian females in their most productive years. It was the commonest cancer reported from Ibadan, Eruwa, Zaria, Jos, Benin and Calabar and in the early years, second to breast in Enugu and Ife-Ijesha , as indicated by the study conducted by professor, Fatimah Abdulkareem,  of the College of Medicine, University of Lagos.

 

Recent data shows that it has however, been overtaken by breast cancer; except in Kano where it was reported as the most common cancer in both sexes.  In Jos, it is the most common female cancer.

On the other hand, incidence of other gynae cancers such as choriocarcinoma  and endometrial has reduced  drastically.The age range is between 17-80yrs with peak in the 5th decade.Multiple marriages, late presentation are common and majority of the patients have not had Pap smear done before.

Human papillomavirus (HPV) is a necessary cause of cervical cancer being present in 99.9% of cases. In a study of 233 cases of cervix cancer from Lagos, HPV 16 and 18 were present in 65.2%. This supports data that effective vaccination against these 2 types will reduce the cervical burden in Nigeria.

You can get HPV by having sexual contact with someone who has it. There are many types of the HPV virus. Not all types of HPV cause cervical cancer. Some of them cause genital warts, but other types may not cause any symptoms.

Most adults have been infected with HPV at some time. An infection may go away on its own. But sometimes it can cause genital warts or lead to cervical cancer. That’s why it’s important for women to have regular Pap tests. A Pap test can find changes in cervical cells before they turn into cancer. If you treat these cell changes, you may prevent cervical cancer.

Abnormal cervical cell changes rarely cause symptoms. But you may have symptoms if those cell changes grow into cervical cancer.

Symptoms of cervical cancer may include:

Bleeding from the vagina that is not normal, such as bleeding between menstrual periods, after sex, or after menopause.

Pain in the lower belly or pelvis.

Pain during sex.

Vaginal discharge that isn’t normal.

The treatment for most stages of cervical cancer includes:

Surgery, such as a hysterectomy and removal of pelvic lymph nodes with or without removal of both ovaries and fallopian tubes.

Chemotherapy.

Radiation therapy.

Prevention of cervical cancer

The Pap test is the best way to find cervical cell changes that can lead to cervical cancer. Regular Pap tests almost always show these cell changes before they turn into cancer. It’s important to follow up with your doctor after any abnormal Pap test result so you can treat abnormal cell changes. This may help prevent cervical cancer.

If you are age 26 or younger, you can get the HPV vaccine, which protects against two types of HPV that cause most cases of cervical cancer.

he virus that causes cervical cancer is spread through sexual contact. The best way to avoid getting a sexually transmitted infection is to not have sex. If you do have sex, practice safer sex, such as using condoms and limiting the number of sex partners you have.

Prostate Cancer

The prostate is a gland that is a part of the male reproductive system that wraps around the male urethra at its exit from the bladder. Common problems are BPH (Benign Prostatic Hyperplasia), acute and chronic bacterial prostatitis and chronic prostatitis (non-bacterial)

Prostate cancer is common in men over 50, especially in African-Americans and in men who eat fatty food and/or have a father or brother with prostate cancer.

It  Is the most common cancer in Nigerian males; having overtaken liver cancer.It accounts for 6.1-19.5% of all cancers and incidence is increasing. Current data from most parts of the country show it to be the 3rd most common cancer, except in Calabar where a very high figure was recorded for prostate cancer as the most common in both sexes accounting for 34.7% of all cancers. Earlier report from that center between 1979-88 had recorded 28.6% of all male cancers.

Compared to African-American men, Nigerian men are 10 times more likely to have prostate cancer and 3.5 times more likely to die from it. Environmental and most importantly, genetic factors have been incriminated as the reason for the geographic differences in incidence.

Risk factors for prostate cancer include:

  • race,
  • age above 40years,
  • positive family history,
  • high fat diet and
  • high serum androgens levels; the latter being most consistent.

Symptoms of prostrate Cancer

Symptoms of prostate problems (and prostate cancer) include urinary problems (little or no urine output, difficulty starting (straining) or stopping the urine stream, frequent urination, dribbling, pain or burning during urination), erectile dysfunction, painful ejaculation, blood in urine or semen and/or deep back, hip, pelvic or abdominal pain; other symptoms may include weight loss, bone pain and lower extremity swelling

Prostate cancer is definitively diagnosed by tissue biopsy; initial studies may include a rectal exam, ultrasound and PSA (prostate-specific antigen) levels

Treatments for prostate cancer may include surveillance, surgery, radiation therapy, and hormone therapy

PSA testing is considered to be yearly PSA tests; not all agree this should be done

Identify prostate problems early is a way to reduce future prostate problems

Diagnosis of prostate cancer

The diagnosis of prostate cancer mostly involves a combination of three tests:

Digital rectal examination: As part of a physical examination your doctor inserts a gloved and lubricated finger into your rectum and feels toward the front of your body. The prostate gland is a walnut or larger sized gland immediately in front of the rectum, and beneath your bladder. The back portion of prostate gland can be felt in this manner. Findings on this exam are compared to notes about the patient’s prior digital rectal examinations.

The exam is usually brief, and most find it uncomfortable due to the pressure used to adequately examine the prostate gland. Findings such as abnormal size, lumps, or nodules, may indicate prostate cancer.

This examination should be part of an annual physical in all men over 50 years of age to note changes in the prostate. In men with a family history of prostate cancer, or in African American men exams should begin at 40 years of age.

Prostate specific antigen (PSA) blood test: The PSA blood test measures the level of a protein found in the blood that is produced by the prostate gland and helps keep semen in liquid form. The PSA test can indicate an increased likelihood of prostate cancer if the PSA is at an increased or elevated level, but it does not provide a definitive diagnosis. Prostate cancer can be found in patients with a low PSA level but this occurs less than 20% of the time.

If the PSA level is elevated (levels can depend upon your age, on the size of your prostate gland on examination, certain medications you may be taking, or recent sexual activity), further testing may be needed to rule out prostate cancer.

PSA measurements are often tracked over time to look for evidence of a change. The amount of time it takes for the PSA level to increase is referred to as PSA velocity. A PSA doubling time can be also tracked in this fashion. PSA velocity and PSA doubling time can help your doctor determine whether prostate cancer may be present.

The presence of an abnormal result on digital rectal examination, or a new or progressive abnormality in a PSA test may lead to a referral to a surgeon who specializes in diseases of the urinary system (a urologist) who may perform further testing, such as a biopsy of the prostate gland.

Prostate biopsy: A biopsy refers to a procedure which involves taking of a sample from a tissue in the body. Prostate cancer is only definitively diagnosed by finding cancer cells on a biopsy sample taken from the prostate gland.

The urologist may have you stop medications such as blood thinners before the biopsy. On the day of the biopsy the doctor will apply a local anesthetic by injection or topically as a gel inside the rectum over the area of prostate gland. An ultrasound probe is then placed in the rectum. This device uses sound waves to take a picture of the prostate gland and helps guide the biopsy device. The device used is a spring-loaded needle that allows the urologist to extract cores from the prostate gland. Usually 12 cores are obtained, six from each side. Two cores are taken from the upper, middle, and lower portions of the prostate gland. The cores are submitted for analysis to a pathologist (a doctor who specializes in examining tissues to make a diagnosis). Results may take several days.

A biopsy procedure is usually uncomplicated, with just some numbness, pain, or tenderness in the area for a short time afterwards. Occasionally, a patient has some bleeding in the urine after the procedure. Rarely, the patient may develop an infection after a biopsy procedure, or be unable to urinate. The patient will be advised to call and consult a doctor if such problems occur.

Prostate cancer biopsy results

The result of the pathologist’s analysis of the biopsy cores under the microscope is the only way to diagnose prostate cancer. The biopsy procedure is not perfect, and cancer present in the prostate may be missed. If the urologist is still suspicious based on the results of the examination and the ultrasound images seen during the procedure, additional biopsies may be recommended.

The pathologist’s report on the biopsy sample showing prostate cancer will contain much detailed information. The size of the biopsy core and the percentage of involvement of each core will be reported. Most importantly the prostate cancer present will be assigned a numerical score, which is usually expressed as a sum of two numbers (for example, 3 + 4) and is referred to as the Gleason Score. This characterizes the appearance of the cancer cells and helps predict its likely level of aggressiveness in the body. It is often also referred to as the grade of the prostate cancer.

The Gleason score and the extent of involvement of the biopsy core expressed as a percentage, as well as the PSA level as well as your general state of health and otherwise estimated life expectancy all help the doctors make their best recommendations for you regarding how your cancer should be treated.

The accuracy of the PSA test

The PSA test is a tool for use by your doctor but it is not a perfect way to tell whether or not a patient has prostate cancer because is not sensitive enough to pick up all prostate cancers. It is not specific enough in that it may be elevated in people without prostate cancer, such as those whose prostate glands are infected, or just inflamed, but not cancerous. It is also elevated for several days after a digital rectal exam, or after ejaculation. Nevertheless, it accurately measures the amount of PSA in the blood at the time that it is drawn.

The interpretation of the PSA result must be done with care. PSA results must be, for example, interpreted in the context of the patient’s age. Younger men (under 70, and definitely under 60) may have either more aggressive prostate cancers, or more life to lose if not evaluated aggressively. Conversely, men over 70 often have more indolent or slow-moving prostate cancers, or other medical conditions which may be greater threats to their lives over the next 10 years than may prostate cancer, and thus less aggressive evaluation and treatment may be warranted. The test is best used to establish a pattern in a man with serial measurements obtained over years.

It is now thought that doctors probably only find the more aggressive prostate cancers. The disease is common as men age. It is estimated 16% of men will be diagnosed with prostate cancer in their lifetime and yet only 3% will die of it. Many men likely have small prostate cancers present by the time they are over 60 years of age, with estimates ranging from 30% to 40% having prostate cancer cells in their prostates. The presence of these small cancers also likely further increases with age. Most of these cancers are very slow-growing and not aggressive in their tendency to spread as they are never discovered or symptomatic during the men’s lives. Diagnosing these prostate cancers may only increase the cost and result in treatment-related complications in these men.

Talk to your doctor about the risks and benefits of having PSA testing if you are 40 years of age with a family history of prostate cancer (or age 50 if you do not have a family history), or are of African American ancestry. The test results should be considered in the context of the man’s urinary symptoms, if any, his family history, his race and ethnicity, his diet, weight, and physical findings. Further there should be attention given to the pattern of change in his serial PSA measurements.

        Treatment of prostrate cancer

Treatment options for prostate cancer are many, and while this is an advantage in that prostate cancer is such a common disease in men, it can also be a cause of great confusion. The following overview presents some information about these options, but it is not a complete explanation of any of these.

Surgery

The removal of the entire prostate gland and the attached seminal vesicles is referred to as a radical prostatectomy. This is usually done through an incision or incisions made over the front of the lower abdominal wall with the procedure, taking place behind the pubic bones at the front of the pelvis (a retropubic approach). Today the main choice is between a standard open radical prostatectomy and the use of a robotic system for performance of the procedure through smaller incisions. The former allows the surgeon to feel the tissues and make the cuts themselves. The latter uses an operating system robot, which the surgeon guides. The former takes longer to recover from, and has more risk of blood loss associated with it. The latter results in a more rapid recovery and less blood loss generally.

Intact pelvic nerve bundles on either side of the prostate in the pelvis are essential for a man to be able to have an erection. Impotence — or the inability to have and sustain an erection of a quality sufficient for successful intercourse — can occur after this operation. The likelihood of impotence is primarily dependent on whether or not the necessary nerves can be preserved during surgery, AND the patient’s true preoperative ability to still have an erection. Nerve-sparing surgical technique is desirable and the surgeon should plan to do this, if possible. These important pelvic nerve bundles may need to be sacrificed if they are too close to or are involved with the cancer. The objective of the surgery is to cure the patient of the prostate cancer with the least number of problems afterward as possible, but the performance of a potentially curative procedure must remain the primary objective of the surgeon.

The radical prostatectomy involves the removal of a portion of the urethra. The urethra is the tube that runs from the bladder to the outside through the penis. It runs through the prostate gland. The procedure can disrupt the sphincter or valve, which controls urine flow from the bladder. The surgeon reconnects the urethra to the bladder after the prostate is out. The more careful and experienced the surgeon, the less the risk of long-term inability to control the flow of urine (incontinence).

The risks of an operation lasting several hours also remain substantial and include heart problems, blood loss, as well as a risk of infection, blood clots, and rarely death. Such operations are appropriate for patients whose cancer appears to be confined to the prostate gland.

Radiation therapy

Radiation therapy involves potentially curative treatment using machines that generate and administer controlled, invisible beams of energy known as radiation. This is called external beam radiation therapy (EBRT). It also can be done using radioactive sources, or seeds, implanted permanently, or higher energy sources placed temporarily into the body. This technique is called brachytherapy.

An X-ray machine uses a low energy radiation beam to take a picture of a portion of the body. Radiation therapy machines put out high energy beams that can be focused very precisely to deliver treatment to a site. The radiation does not “burn out” the cancer, but damages the cells’ DNA, which causes the cancer cells to die. This process can take some time to occur after the radiation treatments have been given.

The radiation passes directly through the tissues in EBRT. Radiation treatment used today delivers very little energy to normal tissues. It just passes through. Most of the energy is able to be focused and delivered directly to the area of the prostate gland containing cancer. This process minimizes damage to healthy tissue.

EBRT can be administered in a variety of different ways including 3-D CRT, IMRT, and others. EBRT is classically administered in brief daily treatments, 5 days a week over several weeks. While the radiation does not remain in the body with this approach, the effect of the daily fractions is cumulative. Newer forms of EBRT using machines called CyberKnife may be completed in shorter periods of time.

Radiation therapy to the prostate gland by external beam technique may cause fatigue and bladder and/or rectal irritation. These effects are usually temporary but may recur or persist long after treatments are finished. Radiation damage to adjacent tissues can cause skin irritation, and local hair loss. Delayed onset of impotence can occur after radiation therapy due to its effect on normal tissues including nerves adjacent to the prostate. Radiation therapy may be given alone or in combination with hormonal therapy which can also shrink up the prostate gland thereby reducing the size of the radiation area or field that needs to be treated.

A recently popular technique of EBRT is called proton beam radiation, which can theoretically more closely focus on the area being treated. Proton beam radiation therapy is more expensive. Its side effects presently appear similar to those discussed for standard radiation therapy. Studies comparing the effectiveness and overall results of conventional radiation therapy versus proton beam therapy have not been completed yet.

EBRT is appropriate for men who are candidates for radical prostatectomy but do not wish to undergo the surgery. It is also used to shrink tumors and reduce pain in areas where metastatic prostate cancer is damaging bone, or is pressing on important structures including the spinal cord.

Brachytherapy refers to the use of radiation sources — sometimes referred to as seeds — placed into the prostate gland. Brachytherapy may be done with what is called low-dose rate (LDR) or hight dose rated (HDR) technique. In LDR brachytherapy types of radioactive seeds, which only briefly put out a form of radiation which does not travel very far through tissues, are permanently implanted in the prostate gland. High-dose rate (HDR) brachytherapy involves the temporary placement of different types of seeds or sources which give off higher amounts of more penetrating radiation. These seeds administer higher doses of radiation for longer periods of time and cannot be left in the body. Such sources are placed in the prostate gland through surgically implanted tubes. These HDR sources are removed along with the tubes in a couple of days. In LDR brachytherapy, the seeds are placed in the operating room using image guidance to ensure the seeds go into the right places; 40 to 100 seeds may be placed. With LDR, you can go home shortly after you wake up after the procedure. In HDR, you must stay at the hospital for a few days. If the prostate gland is large, hormonal treatment may be used to shrink the gland before the brachytherapy is done. Brachytherapy may also be combined with external beam radiation therapy to further increase the dose of radiation therapy given to the prostate gland.

Brachytherapy can cause some blood in the urine or semen. It can cause a feeling similar to constipation due to the swelling of the prostate gland. It can also make you feel that you want to move your bowels more often. There may be some long-term problems with irritation of the rectum, difficulty urinating due to scar tissue formation, and even delayed-onset impotence.

Brachytherapy is appropriate for men with tumors staged T1 to T3 with PSA less than 20. It is not appropriate if you have had a prior procedure — transurethral prostatectomy (TURP) — which removes part of the prostate in cases of benign prostatic hypertrophy (BPH).

Note: Radiation therapy can be performed after radical prostatectomy if prostate cancer recurs in the region where the prostate was, and can potentially cure a locally recurrent prostate cancer if it has not spread beyond the area after radiation therapy has been given.

If radiation fails to control the cancer, surgery is difficult — if not impossible — to perform due to scar tissue which develops in the area.

Colo-rectal Cancer

Most colorectal cancers arise from adenomatous polyps.  Such polyps are comprised of excess numbers of both normal and abnormal appearing cells in the glands covering the inner wall of the colon. Over time, these abnormal growths enlarge and ultimately degenerate to become adenocarcinomas.

People with certain genetic abnormalities develop what are known as familial adenomatous polyposis syndromes. Such people have a greater-than-normal risk of colorectal cancer.

In these conditions, numerous adenomatous polyps develop in the colon, ultimately leading to colon cancer.There are specific genetic abnormalities found in the two main forms of familial adenomatous polyposis.

Colorectal carcinoma is the commonest malignancy of the gastrointestinal tract worldwide.Previous studies had shown it to be a rare disease in Nigeria representing 3-6% of all malignant tumours in most studies.It accounts for 10-50% of all GIT malignancies in Nigeria.Peak incidence-60-70yrs; mean age in Lagos is 50.7yrs.When it occurs in the young, associated with polyposis syndrome or ulcerative colitis should be suspected.

Contrary to previous report which showed it to be rare, recent report shows the incidence to be increasing;  an 81% increase over a period of two decades was reported from Ibadan.A recent study from Lagos & Sagamu showed similar trend with an increase in annual frequency of this cancer from 14 cases/annum to 32.3cases /annum.The low incidence in Nigerians was attributed to fibre rich diet which is common practice and rarity of the familial polyposis syndrome and IBD.

Recent urbanization/civilization has resulted in upsurge of confectionary food outlets in major cities resulting in many Nigerians changing their dietary habit from a fibre rich diet, which was common practice to a highly refined carbohydrate and fat diet.

Colon Cancer Symptoms

Cancer of the colon and rectum can exhibit itself in several ways. If you have any of these symptoms, seek immediate medical help. You may notice bleeding from your rectum or blood mixed with your stool.

  • People commonly attribute all rectal bleeding to hemorrhoids, thus preventing early diagnosis owing to lack of concern over “bleeding hemorrhoids.” New onset of bright red blood in the stool always deserves an evaluation. Blood in the stool may be less evident, and is sometimes invisible, or causes a black or tarry stool.
  • Rectal bleeding may be hidden and chronic and may only show up as an iron deficiency anemia.
  • It may be associated with fatigue and pale skin due to the anemia.
  • It usually, but not always, can be detected through a fecal occult (hidden) blood test, in which samples of stool are submitted to a lab for detection of blood.
  • If the tumor gets large enough, it may completely or partially block your colon. You may notice the following symptoms of bowel obstruction:
  • Abdominal distension: Your belly sticks out more than it did before without weight gain.
  • Abdominal pain: This is rare in colon cancer. One cause is tearing (perforation) of the bowel. Leaking of bowel contents into the pelvis can cause inflammation (peritonitis) and infection.
  • Unexplained, persistent nausea or vomiting
  • Unexplained weight loss
  • Change in frequency or character of stool (bowel movements)
  • Small-caliber (narrow) or ribbon-like stools
  • Sensation of incomplete evacuation after a bowel movement
  • Rectal pain: Pain rarely occurs with colon cancer and usually indicates a bulky tumor in the rectum that may invade surrounding tissue.

 

 

Other factors that may affect your risk of developing a colon cancer:

Diet: Whether diet plays a role in developing colon cancer remains under debate. The belief that a high-fiber, low-fat diet could help prevent colon cancer has been questioned. Studies do indicate that exercise and a diet rich in fruits and vegetables can help prevent colon cancer.

Obesity: Obesity has been identified as a risk factor for colon cancer.

Smoking: Cigarette smoking has been definitely linked to a higher risk for colon cancer.

Drug effects: Recent studies have suggested postmenopausal hormoneestrogen replacement therapy may reduce colorectal can cer risk by one third. Patients with a certain gene which codes for high levels of a hormone called 15-PGDH may have their risk of colorectal cancer reduced by one half with the use of aspirin

Also at high risk for developing colon cancers are people with any of the following:

Ulcerative colitis or Crohn’s colitis (Crohn’s disease)

Breast, uterine, or ovarian cancer now or in the past

A family history of colon cancer

The risk of colon cancer increases 2-3 times for people with a first-degree relative (parent or sibling) with colon cancer. The risk increases more if you have more than one affected family member, especially if the cancer was diagnosed at a young age.

When to Seek Medical Care

Any of the following symptoms warrants an immediate visit to your health care provider:

Bright red blood on the toilet paper, in the toilet bowl, or in your stool when you have a bowel movement

Change in the character or frequency of your bowel movements

Sensation of incomplete evacuation after a bowel movement

Unexplained or persistent abdominal pain or distension

Unexplained weight loss

Unexplained, persistent nausea or vomiting

 

Any of the following symptoms warrants a visit to the nearest hospital emergency department:

Large amounts of bleeding from your rectum, especially if associated with sudden weakness or dizziness

Unexplained severe pain in your belly or pelvis (groin area)

Vomiting and inability to keep fluids down

Exams and Tests

You may have a test called a colonoscopy.

This is a test that allows a specialist in digestive diseases (a gastroenterologist) to look at the inside of your colon.

This test looks for polyps, tumors, or other abnormalities.

Colonoscopy is an endoscopic test. This means that a thin, flexible plastic tube with a tiny camera on the end will be inserted into your colon via your anus. As the tube is advanced further into your colon, the camera sends images of the inside of your colon to a video monitor.

Colonoscopy is usually done with sedation and is not an uncomfortable test for most people. You will first be given a laxative solution to drink that will clear most of the fecal matter from your bowel. You will be allowed nothing to eat for a short period before the test and a liquid diet only for a day before the test.

Flexible sigmoidoscopy is similar to colonoscopy but does not go as far into the colon. It uses a shorter endoscope to examine the rectum, sigmoid (lower) colon, and most of the left colon.

CT colonography is another way to examine the colon. Again, the stool must be cleared from the colon before the examination. Colonoscopy allows sample to be taken (biopsies) if an abnormality is found. Colonography does not allow that, as there is no direct visualization of the interior of the colon.

Air-contrast barium enema is a type of X-ray that can show tumors.

Before the X-ray is taken, a liquid is introduced into your colon and rectum through your anus. The liquid contains barium, which shows up solid on X-rays.

This test highlights tumors and certain other abnormalities in the colon and rectum.

Other types of contrast enemas are available.

Air-contrast barium enema frequently detects malignant tumors, but it is not as effective in detecting small tumors or those far up in your colon.

If a tumor is identified in the colon or rectum by a biopsy performed during a sigmoid or colonoscopy, you will probably undergo CT scan of your abdomen and a chest X-ray to make sure the disease has not spread.

Medical Treatment

The primary treatment of colon cancer is to surgically remove part of your colon. Suggestive polyps, if few in number, may be removed during colonoscopy.

Chemotherapy after surgery can improve your likelihood of being cured if your colon cancer has spread to nearby lymph nodes.

Radiation treatment after surgery does not improve cure rates in people with colon cancer, but it is important for people with rectal cancer.

Given before surgery, radiation may reduce tumor size. This can improve the chances that the tumor will be removed successfully.

Radiation before surgery also appears to reduce the risk of the cancer coming back after treatment.

Radiation plus chemotherapy before or after surgery for rectal cancer can improve the likelihood that the treatment will be curative

Liver cancer

Primary liver cancer is a condition that happens when normal cells in the liver become abnormal in appearance and behavior. The cancer cells can then become destructive to adjacent normal tissues, and can spread both to other areas of the liver and to organs outside the liver.

Malignant or cancerous cells that develop in the normal cells of the liver (hepatocytes) are called hepatocellular carcinoma. A cancer that arises in the ducts of the liver is called cholangiocarcinoma.

What is metastatic liver cancer?

Metastatic cancer is cancer that has spread from the place where it first started (the primary site) to another place in the body (secondary site). Metastatic cancer in the liver is a condition in which cancer from other organs has spread through the bloodstream to the liver. Here the liver cells are not what has become cancerous. The liver has become the site to which the cancer that started elsewhere has spread. Metastatic cancer has the same name and same type of cancer cells as the original cancer. The most common cancers that spread to the liver are breast, colon, bladder, kidney, ovary, pancreas, stomach, uterus, breast, and lungs.

Metastatic liver cancer is a rare condition that occurs when cancer originates in the liver (primary) and spreads to other organs (secondary) in the body.

Some people with metastatic tumors do not have symptoms. Their metastases are found by X-rays or other tests. Enlargement of the liver or jaundice (yellowing of the skin) can indicate cancer has spread to the liver.

Liver cancer is the most common cause of cancer death in Nigeria and most common liver malignancy in Nigeria is hepatocellular carcinoma (HCC). Data from various parts of Nigeria show that it accounts for between 1.6%- 7.2% of all cancers in both sexes and represent the 2nd or 3rd most common cancer in males.

HCC was earlier reported to be the most common male cancer until recently when was overtaken by prostate cancer.  It is the most common malignancy on medical wards.

It is the most common cause of liver disease in Nigeria accounting for between 29.3% – 64% of all liver biopsies in several studies. The peak age incidence has been found to be a decade earlier than for liver cirrhosis and hepatitis. A significant number of cases occur in association with liver cirrhosis.

Most people who get liver cancer get it in the setting of chronic liver disease (long-term liver damage called cirrhosis), which scars the liver and increases the risk for liver cancer. Conditions that cause cirrhosis are alcohol use/abuse, hepatitis B, and hepatitis C.

The causes of liver cancer may be linked to environmental, dietary, or lifestyle factors. For example, in Nov. 2014, researchers at the University of California, San Diego School of Medicine, found that long-term exposure to triclosan, a common ingredient in soaps and detergents, causes liver fibrosis and cancer in laboratory mice. Although triclosan has not been proven to cause human liver cancer, it is currently under scrutiny by the FDA to determine whether it has negative health impacts.

How is liver cancer staged?

According to the American Cancer Society, “The stage of cancer is a description of how widespread it is. The stage of a liver cancer is one of the most important factors in considering treatment options. A staging system is a standard way for the cancer care team to sum up information about how far a cancer has spread. Doctors use staging systems to get an idea about a patient’s prognosis (outlook) and to help determine the most appropriate treatment. There are several staging systems for liver cancer, and not all doctors use the same system.”

Liver biopsy as well as imaging studies help in classifying liver cancer stages as per the American Joint Committee on Cancer (AJCC) TNM system, the Barcelona Clinic Liver Cancer (BCLC) staging system, the Cancer of the Liver Italian Program (CLIP) system, or the Okuda system.

 Treatment for liver cancer

The treatment chosen depends upon how much the cancer has spread and the general health of the liver. For example, the extent of cirrhosis (scarring) of the liver can determine the treatment options for the cancer. Similarly, the spread and extent of spread of cancer beyond the liver tissue plays an important part in the types of treatment options that may be most effective.

Surgery: Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. Surgical options are reserved for smaller sizes of cancer tumors. Complications from surgery may include bleeding (which can be severe), infection, pneumonia, or side effects of anesthesia.

Liver transplant: The doctor replaces the cancerous liver with a healthy liver from another person. It is usually used in very small unresectable (not able to be removed) liver tumors in patients with advanced cirrhosis. Liver transplant surgery may have the same compliations as noted above for surgery. Also, complications from medications related to a liver transplant may include possible rejection of the liver transplant, infection due to suppression of the immune system, high blood pressure, high cholesterol, diabetes, weakening of the kidneys and bones, and an increase in body hair.

Ablation therapy: This is a procedure that can kill cancer cells in the liver without any surgery. The doctor can kill cancer cells using heat, laser, or by injecting a special alcohol or acid directly into the cancer. This technique may be used in palliative care when the cancer is unresectable.

Embolization: Blocking the blood supply to the cancer can be done using a procedure called embolization. This technique uses a catheter to inject particles or beads that can block blood vessels that feed the cancer. Starving the cancer of the blood supply prevents the growth of the cancer. This technique is usually used on patients with large liver cancer for palliation. Complications of embolization include fever, abdominal pain, nausea, and vomiting.

Radiation therapy: Radiation uses high-energy rays directed to the cancer to kill cancer cells. Normal liver cells are also very sensitive to radiation. Complications of radiation therapy include skin irritation near the treatment site, fatigue, nausea, and vomiting.

Chemotherapy: Chemotherapy uses a medicine that kills cancer cells. The medicine can be given by mouth or by injecting it into a vein or artery feeding the liver. People can have a variety of side effects from chemotherapy, depending on the medications used and the patient’s individual response. Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhea, and mouth sores. These side effects are usually temporary.

Targeted Agent: Sorafenib (Nexavar) is an oral medication that can prolong survival (up to 3 months) in patients with advanced liver cancer. Side effects of sorafenib (Nexavar) include fatigue, rash, high blood pressure, sores on the hands and feet, and loss of appetite.

How to follow-up after receiving  treatment for liver cancer

Patients are advised to follow up with the doctor for lab tests and office visits. Patients with chronic liver disease should avoid alcohol and any drugs that can harm the liver. Patients with liver transplants will need to take antirejection drugs for the rest of their life to prevent their body from rejecting the new liver.

What is the prognosis of liver cancer? What are the survival rates for liver cancer?

The prognosis for liver cancer depends on multiple factors such as the size of the liver cancer, the number of lesions, the presence of spread beyond the liver, the health of the surrounding liver tissue, and the general health of the patient. Life expectancy depends on many factors that impact whether a cancer is curable.

The American Cancer Society states the overall 5-year survival rate for all stages of liver cancer is 15%. One of the reasons for this low survival rate is that many people with liver cancer also have other underlying medical conditions such as cirrhosis. However, the 5-year survival rate can vary depending on how much the liver cancer has spread.

If the liver cancer is localized (confined to the liver), the 5-year survival rate is 28%. If the liver cancer is regional (has grown into nearby organs), the 5-year survival rate is 7%. Once the liver cancer is distant (spread to distant organs or tissues), the survival time is as low as 2 years.

Survival rate can also be affected by the available treatments. Liver cancers that can be surgically removed have an improved 5-year survival rate of over 50%. When caught in the earliest stages, and the liver is transplanted, the 5-year survival rate can be as high as 70%.

Childhood Cancer

About 50% of patients seeking medical attention in many general hospitals in Nigeria are children and majority of them suffer from preventable diseases.

Previous autopsy study from Lagos revealed that 39.7% of childhood deaths are due to infective causes, only about 3.3% of deaths were attributed to neoplasm

However with improved child survival due to improved immunization against childhood infections and improved management modalities, the role of malignancies in childhood mortality is becoming more apparent.

Earlier studies from Ibadan had also reported remarkable percentage of brain tumours and leukaemias,

Burkitt’s lymphoma (BL) which is strongly associated with malaria, Epstein Barr virus and malnutrition has higher frequency in the southern forest areas compared to the northern savannah areas.

The recent decrease noted in the incidence of BL has been attributed to improved living condition and better malaria control.

While retinoblastoma and nephroblastoma are common under 5years, lymphomas and sarcomas occur in older children.

The challenges of childhood cancers

Probability of second malignancy after irradiation e.g. leukaemias and thyroid cancers;

Unavailability of immunocytochemistry and other modern diagnostic modalities pose diagnostic challenges as many of these tumour histologically appear as small round blue undifferentiated cells on light microscopy;

Poor management outcome due to late presentation, poverty and unavailability of radiotherapy.

Although  >70% of childhood cancer is now curable with best modern therapy, the treatment is expensive and majority of children (80% of world’s children) currently have little or no access to it in economically disadvantaged countries like ours.

References:

Report compiled by Temitope Obayendo, with additional information from Professor’s Fatimah Abdulkareem’s work on: “Epidemiology & Incidence of Common Cancers in Nigeria”; American Cancer Society; WHO; National cancer institute; thenationonlineng;  and emedicinehealth

 

 

Symptoms of Cancer you are likely to ignore

By
Admin
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cancer

While some symptoms of cancer can be rather obvious and deeply concerning, other symptoms can be much less noticeable and alarming. Remedist has listed some nine symptoms of cancer that are not easily diagnosed below;

Chronic Fatigue

Although general fatigue is commonly associated with the daily grind of life, extreme fatigue that doesn’t seem to go away can potentially be a cause for great concern.

According to the American Cancer Society, chronic fatigue, or fatigue that can’t be remedied by sleep, can be a sign of leukemia, colon cancer, or cancer of the stomach. It is worth noting, as a means to avoid fear-mongering, that chronic fatigue or any issue documented in this list is merely a possible symptom of cancer, not a formal diagnosis.

Unexplained Weight Loss

Similar to chronic fatigue, unexplained weight loss can be a serious yet often ignored symptom of cancer.

If you lead a rather active lifestyle, the concept of losing weight without the means of a drastic diet plan probably won’t resonate with you in terms of a legitimate concern. However, that line of thinking can often play a major role as to why this particular symptom has the distinction of being ignored.

If you’re losing weight, even though you’ve maintained your daily living routine, you could be in the early stages of any number of cancers. Esophageal, lung, pancreatic, and stomach cancers often include symptoms of unexplained weight loss. (Source: American Cancer Society)

Pain

While pain can occur due to a variety of reasons, many of which are not serious, long-lasting pain and/or pain that doesn’t go away with the help of basic medication(s) can be a symptom of cancer.

Per the American Cancer Society, sustained back pain can be a sign of colon or ovarian cancer, while a lengthy headache that produces pain for several days without relief can be a sign of brain cancer. Additionally, bone and testicular cancer can often produce aching or sharp pains in the early stages of development.

Pay attention to your body and never dismiss pain that seems to last for days or weeks at a time.

Lumps under the Skin

While lumps under the skin are often associated with breast or testicular cancer, lumps can occur in virtually any soft tissue area of the body regardless of gender.

If you detect the presence of a lump or mass under your skin, your best plan of action is to take action. Discovering a mass in its earliest stage could very well be the key to your physical well-being in the long term.

The University of Texas MD Anderson Cancer Center suggests that you consult your doctor as soon as possible once you discover a problem of this nature. It is important to be naturally self-conscious of your body as a way to detect unusual physical changes.

Swollen Foot

In respect to common cancer symptoms ignored by women, the presence of a swollen foot or leg could potentially be a cause for concern.

According to the University of Texas MD Anderson Cancer Center, swelling in these areas, while accompanied with pain and/or vaginal discharge, could be a sign of cervical cancer.

While a swollen leg has a marginal return in respect to a serious medical condition, it is important to pay attention to your symptoms and never dismiss them, especially if they’re accompanied by other ailments such as discharge or pain.

White Patches in Mouth

Even though this particular ignored symptom of cancer is more notable in men than women, the condition known as leukoplakia is all-encompassing in respect to gender. Frequently associated with all forms of tobacco use according to both the American Cancer Society as well as the University of Texas MD Anderson Cancer Center, leukoplakia is a precancerous condition that is marked by various white patches within the mouth and gums.

Although mouth sores and ulcers are often ignored and dismissed as nothing more than routine irritations, if you’re a regular user of tobacco you need to be mindful of any changes that take place within your mouth.

As noted above, leukoplakia can impact both men and women through smoking, but the condition is found more often in men who abuse cigarettes as well as smokeless tobacco.

Changes on Skin Surface

While skin cancer is unfortunately quite common in our society, the symptoms of skin cancer are all too often ignored.

Brushed aside as a common sunburn or darkened mole, for example, many people dismiss skin cancer symptoms while under the assumption the changes are simply due to natural sun exposure or the unfortunate, yet common, part of the aging process.

In truth, any freckle, mole, or wart that changes its shape or color should garner your full attention. Changes in your skin that are accompanied by excessive itching need to be strongly recognized as well. Various types of skin cancer, including melanoma, can be the cause of these symptoms.

The primary cause of melanoma is sun exposure. In terms of combative efforts, if a patch of skin has changed or a common mole has dramatically shifted in color and size, you’re advised to consult your doctor. (Source: American Cancer Society).

Changes in Bowel Habits

Have you noticed changes in your restroom habits in respect to urination and/or bowel movements? If you’ve found the need to urinate more frequently or less often than before, you could be experiencing an early sign of bladder or prostate cancer.

Per the University of Texas MD Anderson Cancer Center, blood in your urine or stool could also be a symptom of a serious medical condition.

Changes in bowel habits, such as the aforementioned bloody stool or frequent diarrhea can be a sign of colorectal issues.

Prolonged Fever

Although a slight fever can often be ignored and attributed to various minor health issues such as the common cold, a prolonged fever can serve as the warning sign for a potential life-threatening condition.

Many times cancers such as leukemia and lymphoma can impact the immune system in such an aggressive fashion the body attempts to fight off the infection to the point of fever.

The American Cancer Society encourages you to never gloss over a fever that is long-lasting and fails to go away with common remedies.

remedist.net

Infinity Prescription drugs Streamlines their Enterprise with Oracle BI

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Infinity Prescription drugs was challenged with a number of, disparate programs – see how Oracle BI helped get everybody, from executives to division heads, on the identical web page

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Saving Nigerians from incessant Lassa fever deaths

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For the past few weeks, Nigeria has, once again, been confronted with another outbreak of Lassa fever which has killed over 60 people out of 212 suspected cases across 64 local government areas in 17 states of the country. These figures could soon escalate as there are strong indications that the outbreak may claim the lives of more people before it is eventually contained. The Minister of Health, Professor Isaac Adewole, warned that the outbreak could kill up to 1,000 people.

The current outbreak, according to the health minister, was traced to incidences of the disease in August 2015 at Foka Village in Niger State which killed about 17 villagers in quick succession. Sadly, these occurrences were not reported to the appropriate health authorities or the state government for proper containment action because of the villagers’ superstitious beliefs. Prof. Adewole cited this reticence of the villagers as the catalyst behind the current outbreak as it is now difficult to do proper contact tracing of all those who came in contact with the victims of the disease at Foka Village.

Beyond the minister’s observations, however, is a more worrisome issue. The recent outbreak of the disease is only the latest in a string of outbreaks that have become almost an annual occurrence and resulting in needless deaths. According to the WHO, Lassa fever, an infectious disease which virus was first identified in 1969 in a town called Lassa in the present day Borno State, is an endemic disease in West Africa, and it kills about 5000 people annually.

Considering how much knowledge is available on the preventive measures and treatment options for this disease, it is quite sad and unacceptable that Nigeria loses hundreds of her citizens to this condition annually. Indeed, it is inexcusable that rather than being proactive in preventing such incidents, as well as providing a standard template for ensuring a swift and well-coordinated response in the unfortunate event of an outbreak, Nigeria’s reaction to this particular outbreak has been so dismal and disjointed. This is unacceptable.

A glaring testament to the nation’s ill-preparedness for the disease was the belated decision of the health minister to hurriedly convey an emergency National Council on Health (NCH) meeting which he said was aimed at facilitating discussions on the control of the Lassa fever outbreak and developing strategies for prevention and management of all cases in Nigeria. This was after over 40 people had died. Again, this is lamentable.

While the minister’s intention in itself was laudable, the timing was unjustifiably poor. It is our belief that considering the fact that Lassa fever is not a new disease like Ebola, this meeting should have been held long before now.

A nation as diverse as Nigeria should have a national response strategy for disease outbreak which should be automatically activated once there is an outbreak of a highly infectious disease like Lassa fever. It is imperative to strengthen the nation’s National Centre for Disease Control to ensure this important agency is able to deliver on its mandate of helping to prevent disease outbreaks and needless deaths of Nigerians from conditions like Lassa fever that are preventable and treatable.

It is also important that Nigerians themselves are orientated to pay more attention to disease prevention. The health ministry must leave no stone unturned in ensuring that Nigerians are enlightened about strategies to adopt to prevent diseases because prevention is cheaper and better than cure. For Lassa fever, which is caused primarily by exposure to infected multimammate rats (the main vector) that can contaminate food and household utensils through their urine and faeces, it is imperative to educate Nigerians that the improved personal hygiene measures that served the nation so well during the Ebola virus disease outbreak should not be discarded.

Nigerians should also be enlightened that environmental fumigation to get rid of rats and other pests will help in preventing Lassa fever and other diseases, while prompt and proper treatment of those infected can go a long way in preventing further infection of other people through bodily fluids of infected patients. Health care givers should also take precautions when tending to patients to avoid getting infected inadvertently.

The good news is that unlike Ebola, Lassa fever can be treated as there are antibiotics that have proven effective in its treatment. Most importantly, however, the Nigerian nation must take adequate steps that will ensure that we do not have Lassa fever outbreak again in the country because it is possible.

 

2015 IN RETROSPECT

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IMG-20151229-WA00041

JANUARY

*Former PCN registrar, Dr. Ahmed Tijjani Mora (Wakilin Maganin Zazzau) gave out his daughter, Fai’zah Ahmed Mora, a Law graduate from ABU, Zaria, in marriage to her heartthrob, Mallam Muhammad Bello Abdulkareem, a lecturer with the Nasarawa State University on 3 January at the family house in Tudun Wada, Zaria.

*GlaxoSmithKline (Consumer) Nigeria Plc unveiled two new brands – Scott’s Emulsion Cod Liver Oil and Panadol Suspension for Children at Oriental Hotel, Victoria Island, Lagos on 15 January.

*Prof. Abayomi Sofowora, former Chairman of WHO Regional Expert Committee on Traditional Medicine died on 22 January after a brief illness.

*The Nigerian Academy of Science (NAS) held a public lecture at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, on 28 January.

 

FEBRUARY

*The 15th Annual Health Week of the Pharmaceutical Association of Nigeria Students (PANS), Olabisi Onabanjo University (OOU) took place at the main auditorium of the College of Health Sciences, Ogun State, on 17 February.

*Nigerian Association of Pharmacists in Academia (NAPA), Lagos branch held its maiden edition of practice grand rounds at Faculty of Pharmacy University of Lagos (UNILAG) on 27 February.

*Pharm. (Mrs) Abiola Paul-Ozieh was elected chairman of the Association of Community Pharmacists of Nigeria (ACPN), Lagos branch at the Pharmacy Villa, Ojota on 25 February.

 

MARCH

*The 2nd Annual Alumni Lecture of the Faculty of Pharmacy, University of Lagos (UNILAG), took place at the main auditorium of the institution in Akoka, on 3 March.

*The Faculty of Pharmacy, University of Lagos (UNILAG) inducted 138 graduands on its Akoka campus on 5 March.

*Pharm. Linda Chidinma Okeke was announced winner of the maiden edition of the prestigious Bowl of Hygeia award in Nigeria during the induction and oath-taking ceremony of 138 graduates of the Faculty of Pharmacy, University of Lagos (UNILAG) on 5 March.

*The 2nd Annual ‘White Coat’ ceremony of 175 pharmacy undergraduates was held by the Faculty of Pharmacy, University of Lagos (UNILAG) at the school auditorium on 13 March.

*The 80th birthday celebration of pioneer pharmacologist and former Vice-Chancellor of Ahmadu Bello University (ABU), Zaria, Professor Gabriel Ediale Osuide, was marked at the Civic Centre, Victoria Island, Lagos on 15 March.

*Pharm. Dahiru Wali, a Fellow of the Pharmaceutical Society of Nigeria (FPSN), officially donated 60 volumes of pharmacy textbooks and journals to the Faculty of Pharmaceutical Sciences, Kaduna State University (KASU) on 23 March.

*The Induction/Oath-taking ceremony of the Faculty of Pharmacy, University of Benin (UNIBEN) took place at 25 March.

 

APRIL

*Nigeria Academy of Pharmacy (NAPharm.) in collaboration with the Pharmaceutical Society of Nigeria (PSN) and the Pharmacists Council of Nigeria (PCN) held a three-day education summit at the University of Lagos Conference and Guests Centre, Akoka on 22 – 24 April.

*SKG Pharma Limited had its annual Trade Partners Conference and Awards at the De-Renaissance Hotel, Ikeja, Lagos, on 23 April.

*Faculty of Pharmacy, University of Ibadan (UI), celebrated its maiden edition of the White Coat/Orientation Ceremony for 100 to 500 levels students on 29 April at the institution’s auditorium.

 

MAY

*Faculty of Pharmacy, Obafemi Awolowo University (OAU) held its annual Prof. Marquis Memorial Lecture at the institution on 6 May.

*The 28th induction and oath-taking ceremony was conducted for the 2013/2014 set of University of Ibadan’s (UI) pharmacy graduands on 14 May 2015 at the Trenchard Hall, Ibadan.

*The Pharmacy Estate located in Eguru Village, Ogun State, was officially commissioned on 30 May by the President of the Pharmaceutical Society of Nigeria (PSN), Pharm. Olumide Akintayo.

*The 34th edition of the Annual National Conference of the Association of Community Pharmacists of Nigeria (ACPN) was held from 31 May to 5 June, 2015, in Akure, Ondo State.

 

JUNE

*The Association of Community Pharmacists of Nigeria (ACPN) hosted its 32nd Annual National Conference at the Cultural Centre in Calabar, Cross River State from 3 to 7 June.

*Ranbaxy Nigeria Limited (A Sun Pharma Company) held its 12th Annual Distributors’ Reward Function at African Sun Hotel, GRA, Ikeja Lagos on 16 June.

*Sanofi Nigeria introduced a new antihypertensive product, Aprovasc, at Oriental Hotel, Victoria Island, Lagos, Lagos State University Teaching Hospital (LASUTH) on 17 June.

*The duo of Pharm. (Sir) Ifeanyi Atueyi, managing director of Pharmanews Limited and Olorogun (Dr) Sonny Kuku, co-founder, Eko Hospital Plc, were decorated with Lifetime Achievement Award by Nigerian Healthcare Excellence Award (NHEA) at Eko Hotel & Suites, Victoria Island, Lagos on 26 June.

*A three-day grand health bazaar was held by LiveWell Initiative at Grace Garden Events Centre, Lekki Phase 1, Lagos, on 30 June.

*The 27th Annual General Meeting (AGM) and scientific symposium of the West African Postgraduate College of Pharmacists (WAPCP) was held Welcome Centre Hotel, Lagos from 29 June – 2 July.

 

JULY

*Pharm (Sir) Ifeanyi Atueyi and Pharm. Aloysius Anieke were both decorated with the Pharmacy Legend award during the 36th annual Pharmacy health week organised by the UNIBEN chapter of the Pharmaceutical Association of Nigeria Students (PANS) on 7 July.

*Five pharmacists – Pharm. Chukwuemeka Obi, Pharm Chris Iyare, Dr. Collins Aireminen, Prof. Ehijie Enato and Dr. Patrick Igbinaduwa were each honoured with Pa E. A. Osadolor Merit Award during the 36th annual Pharmacy health week organised by the UNIBEN chapter of Pharmaceutical Association of Nigeria Students (PANS) on 7 July.

*The 2nd annual Sir Ifeanyi Atueyi National Essay & Debate Competition, organised by the Pharmaceutical Association of Nigeria Student (PANS), held on 9 July at the University of Benin (UNIBEN).

*The 2015 PSN Board of Fellows (BOF) mid-year meeting and dinner held on 29 July, 2015 at Diplomat Hotel, Maryland, Lagos.

 

AUGUST

*Dortemag Pharmaceutical Ventures in conjunction with its Malaysia-based partner, Kotra Pharmaceuticals, held its 2015 annual Infectious Disease Forum at Lagos Airport Hotel, on 5 August.

*Pharm. (Mrs) Marcelina Onasanya, a Fellow of the Pharmaceutical Society of Nigeria (FPSN), was honoured with the prestigious Retail Pharmacy Legend Award at the 7th edition of The Panel business summit organised by Pharmalliance on 11 August at the Sheraton Hotel and Suites, Ikeja, Lagos.

*The 2015 Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) Day was marked at the Lagos University Teaching Hospital (LUTH) on 12 August.

*The death of Pharm (Chief) Timothy Adebutu, managing director of Gem Pharmacy Surulere, Lagos, was announced on 13 August.

*Pharm. (Dr) Ahmed Tijjani Mora, former registrar of the Pharmacists Council of Nigeria (PCN) was elected national president of the Ahmadu Bello University (ABU) Alumni Association during the 10th Annual General Assembly of the association on 14 August.

*The Pharmaceutical Society of Nigeria (PSN), Lagos Chapter held 2015 Pharmacy Week on 14 August, at the Welcome Event Centre, Lagos.

*The Nigerian Association of Pharmacists in Academia (NAPA) UNILAG branch’s annual one-day symposium held at the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos on 14 August.

*PCN, BOF, PMG-MAN, others lauded Mazi Sam Ohuabunwa, former Chief Executive Officer of Neimeth Pharmaceuticals Plc during his 65th birthday celebration at Sheba Events Centre, Ikeja, Lagos on 17 August.

 

SEPTEMBER

*Roche Nigeria sponsored 15 Nigerian health journalists drawn from the print, broadcast and new media through an academy in partnership with the School of Media and Communication (SMC) at the Pan-Atlantic University, Ibeju-Lekki, Lagos from 1-4   September.

*Prince Julius Adelusi-Adeluyi won THISDAY Lifetime Achievement Award at the 20th annual award anniversary ceremony of the Newspaper outfit held at Eko Hotel and Suite on 6 September.

*The 3rd Nigeria Pharma Manufacturers Expo organised by GPE Pharma Exhibitors in collaboration with Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) took place at The Haven, on 7 September.

*The Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) elected Dr Nkere Ebube as its new president during its 2015 Annual Scientific Conference and Exposition in Detroit, Michigan from 17 – 20 September.

*The 75th International Pharmaceutical Federation (FIP) World Congress of Pharmacy and Pharmaceutical Sciences held in Dusseldorf, Germany, from 29 September to 3 October.

*The 2015 annual health week of the Pharmaceutical Association of Nigerian Students (PANS), UNILAG Chapter held at Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos on 29 September.

 

OCTOBER

*Pharm. Seun Omobo made history as the first African to emerge chairperson of the International Pharmaceutical Federation–Young Pharmacists’ Group (FIP-YPG) during the FIP Annual Congress in Dusseldorf, Germany on 3 October.

*The 2015 edition of the Medic West Africa Exhibition and Congress (MWA) took place from 14 – 16 October at the Eko Convention Centre, Lagos.

 

NOVEMBER

*The 2015 Annual National Conference of the Pharmaceutical Society of Nigeria (PSN) held at International Conference Centre, Abuja from 9 to 13 November.

*Pharm. Folashade Lawal, a distinguished community pharmacist was announced winner of the 2015 edition of the May & Baker Professional Service Award in Pharmacy during the 88th PSN Conference at International Conference Centre, Abuja on 11 November.

*For the second consecutive time, Pharmanews has clinched the 2015 edition of the annual Global Quality Excellence Award held at Nicon Luxury Hotel, Abuja on November 12

*Pharmanews, Channels TV, eight others bagged different categories at the 2015 Media Health Award which took place at R & A City Hotel, Ikeja, Lagos on November 19

*Neimeth International Pharmaceuticals Plc announced the appointment of Pharm. (Mrs) Ebere Igboko Ekpunobi to replace the retired Pharm. Emmanuel Ekunno as acting managing director and chief executive officer on 23 November.

*Pharm. Regina Ezenwa’s not-for-profit organisation, Roses Ministry celebrated its Widows Day at National Population Commission (NPC) secretariat in Surulere, Lagos, on 26 November.

*Dr Poly Emenike, managing director of Neros Pharmaceuticals celebrated his 60th birthday at the Landmark Centre, Victoria Island, Lagos on 28 November.

*The 2015 NAFDAC SummEx Summit & Exhibition with the theme “Exceeding Industry Baseline” held at Muson Centre, Onikan, Lagos on 30 November.

 

DECEMBER

*Emzor Pharmaceuticals’ annual thanksgiving party took place at City Hall, Lagos Island, on 5 December.

*The Association of Community Pharmacists of Nigeria (ACPN), Lagos branch held its continuing education conference at NECA House in Agidingbi area of Lagos on 10

 

Popoola reveals ageing effects on Fellows

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Untitled

Chairman, Board of Fellows (BOF) of the Pharmaceutical Society of Nigeria, Pharm. Israel Adesanmi Popoola is a man virtually every pharmacist in the country wants to identify with, and rightly so.  Aside being managing director of Reals Pharmaceuticals, his charismatic nature and professional handling of affairs among Fellows has been quite remarkable. In this interview with Adebayo Folorunsho-Francis, the pharmacist reveals the intricacies of running a board of senior citizens of the profession, and the attributes he hopes to see in the new PSN leadership. Excerpts:

Three years after your election as BOF chairman, how would you describe the journey so far?

Well, the journey has been smooth. Over the years I have interacted with the board at the executive level. I used to be   secretary of the Board, so I was familiar with the relationship and interface of issues between BOF and the Pharmaceutical Society of Nigeria (PSN). Sometimes it is often challenging. But thank God that in the past two to three years, I have had a wonderful relationship with the president of the PSN.

I am happy that the National Executive Committee (NEC) and the council have had a smooth relationship, too. I have been able to resolve issues surrounding the pharmacy profession as a whole which was one of the primary assignments given to the Board – to ensure a smoother relationship within the profession. We have been able to achieve that in our tenure. In the last three years, I have become more mature in the way I handle issues. Prior to becoming chairman, I would have handled some issues differently. Now I know every statement I make or every move I make might be misinterpreted; so I am always careful. So I will say it has been a good time for me.

 Have you been able to meet the objectives you set out to achieve at the beginning of your tenure?

Basically in the last three years, I have been able to engage all stakeholders. When I came in, there were several areas of conflict. The issues on ground were so many that we had to bring in other elders to resolve them. It was at the time that the pharmacy advisory board was set up. In fact, the advisory board had to wade in to assist me. After one year, things became normal again. That was how we were able to now move the profession forward which was in line with my set objectives. I had resolved within myself that during my tenure, I would not be having conflict at the top. The other is to resolve the conflict within the board that might affect leadership. That objective, I believe, has been achieved.

What about the objective of repositioning the pharmacy profession you mentioned during our last interview?

Yes, I remember saying that. You know, when you have conflicts, it is two steps forward and one step backward. But when there is no conflict, everybody will pull in the same direction. Honestly in the last two years, Pharmacy has been pulling in the same direction which has helped us to get the current council in place. I thank God that all the issues that came up, we were able to resolve amicably. Pharmacy as a profession is very strong now. You cannot take away those who will still remain disgruntled.  People will always have issues, but as they come up, we will always resolve them. That is what makes the world to move forward.

Has the issue of funding improved?

Funny enough, I found out that we actually had money. But the money was with our members. So what I did was to say “No! Any member who has not paid for some time will be delisted.” And it worked wonders!

In terms of attendance and support of Fellows, you once said that it was not more than 40 per cent. Has it improved?

Well, what we have done is to bring up activities to stimulate the interest of Fellows. We also engaged them through communication. We also made the chapters to be vibrant. Once the charpter is vibrant, it throws people in the centre for attendance and meetings.  I can confidently say that, at the last conference, we had the best attendance so far. The attendance at the midyear was superb and the one at the general meeting was fantastic. It was one of the best we had ever had as a board. We have moved above 40 per cent.

That notwithstanding, what I have found out in the last few years is that the Fellows are ageing. And when people age, there is this challenge of mobility. What we discovered is that age has slowed down several Fellows and they are not able to attend meetings. What we do is that we use the chapter to reach out to them. We have given out money and other forms of support to others.

The late (Chief) Timothy Adebutu, managing director of Gem Pharmacy, once lamented about being deprived of fellowship despite his age and contribution to Pharmacy. Is there no consideration for this set of people?

The board does not confer fellowship on pharmacists. It is the responsiblity of the PSN through the recommendation of its branches and committees. The person we are talking about, I will confess, I was just hearing about him for the first time in my life through his obituary where they wrote MPSN and aged 80-something years. I kept wondering: How could someone be that advanced in age and I had been actively around for close to 30-something years in Pharmacy and never heard of that name?

He had not been actively participating in the activities of the profession. With due respect, the fellowship recognises your contribution to the profession, the society at large and your impact to Pharmacy. I don’t know what transpired in the last years before I became active in the pharmacy profession. But the truth is that I had not heard of his name.

My decision to study Pharmacy was circumstantial – former PCN Chairman

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Untitled

Until its dissolution in July 2015, Pharm. Bruno Nwankwo was chairman of the Pharmacists Council of Nigeria (PCN). A native of Umuabiama village, Ajali, Anambra State the pharmacist was educated at Government Secondary School, Owerri. He graduated from the Nigerian College of Arts, Science and Technology, first with a diploma in 1963 and followed it up with B.Pharm from the University of Ife in 1966. In this interview with Adebayo Folorunsho-Francis, Nwankwo bares his mind on the journey so far and why he thinks pharmacists need to upgrade.

Tell us briefly about your work experience

I worked briefly in research before the Nigerian Civil War started. I worked at the General Hospital, Enugu, and also rendered some war services. After the war, I went back to the Ministry of Health in Enugu, before I joined Ciba Geigy in August 1970 as medical representative and, later, head of division, executive director and chairman. I was with them until 1992 when I retired.

Can we say your official work experience started in the hospital?

To some extent, yes. I had a chequered career. After my diploma, I started working immediately with Lagos Island Maternity, a general hospital committed to the health of women. But after one year, I joined a small pharmaceutical company (Arco) as a medical representative. Then in 1965, we (those with diploma) went back to the university for a one-year programme (Part 3) of the B.Pharm.  My journey to the general hospital in Enugu was a war-time affair where everybody had to go.

Whose decision was it for you to study Pharmacy?

It was a personal decision but a circumstantial one, though. Like every other young man in my day, I had my eye on Medicine since we were Biology or science-inclined. In my second year A Level at Nigerian College, Enugu, it turned out that the government announced that there would be no scholarship to study medicine. However there was a scholarship to study Pharmacy. Therefore, I had to make a switch. That was why I mentioned earlier that it was circumstantial.

 In retrospect, did you regret taking that step?

I don’t think so. It has been challenging, not quite as rewarding as one had earlier hoped. But I don’t regret because that is where I find myself.

How would you rate today’s practice compared to your time?

Pharmacy practice in our day was probably not as advanced and evolving as it is today. You will get  more contents in the practice today. There is also more technology now unlike when we came out. Again, the practitioners have evolved in line with best practices outside and improved in competence and technology.

There are complaints that most pharmacists are not meeting up with expected standard. Why is that?

I will say less commitment. Most pharmacists are largely less committed. Job satisfaction, to some extent, is also less. I view it from two points. First is that the reward system is not as good as one will expect. But again, the professionalism is not there because many of the Fellows today want to be more than one thing at the same time. They are not developing themselves as required by the demand of the patient or demand of the products. The pharmacopoeia in our day was very limited. Therefore, it was easy for us to know everything that we needed to know. But today, the array is so wide that you need to work extra hard to know what the various products are, their merits and demerits, where they can be better than others and where they are not as good as others so that you can be of service to the patients and the doctors. It is only then you can say, “Doctor, it is advisable to use this formulation” and so on. Today’s pharmacists are not necessarily on board because of their lack of dedication. They are always trying to do more than one thing almost at the same time. They want to be called a pharmacist and want to be called a contractor at the same time. And they are not there to do the job they present themselves to do. So there is that constraint.

How best can the perennial problem of drug counterfeiting be curbed?

Public enlightenment is one thing. Knowledge by the pharmacist himself is another thing. He must be competent in recognising the tell-tale signs of fake drugs. He must also be competent in terms of advising the not-so-literate patients on what to do. Information is important from the point of view of the patient.

There is nowhere in the world that is free of counterfeiting. It is a matter of relativity. At a point in time, it was rampant in Nigeria. We have not been able to wash away that slur off the character of the Nigerian pharmaceutical market. But a lot has been done in terms of creating awareness, technology for identification, pharmacovigilance and reporting.

We must acknowledge that we have come a long way. More can still be done by reducing counterfeiting further through public enlightenment and, of course, through economic empowerment. This is because many of the people who patronise fake drugs do so out of poverty. During one of our meetings at the last PSN conference in Abuja, a patient was said to have been shown two products – one fake, the other genuine. Having been briefed about their nature and prices, he was asked which one he would go for. The patient still ended up choosing the fake because it was what he could afford. It is a hydra-headed monster.

What is your view about pharmacists in politics?

Great. Although I cannot go myself because I cannot really face what it takes. For me, it is a rugged terrain which I am not cut out for. But certainly, politics rules the world and we cannot get what we need except we are politically well-placed.

How active are you especially in pharmaceutical activities?

I think I have been there right from my student days. I was president of PANS in my time. My association with Pharmacy and the struggles of Pharmacy date back to my student days. When I came out after the war, I was assistant national secretary for two years. I’ve been involved in projecting pharmacy interest within the industry, mentoring the young ones, getting involved in continuing education in Pharmacy through presentation of papers at workshops, colloquiums and others. I think I have done the bit I could. Even as a Fellow of the Society, I was the past chairman of the Board of Fellows.

Are there some honours or awards to show for your selfless services?

I am a Fellow of the PSN, Fellow of WAPCP, Fellow of NAPharm. etc. Most of the awards I can have as a pharmacist in Nigeria, I already have and I am proud of them.

If you were to choose another profession outside Pharmacy, what would it be?

As I said earlier, I wanted to be a doctor. Maybe I would have turned out to be one. I have not thought of veering into any other profession outside.

What is your advice to young pharmacists looking up to you?

Commitment and dedicated service to your profession and the patient is important. They should also work for self-fulfilment.

Iykmavian Pharmacy, 26 others win Reload 2015 Promo

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– As ACPN lauds PharmacyPlus on initiative

L-R: Pharm Ogheneochuko Omaruaye, managing director of New Heights Pharmaceuticals; Pharm. Abiola Paul-Ozieh, Lagos ACPN chairman; Pharm. Chukwuemeka Obi, chief operating officer of PharmacyPlus Limited; Omotunde Adebowale David (Lolo 1), ace broadcaster of Wazobia FM, and Pharm. Joseph James, marketing manager of the company.
L-R: Pharm Ogheneochuko Omaruaye, managing director of New Heights Pharmaceuticals; Pharm. Abiola Paul-Ozieh, Lagos ACPN chairman; Pharm. Chukwuemeka Obi, chief operating officer of PharmacyPlus Limited; Omotunde Adebowale David (Lolo 1), ace broadcaster of Wazobia FM, and Pharm. Joseph James, marketing manager of the company.

 The maiden edition of Reload Multivitamin Win-Win Promo has produced 27 winners out of 250 community pharmacies in the retail segment of the Nigerian pharmaceutical market who participated in the event.

The glitzy raffle draw, which was organised by PharmacyPlus Limited on 23 December 2015 at Protea Hotel, Ikeja, Lagos, saw Iykmavian Pharmacy emerge winner of the much coveted grand prize of an all-expense paid 5-day trip to Dubai, while 26 others clinched the remaining prizes of ten electric irons, two 32-inch plasma television sets, two home theatre systems, ten ceiling fans, two units of refrigerators and one air conditioner.

In his welcome address, Pharm. Chukwuemeka Obi, chief operating officer of PharmacyPlus Limited, explained that the promotion which started early last September was a way of giving back to Reload multivitamin retailers who had been exceptionally loyal to the company.

“We have achieved our objective of rewarding those partners that we consider key stakeholders in building the reward brand in our society towards improving the health of the consumers. They have helped put the brand in the marketplace, reach out to Reload customers on our behalf, which is the whole essence of the raffle draw,” he said.

Buttressing his view, Pharm Joseph James, marketing manager of the company, further emphasised the importance of multivitamins in the day-to-day lifestyle of Nigerians.

“We live in a very stressful environment. And looking at our eating habits, there is possibly no way we can get all our daily nutrition requirements from the food we eat, except through multivitamins. Most times too, we encourage nursing mothers to take Reload multivitamin because we understand that many don’t usually breastfeed babies for 1,000 days. However, with continuous use of Reload, there is no cause for alarm,” he reassured.

While expressing appreciation on behalf of retail pharmacists, Pharm. Abiola Paul-Ozieh, chairman of the Lagos branch of Association of Community Pharmacists of Nigeria (ACPN), commended PharmacyPlus for engaging the retailers, as well as rewarding them for supporting the Reload brand.

Paul-Ozieh who was the special guest of honour at the draw recalled that the first time she saw the Reload range of multivitamin, was at a programme organised by New Heights Pharmaceuticals in Lagos.

“Let me reiterate how impressed I am with PharmacyPlus. To succeed in business, a good entrepreneur is expected to find a need and fill the void. That is exactly what this company has done! It started with Alphabetic (later Alphabetic Plus) and now Reload, a product, which I believe, is less than four years old in Nigeria. And here we are today celebrating both retail pharmacists and Reload multivitamin,” she enthused.

The Reload multivitamin range of products has been developed as food supplements to make up for vitamins and mineral deficit. It contains 24 fruits and vegetables. Products in the range include: Reload Men’s formula, Reload Men’s 50+ Formula, Reload Women’s Formula, Reload Women’s 50+ Formulas, Reload Extra formula, Reload Immunity Formula, Reload 4 Kids Tablet and Reload 4 Kids Syrup.

Dignitaries who attended the event include Omotunde Adebowale David (Lolo 1), ace broadcaster of Wazobia FM; Mr Peter Inukwe, chief operating officer of Greenmeans Healthcare; Pharm Ogheneochuko Omaruaye, managing director of New Heights Pharmaceuticals Limited and staff of PharmacyPlus Limited.

Stakeholders charge community pharmacists to maximise opportunities

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…As Lagos ACPN holds continuing education programme

L-R, Pharm. Ike Ugwu, keynote speaker; Prof. Bola Sylva, dean, Faculty of Pharmacy, UNILAG and Pharm. Abiola Paul-Ozieh, chairman, ACPN, Lagos Chapter, at the Continuing Education Conference organised by the Association of Community Pharmacists of Nigeria (ACPN), Lagos State Branch, at NECA House, Alausa Ikeja, Lagos
L-R, Pharm. Ike Ugwu, keynote speaker; Prof. Bola Sylva, dean, Faculty of Pharmacy, UNILAG and Pharm. Abiola Paul-Ozieh, chairman, ACPN, Lagos Chapter, at the Continuing Education Conference organised by the Association of Community Pharmacists of Nigeria (ACPN), Lagos State Branch, at NECA House, Alausa Ikeja, Lagos

Stakeholders in the pharmaceutical profession, including Pharm Ike Ugwu, chief executive director, Pharmacare Support Group, have said that for the profession to attain enviable and fulfilling heights, pharmacists in the country must acquaint themselves with new opportunities and make the best use of them.

Pharm. Ugwu, who is a Fellow of the Pharmaceutical Society of Nigeria (FPSN) and the Nigeria Academy of Pharmacy (FNAPharm) made his submission while delivering a keynote address on the topic, “Positioning Community Pharmacists for Evolving Opportunities”, at the Continuing Education Conference organised by the Association of Community Pharmacists of Nigeria (ACPN), Lagos State Branch, at NECA House, Alausa Ikeja, Lagos, last December.

The revered pharmacist stated that many pharmacists are not quick to recognise opportunities and some who do don’t make judicious use of them.

Speaking further, Ugwu noted that over the past 40 to 50 years, the role of the pharmacist has evolved from provision of drugs and information to patient care, adding that pharmacy as a profession has come a long way and must continue to advance.

“I want to advise you to always strive to be the best pharmacist in your community so that when people are looking for the best they think about you first,” he said.

Ugwu also emphasised the need for thorough preparation   and personal development, as these not only help to maximize opportunities but also to cope with challenges and competition.

He said: “I was amazed when I learnt people were afraid of chain pharmacies coming to the country and I asked, are Medplus and Healthplus pharmacies not chain or is it because they are run by pharmacists? I have said it time without number that we should not be afraid of anything, provided we have our own home work and prepare well.”

Using his own example, he added that pharmacists must not become complacent after opening one or two pharmacies.

“I made a similar mistake when I started out in Festac area of Lagos State and I stopped expanding after opening my second pharmacy as I was contented that I had got it all; but today, close to 100 pharmacies have taken over Festac Town. So do not stop expanding and ensure you plan very well ahead of any of your steps,” he advised

Speaking in the same vein, Prof. Bola Sylva, dean, Faculty of Pharmacy, University of Lagos (UNILAG), who was also chairman of the occasion, stated that the opportunities in Pharmacy are numerous, adding that all a practitioner needs to do is to be mentally ready for the opportunities and be ready to tap into them.

While speaking with journalists at the event, chairman of ACPN Lagos, Pharm. (Mrs) Abiola Paul-Ozieh said the conference was designed to ensure members of the association were not left out in the scheme of things even as the world keeps developing every day.

“I want to believe there many of us who have not heard about some new opportunities in the practice and it is our responsibility to open their eyes to them. So, what we aim to do basically is to look at how to improve our practice, using technological means – for example, we now have electronic means of doing business and so many other technological improvements,” she said.

Speaking further, Pharm. Paul-Ozieh disclosed that the Continuous Education Conference programme in Lagos had been held consistently over the years because of the importance that the Lagos ACPN places on knowledge and effective service delivery.

“In recent times, we included motivational talks, such that pharmacists can have some personal developmental tips on how to improve themselves, how to improve their practice and how to improve their businesses. This is essentially a capacity-building programme for community pharmacists.”

Other dignitaries at the event included: Pharm. Deji Osinoiki, former national chairman of ACPN; Pharm. Albert Kelong Alkali, current national chairman, ACPN; Pharm. Ahmed Yakasai, president, PSN, represented by Pharm. (Mrs) Uzamat Akinbile-Yusuf, Hon Commissioner for Youth and Social Development who was also the guest of hounour; Pharm. N.A.E Mohammed, registrar, PCN, represented by Pharm. Augustine C. Ezeugwu; Pharm. Gbenga Olubowale, chairman, PSN, Lagos State; Pharm. Gbenga Falabi; Pharm. Folashade Lawal, among others.

Determining a mutual mistake in a transaction

By
Dozie David
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Dr Peterside plans to establish a private hospital in Port Harcourt. For this purpose, he contacts the estate agent for Garden City Complex, which has available facilities in Blocks A, B and C. After careful examination of the premises, the doctor settles for the ground floor of Block B.

A lease agreement is drawn up and sent to Dr Peterside for signing and payment of the fees due. The document contains the terms of agreement including the annual rent, caution deposit, a 10 per cent charge for agency fees and another 10 per cent for legal fees. The document does not specify the tenure of the lease.

On presentation of a cheque for payment, a dispute arises between Dr Peterside and the estate agent. The doctor has written a cheque to cover one year’s rent and additional charges, as determined by the lease. However, the estate agent had been expecting the initial payment to cover two years’ rent, as is the custom of lease agreements in Port Harcourt. He explains that the whole transaction was premised on the anticipation of two years’ rent and presents receipts of payments for other tenants, to support his position. The estate agent demands that Dr Peterside pay the rent for two years or forfeit the lease.

In this scenario, what is the legal position of the parties concerning the mistake made in the transaction?

As previously discussed, there are three classes of mistake in law: a) Common mistake; b) mutual mistake; and c) unilateral mistake. The subject of the above scenario is mutual mistake. When one party makes to the other an offer which is accepted in a fundamentally different sense from that intended by the offeror, it is classified as a mutual mistake.

The legal issues to be addressed are:

  1. How is a mutual mistake determined in law?
  2. The effect of a mutual mistake in a transaction.

The general rule, as applied in the case of Wood v. Scarth, is that where the occurrence of a mutual mistake is established, the contract will be void. This is because there is no correspondence between the offer and acceptance. There is no consensus ad idem (meeting of minds). In determining the existence of a mutual mistake, the court adopts an objective test. The conduct of the parties and all relevant documents and transactions are considered. If they all point to the existence of a contract, as alleged by one of the parties, the court will enforce the contract on those terms, irrespective of the motive or subjective intention of the parties. The court bases its decision on the external appearance of things and ignores all subjective factors.

If, on the other hand, all these external factors do not point to the existence of one contract, but to two or more possible interpretations of what transpired between the parties, then there can be no contract. The agreement will be void for mutual mistake.

In this matter with Dr Peterside and the estate agent, a transaction was made for the lease of property in Port Harcourt. According to the expectation of the estate agent, the lease should run for an initial period of two years. This would translate to the payment of two years’ rent by Dr Peterside for the property. The doctor, on his part, had made no commitment to pay the rent for two years upfront. Indeed, his plan was to pay the annual rent with additional charges and so, a cheque for that amount was made available.

The argument of the estate agent is that the practice of two years’ lease is common in the city of Port Harcourt. Proof of this is provided by the presentation of receipts of payments for other tenants, who apparently had paid in advance for two years. In view of this, it is not doubtful that the estate agent had the expectation of concluding a two-year lease. Nevertheless, the rule regarding mutual mistake requires the application of an objective test. In this situation, there must be an examination of the document of transaction.

The lease of agreement between the parties is specific on the terms of transaction. This lease stipulates the annual rent, caution deposit, a 10 per cent charge for agency fees and another 10 per cent for legal fees, but fails to mention the duration of tenancy and the number of years required to be contracted for.

In the similar case of Wood v. Scarth, the defendant offered in writing to let a public house to the plaintiff for 63 pounds per annum and the plaintiff, after an interview with the defendant’s clerk, accepted the letter. The defendant intended that a premium of 500 pounds be included, but this was neither mentioned in the letter of offer nor by his clerk in the interview. The plaintiff, on his part, believed that his obligations were limited to 63 pounds per year.

When the defendant refused to execute the lease agreement, the plaintiff brought an action for specific performance and the defendant raised the defence of mistake. It was held by the court that there was no mistake at law. No reasonable man, looking at what had transpired between the parties, would have interpreted the agreement to mean anything other than that it was a simple lease agreement for 63 pounds per annum.

In applying this rule, the lease of Dr Peterside does not, in any way, bind him to a contract of two years and subsequently, the payment of two years’ rent. It is therefore concluded that the contract is valid on the payment of the stated fees.

Principles and cases are from Sagay: Nigerian Law of Contract

Maintaining a balanced body

By
Ifeanyi Atueyi
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Pharm. (Sir) Atueyi
Pharm. (Sir) Atueyi

Balance is an essential part of life. Acrobats are experts on balancing and can walk on a rope many feet high. Your car will have smooth movement on the road when the wheels are balanced. And unless you balance a mathematical or chemical equation, you cannot arrive at the solution.

Your life needs a balance also. To live successfully, you need a balance of your physical, spiritual, social, psychological, emotional, intellectual, economical, recreational aspects of life. For instance, one who does not maintain a good balance between work and rest can easily wreck his or her God-given body. Proverbs 23:4 warns, “Do not wear yourself out to get rich; have the wisdom to show restraint.”

The body needs a balance in a lot of things to maintain health. Too much of even something good is bad. That is why a balanced diet is always emphasised. The body needs carbohydrates, proteins, fats and oils, vitamins and minerals, Deficiency of any of results in ill health.

One area of balance that is vital but often neglected is acidic/alkaline balance, which is essential for good health. The human body is alkaline (around pH 7.4). God has designed the body to be maintained around this pH for proper functioning. Making the body more acidic (pH below 7.4) or more alkaline (pH above 7.4) throws it out of balance with undesirable consequences.

Unfortunately, many people do this out of ignorance but cannot escape the consequences. If someone offers you diluted sulphuric acid as a herbal medicine and you drink it, your tongue, mouth, throat etc must be burnt – regardless of the fact that you took it in ignorance.

The commonest way we disrupt the acidic/alkaline balance of the body is through food and drinks. The body is designed to consume predominantly alkaline foods to maintain alkaline environment for survival and good health. If the pH drops below 7.4 as a result of consuming too much of acidic foods, the body desperately attempts to neutralise the acidity. It achieves this by drawing calcium (an alkalising mineral) from the bones. This loss of calcium from the bones leads to low bone density or osteoporosis (a risk for bone fracture). Bone structure is kept strong in alkaline medium.

Acidity of the body creates an environment where bacteria, yeast, fungus, and mould thrive. That means that people who are prone to various types of infections must check the body pH. One unpleasant thing about infections is that pathogenic microorganisms produce wastes or mycotoxins which pollute the body and make it more acidic thereby worsening the environment.

If the pH of the blood drops below 6.9 the body is likely to go into coma and eventually die. Allowing the body to become too acidic (acidosis) or too alkaline (alkalosis) is unhealthy.

The question now is how do we maintain acidic/alkaline balance? As I said before, moderation is key. A lot of the foods and drinks we take are acidic. We sometimes need to take these things but we must be aware of their implications in the body.

Most grains, dairy products, meats, seeds, legumes and nuts tend to have an acid ash. Beef, chicken, eggs, white rice, wheat, bread, pineapple, fruit juice, soft drinks (sodas), alcohol, wine, spirits, coffee etc. all have this characteristic.

People who consume a lot of soft drinks and fruit juice, in particular, expose themselves not only to excess sugar in the body but also high acidity. Excess sugar in the blood leads to insulin resistance which is a precursor to type 2 diabetes. In addition, plaque bacteria use the sugar to produce acids that attack the enamel, the hard surface of the tooth.

Acidic minerals also destroy the teeth in the same way. This is why children, in particular, should be discouraged from drinking a lot of soft drinks and consuming sweets. Consumers of alcohol (beer, wine and spirits) must equally be aware that they are not only loading the body with alcohol but also acidifying it. Drinking alcohol in large amounts for a long time affects brain function, causes liver inflammations, heart and pancreas damage and also certain cancers.

On the other hand, the alkaline foods (which include most fruits and vegetables) should be included in your diet. These include cucumber, cabbage, garlic, spinach, tomato, banana, avocado, broccoli, ginger, carrot, green beans, lettuce, soybeans, lemon, coconut etc.

Coconut water is naturally high in alkaline – forming minerals notably potassium, calcium and magnesium and support the body’s proper pH balance. The pH acidic level in the body turns alkaline when you drink coconut water. It is therefore recommended for people suffering from acidity and heartburn.

Maintaining a healthy balance in our diets is the secret of enjoying good health. Everything we eat has good and bad effects. You do not have to abstain from certain food except on medical grounds like allergic reactions. But you should not indulge in any one. If you enjoy red wine because of its high concentration of resveratrol, which protects from both heart disease and cancer, remember that wine may be alcoholic or non-alcoholic. When you eat even good things, avoid gluttony or overeating. 1 Corinthians 10:31 says, “So, whether you eat or drink, or whatever you do, do all to the glory of God.”

What future has Pharmacy in Nigeria?

By
Lolu Ojo
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Dr Lolu Ojo
Dr Lolu Ojo

Pharmacy is the science and technique of preparing and dispensing drugs. It is the health profession that links the health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs (Wikipedia). From this definition, the importance of Pharmacy to health care delivery in any nation cannot be overemphasised. It occupies a central position now and will continue to be so for as long as there are diseases which require drug therapy. It is therefore necessary and very important for us to continue to talk about the future of the profession with a view to catching up with the rest of the world.

Pharmacy in Nigeria has gone through different stages of development. From mere government dispensers many years ago, pharmacists have moved on to become first class scientists with specialisation in different fields of Pharmacy. Today, there are about 17 schools of Pharmacy in Nigeria (accredited by the Pharmacists Council of Nigeria (PCN)) offering courses from Bachelor of Pharmacy degree to the Doctor of Philosophy (PhD) level. There are 19,559 pharmacists in the register of the PCN but only 11,336 of this number renewed their licences in 2014. With a population of more than 170 million, Nigeria has one of the lowest “pharmacist to 10,000” population figures (less than 1). This pharmacist to population ratio may not improve significantly very soon as our universities are only producing an average of 1,165 pharmacists per year (2012-2014 data). There about 6000 Nigerian pharmacists practising abroad, mostly in Europe and America, and there are so many others who have chosen other endeavours in Nigeria.

In terms of practice, it was estimated in 2013 that there are about 127,068 health care facilities in Nigeria, largely skewed in favour of urban settlements, leaving the rural setting with little or nothing. Most of the federal and state government owned facilities have pharmacists in their employment. There about 8,500 community pharmacy outlets and 52,000 patent medicine stores. This number refers to the registered outlets and I am sure that the number of unregistered outlets will be in multiples of the quoted figures. Nigeria has a potentially huge local demand for drugs but with pervasive poverty and extreme inequality, only a small percentage of the population can afford quality health care and quality drugs. The Nigerian pharmaceutical industry at an estimated size of $1 -1.6 billion is a negligible contributor (about 0.3%) to the country’s GDP and it is virtually non-existent in the world pharmaceutical map. Only 30 per cent of the drugs sold in Nigeria are manufactured locally. 70 per cent is imported, largely from China and India, and because of weak local control, the market is bedeviled with circulation of fake and adulterated drugs. There is practically no R&D activity as most of the research based companies only have scientific offices in Nigeria.

This profile of the profession and the practice should ordinarily suggest a future that should be exciting as much as it should be interesting. However, the peculiar nature of our society has practically removed the factor of excitement and reduces the work of the pharmacist to that of existence struggle. Despite their sound education, the environment of practice does not allow young graduates to give their best. They are practically released into a system that is completely strange and for which they are ill-prepared. They have to struggle in practically all areas of practice. In the hospital, the doctor is the ‘boss’. He has cornered everything and in fact, will prefer the pharmacist and other ‘irritating’ para-medicals (as he derisively calls the other health professionals) to be thrown out of the hospital. There can only be one head of department who will probably retire as an assistant director or at best a deputy director. Everyone one else must wait. The various leaders at the different federal and state health institutions have not helped matters. Their development agenda have not always have Pharmacy as a focal point of attention. The current and persistent but unnecessary leadership tussle in the health sector has done much damage than good and we can only hope that good reason will prevail very soon. The prejudice against pharmacists and other non-medical health care professionals should stop and the focus should be on the delivery of the best services possible to the patient. When are we going to have a minister of health who will set a developmental target of getting new molecules to treat diseases to come from Nigeria and set the necessary templates or create the enabling environment for this to happen? When are we going to have collaborative medication therapy management, involving doctors and pharmacists, for the benefit of the patients in our hospitals? There so many more questions which I believe, one day, the appropriate leadership will emerge and provide the answers to the satisfaction of all.

For now, the future of Pharmacy is in the hands of the pharmacists themselves. We must continually uphold the tenets of our profession with a firm resolve to protect the interest of the patients at all times. We must adhere strictly to the core values as enunciated by the Pharmaceutical Society of Nigeria. We must remember that the system will appreciate you more for who you are and not for whom you claim to be. It is therefore important for us to repeatedly ask ourselves what our contributions are to the wellbeing of the system that we are serving. We should quit complaining about the system and the environment. If the environment in which you find yourself is not conducive, then create your own environment. The hospital management led by the doctors may not allow you to enter the wards but they will not stop you from organizing educational seminars for patients on drug therapy, particularly for chronic diseases in your department. You will have to live above your environment to have a chance to influence your world.

The Pharmaceutical Society of Nigeria (PSN) and the various technical groups have a role to play in charting the future path for the profession. We need to get the young ones to appreciate the challenges ahead early in their professional lives. They need to decide quite early the area of practice where they want to specialise and this is where mentoring is important for the desired future. The benefits of professional community pharmacy practice must be expanded to the rural setting. We must devise a way to take the emphasis away from self to the society we claim to serve. We must try and replicate successes from one point to the other and spread the benefits of Pharmacy across the country. We must create, develop and sustain a distinct public identity and put a permanent stop to the mentality of comparing ourselves to any other person.

It is my hope that this future is not too far from us. A future where pharmacists will excel beyond the current limitations and expand the horizon of practice. A future where dispensing will be separated completely from prescribing. A future when Nigeria will become a manufacturing hub for pharmaceuticals in Africa and the world. A future when research and development activities will take top priorities in our universities. We really have cause to be proud of whom we are as past and recent histories have listed pharmacists among the world most famous in politics, inventions and management. The three most popular soft drinks in the world were invented or developed by pharmacists: Dr John Pemberton (Coca-Cola), Charles Alderton (Dr Pepper) and Caleb Bradham (Pepsi-Cola). Hubert Humphrey, a pharmacist, was the Vice-President of USA in the sixties. Back home, Prince Julius Adelusi- Adeluyi, at 47 years old, cleared all the top prizes at law school in 1987 and has remained till today a mentor to a vast number of people across the profession. If these people could succeed despite the hostility of their practice environment, then I am quite convinced that we can do better. Dr Hiroshi Nakajima, a Japanese doctor and one-time Director-General of WHO, was reported to have said that: “without drugs, a health care delivery system has no substance and no credibility”. This statement remains evergreen and confirms that the pharmacist’s work as custodian of drugs gives substance and credibility to the nation’s healthcare delivery system. Here lies the future and the hope that the land is green for Pharmacy and pharmacists.

 

Dr Lolu Ojo presented this keynote address (abridged here) at the Induction/Oath-taking ceremony of the Faculty of Pharmacy, Igbinedion University, Okada on Wednesday, 6 January 6, 2016

Effective treatment of rheumatism and arthritis

By
Admin
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rheumatoid-arthritis-handOsteoarthritis-knee Rheumatism” is derived from the Greek word “rheuma,” which means a swelling.

It refers to an acute or chronic illness, which is characterised by pain and swelling of the muscles, ligaments and tendons or of the joints. It is a crippling disease, which causes widespread invalidism, but seldom kills.

This disease affects men and women, both young and old. Quite often, it extends to the heart and the valves, and the lining of this vital organ becomes inflamed. It is the most common cause in 80 per cent of the cases of valvular organic diseases of the heart.

Rheumatism, perhaps, more than any other disease, although readily diagnosed, is never the same in any two individuals. There are too many variations in the development of the disease.

Broadly speaking, however, rheumatism, which may be acute or chronic, can be roughly grouped into two classes. These are: muscular rheumatism, which affects the muscles; and articular rheumatism, which affects the joints. The muscular variety is, however, far less common than that affecting the joints.

In the acute form, it is found among children and young people. But in the chronic form, it is generally confined to the adults.

Osteoarthritis-knee

Arthritis: Not a single disease

Arthritis literally means joint inflammation. Arthritis is not a single disease. Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints.

Any part of your body can become inflamed or painful from arthritis. Some rheumatic conditions can result in debilitating, even life-threatening complications or may affect other parts of the body, including the muscles, bones, and internal organs.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. The incidence of arthritis increases with age, but nearly three out of every five sufferers are under age 65.

If left undiagnosed and untreated, many types of arthritis can cause irreversible damage to the joints, bones, organs, and skin.

 Osteoarthritis

Osteoarthritis, also known as degenerative joint disease, results from wear and tear. The pressure of gravity causes physical damage to the joints and surrounding tissues, leading to:

*    pain

*    tenderness

*    swelling

*    decreased function

Initially, osteoarthritis is non-inflammatory and its onset is subtle and gradual, usually involving one or only a few joints. The joints most often affected are the:

*    knees

*    hips

*    hands

*    spine

Risks of osteoarthritis increase with age. Other risk factors include joint trauma, obesity, and repetitive joint use.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease that occurs when the body’s own immune system mistakenly attacks the synovium (cell lining inside the joint). Rheumatoid arthritis is a chronic, potentially disabling disease which causes:

*    joint pain

*    stiffness

*    swelling

*    loss of joint function

While the cause remains elusive, doctors suspect that genetic factors are important. Rheumatoid arthritis can be difficult to diagnose early because it can begin gradually with subtle symptoms.

Juvenile arthritis

Juvenile arthritis is a general term for all types of arthritis that occur in children. Juvenile rheumatoid arthritis is the most prevalent type of arthritis in children. There are three major types:

*    polyarticular (affecting many      joints)

*    pauciarticular (pertaining to       only a few joints)

* systemic (affecting the entire         body)

Signs and symptoms of juvenile rheumatoid arthritis vary from child to child. No single test can conclusively establish a diagnosis. Juvenile arthritis must be present consistently for six or more consecutive weeks before a correct diagnosis can be made.

Psoriatic arthritis

Psoriatic arthritis is similar to rheumatoid arthritis. About five per cent of people with psoriasis, a chronic skin disease, also develop psoriatic arthritis. In psoriatic arthritis, there is inflammation of the joints and sometimes the spine.

Fibromyalgia

Fibromyalgia syndrome is a painful condition characterised by muscle pain, chronic fatigue and poor sleep. The name fibromyalgia means pain in the muscles, ligaments and tendons. Fibromyalgia is a type of soft tissue or muscular rheumatism and does not cause joint deformities.

Gout

Gout is a painful type of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in the joints, especially the big toe. The pain and swelling associated with gout are caused by uric acid crystals that precipitate out of the blood and are deposited in the joint.

Pseudogout / CPPD

Pseudogout, which is also known as Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD), is caused by deposits of calcium phosphate crystals (not uric acid) in the joints. CPPD is often mistaken as gouty arthritis. Since CPPD is a different disease from gout, treatment is not the same as gout.

Scleroderma

Scleroderma is a disease of the body’s connective tissue that causes thickening and hardening of the skin. It can also affect the joints, blood vessels and internal organs.

Lupus / SLE

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can involve the skin, kidneys, blood vessels, joints nervous system, heart and other internal organs.

Symptoms vary, but may include a skin rash, arthritis, fever, anaemia, fatigue, hair loss, mouth ulcers, and kidney problems. Symptoms usually first appear in women of childbearing age, but, can occur in children or older people. About 90 per cent of those affected are women.

Recognising signs and symptoms of arthritis

Because there are over 100 different types of arthritis, symptoms of the disease can be variable, but there are certain signs which point to the disease.

You might suspect you have arthritis if you have signs and symptoms which include the following:

*Persistent joint pain.

*    Pain or tenderness in a joint         which is aggravated by movement or to fill out a written questionnaire at your first appointment.

Be ready for your medical history by having a list of current medications, medication allergies, past and present medical conditions you are being treated for, and the name of your primary doctor and other specialists, along with their contact information.

Keep a symptom diary. A symptom diary can help you keep track of pertinent facts about your condition and also help you track changes that may occur. With the diary, you are more inclined to give your doctor a good overall picture of the symptoms you are experiencing.

 Physical examination

Your doctor will perform a physical examination to try to see any visible signs and symptoms that point to arthritis:

*    Redness/warmth around a joint (inflammation)

*    Joint stiffness or tenderness

*    Joint fluid or swelling

*    Bumps or nodules

*    Pattern of affected joints (e.g. symmetric or asymmetric)

*    Limited range of motion

*    Fever

*    Fatigue

 Laboratory tests

After a medical history and physical examination have been completed, your doctor will likely need more information. Blood tests can provide more specific information and often serve to confirm what the doctor suspects is the diagnosis. Blood tests are also used to monitor disease activity and treatment effectiveness after a diagnosis has been established.

Treatment of arthritis

An effective arthritis treatment regimen can help manage the disease. There are many treatment options which you should know about. Over time, you may try several different treatments and change your treatment plan. Finding the best treatment for you can be a long process.

 Goals of arthritis treatment

The goals of arthritis treatment are to:

*    Decrease arthritis symptoms

*Slow progression of the disease

*    Prevent or minimise joint damage and deformities

*    Maintain joint function

*    Preserve mobility and range-      of-motion

People with early symptoms of arthritis are often inclined to self-treat with over-the-counter medications, topical creams, or conservative measures such as ice and heat. The Arthritis Foundation recommends seeing a doctor if you have joint pain, stiffness, or swelling which persists for two or more weeks, whether or not your symptoms began suddenly or gradually. Only a doctor can diagnose arthritis. An accurate diagnosis is needed so treatment can begin.

A rheumatologist (arthritis specialist) will help you understand all of your treatment options and also help you steer clear of unproven remedies. Discuss the potential benefits and risks of each treatment option with your doctor.

Arthritis medications

Medications are considered traditional treatment for arthritis. Depending on the severity of your arthritis symptoms when you first consult with your doctor, one or more medications will likely be prescribed.

Drug classes used to treat arthritis include:

*    NSAIDs (nonsteroidal anti-inflammatory drugs)

*    COX-2 Inhibitors

*    Pain Medication (analgesics)

*    Corticosteroids

*    DMARDs (disease-modifying anti-rheumatic drugs)

*    Biologic Response Modifiers (i.e. Biologics)

 Injections into a joint

There are several types of injections which can be given locally into the joint. Viscosupplementation is a procedure that involves the injection of gel-like substances (hyaluronates) into a joint (currently approved for knee) to supplement the viscous properties of synovial fluid. The five types are:

*    Synvisc

*Orthovisc

*    Supartz

*    Euflexxa

*    Hyalgan

Local steroid injections can be used for a specific, painful joint.

Three steroid injections per year into a joint is the maximum allowed by most doctors. Steroid injections were used long before viscosupplementation became a treatment option. Both are still used though, depending on patient preference.

Natural treatments

Some people are more interested in natural treatments than traditional medications. If you prefer a natural approach to treating arthritis, it’s still imperative that you tell your doctor what you are taking or what you want to try. There are many natural treatment options, also referred to as alternative treatments, which are popular but not fully endorsed for effectiveness and safety. Be aware.

*    Acupuncture / Acupressure

*    Biofeedback

*    Chiropractic

*    Magnets

*    Massage

*    Meditation

*    Tai Chi

*    Yoga

*    Supplements such as fish oil, glucosamine, chondroitin, MSM

Complementary medicine

The terms, complementary medicine and alternative medicine, are sometimes used interchangeably. The difference is that complementary treatments are used together with your usual treatment regimen. Alternative treatments imply that they are used instead of your usual treatment.

Regular exercise is strongly recommended for arthritis patients. Exercise can reduce pain and improve physical function, muscle strength, and quality of life for people with arthritis.

Eating a nutritious diet is important for maintaining ideal weight and for bone health too. There is no known diet which can cure arthritis, but eating well is important.

Stress management may also be useful as a complementary treatment. Reducing stress helps to reduce pain and stiffness associated with arthritis.

Surgical options

Joint surgery is usually considered a last resort treatment option. Joint surgery is typically considered if other more conservative treatment measures are unsatisfactory or have stopped working. When joint damage is severe and when pain interferes with daily activities, joint surgery may be an option with the goal of decreasing pain and restoring function.

Pain relief

Pain is debilitating and can greatly interfere with daily living. Better treatments are always being sought, so people living with arthritis pain can achieve pain

 When symptoms affect normal activities

If symptoms are severe enough to interfere with normal functioning and your ability to perform usual activities early in the course of rheumatoid arthritis, you may bite the bullet and go to the doctor. The disruption in your life serves as the incentive to consult with a doctor.

If symptoms are not terribly disruptive, you may choose to wait before consulting a doctor. It is really quite simple is there a sense of urgency? A sense of urgency, or lack of, dictates when a doctor is consulted.

Explanation of symptoms

How did your aches and pains begin? Was there an event, such as an injury, that caused your symptoms? Did the symptoms begin gradually or suddenly, without obvious cause?

Typically, patients who feel comfortable with the explanation of their symptoms will wait before consulting a doctor. For example, if you walked into a wall and you developed aches and pains, you are more likely to give the symptoms a chance to subside on their own. But if there is no logical explanation surrounding your symptoms, you likely will choose to see a doctor, so the symptoms can be evaluated.

Knowledge of rheumatoid arthritis and treatment options

If you know much about rheumatoid arthritis, you know that an accurate diagnosis and early treatment is essential. Early treatment with DMARDs (disease-modifying anti-rheumatic drugs) and biologics may help prevent joint damage and subsequent disability.         With new treatments treatments that were marketed since 1998 the prognosis for rheumatoid arthritis is better. Realising that early treatment is important, is it not worth consulting a doctor and agreeing on your treatment regimen, so you can be assured that you are on the right path?

 Attitude towards the medical profession

If you have had positive experiences with doctors in the past, you are more likely to consult with a doctor about your aches and pains sooner rather than later. If you have respect for doctors in general, and if you trust those you have had in the past, you likely will not balk at getting your symptoms checked out.

The problem occurs if you have a history of bad medical experiences, or if you find it difficult to trust doctors. There are even conspiracy theorists who think doctors like to keep us sick because drug companies give them kickbacks to do so.

 Point to remember

Simply put, if your symptoms are interfering with normal life, if you understand that early treatment is important, and if you trust your doctor to know what to do and how to help you, you are more likely to see the doctor.

Misconceptions about arthritis

There are many misconceptions about arthritis. The most common misconceptions about arthritis seem to persist. Patients need facts and valid information, not myths and misconceptions, so they can better manage their illness.

Misconception #1 – Arthritis is an old person’s disease

Fact: Anyone can have arthritis.

The most common misconception about arthritis is that it is a disease only of old people. In actuality, arthritis can affect anyone at any age, not just the elderly, including children, young adults and middle-aged people.

Arthritis is not age or gender specific. There are over 100 different types of arthritis and related rheumatic conditions and some are more commonly found in particular groups.

Rheumatoid arthritis, fibromyalgia, and lupus are more commonly found in women than men. Gout and ankylosing spondylitis appear more often in men than women. In terms of gender, psoriatic arthritis affects men and women nearly equally. Older people are more inclined to have osteoarthritis, the degenerative form of arthritis.

Misconception #2 – Arthritis is induced by a cold, wet climate

      Fact: Climate itself is neither the cause, nor the cure.

It has long been theorised that arthritis is caused by a cold, wet climate. Moving to a warm, dry climate has been regarded by some as the cure. Logically, one can infer that if a warm climate cured arthritis, no one in other warm regions would have arthritis. Bone rubbing on bone after cartilage has worn away causes pain in any climate. However, warmth can be soothing. People without arthritis often feel better in warm climates too.

Warmth may relieve symptoms of arthritis, as does soaking in a hot-tub or taking a hot shower.

Misconception #3 – Arthritis can be cured

      Fact: There has been no scientific evidence that a cure for arthritis exists.

The notion that arthritis can be cured is a fallacy. To date, there is no known cure for the disease. Much has been discovered, in terms of better treatment options and slowing down the disease progression, but nothing yet has been found to successfully halt the disease. Since there are so many different types of arthritis, the prognosis varies.

Since arthritis is a lifelong process, the importance of gaining knowledge and understanding of your own health condition cannot be overstated.

Misconception #4 – Arthritis is caused by a poor diet

      Fact: There is no scientific evidence that specific foods prevent or cause arthritis.

There has been an abundance of speculation about the importance of diet with regard to arthritis. It is certain that a nutritious, well-balanced diet and ideal weight maintenance improves overall health and wellness for everyone. There are a few examples where there is a definite diet connection, such as between high uric acid levels and gout.

There is no scientific evidence, though some specific foods prevent or cause arthritis. Good diet does not prevent arthritis. Unless a person is found to have a particular food allergy which causes their arthritis to flare, there is no proven direct link between a particular food source and arthritis.

 Misconception #5 – Arthritis consists of only minor aches and pains

Fact: Arthritis consists of much more than just minor aches and pains.

It is another common misconception that arthritis exhibits only minor aches and pains. Television commercials, which claim that a couple of aspirin or another over-the-counter pain reliever takes away the minor aches and pains of arthritis, tend to mislead the public.

Such advertising, along with a lack of knowledge about the disease, expand some people’s unawareness of the more complex forms of arthritis, which require more aggressive forms of treatment.

Misconception #6 – “You felt fine yesterday… why so tired today?”

Fact: There is variation in the duration and severity of the symptoms of arthritis.

Since arthritis is a disease characterised by periods of flares and remissions, it is often difficult for the family and friends of an arthritic person to comprehend why they feel so much better or so much worse on any particular day. The inconsistency of arthritis can even lead some people to believe the disease is “all in your head”.

Arthritis is characterised by a mix of good days and bad days. Some days, the joint pain and fatigue is more exacerbated. A balance between rest and activity may be necessary to best manage living with arthritis.

Misconception #7 – “You have arthritis, you can’t….”

Fact: There is much a person with arthritis CAN do.

The limitations that arthritis imposes on an individual can cause people closest to them to become overprotective. Sometimes people do too much to try and help the person with arthritis. The disease does interfere with some physical ability, but certainly the arthritic person should not be viewed as totally dependent and invalid.

A certain amount of help and dependence is likely to be required. It must be remembered though that it is best to maintain as much independence as possible for both physical and emotional reasons.

 

Report compiled by Adebayo Folorunsho-Francis with additional information from Dr. Zashin, author of “Arthritis Without Pain” and About.com Health’s Disease and Condition

 

PANS UI lecture secondary students on pharmacists’ roles

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Temitope Obayendo
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It was a day of to remember, as the Pharmaceutical Association of Nigeria Students (PANS), University of Ibadan Chapter, hosted youngsters from neighbouring secondary schools to a symposium tagged “Wetin Pharmacists Dey Do Sef?”

The event which was aimed at sensitising secondary school students on the importance of pharmacists and the pharmacy profession was one of the programmes featured in the 2015/2016 PANS Week

Speaking on the importance of pharmacists, Pharm. Niyi Aje, a lecturer in the Department of Clinical and Administrative Pharmacy of the Faculty of Pharmacy, UI, described a pharmacist as a “health care professional who is trained and licensed to manufacture, distribute and dispense drugs and to advise patients on the use of drug”, adding that a pharmacist is “a professional who knows something about everything and everything about something. He possesses diversified skills and gets involved in decisions to improve the health of patients.”

Corroborating the first speaker, Pharm. Thomas of the Department of Pharmaceutical Chemistry, UI, corrected the misconception that the role of the pharmacist is to dispense drugs prescribed by doctors. He stressed that “pharmacists do not just dispense, they also identify, isolate and synthesise drugs”.

He encouraged the youngsters to study Pharmacy so as to fill the void damagingly occupied by quacks and profiteers. He cited “high demand and rewarding job opportunities” as inducement to the profession.

Chairman of the symposium, Pharm. Lekan Fashesin who is also the Grand Patron of PANS UI, rejoiced with the young students on being privileged to know about the pharmacy profession that early. While encouraging the youngsters, he advised that they should have a passion for what they do and also seek to match their temperament to their chosen profession.

The students were not left out in the discussion as they were given opportunities to air their views and ask questions where necessary. Present at the Reacting to some of the opinions of the youngsters, Sub-Dean (Undergraduate) of the Faculty of Pharmacy, UI, Dr Dapo Adetunji, he noted that “thinking Pharmacy is an alternative to Medicine is a gross error”.

Also lending his voice to the discussion, PANS UI President, Mr Elijah Ajiga, asserted that pharmacists are “dynamic people” and “partners in health”.

 

Odukoya tasks scientists on new research strategies

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Temitope Obayendo
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Professor Kemi Odukoya
Professor Kemi Odukoya

For Nigeria to derive maximum economic benefits from research efforts, researchers must begin to apply new research strategies, former Dean of Pharmacy Faculty, University of Lagos, Professor Kemi Odukoya, has said.

Odukoya, who made the submission, during UNILAG’s 10th Annual Research Conference & Fair 2015, held recently at the Multipurpose Hall, University of Lagos, Akoka, said research was indispensable for national development.

“There must be research in all ramifications,” she said. “If you look at Pharmacy today, most of the disease states are not responding to old molecules anymore, so new molecules must be developed for disease states. And the only way to get there is through research. Thus the implementation of new research strategies for national transformation is key. How can you transform the nation with the old strategies?”

Odukoya stated further that research had suffered a major setback due to lack of commitment on the side of the government and the society as a whole.

“It’s unfortunate that Nigerians, don’t appreciate research; they only want the end product. How you start as an inventor, how you put all resources together to achieve the end product is of no interest to anyone. Being a successful scientist is more than just being a graduate, it’s what you have been able to produce from your end that speaks for you. It’s not all about money; the ivory tower at the university is for teaching, research and service”, she noted.

She therefore urged all students, academicians, and government to devote more time and resources to academic investigation, in order to boost the nation’s economy through research outputs.

Also speaking at the event, Deputy Vice Chancellor (Academic & Research), UNILAG, Professor Babajide Alo, stated that there would be no new knowledge, without new research efforts.

“That is why we at the University of Lagos believe seriously that it is only through research that our country can grow. It is only through research that the transformation we are looking for can take place, he said.”

Alo, who gave ample descriptions of research efforts at the institution, urged members of the society to take active part in the research process, by reporting challenges to academic and research institutions and looking up to them for solutions.

He added that as a public institution, the institution had an obligation to the society which was to provide solutions to the challenges of individuals in the society.

“Essentially this annual research conference is designed by the university to provide solutions to national challenges, and perennial challenges of the people of the nation. We are actually moving forward, because several works of the university are being utilised in the industry,” he said.

 

Accolades for Neros boss at 60

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L-R: Dr. Poly Emenike, the celebrant; Emeka Onwuka, former chief executive officer of Diamond Bank and Pharm. Nnamdi Obi, chairman, Association of Pharmaceutical Importers of Nigeria (APIN) at the event.

 It was a spectacular show of glamour at the Landmark Events Centre, Victoria Island extension, Lagos, where top government functionaries, politicians, pharmacists, technocrats and international figures gathered recently to honour Dr Poly Emenike, chairman of Neros Pharmaceuticals, as he celebrated his 60th birthday.

Extolling Emenike’s virtues, Prof. Pat Utomi, former presidential aspirant, described him as a special breed worthy of showcasing to future generations.

“We are in a society where people are beginning to think that education does not matter anymore as long as you have money. At other times, you hear things like you must know somebody in authority to be successful in life. I have spent years challenging such fallacious expressions. I am happy that Poly has justified my belief” he enthused.

A director of registration and regulatory affairs with the National Agency for Food and Drugs Administration and Control (NAFDAC), Dr Monica Hemben-Eimunjeze, equally expressed her admiration for the Neros chairman.

“He is such a hardworking man who stops at nothing to get things done the proper way,” she said. “NAFDAC is proud to be associated with him.”

In the words of Pharm Okey Akpa, chairman of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), the celebrant is more than just a public figure.

“Such an active fellow he is! In PMG-MAN, we regard him as one of our trusted and most reliable members,” he said.

Pharm. Nnamdi Obi, chairman of the Association of Pharmaceutical Importers of Nigeria (APIN) noted that the Neros helmsman, who he described as a bosom friend, had to surmount several obstacles to triumph over abject poverty and wretchedness to become a paragon of excellence.

“As one of his closest friends, I can categorically tell you that his journey in life was a practical demonstration of the triumph of the human spirit,” he said.

Born on November 28, 1955, at Nnanka in Orumba North Local Government Area of Anambra State to a peasant farmer and a petty trader mother, Emenike is the sixth child in a family of eight. He was baptised and enrolled in  schools managed by churches even though his parents were not Christians.

‘    On completion of primary school in 1971, Emenike  looked forward to his admission into secondary school with his mates. But that lofty dream was cut short despite coming out in flying colours in his Common Entrance Examinations. Young Emenike was rather sent to Onitsha, to live with his maternal uncle, a lawyer.

After spending three years in his uncle’s house without being allowed to go to school, Emenike  left his uncle and started saving for the future while working as a young entrepreneur.

At the age of  32, with a wife, children and a thriving enterprise, he enrolled as a pupil at Ansar-Ud-Deen Grammar School, Surulere, in Lagos State, wearing the school uniform like his much younger schoolmates. In 1988, he completed his O’Level studies. Thereafter,  his hunger for academic excellence drove him to the University of Lagos, where he obtained his BSc and MSc degrees in 1997 and 1999 respectively.

A reserved gentleman, Dr Emenike is the first non-American and fourth person to be honoured in the 50-year history of the Napoleon Hill’s Foundation as well as a recognised Member of the Order of the Niger (MON).

In 2012, at the International School of Management, Paris, France, Emenike capped his academic laurels with a doctorate degree.

Following his acclaimed exploits at home and abroad, he was honoured with the award of Odenigbo Nanka by his beloved people.

In attendance at the birthday bash were Dr Alex Ekwueme, former vice president of Nigeria; Pharm. Kennedy Izunwa, APIN technical director; Prof. Onwuchekwa Jemie, editor-in-chief of Business Day Newspaper; Sir Ifeanyi Atueyi, managing director of Pharmanews Limited; Mr Emeka Onwuka, former chief executive officer of Diamond Bank; Chief Chidi Anyaegbu, chairman of Chisco Transport; and Bishop Paulinus Ezeokafor, spiritual father of the day.

Others were Dr Peter Obi, former governor of Anambra State; Dr Andy Uba, member, senate special committee on public accounts; AVM Lucky Ararile, the Ovie of Umiaghwa Abraka Kingdom, Delta State; Dr Chukwuka Obiora, chairman of Greenlife Pharmaceuticals; Mike Okeke, former vice president, National Football Federation (NFF) and representatives of Meko Pharmaceutical.

NAFDAC, pharmacists, others applaud Emzor’s thanksgiving dinner

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L-R: Mrs Osinachi Kalu, gospel artiste; Mrs Ndidi Nwuneli, co-founder of LEAP Africa; Mrs Dayo Benjamins-Laniyi, media entrepreneur and Dr Stella Okoli, Emzor Group’s CEO at the thanksgiving dinner

The 2015 edition of Emzor Pharmaceutical Industries Annual Thanksgiving Dinner witnessed a massive turnout of pharmacists, top government functionaries, captains of industry, technocrats, politicians and professionals from all walks of life.

According to Dr Stella Okoli, Emzor Group’s chief executive officer, the colourful ceremony which held in December 2015 at City Hall in Lagos Island, was her own way of showing appreciation to God.

“When the company started, it has only one product – Emzor Paracetamol. It is a product I still refer to as the best paracetamol in the whole universe,” she enthused.

Okoli reminisced that when she returned to Nigeria from abroad, she, along with other enthusiastic pharmacists, were encouraged to go to into pharmaceutical manufacturing.

In her summation, the Emzor boss lamented that nobody warned her about how tough the terrain was until she discovered much later. Nevertheless, Okoli said that she was grateful to God for strengthening her in weathering the storm.

She added that Emzor’s story is one filled with testimonies because each year, it strives to take a giant stride.

“After a while, doctors in Nigerian hospitals started acknowledging the efficacy of Emzor Paracetamol. It is so good that everybody, including NAFDAC, testifies about its quality.

“As we thank our Almighty God, we are also celebrating complete wellness in Nigeria and Africa as a whole. Very soon, we know that it will go global because Emzor Paracetamol is God’s Own Product (GOP)” she stressed.

Praising Okoli’s courage in birthing and nurturing Emzor to its present state, Pharm (Mrs) Elizabeth Awagu, special adviser to NAFDAC’s director general, described her as a wonderful, charitable, straightforward, loving, kind and God-fearing individual.

Sharing her view, Prof. Cecilia Igwilo, a Fellow of the Pharmaceutical Society of Nigeria (PSN) remarked that providence had continued to bless Emzor as a company because of Okoli’s appreciative stance with God.

“She is a daughter of Zion, a child of God. She has been having this thanksgiving dinner consistently every year. People tend to neglect appreciation when things are going well, but she doesn’t.

“Remember the biblical story about the ten lepers where only one came back to show appreciation. What happened to the other nine? Let us learn to be appreciative always,” she counselled.

In his address, Dr Ernest Ndukwe, chairman of the occasion, who remarked that he was pleased with the attendees’ response to the praise and worship session of the event, said he had always admired the personality of Okoli.

“When I was asked to be the chairman of this event, I quickly accepted because of the personality of Dr Okoli. I am always impressed with the company’s policy concerning wellness which I believe was built on solid foundation.

“Besides, the calibre of people and government functionaries represented here today says a lot about the personality of Emzor’s chief executive officer, Dr Stella Okoli.”

Ndukwe, the immediate past chief executive officer of Nigerian Communication Commission (NCC), further disclosed that he was quite captivated with what he had just witnessed and was eager to replicate same in his household.

The ceremony equally witnessed inspiring hymns and soul-lifting songs from the duo of Frank Edward and Sinach, while Pastor J. T. Kalejaiye, of the Redeemed Christian Church of God, gave an exhortation.

Among the dignitaries who also graced the ceremony were Mrs Uzoma Ezeoke, Emzor’s director; Senator Oluremi Tinubu, wife of APC National Leader, Ashiwaju Bola Tinubu; Mrs Bolanle Ambode, First Lady of Lagos; Pharm. (Dr) Monica Hemben Eimunjeze, NAFDAC director of registration and regulatory affairs; Princess Adejoke Orelope-Adefulire, former deputy governor of Lagos; and Dr Femi Olugbile, former chief medical director of Lagos State University Teaching Hospital (LASUTH).

Others were Sir Ifeanyi Atueyi, managing director of Pharmanews Limited; Pharm Ebenezer Adeleke, managing director of Living Hope Pharmacy & Stores Limited; Dr Babatunde Sowemimo, former director of Pharmaceutical Services, Lagos State; Dr Emmanuel Egbogah, former special adviser to the president on petroleum matters and Dr Chimezie Anyakora, chief of party, United States Pharmacopoeia.

Emzor Pharmaceutical Industries Limited is a wholly private indigenous pharmaceutical manufacturing group founded in 1984 by Dr Stella C. Okoli, OON. The company manufactures high quality pharmaceutical products and medical consumables. Its holding company, Emzor Chemists Limited, opened for retail business in January 1977 in Yaba, Lagos.

The rapid growth of the retail business encouraged Emzor Chemists Limited to venture into the importation and wholesale of assorted pharmaceuticals. The idea to manufacture locally came later and this was predicated on the need to develop local capability, create jobs and provide high quality pharmaceutical products and services to the Nigerian people at prices that were not only affordable but represented value.

Emzor Pharmaceutical Ind. Ltd. started pilot production in 1985. By 1988 it had become an established pharmaceutical manufacturing company especially with the introduction of Emzor Paracetamol which is today a leading brand of analgesic not only in Nigeria but across Sub-Saharan Africa.

The company’s factory is located in the Isolo industrial area of Lagos with facilities to make a wide variety of high quality pharmaceutical products that meet international standards at affordable and competitive prices. All Emzor products meet the highest international standards and are duly registered with NAFDAC.

The then secretary of Health to the Interim National Government Dr Christopher Okojie officially commissioned the company’s factory in July 1993. The company has since attracted foreign missions, scholars, and students of pharmacy, microbiology and chemistry. In April 1999, Prof. Debo Adeyemi, the Honorable Minister of Health, commissioned the factory extension.

Strive for excellence, experts urge pharmacy students

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L-R: Prof. ’Fola Tayo, Caleb University’s pro-chancellor and chairman of council; Pharm (Sir) Ifeanyi Atueyi, managing director of Pharmanews Limited and Pharm. Remi Adeseun, chairman of Rodot Nigeria Limited in a warm handshake during the event

In a strategic move towards greater excellence in pharmaceutical practice, experts have called on pharmacy students to embrace a paradigm shift by challenging the status quo.

In his keynote address themed “Pharmacists’ Role in National Healthcare Policy Making” at a symposium held at Lagos University Teaching Hospital (LUTH), Idi-Araba,  Lagos  recently, Pharm. Remi Adeseun, chairman of Rodot Nigeria Limited, counselled students not to limit themselves to the conventional sub-fields of the profession.

He urged them to consider areas such as public health pharmacy which had become a growing area for modern-day professionals to explore.

“It is nothing to be scared of,” he assured. “Thank God we have trailblazers like Prof. ’Fola Tayo who are now experts in that aspect. For instance, how many of you are aware that nurses and pharmacists have been included in the prescription-based medicine policy of the United Kingdom, away from the conventional doctors-only policy of old?” he noted.

The pharmacist cum entrepreneur expressed confidence that Nigeria would soon be joining the trend, adding that young pharmacy students must necessarily broaden their knowledge,instead of limiting their scope of learning to what their lecturers taught them.

In a related development, Pharm (Sir) Ifeanyi Atueyi, managing director of Pharmanews Limited, equally advised final year students of the faculty to use the pharmacy profession to serve God, as this would make the profession more fulfilling for them.

“This has a lot to do with innate ability and talent in your calling. Money is good but it should not end there. Learn to give a listening ear to God. I want you to enjoy the profession because I am  enjoying it,” he enthused.

Another distinguished expert, Prof. ’Fola Tayo, also affirmed that the face of Pharmacy was changing strategically. The Caleb University’s pro-chancellor and council chairman further used the opportunity to warn those who were not interested in practising with their licence after graduation.

“Every licence has an expiration date which can be renewed based on how active you are. In the advanced world, if you don’t practise until expiration, such licence will be revoked. You will be asked to go back to school. I am sure none of you here wants that,” he stated.

Also lending his voice to the discourse, Pharm. Adeshina Opanubi, lead consultant of PharmAlliance, used a few parables to emphasise the need for the students to be proactive and persevering in challenging the status quo.

“Life is neither always easy nor comfortable. Things don’t happen as we wish. People don’t treat us as we hope. We work very hard, yet get few results. The way out is for us to make something good from the difficulties we face. Only through such means can we learn new things – new knowledge, new skills and new abilities. Above all, we tend to grow in experience. To succeed in life, we must try and try again. We must believe in what we are doing and must not give up,” he urged.

The annual health week programme organised by Pharmaceutical Association of Nigeria Students (PANS), UNILAG chapter was equally attended by Prof. Olukemi Odukoya, former dean, UNILAG Faculty of Pharmacy; Pharm. Charles Akinsete, chief executive officer of Biospec Network Limited; Pharm. (Dr) Monica Hemben Eimunjeze, NAFDAC director of registration and regulatory affairs; Pharm. Gbenga Olubowale, chairman, Lagos chapter of Pharmaceutical Society of Nigeria (PSN); Pharm. (Dr) Segun Adesegun, acting head, department of Pharmacognosy, UNILAG; and Dr Abimbola Sowemimo, sub dean, UNILAG Faculty of Pharmacy.

How God led me to care for widows, orphans, others – Pharm. Ezenwa

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Second from right, Pharm. Regina Ezenwa with other members of the team, presenting gift items to one of the widows.

 The story of the Roses Widows’ Day is a unique one, which started with only 35 widows in a small room, but has now grown up to over 800 widows during this year’s celebration. Spearheading this success story is no other person than Pharm. Regina Ezenwa, managing director, Rozec Pharmacy Ltd. Ezenwa received the call to care for the widows and the needy in the nineties, prompting her to start Roses Ministry. Since then, she has not allowed her professional obligations to hinder her from the extra role she was divinely assigned.

Althoug, the Roses Ministry has different departments – for the youths, the elderly and the widows-, this year’s Widows Day was outstanding, with lots of gifts for the women called ‘wives of Jesus’, to take home. Aside from food and clothing items, the widows’ health was also taken care of, as they were screened and given drugs by medical doctors alongside Association of Community Pharmacists of Nigeria members from Surulere branch. Temitope Obayendo had a chat with Pharm. Ezenwa at the event. Excerpts:

As a Fellow of the Pharmaceutical Society of Nigeria, what informed your decision to form an NGO?

Sometime in the 90s, as I submitted myself to the Lord as a willing vessel in the Full Gospel Business Men’s Fellowship International, the Lord began to speak to me: “feed my people.” Understanding feeding to mean giving people foodstuffs and spiritual foods, I did this, both at my community pharmacy and other places. As I ministered the word to people, their lives started changing, and I felt I was there. I had received the name in the 90s – “the Roses”; the Lord made me understand that that was the name, and I penned it down.

By 2006, however, the passion had become stronger, and it occurred to me that what I was doing was not what God was actually asking from me. Towards the end of that year, I was in a state where I was not aware of my physical condition (trance). In that state, the Lord appeared to me and said “the time is now”. The Lord gave me the words in Matthew 25: 35-36, “… I was hungry, you fed me, I was thirsty, you gave me drink, I was ill and you visited me…”

That passage became huge to me, and I asked myself, “Where do I start from?” I told my friends about the vision, and many of them offered to join me.

How was starting up like, with little or no resources?

We visited a school for the partially deaf and dumb at Surulere. We had a wonderful time with them, as we shared food and other things with them, and we went home fulfilled. After we had done this visitation for a while, it occurred to us that we needed a prayer backing; so we started from my sitting room. After a while, my sitting room was no longer conducive for us, as the number continued to increase. Thus we had to rent a space at Tantalizers that could accommodate up to 50 people. Eventually the Lord relocated us here, when our former place became too small for us.

Looking backward, what was the first Widows’ Day like?

In January 2007, the Lord said to me to show his love to these women (widows) whom He called His wives.      The very first Widows’ Day, we had about 35 widows. We had foodstuffs in small bags and also wrappers (fabric) for each of the women. The widows felt the love of God in their lives. This was how the 35 widows we started with grew to 804 widows this year.

Thereafter, were there other additions to the programme?

As we continued with the widows, we discovered that some of them were dying due to terminal diseases. So by 2009, we started medical intervention by screening them for high blood pressure and diabetes, as well as referring them to hospitals. But many of them returned to us to say they didn’t have money to pay to doctors. So we adopted the screening as part of the Widows’ Day last year. Thus for this year’s programme, we split it into two days – the first was for the medicals, which was in collaboration with the ACPN, Surulere Zone, and some doctors who offered their services to some patients who wished to see them.

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Through this medium, we have consistently given drugs to our hypertensive widows on a quarterly basis. We give them three-month packs of antihypertensive, and the diabetics have also been receiving free treatment too. I am glad to say that it was the Lord’s leading, because there was no patient that came for the medicals that was not attended to. Other drugs for malaria, anti-inflamatory, cough and catarrh were also dispensed to patients who needed them. We are really grateful to all companies who partnered with us on drugs and other items.

 From the medical screening conducted, what would you say is the predominant health challenge of widows?

From the screening conducted, it was discovered that the biggest health challenge of the widows is hypertension, as over 300 of them were found with the condition. Managing hypertension has to do with lifestyle, and we counselled them on low salt, low oil, more exercise, adequate rest, and staying away from undue worry.

 How do you hope to continue funding this project?

We have nothing of our own to support these widows, except individuals and few pharmaceutical companies. We urge government and bigger organisations to look for credible NGOs like us to support. We have credible team members who are contributing their time, talents and treasures. If we have corporate sponsorship, then we will be able to establish these women much more. We need funding to set up these widows in the different skills they have acquired, so that they will be able to cater for their families.

 

Why I dropped Biochemistry to focus on skincare – Dazzle MD

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Ms Adaobi Nnoli Nwaju is the managing director of Dazzle Beauty and Skin Care Specialist Home, a skincare home for treatment of all kinds of skin and scalp related conditions. In this interview with Pharmanews recently, the Anambra State born professional skincare specialist, who graduated from Nnamdi Azikiwe University, Awka, Anambra State as a biochemist,  speaks on the mission of her four-year-old company and how best Nigerians should care for their skin. Excerpts:

 Who is a skincare specialist?

Skincare specialists give facials, full-body treatments, and head and neck massages to improve the health and appearance of the skin. Some may provide other skincare treatments, such as peels, masks or scrubs, to remove dead or dry skin.

In addition to working with clients, skincare specialists also keep records of skincare regimens that their regular clients use. A growing number of specialists actively sell skincare products, such as cleansers, lotions, and creams. Those who operate their own salons have managerial duties that may include hiring, supervising, and firing workers, as well as keeping business and inventory records, ordering supplies, and arranging for advertising.

The job may involve a great deal of standing. Because skincare specialists must evaluate the skin’s condition, good lighting and clean surroundings are important. Protective clothing and good ventilation also may be necessary because skincare specialists often use chemicals on the face and body.

At Dazzle, we refer clients to medical personnel for treatment of serious skin problems. We advise clients about colours and types of makeup and instruct them in makeup application techniques. We sell makeup and other skin care products to our clients, while we collaborate with plastic surgeons and dermatologists to provide patients with preoperative and postoperative skin care.

 You graduated from the university as a biochemist. What informed your decision to go into skincare business?

I studied biochemistry in school as a course of study but along the line, I developed great passion for skincare and I started practising as an undergraduate. So, after my graduation, I quickly enrolled into a Beauty and Cosmetology School in Abuja, after which I also went to learn about cosmetics production.

When was Dazzle established and what were your objectives?

Dazzle Beauty and Skincare Specialist Home was established four years ago after I finished from beauty school. I initially started in Lagos before relocating to Abuja where we are presently; and to the glory of God we are doing tremendously well such that I have no regret dropping biochemistry to be a skincare expert.

At Dazzle Beauty and Skin Care Home, we treat all kinds of skin-related issues like acne, stretchmark, sunburn, skin rashes, ringworm, hyperpigmentation and hypopigmentation, acne scars, dehydrated skin, blackheads, enlarged pores, skin discoloration, scarring, dark patches, wrinkles and fine lines. We are also into hair and scalp related issues like hair breakage, dandruff, oily and dry scalp treatment – and all our treatment are guaranteed.

 

How well are your products doing in the market and what are you doing to ensure they are not counterfeited?

Dazzle beauty products are doing very well in the market because a lot of people that have used them have testified to their effectiveness. We are working so hard to make sure they are not faked because most of our products are herbals and they regenerate very fast.

 How relevant are skincare experts in the country and what does it cost to patronise them?

Skincare experts are very relevant in this country, especially in developed cities like Abuja, Lagos, Port Harcourt, Ibadan and many others. The reason is that so many people who live in these cities know the importance of skincare and beauty.

I have come to realise that so many people are dying in need of skincare experts for their skin-related issues but are afraid that it is only the rich and the celebrities that can afford skincare experts.  Also, we have so many who ignorantly patronise quacks, who rather than help them end up worsening their conditions.

At Dazzle Beauty Home, we guarantee every of our customers maximum satisfaction as we do proper skin analysis on each customer before commencing treatment.

 From your experience and observation, how well do Nigerians care about their skin? 

As I said earlier, it all boils down to the need for proper orientation as majority of  Nigerians who are properly enlightened care so much about their skin and therefore know what to do when they have issues with their skin. Our outward look is as important as what we take in; but most people care so much about what they eat and the drugs they take, in order to look healthy while they care less about their skin and their outward beauty. On the average, only about 30 per cent of Nigerians visit beauty homes to look after their beauty and care for their skins. The greater majority see it as needless extravagance.

 What keeps you passionate about helping people look beautiful?

What keeps me passionate about my job is the fact that I am able to put smiles on people’s faces in the little way I can. In fact, seeing my clients happy and satisfied after being treated or attended to makes me happier. Those are the things that keep me going in this business and I must say I am fulfilled in what I am doing.

In your opinion, why do people bleach?

People bleach for so many reasons, one of which is lack of confidence and inferiority complex. Bleaching has become a major practice in our society, to the extent that people now use different kinds of cream and soaps to achieve this. Studies reveal that most young boys and girls prefer using skin whitening products so that they can get a good standing in their groups, families and communities. In fact, the commercials shown on television these days also portray the same thing. These commercials have a great impact on the minds of young men and women and they opt for whatever cream or pill they can afford.

However, regardless of being a man or woman, skin bleaching is a good option to get rid of the black spots or any other type of spots on skin; but the options have become very complicated these days as there are plenty of options available in the market, leaving the customers confused.

 What are the side effects of bleaching?

Although skin bleaching or whitening could be a good option for getting rid of dark spots or skin discoloration, the process is not free from side effects. Some of the products are very harmful and can even cause skin cancer. Therefore, it is very important that people find out the side effects of skin bleaching before opting for it. Some other side effects are dark grey spots, acne, swelling of the skin, thinning of the skin, cataracts, settling down of fat on face, chest, upper back and stomach. There is also increase in appetite and weight gain; osteoporosis; neurological and kidney damage, due to high level of mercury used in the creams; psychiatric disorders; and severe birth defects. Some these side effects could be seen almost immediately while some are seen only after prolonged use of skin whitening creams.

What advice do you have for those who bleach and those who are careless about their skin?

Diet is the most important part that people should take care of if they want a flawless skin. Doing away with all refined food products and replacing them with healthy and nutritious ones is the secret.  Also when it comes to knowing how to taking care of one’s skin, it’s a matter of selecting the right product and importantly, being completely aware of the ingredients used in any product being considered.

It is important to consult a skin expert when considering trying a new skin care product to improve skin tone, remove age spots, sun spots, and other blemishes. That is why Dazzle Beauty Home is here.  $Our services are professionally offered  and our products are the best in the market.

NAIP, NIROPHARM laud Miraflash’s newly commissioned factory

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R-L: Pharm Moses Oluwalade, Miraflash’s managing director; Mrs Bridget Oluwalade, his wife; Prof Ayo Arije, chairman of the occasion; Pharm Ade Popoola, director of Reals Pharmaceutical and Elder J. A. Oluwalade, father of Miraflash’s director during the official commission of the company’s factory in Magboro, Ogun State
R-L: Pharm Moses Oluwalade, Miraflash’s managing director; Mrs Bridget Oluwalade, his wife; Prof Ayo Arije, chairman of the occasion; Pharm Ade Popoola, director of Reals Pharmaceutical and Elder J. A. Oluwalade, father of Miraflash’s director during the official commission of the company’s factory in Magboro, Ogun State

The Association of Industrial Pharmacists of Nigeria (NAIP) and the Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM) have congratulated the management of Miraflash Pharmaceuticals, following the successful commission of its new factory in Ogun State.

The colourful event, which was held on 16 December 2015, attracted top government functionaries, patent medicine dealers, clergymen, community leaders, as well as several industrial, community and hospital pharmacists. While congratulating Pharm. Moses Oluwalade, managing director of the company, NIROPHARM’s vice chairman, Femi Soremekun, disclosed that all members of the association were proud of the achievement.

“Oluwalade is one of us. NIROPHARM rejoices with him. In particular, we are happy with his doggedness and determination to go through the rigour of setting up this factory. It is not easy. We wish him all the very best. And for those of us still hoping to set up a similar factory, he has set the pace for us to follow,” he said.

Sharing the same sentiments, Pharm Seye Agboola, chairman of Dortemag Pharmaceuticals, described the commissioning of the manufacturing plant as a great initiative.

“Among other things, it will help to absort people from the labour market. It will also motivate people to start seeing local manufacturing as the future of pharmaceuticals in the country. This is the time we hope the government can wake up to its responsibility by putting stable power, good roads and infrastructure in place. I wish Miraflash the best of luck,” he noted.

Also speaking at the event was Dr Lolu Ojo, former NAIP chairman, who admitted that the timing of the factory unveiling came to him as a surprise, given prevailing economic challenges.

“I congratulate the management and staff of Miraflash. It is a good thing. I must admit that it came to me as surprise because, in truth, this is a trying period when many companies are folding up. But for an indigenous manufacturing company to come up with a factory as big as this is indeed no mere feat. I congratulate the host State (Ogun), PSN, NAIP and Nigerians at large,” he remarked.

Ojo, who is also the managing director of Merit Healthcare Limited, Isolo, Lagos, started that the arrival of Miraflash plant would add to the growing list of local manufacturing companies, as well as benefit the country with quality products and employment creation.

In his welcome address, Prof. Ayo Arije, a consultant physician at the University College Hospital (UCH), Ibadan, educated the audience on the importance of pharmaceutical products where health is concerned.

“When you talk about drugs, we are discussing things that have a lot to do with the human life. It demands quality. It is even more important to engage a company that can deliver such quality,” he stressed.

The physician recalled that there was a time that his institution placed restriction on some drugs because the pharmaceutical companies manufacturing them were inconsistent in terms of quality control, adding that the country had gone beyond the stage of mediocrity and ignorance.

“In the past, we focused too much on witchcraft, where chronic diseases and illnesses were concerned. Thank God that such ignorance has been done away with. Nigeria is a developing country where making drugs revolves around availability and affordability. Let us continue to support local manufacturing companies like Miraflash,” he urged.

In his words of exhortation, Pastor Magnus Maduka, of the Redeemed Christian Church of God, Province 64, admonished the staff to sustain whatever they had done to bring the company to such enviable level.

While expressing his gratitude, Pharm Moses Oluwalade, Miraflash’s managing director, who described the launch as “an event of joy,” expressed optimism about the future of local manufacturing companies in the country.

“We are also particularly grateful to both the Pharmacists Council of Nigeria (PCN) and the National Agency for Food and Drugs Administration and Control (NAFDAC) for their invaluable support” he said.

According to him,  Miraflash, as at 2005, was only involved in the local manufacturing of four oral dry suspension powders which, include: Miramox (Amoxycillin), Miraclox (Ampiclox), Mirapicin (Ampicillin) and Cephaflash (Cephalexin) 125miligrammes.

He noted, however, that through hard work and purpose-driven management, Miraflash Nigeria Limited had made tremendous progress with the introduction of a capsule line at the newly commissioned factory.

Approval for the new range of capsules was given by both the National Agency for Food and Drug Administration and Control (NAFDAC) and the Pharmaceutical Council of Nigeria (PCN). “Today, the company sells over 37 high quality products at affordable prices all over Nigeria” he said

Speaking further, Oluwalade declared that Miraflash was one of two pharmaceutical companies selected in Nigeria by Standford Seed Innovation Programme (West Africa) in March 2015 for transformation of developing economies through the scaling of medium to large companies by intensive training and development of manpower and structural capacity.

The programme has enabled the company as a medium-sized company to establish some set goals to be achieved within five to ten years. He, however, called on the government to tackle the issue of the current prohibitive interest rate of commercial banks as no manufacturer can survive with an interest rate above 10 per cent.

The pharmacist urged pharmaceutical companies not to compromise on the quality of their products, while also urging pharmacists to embrace the use of new technologies, especially in checking the incidence of fake drugs.

“What we did in our own case is to adopt the Mobile Authentication Service (MAS) technology to help consumers verify the genuineness of the products they are buying.

“Anytime you buy our products and text the number on the scratch card, you will immediately receive an alert telling whether the drug is genuine or fake. Every pharma manufacturer producing antibiotics and antimalarial has that responsibility,” he emphasised.

The highlights of the event included the unveiling of Miraflash brands and a media tour of the factory which was led by the managing director and other distinguished pharmacists in the manufacturing industry.

In attendance were Pharm Ade Popoola, director of Reals Pharmaceutical; Pharm Ademola Adeoti, managing director of Synergy Healthcare Limited; Olakunle Olufisayo, Miraflash’s general manager (sales); Olufemi Odunayo, area manager and Yusuf Olukule, assistant national sales manager.

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