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Symptoms of poor blood circulation

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Heart disease

(By R. Sharp)

Circulatory problems do not begin in a day. In other words, you could call the heart a very patient organ, which can take years of abuse and when it cannot take it anymore, breaks out with symptoms.

At the outset, we need to remember that poor circulation is an outcome of certain lifestyle choices which we make which are detrimental to our health. Coupled with these are factors like imbalanced diet and lack of physical exercise. All these factors lead to fatty deposits on the arterial walls, which, when hardened, are called plaques. These plaques then block or create obstructions to the smooth passage of blood to and from the heart.

Plaques take a long time to be formed; that is the reason, we find circulatory problems affecting the elderly more often than they affect children. Our food habits also add to an unhealthy build-up of cholesterol which may increase the viscosity of the blood, which again creates anomaly in the smooth flow through arteries and veins.

Since the circulatory system covers our entire body, the problems can also be manifested in numerous ways. For instance:

 

The brain – Our brain receives 20 per cent of the blood circulated in our body. With a drop in the flow, our brain functions sub-optimally, resulting in feeling lethargic, loss of memory, lack of mental clarity, etc. Frequent unexplained headaches and sudden attacks of dizziness are also seen as symptoms of poor blood circulation to the brain.

 

The heart – When poor blood circulation affects the heart, the symptoms would be chest pain, high blood pressure and rise in the level of cholesterol. Difficulty in performing any common task, like climbing stairs; walking a stretch could make you very tired and breathless.

 

The liver – When you suffer from lack of appetite or experience sudden weight loss and your skin looks lustre-less, it is quite possible that your liver is getting ‘sluggish’ and these are the early symptoms of poor blood circulation to the liver.

 

The kidneys – This organ plays an important role in regulating and monitoring our blood pressure other than eliminating the waste and excess water from our bodies. When poor blood circulation affects the kidneys, we notice swelling of hands, feet and ankles, rise in blood pressure, altered heart rate and we feel tired all the time.

 

The limbs – Poor blood circulation can have serious impact on our arms and legs. We can experience sudden numbness of our hands, feet and fingers or suffer painful leg cramps. Symptoms of serious blood circulation problems can be varicose veins or a condition called cyanosis – which is when part of our skin turns blue or black due to lack of adequate oxygen to the concerned tissues.

 

Sex drive – Poor blood circulation can affect our reproductive organs as well. The symptoms are lack of sex drive and fatigue. Symptoms would also include lack of vitality. Serious blood circulation problems could also make one impotent.

 

Source:www.healthguidance.org

 

Lakeshore Cancer Centre opens in Nigeria

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In a renewed effort to bring quality care closer to patients, Lakeshore Cancer Centre (LCC) has formally launched its operations in Nigeria.

lakeshore
L-R: Bindiya Chugani, business manager at Lakeshore Cancer Centre; Dr Chumy Nwogu, the CEO &medical director, special oncologist and cancer prevention expert, Lakeshore; Dr Yinka Akinyemiju, pain & palliative care specialist, Lakeshore; and Dr Jimoh Mutiu Akin, consultant radiation/clinical oncologist, Lakeshore, during the media launch of Lakeshore Cancer Centre in Lagos

The ribbon-cutting ceremony, which took place in the state-of-the-art facility in Victoria Island, Lagos, on 24 January, 2015 witnessed a massive turnout of participants.

Aside offering skeletal services since July 2014, LCC is solely designed by a team of global experts on surgical and radiation oncology, for high quality prevention and treatment of cancer.

Affiliated to the Roswell Park Cancer Institute (RPCI) in Buffalo, New York, USA, Lakeshore Cancer Centre is the oldest cancer centre in the world. The RPCI provides training, education and clinical care oversight and research programmes to the centre.

Speaking at the event, Chief Executive Officer and Medical Director at LCC, Dr Chumy Nwogu, noted that cancer kills more people globally than malaria, HIV and Tuberculosis (TB) combined, and disproportionately affects low to middle income countries like Nigeria.

He explained that the 2012 data of the International Agency for Research on Cancer, stipulates 102,079 new cancer cases every year and 71,571 cancer deaths annually in Nigeria.

“This is probably a marked underestimation, as cancer registration is really poor in Nigeria. Over 70 per cent of patients die despite the fact that we do not capture all of them – over 20 percent of people with cancer are still not captured. This is because many patients usually seek alternative treatments, traditional healers or prayer houses. These numbers are predicted to rise dramatically over the next few years,” Nwogu disclosed.

The medical director, who is a highly respected cancer epidemiologist and thoracic surgical oncologist, further stated that, “the World Health Organisation (WHO) estimates that one third of cancers can be prevented, one third cured and one third effectively palliated; hence the great need for education, screening and early detection.”

He said the LCC is committed to providing cancer patients with tools for early detection, diagnosis and consultation with excellent oncologists, without having to travel away from loved ones at home.

The centre also launched the Foundation for Cancer Care in West Africa (FCCWA) to provide cancer care to the less privileged in Nigeria and across West Africa.

“The treatment for cancer is capital intensive and long term, so most individuals cannot sustain the cost. The Foundation is therefore focused on fostering collaboration between government agencies, corporate organisations, various medical facilities and advocacy groups. Philanthropic donations are always welcome and much appreciated for the care of cancer in West Africa,” Nwogu explained.

Also speaking at the event, Associate Professor of Oncology at the RPCI, Dr Tracey O’Connor, said that early screening and detection are indispensable in the prevention and management of cancer.

“Three cancers – breast, cervical and prostate – claim the highest number of lives in Nigeria. But all of them, if brought to medical attention early in their development, are highly curable. So, basically, testing and early detection can hugely reduce fatalities,” she stated.

O’Connor counselled Nigerians to go for screening. She also recommended the Human Papillomavirus (HPV) vaccine for young girls of 11 to 12 years.

“The vaccine is to prevent the human papillomavirus which cause most cervical cancers,” she explained.

Wife of the Lagos State Commissioner for Transport, Mrs Abiodun Opeifa, who represented the First Lady, Mrs Abimbola Fashola, commended the LCC for establishing “this great cancer facility in Lagos State. This will sure increase awareness about cancer prevention and treatment; and drasticallyreduce incidences of preventable cancer deaths.”

The LCC provides diagnostic imaging services, mammography, pap smear, laboratory services, public education awareness, tissue biopsis, outpatient operative procedures chemotherapy services, and palliative care. The facility also provides minor surgery, oncology consultation, cancer treatment planning as well as outpatient pharmacy.

Now that JOHESU’s strike is over.

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I know what its takes for a staff to be off work for almost three months, all in the name of an industrial action.The good news is that the prolonged strike has been called off after the intervention of Mr President, who had promised to look carefully into all there demands.
Pharmanews Limited- the West Africa’s Foremost Health Journal, seizes this opportunity to wish all health workers happy resumption, and quick recovery on all lost grounds while at home.

Professor Paul Akubue becomes Professor Emeritus

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4x6 main

The Vice-Chancellor, University of Nigeria, Professor Benjamin C. Ozumba (left), congratulates Professor Paul Akubue (right) after conferring on him the title of emeritus professor of the university and presenting him the certificate, during the 44th convocation ceremony of the university, held on 24 of January, 2015. Next to Prof. Akubue on his right is his wife, Associate Professor Felicia N. Akubue.

I’m set for ACPN national chairmanship – Pharm. Alkali

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Pharm Alkali

In this exclusive interview with Pharmanews, current national vice-chairman of the Association of Community Pharmacists of Nigeria (ACPN) Pharm. Albert Kelong Alkali Pharm. spoke on some of the achievements of the present administration under the leadership of Pharm. (Alh) Olufemi Ismail Adebayo, as well as his aspiration to become the next national chairman. Excerpts:

 

Briefly tell us about yourself, especially your academic background

I am Albert Kelong Alkali, a community pharmacist and managing director, Medisal Pharmacy, Abuja. I graduated from Ahmadu Bello University, Zaria, Kaduna State, in 1991, after which I went into the industry as medical representative for Roche Pharmaceuticals Nigeria Limited (before they changed to Swipha), covering the north/east zone. Since leaving Rochi in 1999, I have been in community practice. I am currently a final year student in Pharm. D conversion, and in some couple of months, I will be Pharm. Doctor Alkali Albert Kelong.

Our pharmacy, Medisal Pharmacy, Abuja, has two premises – one in the National Assembly’s Quarters and the other at Wuse Zone 6.

 

How do you combine running a community pharmacy in Abuja with the responsibility of being a national vice-chairman of ACPN?

It all depends on planning.It also boils down to the fact that I have had enough experience, being a former chairman of ACPN, before becoming the national vice-chairman.So, I have mastered my planning and I know the way I plan my activities, so that my personal business and the national assignment do notdisturb each other. I am the superintendent pharmacy for one of the outlets, while the other one is being superintended by another pharmacist. Although it is not an easy task as it entails a lot of sacrifices, but with God, we are doing well and this has inspired me to go a step higher – I am hoping to become the next national chairman of the ACPN by the grace of God.

 

Why did you choose community pharmacy practice ahead of other aspects of the practice?

Let me be sincere with you, community pharmacy practice is very interesting. I started with the industry as a young man because the industry had prestige then, and you were also well-remunerated and well-trained. As medical reps then, we could do presentation and we underwent series of trainings that were quite interesting.Meanwhile, hospital practice was the least interesting then because the environment was not conducive. But I want to tell you that community practice is an embodiment of both the hospital practice and the industrial, because you combine all. Some people come with prescriptions, while others come without any. I think it has been the most interesting as it affords you the opportunity to meet people, solvetheir problems, put smiles on their faces, while you also make money.

 

Why do you intend to vie for the office of national chairman of ACPN?

I know I am capable to be the national chairman after having understudied my present chairman, Pharm. Olufemi Ismail Adebayo from day one in office. I have also been in the Council as the state chairman, FCT branch, in the past.So I know some of the challenges that we are facing and I have the pedigree to be able to lead the association well and achieve greatness for the association.

I also have deep passion for this association and I’m glad that I’m a pharmacist because it has improved and equipped me with a lot of knowledge. With vision and focus, I am ready to steer the association to the next level. Also, with the calibre of chairmen we have had and the wealth of knowledge of the outgoing chairman, coupled with the direction I have set for myself, I think I will be able to, at least, match or supersede what the outgoing chairman has done because I am one of his loyal students (Laughs).

 

What gives you confidence that you can lead an association as complex as the ACPN?

As the national vice-chairman, I have worked closely with my chairman and whenever I advise and he feels the advice is useful, he takes it.Also, from the experience I have garnered working with him, I have developed many ideas for projects and programmes for the advancement of the profession and the association which I would love to implement when I emerge the national chairman of our association.

This administration, under the able leadership of Alh. Ismail has done its best and I am hoping to continue wherever it stops. At the end of the day, I would love to see community pharmacy practice members that are doing well, giving back to the society and providing the public with the needed therapeutic attention, as well ridding the society of fake and counterfeit medicines.

With 23 years’ post-graduation experience and having been a Fellow of the WAPCP since 2005, state chairman and member, National Executive Council (NEC) for five years, and being a national vice-chairman for three years or so, I am quite mature for the job, and I am willing to take this association to the next level by the grace of God.

 

Tell us some of the achievements and challenges as of the present administration in the last three years in office.

 

Well, under the able leadership of my national chairman, Pharm. (Alh) Olufemi Ismail Adebayo, we have been able to come up with the mission and vision statements for the association which have defined our focus and goals from inception. The association now has a new logo and, of course, the public is now better enlightened on whom a qualified and registered community pharmacist is compared to those days when quacks and charlatans almost took over the practice from the professionals.

In addition, we have done enough to improve the welfare of our members and also enhance their practice. However there is still much to be done because we cannot work in isolation. The regulatory agencies also have to do their work so that the practice can be better than it is now. I am very happy that we have a new registrar at the level of PCN and the new board of council. From the way they are going, they are charting a new course for the profession, and if things continue this way, I think pharmacy practice will be much better than what it is now.

 

How do you see pharmacy practice today compared to what it used to be?

It is getting a lot better and I will also like to say that my own pharmacy practice has been enhanced by the fact that I enrolled in the Pharm. D conversion programme, which, to me, is the best thing that has ever happened to pharmacy in Nigeria. I am saying this because, by the time you graduate as a Pharm. D holder, you become well-grounded. The University of Benin that is presently doing the conversion is doing well. Today, I have patients who come to my premises for immunisation, some for counselling, some with chronic ailments such as hypertension, diabetes and others; while some come specifically because they want to see and talk to the pharmacist. This can only be possible when they have confidence in you. So, in a nutshell, pharmacy practice, from my point of view, is now better practised than what it used to be.

 

Are you suggesting that all pharmacists who have B.Pharm. should also go for Pharm. D?

Definitely yes, that is the way forward. All pharmacists should go for Pharm. D, while those who already have B.Pharm. should go for conversion. This doesn’t mean it’s a must for everybody but all those intending to be pharmacists should go for the Pharm. D because it is a unique degree that brings one closer to the patient.

The reason some set of people are trying to take away the practice from us is because we are not close to the patients. So, if we are close to the patients as well as the molecules, other healthcare professionals will respect us as being important in healthcare delivery.

 

As someone who has been in the practice for a while, how would you assess pharmacy practice in the country?

Pharmacy is a profession that is highly specialised and thrives well in a properly regulated society and that is why in the US and the UK, pharmacists are in the top class of society. However, in our country today, the practice environment needs to be sanitised and that is why we have so many of our colleagues not doing too well.

However, despite the chaotic situation we find ourselves, if, as a pharmacist, you are able to define yourself and do what you are supposed to do in your practice area, you will realise that your community will appreciate what you are doing and you will be popular in their midst. So, the practice is highly rewarding for those who know what to do, in terms of pharmaceutical care and others.

 

As one of the stakeholders, what is your view on the happenings in the healthcare sector in the country?

The healthcare sector today, to me, leaves much to be desired. We are supposed to do better than we are doing now, but some doctors (don’t let me say all) continue to see pharmacists as rivals in the industry. I know that it’s just specialisation that separated the two because pharmacy and medicine are the same as they aim at achieving the same result, which is healthcare provision. Also, none of the healthcare providers can work in isolation, because the physician may not be able to work effectively without the pharmacists, while the same applies to others. So, as far as I am concerned, it is just ego problem, which is not good for the sector. Healthcare provision should be about patients.

 

Re: Now that ACTs appear to be failing

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 Below is an insightful rejoinder I received from Professor David T. Okpako on my article, “Now that ACTs appear to be failing.

 

The article in the January 2015 issue of Pharmanews, page 46, with the above title, written by Pharm. Nelson Okwonna, caught my attention and compelled me to write this brief response.

The article dealt with the important issue of emerging Plasmodium falciparum resistance to the artemisinin-based combination therapies (ACTs), now the drugs of choice for the treatment of malaria disease throughout Nigeria. The author raised the apocalyptic scenario of an ‘epidemic of monumental proportions’ for Nigeria, the epicentre of malaria disease, in the event of resistance to ACTs.

I have also raised such alarm before and, again, in a forthcoming book, where I drew attention to modern medicine’s historical experience with the disease caused by tubercle bacillus (TB) which was treated successfully with effective affordable drugs in the 1950s, but which later developed resistance to such drugs, and then to every generation of anti-TB drug that science could invent. Today there are some strains of TB (extensively resistant TB) which do not respond to chemotherapy –a nightmare scenario and one of today’s most intractable chemotherapeutic problems, even in the western world.

Among Nelson’s recommended solutions is a most telling point, i.e., “heading home for answers” -where he suggests that, in our attempt to tackle the problem of multi-drug resistance in malaria,we should look at the possibility of combining our local herbs with known existing therapies. This is a most insightful suggestion for which there is strong scientific evidence, which I may very briefly point to. Basically, malaria is a disease whose pathology is underpinned by inflammatory mechanisms triggered by the presence of the plasmodium parasite.The evidence that malaria is an inflammatory disease is now overwhelmingly incontrovertible. And the herbal remedies used by various indigenous communities in Nigeria to treat fever, aches and pains (FAP), the quintessential manifestations of the inflammatory reaction, have been shown by Nigeria scientists in the last 30 to 40 years to possess anti-inflammatory pharmacological properties.

We can thus say with confidence that ancient Nigerians, in their malaria endemic zones, evolved a rational method of treating what must have been a common ailment, malaria fever,with herbs, that worked.There is no evidence that Africans were near extinction due to malaria disease, before modern chemotherapy came to the rescue.

The ancients were ignorant of the mosquito/parasite origin of the disease, but they treated the symptoms (many people in Nigeria still do).I argue that such successful treatment of malaria-induced FAP is tantamount to cure in Africans living continuously in contact with the anopheles mosquito.This is because the people have partial immunity conferred on them by anti-plasmodium antibodies and numerous genetic protective adaptations e.g., sickle cell gene and glucoe-6-phosphate dehydrogenase enzyme deficiency; their immune system was primed ready to deal with the plasmodiumparasite whenever it showed its presence. In such people, all that is needed is a successful amelioration of the malaria-induced inflammation (some mediators of inflammation, e. g., the cytokine, tumour necrosis factor, TNF, actually suppress immune activity in the sufferer); the resulting surge in anti-plasmodium immune activity in such people would eliminate the parasite, resulting in a cure of the disease. Moreover, the immune status of the individual against the plasmodium was strengthened after every bout of malaria-induced FAP, and successive attacks would be less severe in a process of natural attenuation of the parasite. This was how Africans living in malaria endemic areas came to attain a state of biological equilibrium with the disease before European introduction of modern chemotherapy with plasmodicidal drugs less than 500 years ago.As we now know, the use of plasmodicidal drugs in the treatment of malaria runs against the grain of that age-old biological equilibrium.

An important advantage of herbal treatment is that the parasite is not provoked into mobilising its considerable arsenal of resistance mechanisms, which is what happens when we use plasmodicidal anti-malaria drugs such as chloroquine and the ACTs whose aim is to kill the plasmodium.The malaria multi-drug drug resistance that we see in Plasmodium falciparum is a defence reflex against extinction by an ancient parasite that sees itself threatened.

Drug resistance was an unknown phenomenon in Africa before the extensive use and abuse of anti-malarial drugs, following the introduction of modern chemotherapy. Even when fully fleshed out, this hypothesis is, at best, a most plausible hypothesis; but it can be tested and represents a challenge to the Nigerian medical community which, up till now, seems to accept foreign prescriptions on malaria without question.

Pharmacists and doctors and all who are familiar with this science must work together and pressurise the government to fund concerted research into traditional anti-FAP herbal remedies for development as anti-malaria therapies, or as adjunct to conventional therapies, as Nelson wisely suggested in his article. This is to ensure that not every adult otherwise healthy Nigerian with a competent immune status and partial immunity should have to take powerful resistance-provoking plasmodicidal drugs such as the ACTs for the treatment of FAP that has not been diagnosed as malaria disease. This, plus other smart designs in the use of effective plasmodicidal drugs, will increase their life-span by minimising the chances of drug resistance.

I am thus in full agreement with Nelson Okwonna that we should head home for answers by turning to indigenous herbal remedies. The world is turning to plants for anti-inflammatory medicines because the array of anti-inflammatory chemical entities present in plants is mind-boggling and cannot be matched by non-steroidal anti-inflammatory drugs produced by synthetic chemists in the pharmaceutical industry.

All in all, the time has come (aided by science!) for us in West Africa to begin to see malaria disease as our ancestors understood it – that is, a common ailment treatable with available herbal remedies, not a deadly disease of epidemic proportions as we have been conditioned to perceive it by international experts guided by a persisting fear of the disease; a fear reinforced by their memory of numerous malaria deaths of non-immune Europeans in their first encounter with the disease in West Africa in the 19th century.

David T. Okpako, FPS, FAS.

Quality measurement and management in health care systems

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Maintaining leadership in health care management is unachievable if the quality of health care cannot be measured. A good health care system allows for effective evaluation in order to know what exactly the quality of care is, and how well it is delivered.

Sadly, in most developing countries, there is no mandatory national healthcare system to track the quality of care delivered to the citizens. Much of what is done is spontaneous delivery of health care within an existing cyclic health structure that has existed for many years without recourse to change.

On the other hand, in developed countries, interest in measuring quality of health care has initiated dramatic transformations of health care systems, accompanied by new organisational structures and reimbursement strategies that could affect quality of care.

Why is the measurement of quality in health care difficult in the developing ones? Apart from a lack of documentation about how major illnesses are treated in most health care systems, there are other factors, which include:

  1. A lack of systematic outcome assessment.
  2. A lack of resource evaluation related to quality for specific diseases.
  3. Persisting variations among providers in care for similar patients.
  4. Paucity of formal monitoring systems by health care providers or regulators.

 Assessing quality care

Understanding quality of care is quintessential to effective leadership in health care management. Quality carecan be defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes, become consistent with current professional knowledge, and divided into different dimensions according to the aspects of care being assessed. This cannot be achieved without effective management; in fact, management is the commitment required to achieve quality health care objectives. It involves coordinating, leading and motivating people in order to achieve a set objective. It entails the efficient use of all available resources.

Our focus here is the measurement of the quality of health care. How do we know how well we are doing? Are there precise measurement tools for measuring an existing health care system?

There are quantitative measures that can be used to monitor and evaluate the quality of important governance, management, clinical, and support functions that affect patient outcomes. These quantitative measures are carried out using indicators.Indicators aremeasures that assess a particular health care process. They provide a quantitative basis for clinicians, organisations and planners aiming to achieve improvement in care, and the processes by which patient care are provided. Indicators are a form of clinical quality measures (CQMs).

 About clinical quality measures

      Clinical quality measures(CQMs) are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) within a health care system. These measures use data associated with providers’ ability to deliver high-quality care or relate to long term goals for quality health care.

CQMs measure many aspects of patient care, including, health outcomes, clinical processes, patient safety, efficient use of health care resources, care coordination, patient engagements, population and public health, and adherence to clinical guidelines.

The importance of using an effective indicator cannot be overemphasised. Indicators serve crucial purposes. They make it possible to:

  1. Document the quality of care;
  2. Make comparisons (benchmarking) over time between places (e.g. hospitals);
  3. Make judgements and set priorities (e.g. choosing a hospital or surgery, or organising medical care);
  4. Support accountability, regulation, and accreditation;
  5. Support quality improvement; and
  6. Support patient choice of providers

Also,the use of indicators enables professionals and organisations to monitor and evaluate what happens to patients as a consequence of how well professionals and organisational systems function to provide for the needs of patients.

However, indicators are not a direct measure of quality. This is because quality is multidimensional; hence, in order to understand and measure quality, different measures must be employed. Although indicators are not sole determinants of measuring quality, they must be ideal indicators. They are said to be ideal if they are based on standards of care. These ideal indicators can be evidence-based and derived from the academic literature. Where scientific evidence is lacking, it can be determined by an expert panel of health professionals in a consensus process, based on their wealth of experience. Thus, indicators and standards can be described according to the strength of scientific evidence for their ability to predict outcomes

 Characteristics of an ideal indicator

An ideal indicator:

* Is based on agreed definitions, and described exhaustively and exclusively;

* Is highly or optimally specific and sensitive; that is, it detects few false positives and false negatives;

* Is valid and reliable;

* Discriminates appropriately;

* Relates to clearly identifiable events for the user (e.g. if meant for clinical providers, it is relevant to clinical practice);

* Permits useful comparisons; and

* Is evidence-based. Each indicator must be defined in detail, with explicit data specifications in order to be specific and sensitive.

It is important to know that indicators may vary in their validity and reliability. Validity is the degree to which the indicator measures what it is intended to measure. This means the result of a measurement corresponds to the true state of the phenomenon being measured. A valid indicator discriminates between cares, otherwise known to be of good or bad quality, and concurs with other measures that are intended to measure the same dimension of quality.

Reliability, on the other hand, is the extent to which repeated measurements of a stable phenomenon by different data collectors, judges, or instruments, at different times and places, get similar results. Reliability is important when using an indicator to make comparisons among groups or within groups over time. These two qualities must be considered when choosing an indicator.

Types of indicators

There are different classifications of indicators that may be useful when considering which should be used for a given purpose in an organisation. An indicator can be any of the following:

* Rate-based or sentinel;

* Structure/process/outcome-related; and

* Generic or disease-specific.

* Type of care, function, and modality-related

Rate-based and sentinel indicators

A rate-based indicator uses data about events that are expected to occur with some frequency. These can be expressed as proportions or rates (proportions within a given time period), ratios, or mean values for a sample population.

To permit comparisons among providers or trends over time, proportion- or rate-based indicators need both a numerator and a denominator, specifying the population at risk for an event and the period of time over which the event may take place. An example of rate-based indicator is: “clean and contaminated wound infection” where the numerator is the number of patients who develop wound infection from fifth post-operative day after clean surgery and the denominator is the total number of patients undergoing clean surgery within the time period under study who have a post-operative length of stay for five days.

Moreover, a sentinel indicator identifies individual events or phenomena that are intrinsically undesirable, and always triggers further analysis and investigation. Each incident would trigger an investigation. Sentinel events represent the extreme of poor performance and they are generally used for risk management. Example is the number of patients who die during surgery.

2.Indicators related to structure, process and outcomes

There are indicators that can be related to structure, process and outcome of health care. ‘Process’ denotes what is actually done in giving and receiving care; that is, the practitioner’s activities in making a diagnosis, recommending or implementing treatment, or other interaction with the patient.

On the other hand, ‘outcome’ measures attempt to describe the effects of care on the health status of patients and populations. Improvements in the patient’s knowledge and salutary changes in the patient’s behavior may be included under a broad definition of outcome and, so, may represent the degree of the patient’s satisfaction with care.

Further,‘structure’ refers to health system characteristics that affect the system’s ability to meet the health care needs of individual patients or a community. Structural indicators describe the type and amount of resources used by a health system or organiSation to deliver programmes and services, and they relate to the presence or number of staff, clients, money, beds, supplies, and buildings.It is important to note that the assessment of structure is a judgement on whether care is being provided under conditions that are either conducive or inimical to the provision of good care.

* Process indicators: Process indicators assess what the provider did for the patient and how well it was done. Processes are a series of inter-related activities undertaken to achieve objectives. Process indicators measure the activities and tasks in patient episodes of care. An example of process indicator is the proportionof patients treated according to clinical guidelines. Some authors include the patient’s activities in seeking care and carrying it out in their definition of the health care process; others limit this term to the care that health care providers are giving. It may be argued that providers are not accountable for the patient’s activities and these, therefore, do not constitute part of the quality of care, but rather fall into the realm of patients’ characteristics and behaviour that influence patients’ health outcomes.

* Outcome indicators: Outcomes are states of health or events that follow care and that may be affected by health care. An ideal outcome indicator would capture the effect of care processes on the health and wellbeing of patients and populations. Outcomes can be expressed as ‘The Five Ds’: (i) Death – a bad outcome if untimely; (ii) Disease – symptoms, physical signs, and laboratory abnormalities; (iii) Discomfort – symptoms such as pain, nausea, or dyspnea; (iv) Disability – impaired ability connected to usual activities at home, work, or in recreation; and (v) Dissatisfaction – emotional reactions to disease and its care, such as sadness and anger.

It should be noted that intermediate outcome indicators reflect changes in biological status that affect subsequent health outcomes. Some outcomes can only be assessed after years, for example, five-year cancer survival. It is, therefore, important to assess intermediate outcome indicators. They should be evidence-based and reflect the outcome (e.g. HbA1c in diabetes). They can be regarded as short-term outcomes.

Therefore, outcome measures must be adjusted for factors outside the health system, if fair comparisons are to be made. In quality assessment, components that relate to the medical care system should be isolated, which is accomplished by controlling for significant confounding factors that contribute to the outcome.

 

  1. Generic and disease-specific indicators

Generic indicators measure aspects of care that are relevant to most patients, while disease-specific indicators are diagnosis-specific and measure particular aspects of care related to specific diseases. Both generic and disease-specific indicators can focus on structure, process, or outcome.

Generic indicators may be difficult to interpret, especially when making comparisons among hospitals or providers, because there may be profound differences in patient mix. Examples of generic indicators are proportion of specialists to other doctors, registered patients in the emergency department, unscheduled returns to the operating room and in-patient mortality.

Disease-specific outcome indicators can be used to compare hospitals and plans, when data are risk-adjusted. Confounding factors, such as prognostic factors for specific diseases, are likely to be found in the scientific literature for these diseases, thereby, indicating the need for risk adjustment. Example of this type of indicator is the proportion of cardiologists to other doctors treating patients with heart failure at the department of cardiology.

  1. Indicators related to type of care, function, and modality

There are indicators that can be classified according to type of care, function, and modality. These set of indicators, classified by type of care, may be preventive, acute, or chronic.Also, quality measurement can be done based on health care functions such as screening, diagnosis, treatment and follow-up. This must be done alongside the modalities through which the health care process is done. Modalities in the health care process includehistory, physical examination, laboratory/radiology study, medication, and other interventions.

It is critical to evaluate and re-evaluate healthcare performance among professionals and organisations. These indicators can serve as a plumb line if indeed we seek leadership in health care management.

The table below captures this group of indicators and illustrates how they can be classified in quality of care measurement systems, especially in multiple clinical topics. The table displays examples of indicators classified according to type of care, function and modality

Indicator Type of Care Function Modality
Sickle cell disease: children with a positive sickle cell    Chronic Treatment Medication screen of children suspected of being positive for sickle cell disease should be placed on daily penicillin prophylaxis from at least 6 months of age until at least 5 years of age
Urinary tract infection: children with a diagnosed urinary tract infection should be reassessed at 48hours to determine if there is clinical improvement Acute Follow-up Other contact
Well-child care: the child’s weight should be measured at least four times during the first year of life. This information must either be plotted on a growth curve or be recorded with the age/gender percentile Preventive Screening Physical Examination

 

As always, our passion at the Pharmanews Centre for Health Care Management Development is to drive effective leadership through qualitative healthcare management. It is crucial to know that the measurement of health care quality is greatly aided by the use of relevant quantitative indicators, supplementing other approaches that may include qualitative analyses of specific events or processes. For a healthier Nigeria, indicators can also be important with regard to prevention, quality of life, and satisfaction with health care.

We believe that a more effective health care system is possible with the continuous education of health care personnel and the design of an effective platform for discourse among health care professionals. This explains the reason for our aggressive 2015 training campaigns across Nigeria and beyond.Join us as we advance the development of health care management around the globe.

Mentorship in health care leadership

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In health care, leadership positions are continually emerging. There is someone rising to a new position somewhere; at another place, someone is just being replaced, while some others have initiated leadership by creating a position that was previously not in existence, either by a new discovery or leadership simply initiated by knowledge. Though leaders are daily emerging, no one seems to be asking: who is mentoring these neophyte leaders?

Pharmanews Dudai workshop
Participants on a facility tour of the Medcare Hospital during the Health Care Financing and Innovation Workshop held in Dubai last year

Mentorship is principal in ensuring effective and continuous leadership in health care. No other system requires more precision and less error than health care; hence, the need for workers, even leaders, to seek mentorship. Sadly, mentoring in health care is not deliberately carried out, especially in most countries in Africa, where workers or new leaders are thrown in the wild to survive. In fact, there are only a few health mentorship programmes in Nigeria. Many health care organisations do not pay close attention to deliberate mentorship or other leadership development initiatives.

There are those who believe that a mentor-mentee relationship should occur naturally,rather than being a planned programme of action. As Byrne describes it, “mentorship though appears ubiquitous, yet elusive, not deliberately initiated but left to chance.”Developed countries like the United States of America have planned mentorship programmes. For example, the USACentre for Disease Control and Prevention sponsors a formal mentorship programme for Public health advisors – a strategy for developing new managers. So also does the American Dental Education Association (ADEA). Recognising the dearth of women in executive positions and serving as deans of dental schools, ADEA, in 1992, created a programme for women liaison officers (WLOs) appointed by dental school deans.The purpose of the programme was simple: to develop new women leaders.

According to Hawkins and Fontenot (2010), an important gift health leaders can give to their professions is to serve as mentors to those who will lead health care organisations and institutions into the next decades.

 

Requisite skills

Mentors in health care should possess certain qualities for effective mentorship. First, they should be highly cognisant of the professional landscape. They should not only be experienced, but should be fully aware of how the health system works – they should be abreast of long-standing structures and cultures.

Second, mentors should be visionary; they should have strategic insight into events that will later shape the climate of most circumstances in their chosen fields. They need this to provide direction for new leaders. In addition, mentors should be creative, risk-takers, inspirational and possess good communication skills.

Hawkins and Fontenot further add that mentors should be politically astute, sensitive to ebbs and flows of human life, and should possess self-knowledge.

Though these qualities are attractive,the style employed by a mentor can affect the quality of leadership he provides for a mentee in health care.

 

Relevant styles

There are different styles of mentorship adopted by mentors.Mentors’ styles are as varied as the persons who choose careers as health professionals.

According to Hawkins and Fontenot, some mentors appear to have a philosophy of mentoring that one can best characterise as trial by fire or critical, and others appear to have more nurturing styles. Both styles can either be effective or a hindrance for a mentee. The key is to discover the right match between mentor and mentee that will be beneficial to both parties.

Mentors who are toxic can do more harm than good for their mentees. They (Hawkins and Fontenot) quoted Darling (1985) as saying there are four categories of toxic mentors: avoiders who are seldom, if ever available and impossible to reach; dumpers, who believe in the sink or swim approach to surviving as professionals; blockers, who either micromanage or withhold information; and destroyers whose goal seems to be to undermine anything and everything the mentee proposes.

The trial-by-fire mentors may bombard their mentees with criticisms of their work in the extreme. The underlying philosophy appears to be that such hazing will toughen the mentees up for the real world of academia or clinical practice or whatever the field and role for which the mentee is preparing.

The nurturing style of mentoring is one in which the mentor assumes more of a parental role, creating a safe, open environment that allows the mentee to both learn and try new ideas and methods by himself. It is a more participatory style of leadership.

 

Rational strategies

Mentorship can be done in two forms. Byrne (1991), as quoted by Ehrich (1999), says mentoring can be traditional or formal. Under the traditional mentoring system, mentors employ their personal resources to assist their mentees to develop their career. The senior member in the organisation initiates a relationship with young members who he recognises as having certain potentials that could be developed. In this case, the mentor chooses his mentee. This form of mentorship is left to happen naturally, and though it appears sentimental, some best mentor-mentee relationships have been produced by this “natural selection” process.

In the twilight of the twentieth century, Byrne notes, mentorship became formal. Under formal mentorship, raising new leaders is a systemic policy issue and a standard part of management practice. Most times, the effectiveness of the policy rests on the following factors: mentor’s commitment to the programme, mentor’s compatibility with mentees, and mentor’s competences in terms of technicality and interpersonal skills. This type of mentorship is not voluntary.

Additionally, there is the professional mentorship system. This form of mentorship is voluntary. It is a process which is promoted and encouraged by top leadership as part of mainstream staff development. Leaders are simply encouraged to mentor young managers.

 

Resultant success

Studies conducted among health care leaders proved that those who have mentors were more likely to succeed than those who were not on any form of mentorship programme. In other words, mentorship, no matter the form, provides the mentee, as well as the mentor, with immense benefits.

First, the mentee enjoys rapid career advancement. Mentoring helps mentees navigate through the career path because they are being guided by those who have been there. They also enjoy personal support in carrying out their duties as they work under the supervision of a mentor. Mentees in a mentorship programme have the chance of increasing in learning and personal development.The strong sense of being under supervision can also help to increase mentee’s confidence.

Second, those who volunteer to or participate in mentorship programmes enjoy personal fulfilment. Mentors in health care, as in other fields, derive a sense of satisfaction for providing guidance to emerging leaders. This state, psychologists say, is a major motivation for mentors’ participation in a training programme. Also, they getassistance on projects as neophyte leaders can serve as research fellows and help to manage projects.

Third, a well- planned mentorship programme can befinancially rewarding for the mentor. Health care organisation may pay those who get involved in a mentorship programme, as it requires extra work and effort to successfully guide emerging leaders. In the same vein, coaches enjoy increased confidence. Success recorded from a mentorship programme will spur mentors to adopt more protégés and re-vitalise their interest in work.In addition, there are immense benefits for organisations that organise a mentorship programme.

 

Result-oriented structures

As earlier discussed, health care organisations in Africa need to plan, prepare and adopt monthly or yearly mentorship programmes for staff members. These mentorship programmes can be organised in-house or outsourced to health care training providers.

However, there are factors that influence the success of mentoring programmes.First, is the availability of time for mentoring. This often constitutes a major setback in mentoring, as those who should mentor sometimes complain of being short of time. Mentoring leaders require time, attention and a close follow-up on the activities of the mentee. For effective mentoring to take place, senior health executives should be ready to give their time, which in most cases, is very limited.

Second, is the training of mentors. Mentorship can only be as effective as the skills and personality of the mentor. For effective mentoring to happen, mentors must be thoroughly and continuously trained to be able to succeed in both group and individual coaching. A good mentoring programme is designed to train mentors to communicate with rather than talking to the mentee, andto network with other mentors.

Third, matching mentors and mentees can be a challenge to effective mentoring. Issues such as ethnicity, gender, and religion can influence a mentorship process. A good mentorship programme is planned to discourage outright rejection of any mentee or overly sentimental displays by senior executives in the choice of those to mentor.

Other factors include overdependence of mentee on the mentor, possibility of sexual attraction and clash between mentors and chief executives.

Despite all these, organisations still benefit greatly from mentorship programmes in that they lead to the development of their staff. According to Hawkins and Fontenot, physicians, nurses, physical and occupational therapists, dieticians, veterinarians, dentists, pharmacists, psychologists, social workers, and other health professionals assume their first leadership positions often with some trepidation. With formal mentoring, however, the confidence of such personnel is bolstered.

Similarly, mentoring increases staff commitment to the organisation. By enrolling a staff for leadership training, the employee views his organisation as committed to his welfare, and will in turn give away heartily his loyalty. Leadership programmes for mentors and mentees are cost effective, especially, on the long run. A lot is saved by encouraging mentorship among senior executives. Neophyte leaders, entrepreneurs and managers need to embrace mentorship programmes.

 

Recap/summary

In order for organisations to stay ahead in health care, there should be a constant improvement in leadership. The Pharmanews Centre for Health Care Management Development, for over 20 years, has continued to provide relevant and qualitative leadership training for mentors, managers and emerging leaders in the health care system. It is Nigeria’s leading healthcare platform for developing and networking health care leaders. Our leadership development programmes run for different months in the year, each designed to meet specific leadership and management objectives.

We believe that a more effective health care system is possible with a deliberate and well-planned programme of action for emerging leaders in the Nigerian health care industry. Attention needs to be paid to effective leadership through the discourse and implementation of pragmatic leadership models. Our trainings are not just events but well thought-out campaigns designed to initiate change in participating organisations and the health care industry.

We sustain a strong trainer-trainee network as well as promote open channels for mentor-mentee relationships. You can send nominations for any of our 2015 health leadership workshops, starting with the Health Care Entrepreneurship Workshop,scheduled for 24–25 March in Lagos.

Stay on this page, as we begin, from the next edition, a panorama of distinguished leaders in the Nigerian health care Industry.

 

References

Hawkins J. and Fontenot,H. Mentorship: The heart and Soul of health care Leadership. Journal of Healthcare Leadership. 2010: (2) 31-34

Naicker, I.; Chikoko, V. and Mthyiance, S. Does Mentorship Add Value to In-Service Leadership Development for School Principals? Evidence from South Africa.Anthropologist 2014, 17(2) 421-431

Ehrrich, L. Mentoring: Pros and Cons for HRM. Asian Pacific Journal of Human Resources. 1999: 37 (3) 92-107

Colgate Palmolive launches MCP toothpaste

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In its efforts to combat dental cavity and enhance oral health in the country, Colgate Palmolive Nigeria has introduced new toothpaste, Colgate Maximum Cavity Protection (MCP), produced with Pro-Argin Technology, a new anti-cavity technology.

The new toothpaste, which is also a sugar acid neutraliser, was recently presented to dental care professionals at the Sheraton Hotels and Towers, Lagos.

Colgate
L-R: Dr(Mrs) Bimpe Adebiyi, head, dentistry, Federal Ministry of Health (FMOH) and Mrs Hannah Oyebanjo, marketing director, Colgate Palmolive Nigeria during the event.

In its efforts to combat dental cavity and enhance oral health in the country, Colgate Palmolive Nigeria has introduced new toothpaste, Colgate Maximum Cavity Protection (MCP), produced with Pro-Argin Technology, a new anti-cavity technology.

The new toothpaste, which is also a sugar acid neutraliser, was recently presented to dental care professionals at the Sheraton Hotels and Towers, Lagos.

Speaking at the event, Dr Olabode Ijarogbe, president, Nigeria Dental Association (NDA), commended Colgate Palmolive for first introducing the product to dental care professionals before releasing it to the general public. He noted that what the company was introducing to the experts was revolutionary for oral health care.

Dr (Mrs) Bimpe Adebiyi, head, dentistry, Federal Ministry of Health, in her remarks, also commended the company’s initiative, noting that the successful convergence of NDA and other dental care professionals was a proof that the oral health community in Nigeria was united.

In her welcome address, Mrs Hannah Oyebanjo, marketing director, Colgate Palmolive Nigeria, said that the company had a lot of initiative for the country, adding that the introduction of Colgate MCP was just one of such.

Presenting the new product to the professionals at the event, Dr Ogechukwu Mac-Johnson, oral consultant, Colgate Palmolive Nigeria, said Colgate MCP was the first and only family toothpaste with a unique sugar acid neutraliser technology and fluoride.

She said the company was introducing the best cavity-protection toothpaste to the professionals, adding that research had shown that the product was so advanced that it decreased early decay by half.

Fluoride, she added, does not neutralise sugar or prevent cavity, unlike Colgate MCP, which is the future of cavity protection and would make things easy for the dentists.

Colgate MCP, Dr Mac-Johnson said, neutralises acids before they can harm the teeth, strengthens enamel with fluoride and calcium to prevent cavities from forming, decreases early teeth decay by half and reduces new cavity formation by 20 per cent.

 

The Living Sacrifice

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My friend, Ralph, drove some miles to my area of residence in Lagos one Saturday morning, some years ago. He was invited to the wedding ceremony of his nephew and was to serve as the chairman of the wedding reception after the church programme. Ralph drove round, looking for the church but could not locate it. Therefore, he decided to stop over at my house to help him locate the church. I was glad to see him but was not sure of the particular church he was looking for because there were many small churches in the area. I took him to one I suspected to be his target. However, on getting there, there was no life in the premises. The building was not impressive and the entire compound was deserted and unkempt that Saturday morning. Ralph looked around with disappointment and impulsively uttered, “Ifeanyi, let’s leave this place. God cannot be in this kind of place.”
Obviously, Ralph’s understanding was that God would only reside in well-built and attractive churches and would be uncomfortable in poorly maintained and dirty ones. He is not alone in this thinking. Some people still believe that the church is where God lives and you need to go there to meet Him. This is the reason we invest heavily on churches to make them habitable for God and provide conducive environment for the worshippers.
The truth is that, historically, God has always sought to dwell with His people. In the Garden of Eden, He had fellowship with Adam. After Israel left Egypt, He instructed them to build a portable tabernacle where His presence would dwell. In the land of Canaan, God dwelt with His people in the Ark of Covenant. The temple was built in Jerusalem under King Solomon.
However, the coming of Jesus Christ has changed this situation. God now dwells in us and not in buildings made by man. His children and not structures are now the temples or sanctuaries or churches. This truth can only be revealed to us by the Holy Spirit.
There are inherent responsibilities in God taking up His residency in us. God is holy and perfect, and, therefore, His presence demands a particular atmosphere in which to dwell. The totality of our being is to be presented as living sacrifices, holy and pleasing to God (Romans 12:1).
Romans 6:12-13 says, “Let not sin therefore reign in your mortal body, that ye should obey it in the lusts thereof. Neither yield ye your members as instruments of unrighteousness unto sin: but yield yourselves unto God, as those that are alive from the dead, and your members as instruments of righteousness unto God.” Our total being is for serving God. Our hands, eyes, feet, lips, mind and so on are for the service of God. The tragedy is that some people use these organs to work against Him and serve the devil. Being temples of God demands that we guard ourselves against the defilement of the world.
We are temples of God because when Christ saved us, He purchased us as a dwelling place. 1 Corinthians 6:19-20 says, “What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God’s.” This implies that we have lost the ownership of our bodies. We are merely stewards or caretakers of the dwelling-place of God.
It is indeed a great honour and privilege to be a dwelling place of God. I met one colleague during a conference I attended in Finland some years ago. He was the President of a large pharmaceutical company and he invited me for a tour of his facility. The report was published in Pharmanews. We exchanged phone calls a few times and then stopped. Surprisingly, he phoned me last year to inform me that he was visiting Nigeria for a few days and would like to spend the first one night with my family and then check into a hotel to receive his business associates. He told me to ask my wife to prepare local dishes for him to enjoy. As soon I got this message we started cleaning every part of our house and planning for the type of food to serve him. We purchased some fresh local fruits and also invited two family friends for dinner with our guest. We did all these because he was actually honouring us by spending one night with us.
Now I compare the visit of my friend with God coming to reside in our body. The body must be made ready, fit and pleasing to Him. This implies that we must keep the body clean. The type of clothes we put on the body matters to God. What we eat and drink is important to Him. The exercise we give to the body, the sleep we have, the medicines we take and the general care we give to the body are all important to God, who is the owner of the body.

Prof. Okogun tasks scientists on drug production from plant extracts

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Emeritus professor of Chemistry, Joseph I. Okogun, has said that for Nigeria’s indigenous herbals to be fully harnessed for the improvement of health care delivery, production of drugs from active principles is no longer an option but a necessity.

HERBALS
Okogun, who spoke extensively during the public lecture organised by the Nigerian Academy of Science (NAS), held at the Nigerian Institute of Medical Research, Yaba, on 28 January, 2015, called on all scientists, including biologists, chemists, pharmacologists and clinicians in the country to form a formidable team for the formulation of drugs from active principles on a large scale.
Speaking on the topic, “Drug Production Efforts in Nigeria 2: Anti-Cancer Remedies Emerge through Herbs, Chemistry and Biology”, the erudite don asserted that a smooth collaboration could enhance the development of some natural drugs as well as their formulation into prescribed drugs, with the use of the country’s plant extracts.
Okogu chided Nigerian scientists for their negative behaviour towards the efforts of herbal practitioners in the country, noting that such actions would not lead to the development of the health care sector.
He said it was high time researchers supported traditional practice by assisting in standardising the practice through clinical trials and other activities that would promote indigenous plants resources.
Analysing the manufacturing capabilities of the country, the renowned scholar said the country had, among other things, availability of human resources; presence of active principle isolation in over 99 per cent purity; extensive documentation by FDA and NAFDAC; as well as intellectual property protection and maintenance, which make the formulation of local herbal drugs a huge possibility.
He explained further that local manufacturers would be doing themselves and the nation a great disservice, if they persist in importing active principles, rather than utilising local medicinal plants, which can play better roles in the body chemistry of the populace.
Citing the example of a medicinal plant in Nigeria called gedunin, as published in Research Gate with the title: “An unprecedented gedunin rearrangement reaction converts a methyl group into the methylene group of a cyclopropyl ring”, he said the plant has several medicinal and commercial values, as indicated by the publication.
“Some of the activities of gedunin, when tested in the laboratory showed the following medicinal activities: anti-ovarian cancer, anti-colon cancer, anti-malaria, anti-allergy, and insecticides”, he listed.
In his own remarks at the event, Prof. Oyewale Tomori, President of the Nigerian Academy of Science, urged the federal government to give science the priority it deserves in the country. He said there was need to fund and develop drug researches, to reduce the burden of diseases and save many Nigerians.
“With the significant changes taking place in the country, science has not fared well, even with all the steps taken,” he observed. “The federal government should invest in basic science and drug researches to support the growth of the drug industry and other manufacturing industries. This initiative will encourage indigenous drug makers to take bold, strategic steps in local drug production and, in effect, spur the growth of the industry in Nigeria,”
President of the National Association of Nigeria Traditional Medicine Practitioners (NANTMP) Chief Omon Oleabhiele, also contributed by making a comparison between China and Nigeria, stating that if the Chinese could succeed on their native medicine of Acupuncture, which was initially kicked against by the World Health Organisation, then Nigerian scientists were inexcusable for not harnessing their local herbs for the development of drugs for their citizens.
He further mentioned that if government could allow traditional doctors to record the experiences of patients who were successfully treated with native herbs and became well, it would serve as a good platform for clinical trials, a development that would accord local traditional medicines global recognition.

Fever has benefits, says medical expert

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….. as GSK unveils Panadol Suspension, Scott’s Emulsion for kids

In an apparent bid to quell the fears often associated with fever, a consultant neonatologist has hinted that the health challenge is not as serious as many believe.

L-R: Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Kerry Alexander, marketing director, GlaxoSmithKline (Consumer) and Dr Bode Adesoji, GSK’s medical director for Anglophone West Africa, during the unveiling of two brands Panadol Suspension and Scotts’ Emulsion, at Oriental Hotel, Victoria Island, Lagos, on 15 January
L-R: Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Kerry Alexander, marketing director, GlaxoSmithKline (Consumer) and Dr Bode Adesoji, GSK’s medical director for Anglophone West Africa, during the unveiling of two brands Panadol Suspension and Scotts’ Emulsion, at Oriental Hotel, Victoria Island, Lagos, on 15 January

Addressing participants during GlaxoSmithKline (Consumer) Nigeria Plc’s launch of two new brands – Scott’s Emulsion Cod Liver Oil and Panadol Suspension for Children, which took place at Oriental Hotel, Victoria Island, Lagos on 15 January, 2015, Dr (Mrs) Mariya Mukhtar-Yola, a consultant neonatologist with the National Hospital, Abuja, said there was no universal definition for fever.
She added, in her presentation on “Management of Pain and Fever in Children,” that unlike what many people think, fever is a neurochemical response common to many animals.
“If this definition appears complex, perhaps, we should take that of English physician, Thomas Sydenham which states that ‘fever is nature’s engine which she brings into the field to remove her enemy.’ Isn’t it funny to note that, until recently, I never knew that even cats develop fever?” she quipped.
While attributing the major causes of fever to infection, vaccines, biologic agents, trauma, rheumatic disorder and genetic disorder, Mukhtar Yola disclosed that it was also pertinent to consider its benefits.
“For those who don’t know, fever has its own merits in the sense that it plays a protective role on the immune system, inhibits growth and replication of micro-organisms, and aids in acute body reaction,” she said.
Buttressing Mukhtar-Yola’s claims, Dr Yinka Osho, GlaxoSmithKline’s expert detailing manager, remarked that this is one area Panadol suspension (for children) is different.
“Panadol suspension provides fast and effective relief from pain and fever. It is also gentle on tiny tummies, easier to administer and has a pleasant strawberry-flavoured taste,” he said.
While appreciating the efforts of the key speakers, Dr Bode Adesoji, GSK’s medical director (Anglophone West Africa), said the presentations bordered on three domains, namely pharmacovigilance, clinical research and medical information.
In terms of pharmacovigilance, Adesoji said that today GSK’s products are notable for their robust link to the concept.
“Also, when we talk about clinical research, GSK is ahead. We are different from the kind of people you meet in Molue (Lagos commercial shuttle) who sell all-in-one products (that cure diarrhea, headache, fever etc). Our brands come with quality you can trust.
“Finally, in the third domain where we have medical information and promotional practice. It might interest you to know that GSK has moved from the old practice of paying speakers to participate in our programmes. As part of our transparency policy, we believe that once you have something genuine and important to present to the public, the speakers will willingly agree to participate,” he stressed.
Speaking on Scott’s Emulsion Cod Liver Oil, D. Chikara Nwoke, another GSK’s expert detailing manager said that the product was a brainchild of Scott and Bowne Company, established in 1876 in New York City.
Labelled as “Scott’s Emulsion Cod Liver Oil,” it is said to be rich in cod liver oil, which is a natural source of Omega-3 Vitamin A & D, calcium and phosphorus. It is also said to help children to build their natural body resistance to infections like coughs and colds and develop strong bones and teeth during their growing years.
Nwoke described the product as a brand trusted by mothers for generations to help protect their children from coughs and colds, so that they will grow strong and healthy.
The products’ unveiling had several pediatricians, pharmacists, physicians, neonatologists and nurses in attendance. Notable among them were Prof. Olowu Adebiyi, president, Paediatric Association of Nigeria (PAN); Pharm. Olumide Akintayo, president, Pharmaceutical Society of Nigeria (PSN), Pharm. Ismail Adebayo, chairman, Association of Community Pharmacists of Nigeria (ACPN) and T. S. Dayanand, managing director, GlaxoSmithKline (Consumer).
Others were Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Dr Olufemi Dosunmu, managing director, Bomi Clinics, Sango-Ota; and Kerry Alexander, marketing director, GlaxoSmithKline (Consumer).

Dons, pharmacists mourn Prof. Sofowora

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UntitledDistinguished pharmacist, scholar and researcher, Prof. Abayomi Sofowora, former Chairman of WHO Regional Expert Committee on Traditional Medicine is dead.

Sofowora died on 22 January, 2015 after a brief illness. Prior to his death, the erudite pharmacist had lectured Pharmacognosy for over 45 years. He spent 40 year in the Department of Pharmacognosy, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife (October 1967–December 2007). He was head of the Drug Research Unit; Head of Department of Pharmacognosy and dean of the Faculty of Pharmacy. He also served as consultant to WHO, OAU (now AU), UNDP, UNIDO, ADB, ECA and TCDC.

From February 2010 to January 2013, Sofowora was visiting professor to the University of Maiduguri. He spent another two years as adjunct professor in the Department of Pharmacognosy, Delta State University, Abraka.

Speaking on his passing, Prof. Fola Tayo, pro-chancellor, Caleb University described the late don as a luminary and great teacher of Pharmacognosy.

“He came back very active after his training at University of Nottingham. Sofowora was a frontliner in the 1970s. In Ife (OAU), he remained committed and trained quite a number of students,” Prof. Tayo said, adding that, “Sofowora represented so many things – from Fagara project to his mark in sickle cell treatment.”

Prof. Paul Akubue, retired vice chancellor of Madonna University, Port Harcourt, Anambra State told Pharmanews that the news came to him as a shock.

“Honestly, I am still in shock. He was such an active researcher, very much involved in traditional research. Even though I wouldn’t be able to say much about him, I can tell you that we were contemporaries and travelled together on a couple of occasions. This is quite painful!” he lamented.

In his own remarks, Pharm. (Sir) Ifeanyi Atueyi, publisher of Pharmanews, described the death of the celebrated don as a great loss to the pharmacy profession and the entire academic community.

“Professor Sofowora devoted his life to academic pursuit and fully served at the Obafemi Awolowo University, Ile-Ife,” Atueyi said.”The inauguration of the Nigeria Academy of Pharmacy last year offered him the opportunity to share his wealth of experience on academies and constitutional issues. His exit reminds us that death is the lot of mortals and all we need to do is live right while there is life and fulfill our destiny.”

Also commenting on the sad event, veteran pharmacist and Fellow of the Nigeria Academy of Pharmacy, Pharm. Godfrey Obiaga, noted that Sofowora would be greatly missed by the scientific community and the nation as a whole.

“He was a great teacher. Many students of Pharmacy passed through him, one way or the other. He will be greatly missed, but we cannot question God,” he stated.

While praying for the family of the deceased for consolation and fortitude, Obiaga equally challenged fellow pharmacists to sustain the legacies of the departed icon.

“Pharmacists must honour him greatly and do what we can to build upon what this great pharmacist started,” Obiaga enthused.

As reward for his selfless service to pharma research and the community at large, he was honoured with special recognitions, including Fellow of the Nigeria Academy of Pharmacy (FNAP), Fellow of the Pharmaceutical Society of Nigeria (FPSN), Fellow of the West African College of Pharmacy, Great Achievers Award of Obafemi Awolowo University, Fellow of the Nigerian Society of Pharmacognosy (FNSP) and an award by the Sickle Cell Association of Nigeria, Ibadan.Untitled

ACPN cautions against self-medication during strikes

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In view of the unending strike actions in the health sector, the Association of Community Pharmacists of Nigeria (ACPN) has urged members of the public not to resort to self-medication and arbitrary consumption of local herbs.

L-R: Pharm. Christy Ediomo, ACPN national treasurer; and Pharm. (Alhaji) Ismail Adebayo, ACPN chairman at a recent event
L-R: Pharm. Christy Ediomo, ACPN national treasurer; and Pharm. (Alhaji) Ismail Adebayo, ACPN chairman at a recent event.

Speaking exclusively with Pharmanews, ACPN chairman, Pharm. (Alhaji) Ismail Adebayo, explained that the association was fully aware of the sufferings experienced by patients and their loved ones during industrial actions such as the recently suspended strikes by the Joint Health Sector Union (JOHESU) and the Nigerian Medical Association (NMA).

“Whenever we have issues like this, you discover that patients will always seek alternatives. Some are forced to visit hospitals and that can be very expensive. Secondly, the quality of the service, especially when it comes to pharmaceutical care, will be poor”, Adebayo said.

“Besides we know that most private hospitals don’t even have pharmacists. And by virtue of that, it is going to affect the quality of health care delivery that will be given to the citizens,” he added.

The ACPN chairman however noted that the most worrisome fallout of health workers’ strikes is the number of people who resort to self-medication, which could be dangerous for them.

“As the national chairman of ACPN, what we preach when we see patients is proper enlightenment and education on what to do. But how many of them can afford even the consultation fees that private hospitals charge? Consequently, they may resort to self-medication. What can we do? One thing is for pharmacists to give advice, another thing is for people to take to it,” he remarked.

According to Adebayo, self-medication is not limited to those who use local herbs, but also those using cheap and substandard medicines because they cannot afford to visit private hospitals or pharmacies during strikes.

“Of course, we know how much it takes to treat ordinary malaria in this country. By virtue of this, I will implore the government to look at this matter holistically,” Adebayo urged.

It would be recalled that the Nigerian Medical Association (NMA), after several dialogues with the federal government, was compelled to call off its 55 days strike on 25 August, 2014. According to a communiqué released to announce the Call-off, the decision was based on current challenges in the country.

Similarly, the Joint Health Sector Union (JOHESU), embarked on strike on 12 November, 2014 over non-implementation of the agreement entered into by the government, which bordered mainly on issues of improved welfare for health workers. The strike was eventually suspended on 2 February 2015. This was sequel to a meeting between President Goodluck Jonathan and JOHESU during which salient issues regarding the grievances of the union were discussed.

5,000 underage girls give birth Everyday- UN reports

1

pregnant-girls

February 12 of every year is set aside as world sexual and reproductive health day, when nations and organizations discuss issues on teenage pregnancy, and enlighten both parents and teenagers why they should shun the habit.

According to a director at the United Nations Population Fund (UNFPA) Werner Haug, “some 7.3 million teen women give birth every year. 2 million of these are under 15 years of age, and every day, roughly 5,000 girls give birth. Yearly, 70 million young women lose their lives during pregnancy and childbirth”.

In his report,Motherhood in Childhood, released two years back, he said it shows that adolescent pregnancy perpetuates poverty and hampers development in poor countries.

He further noted that adolescent pregnancy is related to a “whole string of human rights violations” and so it must gain more attention in global development policy.

 

 

How daily consumption of coffee reduces cancer risk from the National Cancer Institute.

2

Cup-with-full-of-coffeeHere’s one more reason to feel good rather than guilty about your near-religious java habit: Drinking coffee may lower your risk for melanoma, the deadliest form of skin cancer, suggests new research from the National Cancer Institute.

For 10 years, researchers tracked the coffee-drinking habits and skin cancer rates of nearly 450,000 adults over age 50. After adjusting for factors like UV exposure, age, BMI, physical activity, smoking history, and alcohol intake, they found that coffee drinkers were less likely to be diagnosed with malignant melanoma than coffee skippers. In fact, those who drank four cups of caffeinated coffee per day had a 20% lower risk of skin cancer. Decaf didn’t offer any significant benefit.

What’s the connection? Previous studies show that the morning mud is loaded with compounds like caffeine and polyphenols that appear to suppress UV-induced tumor growth. The bean roasting process, too, spurs the formation of B vitamins that might offer another layer of protection against tumor formation, researchers say.

Still, all that caffeine can come with a cost. Guzzling more than 400 mg of the stimulant can lead to anxiety, restlessness, irritability, headaches, and more. Too much caffeine can also amp up your body’s production of the stress hormone cortisol, which can lead to weight gain (especially around your middle), digestive issues, and even heart disease.

Since an eight-ounce cup of coffee can pack anywhere from 95 to 200 mg of the stuff, it’s smart to stick with just one or two cups per day, says Jacqui Justice, MS, CNS, nutrition director at New York Health & Wellness Center. Drink 12 ounces of water before and after each cup, to counteract caffeine’s dehydrating effects, she says. Once you’ve hit your limit, switch to green tea: A serving maxes out at 45 mg caffeine, and is packed with some of the same skin-saving antioxidants as coffee. Plus, studies show that three cups of green tea a day can increase your metabolism and lead to weight loss.

prevention.com

 

 

 

 

 

Job vacancy for Operations Manager

0

Pharmanews Limited requires the services of an Operations Manager.

Job Title: Operations Manager
Location: Lagos

Job Description

  • Coordinate, manage and monitor the workings of various departments
  • Design training programmes and manage training workshops
  • Prepare and control operational budgets; plan effective strategies for the financial wellbeing of the company
  • Develop operation policies and ensure their adequate execution
  • Plan and support sales and marketing activities
  • Assist in the development of strategic plans for operational activity

 Qualifications

  • Minimum of Bachelors in Pharmaceutical Sciences.
  • A post graduate qualification would be an advantage.
  • Excellent written and verbal communication skills, including technical writing skills.
  • Understanding of business processes.
  • Computer literacy
  • Managerial experience
  • Age: 25-40 yearsRemuneration: Attractive

    Application Closing Date: 27th February, 2015
    Method of Application
    Interested candidates should send their CVs and application letters to: jobs@pharmanewsonline.com by Friday 27th February, 2015

    Only shortlisted candidates will be contacted.

Pharmanews Workshop on HEALTH CARE ENTREPRENEURSHIP

3

          A capacity development workshop that inspires and equips health professionals for efficient and productive service delivery is essential in achieving sustainable outcomes. For 21 years now, Pharmanews Ltd has offered training and consult ancy services to health care personnel in Nigeria. The company is accredited by the Centre for Management Development (CMD) as a management training institution. Our programmes have benefited pharmacists, doctors, nurses, medical laboratory technicians, pharmacy technicians, distribution managers, store officers, and other health care practitioners.

We do request that you nominate/participate in the upcoming training workshop for the course below.

COURSE:         HEALTH CARE ENTREPRENEURSHIP

Date:                 Tuesday 24 – Wednesday 25 March, 2015

Time:                 9:00am – 4:00pm

Venue:            Pharmanews Training Centre, 8, Akinwunmi Street, Mende, Maryland, Lagos

Target Participants: Health care entrepreneurs, community pharmacists, doctors, managers and executives of NGOs and HMOs.

Course Contents:

  • Elements of Business Plan Development
  • Business Financing and Cash Management
  • Elements of the Emerging Wellness Industry
  • Essentials of Health Care Marketing
  • Leading Effective Organizational Development Strategies
  • Comparative Study of Global Health Care Entrepreneurship Models

Course Objectives:

At the end of the workshop, participants will be able to:

  • Understand the processes and considerations involved in developing a viable business plan for a health care organisation.
  • Identify and apply strategies for achieving effective business financing and cash management.
  • Understand the emerging wellness industry and position their organisation for optimum contribution and profitability.
  • Understand the elements of health care marketing, ethical issues in health care entrepreneurship and modalities for an effective marketing drive.
  • Develop the necessary skill-set and attitude required to lead an effective organisational renewal and development strategy.
  • Learn global best-case models for driving health care entrepreneurship ventures.

Registration:

Registration fee is N50, 000 per participant before 24/02/2015 and N55, 000 after 24/02/2015. On-site registration of N55, 000 could also be made at the workshop venue.

Registration fee covers tea break, lunch, workshop materials and certificates ONLY.

Group discounts: 3 – 5 participants: 10%,   6 and above participants: 15%

 Cancellation: For cancellation of registration fee, 90% of the fee will be refunded, if cancelled at least seven (7) days to the workshop and this information communicated to us by sms or email, using: info@pharmanewsonline.com. There will be no refund if cancelled thereafter.

Method of Payment:

Participants should pay into Pharmanews Ltd account in Zenith Bank Plc (A/c No. 1010701673) or Access Bank Plc (A/c No. 0035976695) and send their full names and bank deposit slip numbers by sms or email to Pharmanews Ltd.

For further information, please contact:

Cyril Mbata                                –  +234 706 812 9728

Nelson Okwonna                         –  +234 803 956 9184

Ernest Salami                           –   +234 703 986 8837

Elizabeth Amuneke                     –   +234 805 723 5128

 

Herbals and pharmaceuticals are complementary – Prof. Iwu

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Chairman of Bioresources Development Group (BDG), Professor Maurice Iwu, has stated that integration of scientific components to empirical information, as well as initiating motivation for herbal practitioners, is key to bridging the gap between the development of local herbs and pharmaceuticals.

herbals - prof Iwu
L-R: Prof. Elijah Sokomba, commissioner, Federal Character Commission; Prof. Maurice Iwu, chairman, Bioresources Development Group (BDG); and His Royal Highness, Chief, Prof. T.O. Omon Oleabhiele, president of the National Association of Nigerian Traditional Medicine Practitioners (NANTMP) at the occasion.

Iwu, who co-hosted HerbFEST 2014, a conference on herbs, health foods and natural products in Lagos, noted that there were two different industries in the production of herbal medicines, the local herbal industry and the phytomedicine industry. He assured that the problem of authentication and standardisation was being resolved by NAFDAC, urging practitioners to submit their products for verification in due time, as some approved natural products were already in the market.

He however decried the non-availability of Level 4 Biosafety Laboratory in the country, saying this had caused a whole lot of setbacks for researchers in the country, as they had to travel abroad to access the facility for research purposes.

“We can fight diseases with natural plants, but the challenge is that we don’t have Level 4 Biosafety Laboratory in the country and that is a critical factor, because there are leads but no laboratories; the work being done is done with foreign laboratories system.”

The optimistic BDG’s boss however mentioned that plans were on the way to develop a local biosafety laboratory. He said the researchers would, in the meantime, continue to collaborate with nations who have the laboratories for the job, stressing that the development of a Level 4 Biosafety Laboratory will be in the near future.

Also speaking at the occasion, the Minister of Science and Technology, Dr Abdul Bulama called on researchers, entrepreneurs, traditional medicine practitioners, and other stakeholders in the health sector to intensify efforts towards promoting and improving indigenous bioresources, natural medicine knowledge, natural products resources ,as well as initiating means of connecting these resources to the wellbeing of the citizens.

Speaking on the theme of the workshop, “Herbs, Health Foods, Herbal and Natural Products: Shifting the Boundaries of Health Care”, Dr Bukama said it was very relevant at such a time as this, when the government is aiming at using all available resources of the nation to improve on the welfare of citizens.

He described HerbFEST as a laudable initiative which had potentials to promote the production of healthy indigenous foods and herbal therapies that would assist in addressing local and global food nutrition and health challenges, encourage sustainable utilisation of local biological resources, facilitate conservation of local environment, and assist in job and wealth creation to the nation through industrial expansion, commerce, science, technology and innovation.

Bulama, who was represented by Dr Menesa Gwoza, noted that Nigeria possesses about 40 per cent of medicinal plants. He assured that the Federal Ministry of Science and Technology would continue to provide a credible platform for the development of indigenous natural resources, as well as support innovative research to assist in developing herbal resources research and development outputs, which would ultimately contribute to job and wealth creation and also improve the lives of the people.

In his own contribution, Director General of NNMDA, Dr T.F. Okujagu, who is a co-host of the event, said the overall goal of HerbFEST was to showcase the rich biodiversity and investment opportunities of Nigeria and the West African sub-region to the world. He added that the event would equally enhance the patronage/recognition, productive capacity and income status of small producers of herbal and other natural products through a combination of market promotion, enterprise development, scientific session and training, and simultaneously promote trade and investment in the bio-business sector.

Okujagu further emphasised the uniqeness of HerbFEST 2014, stating that it was targeted at bridging the health gaps created by inefficient use of natural products, showcasing research and products used from nutrition to health and promoting the activities of traditional practitioners and community health workers. He said the event was also to stimulate investment in the herbal and natural products field and contribute to transforming the country by improving health care delivery, creating jobs, wealth and contributing to national socio-economic growth and development.

In her own contribution, Pharm. Ngozi James, executive director (BRG), noted that HerbFEST represents healthy and holistic medicine. “This acts as a platform to showcase the herbal products and orthodox medicine, bringing them together under one umbrella, bridging the gap between the two is our goal”, she stated.

Pharm. James further explained that gone were the days when people went about with the mentality that natural medicines were fetish and related to the occult.

“Most of the natural products are from natural plants. Enough of importing embarrassing products from China and India. We can develop our own natural plants. We are blessed and our bio-resources are enormous. It’s time to harness our biodiversities for the benefits of man. Showcasing what we have is enough to bring investors and encourage practitioners to do better”, she said.

Pharmaceutical events in 2014

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 JANUARY

Pharmacy Plus Limited held its 2014 Annual National Sales Meeting at Solab Hotel & Suites, Ikeja, Lagos, on 24 January.

The Annual Distributors’ Reward Function of Ranbaxy Nigeria Limited was held at Amber Residence in Ikeja, Lagos, on 29 January.

 FEBRUARY

The National Executive Committee (NEC) and past presidents of the Pharmaceutical Society of Nigeria (PSN) paid a courtesy visit to recuperating Governor of Taraba State, Pharm. Danbaba Suntai on 11February

The Golden Jubilee anniversary of the Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, took place from 27 February to 2 March.

The loss of Pharm. Isaac William Osisiogu (Ogbuagu of Old Umuahia), a professor of Pharmacy at the University of Nigeria, Nsukka, and a Fellow of the Pharmaceutical Society of Nigeria (FPSN) was announced on 8 February. He was aged 84.

The management and staff of LASUTH held a befitting retirement party for Dr Femi Olugbile, former chief medical director of Lagos State University Teaching Hospital (LASUTH) and outgoing permanent secretary, ministry of health, Lagos State, at the Medical Research Centre Hall of LASUTH, Ikeja, Lagos, on 28 February.

MARCH

Dr Mu’azu Babangida Aliyu was conferred with an honorary Fellowship of the West African Postgraduate College of Pharmacists (WAPCP) at the college’s 26th Annual General Meeting (AGM)/Scientific Symposium and 56th Council Meeting, held in Accra, Ghana from 10 to 14 March.

Prince Julius Adelusi-Adeluyi was elected president of the Nigeria Academy of Pharmacy at the inaugural meeting of the academy, held at Sheraton Hotels and Towers, Ikeja, Lagos, on 20 March.

Fidson Healthcare Plc won Pharmaceutical Company of the Year 2013 award, at the Nigerian Healthcare Excellence Award (NHEA), which was organised at Eko Hotel and Suites, Victoria Island, Lagos, on 21 March.

Dr Patrick Lukulay, a Sierra Leonean author, officially launched his bestseller – “The Executive in You” – at the Muson Centre, Onikan, Lagos, on 27 March.

The Pharmaceutical Society of Nigeria (PSN), Lagos State branch, held its 2014 Annual General Meeting (AGM) at its Lagos office on 14 March.

 

APRIL

Swiss Pharma Nigeria Limited (Swipha) made history when the World Health Organisation (WHO) declared its manufacturing and laboratory facility as the first West African Pharmaceutical Company to be compliant with the WHO GMP on 2April.

The Pharmacists Council of Nigeria (PCN) inducted 39 graduands from Madonna University at the school conference hall on 11 April.

The 9thAfribaby Babycare and Mothercare Expo took place at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos on 15 April.

  •  The PSN announced the passing away of Pharm. Uford Inyang, former director general of National Institute for Pharmaceutical Research and Development (NIPRID) on 22 April.

The Nigerian Medical Association held its Annual General Conference/Delegates Meeting in Benin City, Edo State, from 27April to 4 May.

 Reckitt Benckiser announced the 50th anniversary of Dettol during the scientific session of the Nigerian Medical Association (NMA) in Benin, Edo State,held on 27 April to 4 May.

 

MAY

UNILAG Faculty of Pharmacy held its 1st annual alumni lecture and luncheon in honour of the 2012/2013 graduating students at the Old Great Hall of the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, on 5May.

The 2014 annual luncheon of the Pharmaceutical Society of Nigeria (PSN), Lagos State branch, took place at the Sheraton Hotel & Towers, Ikeja, Lagos on 4 May.

UNILAG Faculty of Pharmacy inducts 141 graduates at the New Great Hall, University of Lagos, Idi Araba on 8May.

Dr Ahmed T. Mora, dean of the Faculty of Pharmaceutical Sciences, Kaduna State University has launched two new books on pharmacy practice – The Contributions of Students and Alumni Associations in Promoting Pharmacy Education and Practice in Nigeria&The Lizard Shape Model in Drug Distribution in Nigeria at an event held at Arewa House, Kaduna on 17 May.

A 3-day workshop on “Effective Leadership in Health Care Delivery” was organised for doctors, pharmacists, nurses and other clinical professionals by Pharmanews Limited at its Training Centre in Maryland, Lagos from 20 to 22May.

The management of Seagreen Pharmaceuticals announced the passing away of their managing director, Pharm. James Ibeh (aged 54 years), who died on 20 May, after a brief illness.

SKG Pharma Limited rewarded its trade partners for their loyalty, at a function held at the De-renaissance Hotel, Ikeja, Lagos, on 21May.

The Pharmacists Council of Nigeria (PCN) officially confirmed the appointment of Pharm. N.A.E. Mohammed as registrar of the Council,at its secretariat in Abuja on 28 May.

 

JUNE

The Association of Community Pharmacists of Nigeria (ACPN) hosted its 33rd Annual National Conference tagged “Harmony at Midland 2014” at the Cultural Centre in Ilorin, Kwara State from June 2 to 6.

Pharm. Kunle Amusan, a community pharmacist from Ibadan, Oyo State emerged winner of the maiden edition of the Ahmed Yakasai Community Pharmacy Practice Support Award held at the 33rd Annual ACPN National Conference in Ilorin, Kwara State on June 4.

 

The Association of Lady Pharmacists (ALPS) paid a condolence visit to Dr. Paul Orhii, Director General of the National Agency for Food and Drug Administration and Control (NAFDAC) over the death of his predecessor, Prof. (Mrs) Dora Nkem Akunyili, who died in an Indian hospital on 7 June.

 

Neimeth International Pharmaceuticals Plc launched Norduet, a new antihypertensive product at its head office in Ikeja, Lagos on 11June.

 

The 8th edition of the Annual Heart & Soul Gala organised by Chike Okoli Foundation was hosted at the City Hall, Lagos Island, on 14 June.

 

The two-day Nigeria-Pakistan Pharma Investment Forum (NIPIF 2014) took place at Eko Hotels & Suites, Victoria Island from 16 to 17June.

 

Biofem Pharmaceuticals Limited launched Biobetic, a new anti-diabetic drug during a three-day training programme for its marketing staff at the Lagos Chamber of Commerce and Industry (LCCI) building, Alausa, Ikeja, on June 16.

 

The official inauguration of the Nigeria Academy of Pharmacy (NAP) took place at the Sheraton Hotels and Towers, Ikeja, Lagos on 26 June.

 

JULY

UNILAG Faculty of Pharmacy introduces White Coat ceremony into its academic calendar at the Old Great Hall of the Lagos University Teaching Hospital (LUTH), on 2 July.

University of Ibadan Faculty of Pharmacy inducts 40 graduands at a ceremony held in the school’s lecture theatre, on 3 July.

Swiss Pharma Nigeria Limited (Swipha) launched five new over-the-counter (OTC) products during an event at Sheraton Hotel & Towers, Ikeja, Lagos on 10July.

A 6-day international workshop on ‘Healthcare Financing & Innovation’ for healthcare professionals was organised by Pharmanews Limited in Dubai, United Arab Emirates,from 19 to 26 July.

Pharm. Simon Okey Akpa, managing director, SKG Pharma Limited, was elected chairman of the Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria (PMG-MAN) during its Annual General Meeting on 23July.

 

AUGUST

The 1stAnnual Scientific Symposium of the National Association of Pharmacists in Academia (NAPA) held at the Lagos University Teaching Hospital, Idi-Araba, on 18August.

Sir Ifeanyi Atueyi and Pharm. Elijah Mohammed were honoured as Fellows of the Nigerian Institute of Management (NIM) in Lagos on 28August.

The International Pharmaceutical Federation (FIP) hosted its 2014 Annual Congress in Bangkok, Thailand in collaboration with the Pharmaceutical Association of Thailand under Royal Patronage (PAT) from 31 August – 4 September.

 

SEPTEMBER

May & Baker Nigeria Plc, a foremost pharmaceutical company marked its 70th anniversary at Muson Centre, Onikan, Lagos on 11September.

 

The 17th Annual National Conference of the Association of Industrial Pharmacists of Nigeria (NAIP) took place at Welcome Centre & Hotels, MurtalaMuhammed International Airport Road, Isolo, Lagos on 11September.

 

The new bus procured for the Inspectorate by the Pharmacists Council of Nigeria (PCN) was unveiled at the 17th Annual National Conference of the Association of Industrial Pharmacists of Nigeria (NAIP) which held at Welcome Centre & Hotels, Isolo, Lagos on 11September.

 

Pharm. Tony Akhimien, Pharm. Azubike Okwor and Dr. (Pharm) Edward Agulanna were awarded fellowship of the Nigerian Institute of Management (NIM) in Warri on 15 September.

 

The 8th Annual Scientific Conference and Exposition of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA), took place September from 18 – 21 in Orlando, Florida.

 

Sir (Pharm.) IfeanyiAtueyi, managing director of Pharmanews Limited was conferred with a Fellowship of the Professional Excellence Foundation of Nigeria (PEFON) at Hotel Victoria Palace on 27 September.

 

UNIBEN Faculty of Pharmacy wins the maiden edition of Sir IfeanyiAtueyi National Essay & Debate Competition which took place in the school’s conference hall on 24 September.

 

OCTOBER

The 2014 Faculty of Pharmaceutical Sciences Research Fair and Luncheon was held at the Juhel Auditorium of UNIZIK, Awka, Anambra State, on 9 October.

World Wide Commercial Ventures Limited (WWCVL) rewarded its 78 Partners for their unflinching commitment at a function at Intercontinental Hotel, Victoria Island, Lagos on 9 October.

The 2014 Annual Medic West Africa Exhibition held at the Eko Hotels, Lagosfrom October 15–17.

The Association of Community Pharmacists of Nigeria (ACPN) celebrated the 2014 Global Handwashing Day on 15 October at his National Office in Lagos.

May & Baker Nigeria Plc earned WHO GMP Certificate for its manufacturing facility in Ota, Ogun state on 13October.

As part of its Corporate Social Responsibility (CSR), Sanofi held training for officials of Ogun State Ministry of Health on “Advanced Care Clinical Leadership” from 21 to 22October.

Biofem Pharmaceuticals rewarded winners of its ‘Read to Lead’ promo at the company’s premises in Wemabod Estate, Ikeja, Lagos, on28October.

 

NOVEMBER

The 87th Annual National Conference of the Pharmaceutical Society of Nigeria (PSN) held in Uyo, AkwaIbom State, from 3 to 8 November.

Pharm (Mrs.) Margaret Obono, a Fellow of the Pharmaceutical Society of Nigeria (PSN) was announced winner of the 10th edition of the May & Baker professional service award in Pharmacy at the 87th PSN Conference in Uyo, Akwa Ibom State on 7 November.

The United States Pharmacopeia (USP)’s Centre for Pharmaceutical Advancement and Training (CePAT) honoured a former Director General of NAFDAC, Prof. Dora Akunyili (posthumously), and CEO of Emzor Pharmaceutical Industries Limited, Dr Stella Okoli on 8 November, at the Moevenpick Hotel, Accra, Ghana.

Mega LifeSciences Nigeria Limited launched prostacare for the treatment of mild to moderate BPH symptoms at the company’s Lagos office on 8 November

Sanofi, a leading multinational pharmaceutical company and Paediatric Association of Nigeria (PAN) held a media parley to mark 2014 World Pneumonia Day (WPD) at Protea Hotel, Ikeja, Lagos, on 12 November.

As part of activities to mark 2014 World Diabetes Day, Biofem Pharmaceuticals organised a two-day free health screening exercise for the residents of Wemabod Estate, Ikeja, Lagos on 14 November.

Pharm. Regina Ezenwa’s not-for-profit organisation, Rose Ministry celebrated its annual Widows Day Programme at National Population Commission (NPC) secretariat in Surulere, Lagos, on 27 November.

 

DECEMBER

A three-day workshop on ‘Clinical Leadership: Driving Service Improvement’ was organised for pharmacists, doctors and other health care personnel by Pharmanews Limited from 2 to 4December

Emzor Pharmaceuticals 2014 annual thanksgiving party took at the Muson Centre, Onikan, Lagos, on 6 December

  • HealthPlus Pharmacy held its 7th annual thanksgiving dinner and awards ceremony at Civic Centre, Victoria Island, Lagos on 15 December.

Managing rheumatism and arthritis

1

Osteoarthritis-kneeRheumatism” 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.

 

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 relief.

 

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 content.

 

Lessons from the eyes

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(By Oladipupo Macjob)

lie-eye-movement  Several researches have proven that communication does not only come verbally. As a matter of fact, nonverbal communication, also known as body language, reveals much more about the individual than just mere spoken words. It is not what is said, it is the way it is said. This also applies to the eyes – several nonverbal cues can be picked up, provided you are observant enough. These nonverbal cues tell a whole lot about people and actually reveal the real facts behind what is being probed. Therefore, it’s an important skill everyone, including pharmacists, should acquire. It is useful in all kinds of business transactions and even in domestic matters.

Eye signals are a vital part of being able to read a person’s attitude and thoughts.When people meet for the first time, they make series of quick judgements about others, based on what they see first, before making further judgements from what they hear. A study compared peripheral vision between men and women and it was observed that, at a distance of 18 inches from a woman, about 80 per cent of the men found it hard to describe her necklace except they moved their eyes down. So, at a distance of 18 inches, while maintaining eye contact, a man is not necessarily gazing through a woman’s body. The first look is just for gathering data; just by reflex.

Moral looking time

This concept was developed by Dr Ray Birdwhistell. He believes that a person can observe another’s eyes, face, abdomen, legs and other parts of the body for only so long before tension is created in both observers and observed.

Generally, the eye speaks volumes about what is going on in the mind of an individual. Sometimes one good indicator of deception is that a suspect maintains longer than usual eye contacts. Ability to read concealed emotions in the eyes is an important skill set.

Pupil insight

When someone becomes excited, the pupils can dilate up to four times their original size. Conversely, anger causes the pupils to contract to what is commonly referred to as “snake eyes”.

Eckhard Hess, a onetime H.O.D of the Department of Psychology at the University of Chicago and pioneer of the studies of pupillometry, found that pupil size is affected by one’s general state of arousal. If a woman is attracted to a man, her pupils will be dilated at him.

Research has shown that when pornographic films are shown to men, their pupils dilate to three times their size. Most women’s pupils gave the greatest dilation when looking at pictures of mothers and babies. This is why the best-selling children’s toys almost always have oversized pupils.

Centuries ago, prostitutes put drops of belladonna, a tincture containing atropine into their eyes to dilate their pupils and make themselves appear more desirable.   There are some people however, who suffer from heterochromia i.e have a permanently dilated pupil and they constitute about 1 per cent of the population. So there is a need to get the baseline of the individual, while drawing inferences.

Eyebrow flash

The purpose of this is to draw attention to the face, so that clear signals can be exchanged. The only culture that considers eyebrow flash as impolite with definite sexual connotations is the Japanese culture.

Lowering the eyebrow in humans is a sign of aggression or to show dominance towards others, whereas raising the eyebrows shows submission. A good use of this eyebrow flash in any presentation before an audience does a lot of good to endear an audience to you. So if, as a medical representative or manager doing a clinical presentation, you make use of the eyebrow flash quite often during your presentation, you do not come across as aggressive. This is particularly useful to those whose faces are naturally ‘hard’.

Gaze behaviour

Michael Argyle, a pioneer of social psychology and nonverbal communication skills in Britain, found that when Westerners and Europeans talk, their average gaze time is 61 per cent, consisting of 41 per cent gaze time when talking, 75 per cent when listening and 31 per cent mutual gazing. It’s been found that the amount of eye contact in a typical conversation ranges from 25-100 per cent depending on who’s talking and what culture they are from.

When we talk, we maintain 40-60 per cent eye contact, with an average of 80 per cent eye contact when listening. The notable exceptions to this rule are Japanese and some Asian and South American cultures, where extended eye contact is seen as aggressive or disrespectful. Argyle found out that we often maintain more eye contact when listening than when talking. When the customer is not maintaining an acceptable eye contact with you, especially while you are trying to sell the benefits of your brand or product, there is definitely something to worry about.

To build a good rapport with someone else, your gaze should meet theirs about 60-70 per cent of the time, else it comes across as timidity. When two people meet and make eye contact for the first time, the subordinate person looks away first, but if you maintain gaze with your boss, it shows a clear message of disagreement or aggressiveness.

Men’s peripheral vision is far poorer than that of women. Which is why men sometimes have difficulty seeing things in the refrigerators, cupboards and drawers. Just at a distance of 18 inches from a woman, they can hardly tell what the colour of her shoes is, unless they shift their eyes to look down. Women don’t have this problem. Their peripheral vision extends to at least 45 degrees to each side above and below, which means she can appear to be looking at someone’s face while at the same time, she is inspecting their goods and chattels.

When a woman wants to get the attention of a man in a room, she will meet his gaze, hold it for two to three seconds, then look away and down. This gaze sends him a message of interest and potential submission.When a person’s gaze meets yours for more than two-thirds of the time, it is probably because he or she finds you interesting or appealing, in which case, he will also have dilated pupils; or on the other hand, he’s hostile toward you and could be issued a challenge, in which case, the pupils constrict.

Geography of the face

There are three basic types of gazing:

  1. a) Social gaze: During social encounters, the gazers eyes look in a triangular area on the other persons face between the eyes and the mouth for about 90 per cent of the gaze time. This is the area of the face we look in a non-threatening environment.
  2. b) The intimate gaze: When people approach each other from a distance, they look quickly between the other persons face and lower body to first establish what the gender of the person is and then a second time to determine a level of interest in them. In close encounters, it’s the triangular area between the eyes and the chest, and for the distant gazing, it’s from the eyes to the groin.

A woman’s wider ranging peripheral vision allows her to check out a man’s body from head to toe without getting caught. The male’s tunnel vision is why a man will move his gaze up and down a woman’s body in an obvious way.

c) The Power gaze

This gaze focuses between the front part of the head and the gap between the two eyes. By keeping your gaze directly at this area you keep the screws firmly on the individual. The pressure stays on them provided your gaze does not drop below the level of their eyes. Never use this kind of gaze in friendly or romantic encounters. It works on a person who you want to reprimand. The occasion should determine which kind of gaze we use or adopt, or else, we end up sending wrong signals and may likely be misunderstood.

Extended blinking

A normal relaxed blinking rate is about 6-8 blinks per minute and the eyes are closed for only about one-tenth of a second. People under pressure, for instance, when they are lying, are likely to dramatically increase their blinking rate. Extended blinking rate is an unconscious attempt by the person’s brain to block you from their sight because they have become bored or disinterested or feel they are superior to you. When the eyes dart from side to side, it’s the brains way of searching for an escape route as it were.

Research has shown that, of the information relayed to the brain in visual presentation, 83 per cent comes through the eyes, 11 per cent through the ears and 6 per cent through the other senses. It therefore means that a verbal presentation requires frequent repetition of key points to be effective. Use of visual aids is very effective and saves costs and energy.

The point is this, when doing a power point presentation; your audience follows better when your slides are more visual than when you have too many words written on the slide, except it is a quote. It’s worse, if you have to read almost 90 per centof the content to them while presenting. The question that will be on their mind is, why have they come to listen to you if you would still have to read all the slides to them?

Any opportunity you have to make a presentation before people is such an awesome privilege to influence lives, and you just cannot afford to mess things up. A clinical meeting badly presented is company money wasted. This is one of the areas many pharmaceutical companies are missing it, and it’s the major difference between consumer marketing and Pharma marketing. If lesser attention is paid to the messenger who is to deliver the message, it’s simply an error of judgment.

In our next edition we shall go further in looking at some other nonverbal cues through which we communicate or pick up nonverbal communication. Remember, whether you speak or not, your body does.

 

Divine Assurance for the New Year

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  In 1943, Abraham Maslow proposed a theory in psychology known as “Maslow’s hierarchy of needs” and represented as a pyramid with five levels of needs. It is a motivational theory that argues that while people aim to meet basic needs, they seek to meet successively higher needs in form of a pyramid.

The five levels of needs, according to the theory, are: physiological needs,   safety needs, social needs, self-esteem needs and self-actualisation needs.

The most fundamental of these needs are physiological needs, which include necessities such as air, food, water, sleep, clothing and shelter. We require physiological needs to stay alive. Once these needs are met, we have need for safety   and then social needs, followed by self-esteem and finally self-actualisation.

Maslow did not consider spiritual needs in his pyramid. But, obviously,   people have spiritual needs, too. At the physiological level, people tend to be closer to God for their needs. However, spiritual needs run throughout the levels of the hierarchy in different ways.

Jesus appreciates the importance of physiological needs. He knows that without   satisfying them, we cannot survive and hence cannot move up the pyramid. This is why He promised to provide them and asked us not to worry about them. He says in Matthew 6:31-33, “Therefore take no thought, saying, What shall we eat? Or, What shall we drink? or, Wherewithal shall we be clothed?…for your heavenly Father knoweth that ye have need of all these things. But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you.”

Sometimes, we think there is no way our needs can be satisfied but Jesus says He is the way. He makes a way where there is no way. The first miracle He performed was provision of wine needed for a wedding ceremony in Cana of Galilee. One remarkable thing about that miracle was that, before it was performed, His mother, Mary, had said to the servants, “Whatever He says to you, do it.” I believe that one key that opens divine provision of our needs is this expression: Whatever He tells you to do, do it.

Sometime ago, my cash flow was not good and what occupied my mind was what God wanted me to do to remedy the situation. I was asking for divine   ideas and actions to take. God responded with some ideas that worked. Incidentally, one of the ideas was to give out money for certain purposes. This action even depleted my lean purse – but, eventually, my problem was solved. If God tells you to do something and you fail to do it, it is disobedience.

When you obey and do whatever He tells you to do, He not only provides food, drink, and clothing but opens doors leading to higher levels. His favour, goodness and mercy will follow you.

In order to experience divine provisions, you must believe that your salary or income is not your source of supply. If your focus is centred on your occupational source of income, you have already placed a limit to what God can do for you. You will enjoy abundant life if you believe that God is your Source and Provider. He does not depend on your income or resources.

God is not limited to what you have. He takes whatever you have and multiplies it. He multiplies your income. He even multiplies your time. We all have 24 hours in a day but a believer can achieve a 30-hour output in one day. You may call it efficiency or effectiveness but what I am saying is more than that. I have personally experienced it. He does not need to command the sun to stand still again, as He did to enable Joshua overcome his enemies.

The miracle of multiplying a boy’s lunch of five barley loaves and two small fish to feed 5,000 men (without counting women and children) is one that Jesus keeps doing today, for those who believe. God is not just multiplying, He also creating from nothing.

When Jesus was required to pay temple tax of half a shekel in Capernaum, there was no coin available. He just asked Peter to go the sea, catch the first fish that came up, open its mouth, and get out a shekel. That shekel was used to pay the temple tax for Jesus and Peter. Isn’t that fantastic? How did a shekel get into the mouth of that fish? One shekel was all that was needed for the temple tax. If more than one shekel was needed, Jesus could have provided it.

This is how Jesus provides our needs today. He knows exactly what we need and desires to provide them. This is why He said we should not worry. Sometimes, we want to accumulate what we don’t really need. This is greed and lust. Peter did exactly what his Master told him to do and a miracle happened and a need was met instantly. Whatever He says to you, do it. Miracle happens whenever you do what He asks you to do.

 

Experts task pharmacists on patients’ safety— As Lagos ACPN holds continuing education programme

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Experts and scholars in the pharmaceutical profession, including Prof. (Pharm.) Azuka Oparah of the University of Benin, have said that in order to provide drug therapy responsibly, pharmacists must take responsibility for identifying, preventing, and resolving drug therapy problems of patients in a consistent manner.

ACPN Lagos
L-R: Pharm. Deji Osinoiki, former National Chairman ACPN and chairman of the event; Pharm. Olumide Akintayo, president, PSN and Pharm. N. A. E. Mohammed, registrar, PCN at the ACPN Continous Education Programme, held in Lagos last December.

 

Prof. Oparah, who is a Fellow of the Pharmaceutical Society of Nigeria (FPSN), made his submission while delivering a keynote address on the topic, “Patient Safety Issue in Nigeria: The Community Pharmacists Perspectives”, 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 university don stated that no medicine is absolutely safe, noting that every drug or medicine has two inherent qualities of benefits and risks.

“The decision to medicate is based on a balance of probability that the benefits of use outweigh the risks. The harm derivable from drugs varies from one agent to another. It is upon this risk stratification that national and international laws classify medicines into two main groups, namely, over-the-counter (OTC) medicines and prescription only medicines (POM)” Oparah said.

Speaking further, Oparah explained that drugs in the class of prescription-only medicines (POM) do not have high safety margin, unlike the over-the-counter (OTC) drugs, adding that in order to protect public health, decision to use them should not be left in the hands of the general public but a learned intermediary.

“Such medicines are to be dispensed by a registered pharmacist on the prescription of a doctor.Also, the manufacturers of such medicines owe a duty of care to communicate all known and potential inherent risks to the learned intermediary, who in turn, owes a duty of care to convey same information to the consumers,”he urged.

Prof. Oparah also stressed that the goal of pharmaceutical care is to assure the quality of the medication use process through collaborative efforts, adding that the decision to take medications should be based on the balance of probability that the benefits outweigh the risks and that pharmacists owe a professional obligation to guide members of the public to use OTC medicines responsibly.

In his goodwill message at the event, Pharm. Olumide Akintayo, president, Pharmaceutical Society of Nigeria (PSN), commended the Lagos State ACPN for choosing the theme, “Patient Safety Issues in Nigeria”, saying it was inconsonance with the goals of the National Drug Policy in Nigeria.

“What community pharmacists are simply saying is that they want to be in the vanguard of creating an environment whereby Nigerians will consume safe medicines at an affordable cost and accessible at alltimes, even in the remotest part of the country,” he said.

Akintayo also said pharmacists had been working with the National Human Rights Commission (NHRC) in order to come up with a policy that would cover access to medicine as a human right, adding that the time had come for the country to get it right. He also urged community pharmacists and other technical arms of the PSN to keep supporting the NHRC and its mission.

Also, the duo of Registrar, Pharmacist Council of Nigeria, (PCN), Pharm. N.A.E Mohammed and Chairman, Lagos ACPN, Pharm. Aminu Abdulsalam Yinka, maintained that the patient is the major consideration in safety issues in healthcare, adding that what marks out health professionals is their focus on patient safety, not money-making.

Speaking further, Pharm Aminu disclosed that the Continuous Education Conference programme in Lagos has been consistent over the years because of the importance that the Lagos State ACPN places on knowledge and effective service delivery.

“There are new trends even in the management of ailmentsand in order to cope with these, we need to regularly update ourselves, so that we can make positive impacts in the lives of the public. The continuous education programme is a sine qua non in our policy, and in conjunction with the regulatory authority, it is also mandatory”.

Aminu noted that this year’s programme was approved by the Pharmacists Council of Nigeria (PCN) because of the consistency and quality over the years. He said a two–unit credit would be awarded to all pharmacists that attended the programme.

Speaking earlier, chairman of the event, Pharm. Deji Oshinoiki, commended the ACPN, which he described as the window to the pharmacy practice as well as forerunner of the practice, for being consistent in organising the programme every year.

“The world is changing, so also is health care practice; hence the need to consistently update our knowledge in order to meet up with what is going on around the world.And I am very happy that the programme has never failed to live up to expectations since inception”, Oshinoiki intoned.

Other dignitaries at the event include: Prof Anthonia Ogbera, one of the guest lecturers; Pharm. (Mrs) Joke Bakare, managing director, Medplus Pharmacy, also a guest lecturer; Pharm. Gbolagade Iyiola, national secretary (PSN); Pharm. Adeoye Afuye, national secretary (ACPN); Pharm. Madehin Gafar Olanrewaju; Pharm. Tony Oyawole; Pharm. Felix Anieh Felix; Pharm. Akintunde Obembe, among others

 

Smartphone use in nursing practice: evolution or revolution?

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AA female nurse using smartphone

(By Cheryl D. Parker, PhD, MSN, RNBC, FHIMSS)

Since smartphones were introduced in 2002, a communications revolution has taken place. We talk on our smart phones, we text on them, we take pictures and post them to social networks, we communicate in 140-character “tweets,” and share our thoughts and events on our personal networks. We use Smartphone applications to monitor our exercise, manage our calendars, and practice our deep breathing. For many people, forgetting their smartphone causes instant panic.

In health care, physicians’ smartphone use has grown exponentially. Just 6 years ago, I listened as chief information officers (CIOs) at the largest health care organisations in Texas insisted emphatically that a bring-your-own-device (BYOD) policy would never happen in their facilities. Of course, things don’t always go as planned. According to the Wolters Kluwer Health 2013 Physician Outlook Survey, approximately 80 per cent of physicians now use smart phones in their work.

But in the context of nursing practice, the communications revolution is only now starting to make a direct impact. Most nurses continue to use voice-only phones, multiple pagers, or wearable voice-activated two-way communication devices provided by their employers. While we may use smartphones in our private lives, many of us still use outdated communication devices at work. Or do we?

After visiting health care facilities across the country, I’m convinced nurses are in on the communications revolution. I’ve seen them use their own devices—not those provided by their employers—to text other healthcare team members (including physicians) outside the facility, access reference materials, and perform many other functions on their smartphones that aren’t supported by employer-provided technology.

Is this a problem? For several reasons, increasing use of personal smartphones should raise concern for healthcare facilities. (See Infection prevention for smartphones.)

Legal and regulatory compliance

The foremost concern is legal regulatory compliance. Despite hospital policies forbidding use of personal phones by employees during work hours, 67 per cent of hospitals reported in 2013 that their nurses used personal devices to communicate and support their workflow. This means, in effect, that nurses could be violating federal laws (specifically, the Healthcare Insurance Portability and Accountability Act), hospital security policies, and the American Nurses Association’s Code of Ethics. If they’re sending protected health information (PHI) on their smartphones in a way that can be linked to a specific patient, they’re also violating state nurse practice acts. Sending PHI could lead to loss of employment, financial fines, jail sentences, and loss of one’s nursing license.

To make sure they’re not jeopardizing their jobs, nurses must determine if their communication and workflow habits comply with applicable laws, policies, and procedures.

 Cell phone security

What about security? Don’t most people secure their smart phones? In a word, no. Two of five people surveyed don’t take the most basic smart phone security precautions. Criminal hackers are focusing more attention on smart phones than on other electronic devices, according to cyber security experts.

A 2013 survey asked 1,000 full-time American workers to describe their personal smart phone use in the workplace. Among respondents who chose health care as their employment sector, 88.6 per cent said they used their personal phones for work purposes. Among all respondents, 39 per cent said they don’t password-protect their phones. Potentially more dangerous, 52 per cent used their smart phones on unsecured Wi-Fi networks, such as those at coffee shops. Use of unsecured Wi-Fi is a well-known security vulnerability because it can allow for easy phone data theft.

Do you know if your smartphone’s Bluetooth is set to “discoverable” by other devices, such as your hands-free headset? This is another security layer most people don’t think about. Data on an employer-owned phone usually can be deleted remotely if the phone is lost or stolen. This is sometimes called “wiping” or “bricking,” meaning the device is no longer functional because the operating system, programmes, and data have been rendered inoperable. But it’s rare that data on individually owned devices can be deleted remotely. So even if you never use your smartphone for work, ask yourself if you could delete all those pictures, texts, and emails if you lost your phone. Do you have a backup of your phone’s data just in case you have to delete everything?

 Who owns the phone?

Employers have the greatest control over devices they own and distribute. But even in a BYOD environment, employers can require installation and use of applications that provide the necessary security. Policies and procedures help outline what devices are permitted and specify security requirements to ensure password protection. In many cases, the standard four- to six-digit password is not secure enough; a hacker could crack a password such as 654256 in less than one second.

Policies need to spell out clearly who’s responsible for smartphone-related services, including dealing with problems accessing the facility’s secure network. Employers need to decide which applications are allowed, when updates must be performed to maintain application security, and what happens if the employee leaves the organisation.

In a BYOD environment, wiping the device in case of theft or loss becomes an interesting question. If the device is storing both organisational and personal data, both types will be lost in the wipe. What are the rights of the individual and the organisation in this situation? This is another area where policies and procedures must be made clear to all. If you’re using your personal device at work, find out if your organisation has a BYOD policy and ensure that you’re in compliance.

In the future, certain communication exchanges may become part of the electronic health record (EHR). Such data, including pictures, shouldn’t reside on smartphones no matter who owns them, but instead should be stored on a secure server with audit tracking.

 Future of smartphones in nursing

Facilities considering use of smartphones for clinical staff need to think about clinical communication as part of the patient-care process instead of just replacing current phones and functionality. Nurses need choices in communication methods, including secure, encrypted texting and email. Communication must be put in a clinical context to properly identify the patient, who should be at the heart of the communication exchange. Use of pictures, such as of a patient’s wound, should be part of the available communication methods even if the photos can’t be uploaded to the EHR.

Even more important, just as smartphones give us cognitive support in our personal lives, we need to look for solutions that do the same in the complex work of nursing. Just as personal smartphones remind us that our best friend’s birthday is next Saturday, nurses could use employer-provided smartphones and technology to help them in clinical practice.

If you’re asked for input on your organisation’s next communication solution, consider the issues discussed in this article. It’s not enough that your phone can send texts. Is your phone data secure? Can the phone be disinfected? Will it survive the rough-and-tumble health care environment? What’s the vendor’s vision for the future of its platform, and how will it support nursing practice?

Envision the future of smartphones that can assist us both as nurses and in our private lives. And envision yourself using a smartphone in compliance with laws, policies, and procedures in a way that’s safe and secure.

 

References

Baril AF. Electronic medical record & HIPAA violations. Advance Health Network for Nurses. August 30, 2010. http://nursing.advanceweb.com/continuing-education/ce-articles/electronic-medical-record-hipaa-violations.aspx?CP=2. Accessed June 30, 2014.

Cisco partner firms. BYOD insights 2013: A Cisco partner network study. March 2013. www.structuredweb.com/sw/swchannel/CustomerCenter/documents/8523/22089/Cisco_mCon_BYOD_Insights_2013.pdf. Accessed June 30, 2014.

Mayer A. Smartphones becoming prime target for criminal hackers. CBS News. March 6, 2014. www.cbc.ca/news/technology/smartphones-becoming-prime-target-for-criminal-hackers-1.2561126. Accessed June 30, 2014.

Porter C. Calling all germs. The Wall Street Journal. October 23, 2012. http://online.wsj.com/news/articles/Accessed June 30, 2014.

Spyglass Consulting Group. Healthcare without bounds: Point of care communications for nursing 2014. March 2014. www.spyglass-consulting.com/wp_PCOMM_Nursing_2014.html. Accessed June 30, 2014.

Wolters Kluwer Health 2013 physician outlook survey. Wolters Kluwer Health. (n.d.). www.wolterskluwerhealth.com/News/Documents/White%20Papers/%20Study%20Executive%20Summary.pdf. Accessed June 30, 2014.

Cheryl D. Parker teaches nursing informatics at the Walden University School of Nursing in Minneapolis, Minnesota. She is chief nursing informatics officer for PatientSafe Solutions, based in San Diego, California.

 

Experts lament failings in health sector

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Dr femi olaleye
Dr Femi Olaleye

A seasoned health care management consultant, Dr Femi Olaleye, has bemoaned the seeming incompetence of the current crop of leaders in the health care industry, citing several unresolved challenges in the sector as a proof.

Olaleye, who was speaking on the topic, “Essentials of Clinical Leadership”, at a workshop organised by Pharmanews Limited in Lagos, recently, critically examined leadership qualities as it affects the Nigerian health care delivery system.

In his words: “The issue of leadership, if it comes to health care in Nigeria is bad, and there is no other way to put it better”.

Acknowledging the possibility of health workers attaining leadership position through professionalism, he said it was imperative for such practitioners to learn and acquire leadership skills in order to be successful.

Citing some failures of the health sector leaders, Olaleye noted that Nigeria, at 54, still has huge deficits of health human resources, professionalism, best practices, job description, job roles and team play under universal leadership and co-ordination of medical doctors.

“Clinical team leadership seems to have taken its flight from Nigeria’s public hospitals, with attendant negative consequences on inter-professional relationship and effective service delivery”, he said.

Olaleye opined that crises in the health sector may never be resolved if the leaders fail to improve their orientation and managerial skills. In order to achieve this, he said, they must learn what clinical leadership is all about and how best to achieve result.

He defined clinical leadership as “a set of tasks to lead improvement in the safety and quality of health care delivery, and the attributes required to successfully carry them out”, adding that while good clinical leadership results in excellent patient experience and outcomes, incompetent leadership leads to low staff morale, higher rates of incidents and poor patients experience.

Olaleye also differentiated between leadership and management, describing leadership as setting direction, influencing others and managing change, while management deals with marshalling and organising resources, as well as maintaining stability and growth of the organisation.

He therefore urged leaders of the health sector to aspire to acquire new tools in solving the multifaceted problems.

In his own contribution, Consultant Psychiatrist, Dr Rotimi Coker, harped on the need for health practitioners to effectively manage their stressful environment, as 75 per cent of management staff consider their jobs highly stressful.

The expert, who noted that most health care professionals cannot change their stressors, however pointed out that while stress can add spice to life, it could also be devastating and deadly. He defined stress as “issues that disturb your mental, emotional, social, financial, spiritual or physical status”, describing it as when pressure is higher than coping resources.

The psychiatrist identified sources of stress to include: environmental, social, organisational, life events and daily hassles to mention but a few. He however counselled the participants to note their key stressors and apply suitable techniques such as physical exercise; slow, deep breathing and relaxation among others.

How government aided proliferation of patent medicine dealers – Sir Chukwumerije

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Sir Chukwumerije

In this interview with Adebayo Folorunsho-Francis, Sir Anthony Azubuike Chukwumerije, a Fellow of the Pharmaceutical Society of Nigeria (FPSN) and first president of the Pharmaceutical Association of Nigeria Students (PANS), revealed how government encouraged proliferation of patent medicine dealers. He also disclosed the reason pharmacy students went on hunger strike in the 1960s and why he thinks pharmacists are the most suited for public offices. Excerpts:

Tell us a little about your educational background

I gained admission into Government Secondary School, Afikpo (now in Ebonyi State) in 1953 and I went to the Nigerian College of Arts, Science and Technology, Enugu,for my G.C.E. Advanced Level studies in Physics, Chemistry and Biology In 1958. I also attended the Nigerian College of Arts, Science and Technology, Ibadan (Oyo State), for my diploma studies in Pharmacy, and the University of Ife, Ile-Ife (now Obafemi Awolowo University) in Osun State, for a degree in Pharmacy.

 Would you say studying Pharmacy was a good decision for you?

Pharmacy was a wise choice,   even   though   there were occasions when   one   had   one’s   doubts. For example, while at school,   we learnt that despite the   fact   that we entered pharmacy school   with   G.C.E.   A   Level papers in   three   core science subjects, we were,on graduation,to be placed at a grade level in the civil service that was lower than that of other graduates. At that time, we went on hunger strike and the school authorities had to beg us to call off the strike after nearly four days. This, notwithstanding, pharmacy students were still the busiest, the happiest and the most sought after in the campus.

How does the pharmacy profession in your day compare to today’s practice?

Pharmacy practice was characterised by fighting within and fighting without (in the civil service). We contended with low salary grading and unfavourable practice environment. There was no job satisfaction, and all the years spent at school seemed wasted. Many left for Medicine and others for Law. Community pharmacy practice was fully rewarding and the few who were in it prospered financially and in health. Quackery was minimal and proliferation of adulterated and fake drugs was not common.

What about the problem of drug counterfeiting?

Dealers incounterfeit drugs could easily be traced and dealt with;while multinational drug companies who   dared sell prohibited drugs to the open market were easily identified and their parent companies in Europe queried and admonished. There was strict adherence to discounts to pharmacies, hospitals and doctors. Indigenous drug manufacturing was at its incipient stages and only multinational companies imported drugs and medicinal products.

Soon after, drug detailing started and the early pharmacists who were in it had chauffeur-driven flashy cars and enjoyed bountiful allowances. Then the civil war set in and, after it, every person became a drug seller and governments introduced import licences for importation of drugs, even   to moneybags   who   never went   to school. Abuse inevitably set in and remains uncontrollable.

Did you also contend with the issue of multiple registration of premises?

The Supreme Court’s interpretation of “in continuous supervision” of a premises has finally settled that (the   issue of multiple premises for practitioners) and   considerably reduced the take­home income of our   members, while medical practitioners got away with multiple clinics.

As I earlier mentioned, counterfeit, sub-standard and adulterated drugs are still everywhere. When   Chief Akuneme (now late) was the Chief Inspector in Eastern Nigeria, he would trace any drug classified as poison found in any marketplace to its original manufacturer in Europe or anywhere and inquire why such a drug should be found in the shop of a person not licensed to practise as a pharmacist. Any dealer in counterfeit, sub-standard or adulterated drug was promptly prosecuted.

Some state governments themselves encouraged sale of drugs in open markets by issuing drug importation licences to unqualified persons. Pharmaceutical inspectors were few and could not cope with the problem. Schools of pharmacy were few and only a few pharmacists could be produced. Consequently, community pharmacists already restricted by law to one premises each,could not cope with the expanding population, and colluding governments seized the opportunity to proliferate patent and proprietary medicine stores.

Predictably, in a very short time, the patent medicine dealers outnumbered qualified pharmacists and having saturated the towns, they invaded the open markets, formed very strong unions, and overwhelmed the few fearless pharmacists who wanted to do honest business. The situation has persisted even though the late Director-General of NAFDAC, Dora Akunyili,   dealt severe blows on counterfeiters, open market drug dealers and importers of fake and sub-standard drugs.

What is your view about pharmacists in politics?

I have always advocated that pharmacists should be in politics. We are the only health professionals properly trained to handle men, money and materials. Remember that pharmacy is a profession, a science and a business. Tell me of any business that is more complex than politics and government? If pharmacists are in government, they will correctly interpret the pharmaceutical component of any health bill to their colleagues and be in a position to challenge assaults on pharmacists in any area of practice.

How best do you think the issue of fake drugs and counterfeit medicines can be curbed?

I have earlier suggested that to curb fake drugs and counterfeit medicines, a competent and incorrupt pharmacist should head NAFDAC. Some state directors of pharmacy are also corrupt and issue patent and proprietary medicine licences recklessly; andthey hardly go oninspection nor have a strong inspectorate division.

In our time, part-time inspectors were appointed from practitioners to complement the scarcity in government. Even though governments in Nigeria pay lip service to local manufacturing, I have   not   seen any incentive to local manufacturers of anything. All sorts of things are imported freely into this country; and these include drugs.

To what extent did you participate in pharmaceutical activities?

I was the first president of the Pharmaceutical Association of Nigeria Students (PANS). We started fighting for pharmacy while at the university and I remember being called to the office of the then Vice Chancellor, the Late Prof. Oluwasanmi, to be persuaded to ask pharmacy students to call off their strike and go back to the classroom.

At the end of the Nigerian civil war, I found myself in Enugu.   I enrolled with   the   Enugu   State branch of the PSN, became its Assistant Secretary, then   Secretary, then Assistant Chairman and finally, Chairman. I was member of council for several years and served in various committees both at the state and national levels. This culminated in my award of the Fellowship (FPSN) in 1985.

What is your impression about the annual PSN national conferences?

The annual PSN conference was instituted in our time and pharmacists generally loved it. I remember that as a younger man, I never   missed any PSN or FIP conferences but age has many limitations including less travelling and limited resources. These conferences afford opportunities for   interaction, fellowship, updates in scientific advances, getting to know places and asking questions on confusing issues. Branches and more affluent members should occasionally sponsor older colleagues to some of these conferences.

 Should an active pharmacist be made to retire?

My answer is yes ­ when he can   no longer   understand advances in the profession and would therefore not counsel properly on the correct and safe use of drugs. In my opinion, all professionals should retire at the age of 80 and like the psalmist, number their days to apply their hearts unto wisdom.

What is your advice to young pharmacists?

Young pharmacists should learn to appreciate their profession and do whatever they can in their practice area to adhere to good and ethical practice. The present acquisitive proclivity of the youth is condemnable. Wealth comes through hard work and faith in God whose wish is that we should prosper and be in health, even as our souls prosper. If we all practise ethically and not abet quacks and counterfeiters, no pharmacist has business with poverty.

Why Seagreen launched Gvither Plus and Klovinal – Product manager

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In this exclusive chat with Temitope Obayendo, a product manager with Seagreen Pharmaceuticals Limited, Pharm. Abiola Akinwunmi, explains the company’s vision for the health care needs of Nigerians and why it recently launched two key products into the Nigerian market. Excerpts:

Could you tell us a bit about Seagreen Pharmaceuticals Ltd?                

Seagreen is a fully indigenous pharmaceutical company incorporated in Nigeria. The company commenced operations in 2010. We are a company wholly committed to enhancing the health and wellness status of the Nigerian society. We see a Nigeria where every individual has access to basic essential medicines regardless of their socio-economic status.

Seagreen Pharmaceuticals Limited specialises in manufacturer’s representation, maintenance of scientific offices, importation, distribution, sales and marketing of pharmaceutical products. Our product portfolio includes drugs for management of tropical diseases, anti-infectives, drugs for management of chronic diseases, paediatric health, obstetrics and gynaecology and daily healthy living products.

We continuously scan the health care landscape to come up with products that can deliver exceptional value to health professionals and patients alike, in terms of quality, efficacy and relevance to the health care burden of the society. We specially focus on key challenges in the management of common tropical diseases and essential medicines for women and children’s health needs. Recently, we launched two products to tackle highly prevalent conditions in Nigeria – Gvither Plus, for malaria and Klovinal, for female genital tract infections.

 Could you further explain why you decided to produce Gvither Plus?

The endemicity of malaria in Nigeria, coupled with the high incidence of treatment failures, prompted our search for a solution. Seagreen consequently collaborated with a leading company in the antimalarial therapy field in Africa, Bliss GVS, to avail the society of an efficacious antimalarial product. Bliss GVS has evolved substantial expertise in the antimalarial market in Africa, being the company to pioneer the 80/480 Artemether-Lumefantrine formulation and also Dihydroartemisinin-Piperaquine combination. The company’s antimalararial brands are well known and trusted in over 40 African countries. Gvither Plus is a uniquely cost-effective combination of Artemether and Lumefantrine. Currently, Artemisinin-based combination therapies are the mainstay of malaria treatment and Artemether-Lumefantrine is a well-tolerated and effective ACT.

 It is commonplace for an individual that is down with malaria to use three to four brands before getting well. What is responsible for this?

The need to repeat courses of antimalarial drugs could result from recurrence following treatment. Recurrence of malaria has been attributed to repeat infections, relapsing malaria and recrudescence. Recrudescence is caused by failure of a course of antimalarial treatment and it accounts for majority of cases of recurrence.

The WHO guidelines for malaria treatment notes that treatment failures could result from drug resistance, poor adherence and inadequate exposure to the administered agent. Here, we talk about low quality substitute drugs that, in themselves, promote drug resistance, sub-optimal dosing, and lack of dosing consistency and even outright use of the wrong drugs.

Treatment failures can be minimised by careful selection of antimalarial brands to guarantee quality and efficacy. Brand selection must take bioequivalence into cognisance. Not all substitute brands will achieve the same drug target concentrations as brands that have been tested and proven over the years.

Repeat infections can be reduced by eliminating or minimising exposures to the disease vector, mosquito bites. Proper hygiene and environmental sanitation go a long way to reducing breeding of mosquitoes. Use of insecticides and insecticide treated bed-nets is also a viable means of controlling malaria spread.

Self-diagnosis of malaria by patients is also rampant. Misdiagnosis is as such common, since symptoms of malaria may mimic symptoms of other common ailments such as influenza and typhoid fever. Rapid malaria diagnostic kits are now available to reduce misdiagnosis.

 What are the properties inherent in Gvither Plus which make it unique compared to other antimalarial drugs?

Gvither Plus represents a solution to antimalarial treatment failure. The brands positive attributes include the manufacturer’s track record and competence, assured quality and convenience of administration.

The brand is manufactured by Bliss GVS, a company that has a track record as a leader in antimalarial therapy across Africa. The company manufactures the constituent drug molecules of Artemether and Lumefantrine; this eliminates inter-batch variability so the issues of bioequivalence and quality assurance are addressed.

Gvither plus also promotes dosing compliance. It is formulated as 80/480 tablets for adults. That means just a single tablet is required for each dose. This reduces the pill burden on the patient, provides convenience and promotes compliance.

Treatment failure in children is also common. Here lack of dosing accuracy and consistency plays a major role. The paediatric formulation of Gvither Plus is presented as pleasantly flavoured dispersible tablets. Children find this more palatable and so adherence is improved. Dosing variation and inaccuracy is usually due to human factors introduced by carers that administer the drug, Gvither plus dispersible eliminates this risk because each dose has been carefully measured into a tablet. No measurement is therefore needed on the part of the patient’s carer.

 WHO’s prequalification is gaining credence in the country, and the continuity of this trend may spell doom for pharma manufacturers without the qualification. Is there any plan to get the qualification for your brands?         

Our mission at Seagreen is closely aligned with the WHO’s purpose for prequalification – provision of quality-assured priority medicines. With Seagreen, the goal is to make available good quality pharmacotherapy options for the management of prevalent healthcare challenges in the country. Hence the company adopted a proactive approach to quality right from inception. This has ensured that Seagreen’s activities would not be significantly affected by the prequalification requirements.

We maintain a stringent prequalification and selection process for our manufacturers. Our main manufacturer, Bliss GVS, operates a Total Quality Management (TQM) system that has been validated and accredited by WHO GMP, EU GMP, PIC/S, ISO and NAFDAC.

 In this age of counterfeiting, how do you ensure quality for your customers?

At Seagreen, we hold quality close to our hearts. Apart from this, we have invested in the MAS. Gvither Plus comes with the scratch cards that enable verification of the authenticity of each product pack by the end user. We also invest in other quality monitoring and enhancement activities, including distribution channel and market surveillance.

 Klovinal is another new product from Seagreen Pharma. Could you tell us more about it?

Research has it that, annually, up to 40 per cent of women would suffer episodes of non-sexually transmitted urogenital infections, leading to vaginitis; and over a million and half Nigerian women have recurrent fungal forms of vaginitis annually. These require at least four treatment courses annually.

Infective vaginitis is characterised by abnormal malodorous discharge, itch, burning sensation and dyspareunia. Mixed infections are common. Recurrence is a major challenge to the pharmacotherapy of vaginitis and recurrent vaginitis is a risk factor for sexually transmitted infections including HIV.

Seagreen, being a customer responsive company decided to respond to the yearnings of the health care industry for a solution that can provide sustained cure against vaginitis. This heralded the launch of Klovinal.

Klovinal is a brand of polyactive pessaries introduced by Seagreen in the course of the company’s last business year. It is specially designed and formulated for the management of vaginitis due to bacterial, fungal, protozoal organisms. Klovinal has a spectrum of antimicrobial activity that covers the three most prevalent forms of vaginitis, which are bacteria vaginosis, vaginal candidiasis and trichomoniasis. It is therefore suitable for empirical or syndromic management of vaginitis including mixed infections.

 What elements distinguish Klovinal from competitive brands?

Klovinal is, indeed, a veritably unique product in its category. It represents a whole paradigm shift in the management of vaginitis. Moving from merely eradicating pathogenic species to a system where microbiological cure is augmented by re-establishing the dominance of the healthy normal flora.

Klovinal is different from other agents useful in the management of vaginitis by the following factors: Firstly is its unique composition. Klovinal consists of three active agents – Metronidazole, Clotrimazole and Lactobacillus spores co-formulated as pessaries. The first two actives confer efficacy against the common forms of vaginitis, while Lactobacillus is included as a probiotic. Probiotics, according to the WHO, are live microorganisms which are administered in adequate amounts for health benefits in the human host system. So we purposefully use a species of microorganism to inhibit other pathogenic species.

The essence of the combination is to achieve the dual purpose of achieving microbiological cure and restoring the dominance of the normal healthy vaginal flora with the same agent. The outcome is efficacy against mixed infection and minimisation of the risk of recurrence. This is the first agent available in Nigeria to achieve this.

Secondly, Klovinal is manufactured with outstanding attention to quality in the pessary laboratories of Bliss GVS. That manufacturing facility is WHO GMP compliant, EU GMP compliant, ISO14001 and PIC/S.

Thirdly, Klovinal is produced using a new and innovative formulation technique, termed, SMEDDS – Self Micro Emulsifying Drug Delivery System. SMEDDS guarantees that the pessary will melt rapidly at body temperature and uniformly coat the affected surface. So, with Klovinal, you are sure that the pessary releases the active drug to the site where it is required. Women will not wake up to find administered pessaries falling off wholly or partially without having elicited any effects.

 What is your vision for these products in the next five years?

I sum that up as “sustained relevance”. Health care science and practice are dynamic. In five years, it is our desire that Seagreen attains greater relevance in the health care system; and we are vigorously pursuing this. We are also positive that the products would have attained full acceptance as veritable health care solutions and, barring any major evolutions in science and knowledge, that the health care community would find them dependable allies in the management of the disease conditions.

 

The National Health Act and the road ahead

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 The year 2014 ended with the signing of the harmonised National Health Bill by President Goodluck Jonathan. The Bill, which is now an Act of Parliament, is designed to provide a framework for the regulation, development and management of a National Health System and set standards for rendering health service in the country. Among other things, it provides a comprehensive integration of the functions of the different sectors of health care in Nigeria and provides a description of “The National Health System”.

The Act, which was long in coming, and the processes heralding the emergence of the harmonised version, which is believed to have been signed by the president, reflect the nature of the peculiar challenges facing the Nigerian health care industry. The sheer magnitude of the inter-professional rivalry that exists in the Nigerian health care sector was unveiled in the events leading to the presidential assent.

It is particularly notable that, at the news of the signing, President of the Pharmaceutical Society of Nigeria, Pharm. Olumide Akintayo, in his congratulatory remarks, expressed some reservations, particularly of his hope that the landmark document was not doctored after the harmonised version had been passed at the National Assembly. Prior to the harmonisation, the PSN and other associations had fought hard to ensure that specific clauses that favoured only medical doctors in the operation of the health care system be removed. Though the harmonised copy passed by the National Assembly reflects the success of their efforts, we are yet to confirm if it was the same one endorsed by the President.

In a statement signed by its President, the PSN said: “the harmonised version of the National Health Bill signifies the first time the borders of restriction in health care were opened as major Health professional associations and trade unions are represented in key structures of the new Health Act”. The Act, among other things, makes it a legal statute that 1 per cent of the consolidated revenue of the Federal Republic of Nigeria be dedicated to the funding of Primary Health Care. Though this represents a progressive effort in the right direction, it still does not reflect the realities of the Nigerian challenge. Considering that diseases like malaria account for 60 per cent of outpatient hospital visits in Nigeria, Primary Health Care in Nigeria needs greater attention – one that is embedded in a health insurance system that is adequately funded and managed.

At present, going by the 2013 and 2014 budgets, less than 6 per cent budgetary allocations were made to the health care sector, as against the agreed on 15 per cent in the Abuja declaration by African Heads of States in 2001.It is expected that the funding in 2015 would be even far less, considering the dramatically reduced government earnings, as a result of the global fall in oil prices. Our concern is that, given the level of bickering among health care professionals, the shrinking oil revenues and the present low level of health care funding, there are very tough times ahead. Hence, in as much as we must congratulate ourselves that we now have the Health Care Act, it must be emphasised that the journey is just beginning.

The next vital step is to design a pragmatic implementation system that is focused on the national health insurance structure – one that seeks to protect the lives of Nigerians in the days ahead, guaranteeing access to basic care, making the most of the 1 per cent of consolidated revenue commitment enshrined in the Health Act, while we ask for more.To achieve this, the Federal Government must, once and for all, take up the serious challenge of resolving the inter-professional bickering in the Nigerian health care sector, as this management challenge alone contributes a major bulwark hindering efficiency in the sector.

 

Commercial transactions 1: When is there a contract?

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Legal Angle

While reading the daily newspaper, Mrs Uche comes across an advert for Multivitamin Blood Tonic. She is informed that the product is available at Allen Pharmacy and immediately decides to purchase one when she goes shopping later in the day. On getting to the pharmacy, she sees the sales girl, Stella, who is busy attending to other customers. Mrs Uche picks up a shopping basket and proceeds to select the only bottle of Multivitamin Blood Tonic on the shelf, along with some baby food and household products.

Meanwhile, Stella receives a phone call. It is Madam Tinubu, her regular customer. Tinubu calls to enquire about the blood tonic. Stella confirms that there is one bottle left and promises to keep it for her. Fortunately, the price of the blood tonic can be deducted from a refund that Madam Tinubu was meant to have collected from the pharmacy earlier. Tinubu is happy about this and promises to pass by in the morning to pick up the blood tonic and the balance of her refund.

By the end of the call, Mrs Uche gets to the counter and offloads the contents of the shopping basket with the intention to pay. A serious argument erupts between the two ladies. Stella tries to explain that she has already sold the blood tonic to her regular customer. Mrs Uche, on the other hand, refuses to give up the product, having responded to an advert, driven all the way to the pharmacy and picked up the blood tonic from the shelf.

The question is, who has the legal right to this product?

In law, every business transaction is premised on a contract. A contract is defined as an agreement between two parties which is enforceable. For a contract to be valid there must have been an offer by one party and then an acceptance by the other. Commercial transactions would be problematic if there were no principles governing the conduct of business. The law of contract covers every field of human endeavour.

The scenario above raises some legal questions:

  1. Are the elements of a contract present to make the transaction valid?
  2. What constitutes an offer?
  3. What distinguishes an offer from an invitation to treat?
  4. At what point is the agreement for sale reached?

The foremost authority on Nigerian Law of Contract, Professor Sagay, defines an offer as “a promise made by one party with the intention that it shall become binding on the party making it, as it is accepted by the party to whom it is addressed.” An offer must be precise, leaving no room for speculation.

The offer may be expressly communicated or implied by action. Everyday in life, we engage in activities that constitute the making of offers: When we call for a newspaper from a vendor; when we get into a bus or taxi; when we drive into a petrol station to refuel or when we place an order for food at a restaurant. Each of these actions constitutes an offer to do business with another party.

However, for an offer to be capable of binding the person making it, the offer must be clear and final. If the act is a preliminary step taken towards making the actual offer, it is termed in law, an invitation to treat. In the classic case, Carlill v. Carbolic Smoke Ball Co., the judgement held that when someone offers to negotiate, or issues advertisements that they have got a stock of books to sell (for instance), “there is no offer to be bound by any contract. Such advertisements are offers to negotiate – offers to receive offers.”

In the case at Allen Pharmacy, it is necessary to pinpoint exactly when a valid offer was made in the transaction. We have seen that a newspaper advertisement was published. It may be the view of some that such an advert constitutes an offer for sale of the specific product. Nevertheless, the law is very clear on this issue. The publication of the advert is merely an invitation to potential buyers to come and make offers for purchase. The advertiser reserves the right to reject offers from members of the public who respond to the advertisement.

In this case also, goods were displayed in the shop for the purpose of sale to buyers. It could be argued that the display of goods, in this manner, is an offer for sale which could be accepted, culminating in a valid transaction. On the contrary, in the case of Pharmaceutical Society of Great Britain v. Boots Cash Chemists, it was held that “goods are merely displayed to enable customers to choose what they want and that the contract is not completed until the shopkeeper or someone on his behalf accepts the offer after the customer has indicated the articles he needs.”

It therefore means that the act of selecting a product from the shelf and presenting at the counter is itself the offer that is made. In a shop situation, it is the buyer that makes the offer and the seller that decides whether or not to accept.

In view of this, it was the act of the phone call from Madam Tinubu that constituted a valid offer for purchase. This offer was accepted, resulting in a contract. In conclusion, even though Mrs Uche had received an advertisement; gone to great lengths to make the purchase and actually picked up the product from the shelf, she had not made an offer at the time the phone call came through, leading to the sale. In essence, the blood tonic now belongs to Madam Tinubu who had made a valid purchase over the phone.

 

Principles and cases are drawn from Sagay: Nigerian Law of Contract

Now that ACTs appear to be failing

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Nelson Okwonna
Pharm. Nelson Okwonna

 

It is no longer news, at least to general practice doctors and community pharmacists that our cherished Artemisinin-based Combination Therapies (ACTs) appear to have begun to fail. Though no one has produced a clinical trial documenting the scale and nature of this development in Nigeria, products sourced from leading proprietary and generic brands have been reported by some health care providers to be ineffective in achieving total clearance of the malaria parasite from the bloodstream as they once did. These observations are in volumes too numerous to be completely discounted.

There are many possible reasons for these observations. The first culprit could be poor diagnosis by the clinician. Next are adulteration and the use of mono therapy; and then the one we fear the most – resistance by the protozoa.

Most of our antimalarial medications are sourced from India and China and if one should go by the recent USFDA’s concerns about the quality of medications from these two countries, we might have a lot to be worried about. A notable pharmaceutical company in India, for example, was fined $500 Million dollars by the US FDA in 2013 for seven felony counts related to data fabrication about the safety of the company’s products over the prior decade.

The question is, if the United States could experience such massive scale adulteration by a renowned company, what could be the case for Nigeria, where we are yet to publicly indict any foreign pharmaceutical company? However, we believe that NAFDAC is doing a lot to protect the interests of Nigerians by ensuring consistency in the quality of antimalarial medications in the market.

That said, let’s assume that this is not a case of adulteration but rather, of resistance, which could as well have been caused by adulteration. Let us now evaluate a scenario where the malaria parasite is developing resistance to our therapy.

 In the event of resistance to ACTs

At present, malaria accounts for more deaths and morbidity in Nigeria than in any other country in the world. At least, a whopping 300,000 individuals die annually from malaria in Nigeria. That is about 34 individuals per hour.

Each year, Nigeria experiences more than a 100 million malaria episodes. What this means is that if, for any reason, we fail to not have a cure for malaria, in one year alone, we would be facing an epidemic of monumental proportions. It is therefore right that we endeavour to evaluate scenarios like this so that we can, at least, prepare. It should be borne in mind that there are countries where ACTs have been proven to have failed.

One important thing to note is that, unlike Ebola, we could be facing this alone. Again, if our experience with Ebola and available therapies are anything to go by, the picture is definitely not an exciting one; hence my decision not to shy away from this article, regardless of how gloomy things may appear.

As health care practitioners, our job includes preparing for such public health emergencies and from our training, the following are obvious indicators we could use to evaluate our preparedness for such a day:

  1. The presence of a long term strategic commitment
  2. Institutional mandate
  3. Ongoing research and development projects
  4. Public–private ownership of the development challenge

Essentially, we need to ask ourselves if there is a long term strategic commitment by anyone, public or private, in preparing for a day like this. Is there an institution whose mandate includes harbouring and managing such a commitment? Are there sufficient will and resources deployed in the form of research and development projects to reflect such commitments? If there are, do we have sufficient local engagement of the stakeholders – both private and public – in ensuring the feasibility of such endeavours?

Presence of a long term strategic commitment

A study of the Ebola scenario offers some interesting highlights, one of which is that there was a long term strategy for the virus disease. Somebody was worrying about what could happen and was doing something about it. ZMapp, for example, represented a wonderful demonstration of the power of effective partnerships between public research organisations and the private industry. For such partnerships to occur, there must have been strategic commitment.

At present, malaria receives massive funding from a wide diversity of donors. In 2012 alone, funding for malaria control peaked at US$ 2.5billion, representing more than a fivefold increase since 2004, when funding was less than US$ 400 million. At the center of these interventions, specifically for drug treatments, are the Artemisinin-based Combination Therapies (ACTs). ACTs are recommended as the first-line treatment of malaria caused by P. falciparum, the most dangerous of the Plasmodium parasites that infect humans. By 2012, 79 countries and territories had adopted ACTs as first-line treatmentfor P. falciparum malaria.

According to the 2013 WHO World Malaria Report, parasite resistance to artemisinins has now been detected in four countries of the Greater Mekong sub region: Cambodia, Myanmar, Thailand and Viet Nam. In Cambodia’s Pailin province, resistance has been found to both of the components of multiple ACTs; therefore, special provisions for directly observed therapy using a non artemisinin-based combination (atovaquone+proguanil) have been introduced.

One could say with confidence that there is a commitment to research and development of new antimalarials, but if we are to judge by recent occurrences, such commitments have not yielded a product yet.

Institutional mandates

Still on the Ebola scenario. A study of the efforts made by the US government to prepare for an Ebola Virus Disease situation shows a strong degree of long–term cohesive thrust between different organisations that include the National Institute of Health (NIH), Centres for Disease Control and Prevention (CDC), the United States Army Medical Research Institute of Infectious Diseases (USMRIID), the Canadian government and a host of private pharmaceutical firms.Apparently, each member of the partnering group had been preparing for a time like this and the outbreak was simply an opportunity to evaluate their degree of preparedness.

One could point out that the United States, in particular, had reasons to take the Ebola Virus Disease seriously – considering that there are no known cures for EVD and that Ebola virus constitutes a potential biological weapon. That said, should malaria not be of more concern to Nigeria at least – considering that we bear the largest global burden of the disease?

Going by the volume of funding dedicated to malaria control and the plethora of organisations involved in its disbursement, one could say that “yes, there is a long term strategic commitment. Institutions like Global Fund, World Bank, WHO, National Malaria Control Programme and the Ministry of Health, are the ones leading such interventions in Nigeria.

Ongoing research and development projects

This is one area that I am bit bothered about – not necessarily about the volume of the interventions but in their ownership. Preliminary investigations suggest that there is no ownership, at least in Nigeria, of the much needed research and development endeavours required to prepare for this eventuality – the failure of ACTs, a scenario that is quite predictable.

We all know that, in no distant time, we are going to have increased resistance to ACTs and that Nigeria bears the world’s largest global burden; yet it appears there are insufficient coordinated efforts in preparation for this eventuality. Some of the events seen in the management of the Ebola outbreak suggest that in situations of national emergencies like the one seen with the Ebola Virus Disease, it is possible that seemingly available therapies can be withheld on various grounds.

Ownership is very important. Yes, there are ongoing research and development efforts in finding malaria therapies which, by the way, are not as many as the level of R and D investment in HIV although malaria kills more people than HIV in Nigeria. The issue is that I do not think Nigeria owns these efforts; if it does, it would show in the level of funding dedicated to it.

The National Institute for Pharmaceutical Research and Development (NIPRD), in my opinion, should be leading such an effort. I know they are working on some antimalarial projects, yet the level of funding dedicated to such ventures is abysmal by any standard. Considering the magnitude of the scenario, it should be a national emergency and a malaria research and development tax could be justified if our government believes the problem is insufficiency of resources.

Public-Private ownership of the development challenge

As mentioned earlier, the Nigerian government, through appropriate parastatals, should be engaging other public and private organisations to ensure effectiveness and efficiency. These organisations could be national or international. The private sector, because of their profit motive, bring a certain level of efficiency in their operations and their partnerships as shown also with the USA management of the Ebola scenario are critical in the timely delivery of intervention.

In the Nigeria scenario, government intervention could provide the impetus for private pharmaceutical firms to invest some resources to finding new antimalarial medication.

 Heading home for answers

One area I believe we should look closely at is combination therapies – that is, of combining our local indigenous herbs/extracts with known existing therapies. The ACTs were born in like fashion.

 

Neros CEO launches ‘Entrepreneurial Spirits’

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Managing director/CEO, Neros Pharmaceuticals Limited, Chief Poly I. Emenike, has launched a new book, “Entrepreneurial Spirits”.

Neros Entreprenuer
L-R: Chief Poly I. Emenike, managing director/CEO, Neros Pharmaceuticals Limited and author of the book, ‘Enterpreneurial Spirits’; Mr Emeka Onwuka, former MD/CEO, Diamond Bank Plc and chairman of the occasion; and Prof. Pat Utomi, keynote speaker, during the book launch, held at the Nigerian Institute of International Affairs, Victoria Island, Lagos, recently

Published by Napoleon Hill Foundation, USA, the book is aimed at propagating the teachings of Dr Napoleon Hill, reputed to have inspired many people the world over to achieve financial success,

The memorable book launch, held at the Nigerian Institute of International Affairs, Victoria Island, Lagos, and chaired by Mr Emeka Onwuka, former MD/CEO, Diamond Bank Plc, was graced by distinguished Nigerians, among whom were: Prof. Pat Utomi, Prof. Ben Oghojafor, Chief Olubukunola Okunowo and Dr Helen Ekwueme, wife of former vice president, Dr Alex Ekwueme.

Speaking at the occasion, the author, Chief Emenike, said the book represented his humble contribution towards the expansion of the frontiers of knowledge through writing, adding that ‘Entrepreneurial Spirits’ is the story of how he climbed from the very bottom to the pinnacle of the success ladder. He added that, in the book, he directly acknowledges the far-reaching influence which the writings of Dr Napoleon Hill had had on him in his quest to achieve success in life.

The book, Chief Emenike further said, is “therefore a lucid exposition of the fact that Dr Hill’s success principles can work for people in Nigeria, nay, Africa – just in the same manner as it has continued to work for people in Europe, the Americas and, indeed, the world over.”

The Neros boss also explained that the book was written essentially to teach Nigerians how to employ the power of the mind to their greatest benefit, and to also show how to develop and maintain a positive mental attitude at all times in order to achieve the success they desire in life. He said the book also serves to localise the teachings of Dr Napoleon Hill, since they have universal applications.

Chief Emenike urged other eminent Nigerian leaders in various sectors to document their experiences in writing for posterity, noting that knowledge gained from reading the writings of present day leaders would be useful to the young ones when they assume leadership positions.

Professor Utomi, who was the keynote speaker at the occasion, said Chief Emenike represented a special breed to showcase to the next generation, adding that the author was an example of the saying that ‘if you can dream it, you can make it happen.’

Prof. Utomi, who bemoaned the current obsession with materialism in the country, noted that society is not built by the size of a man’s car or how much is in his bank account, but by people who think. He disclosed that Chief Emenike has continued to read as he builds businesses because he knows that to build is to know, adding that what the Neros boss has done by writing ‘Entrepreneurial Spirits’ is to tell the present and coming generations that it can be done. He stated further that, for the generations to learn about how to climb the ladder of success, they have to read, insisting that motivating them to read should be the concern of all.

Earlier in his opening remarks, chairman of the occasion, Mr Onwuka, urged Nigerians to read the book because it would help change their lives. He added that the book is a must read for anyone aspiring to be successful.

Also at the occasion were Pharm. (Sir) Ifeanyi Atueyi, MD, Pharmanews Limited; Pharm. (Sir) Nnamdi Obi, MD/CEO, Embassy Pharmaceuticals and Chemicals Limited; Dr Obiora Chukwuka, chairman, Greenlife Pharmaceuticals; and Mr Emma Umenwa, MD, Geneith Pharmaceuticals, amongst others.

 

Becoming successful through self-actualisation drive

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 Dr Lolu Ojo
Dr Lolu Ojo

 

 

 

 

 

 

Self-actualisation is a term that was first used by Kurt Goldstein in 1939 to describe the ‘tendency to actualise, as much as possible, the (organism’s) individual capacities’ in the world. Abraham Maslow made the term more popular when he developed a hierarchical theory of human motivation in his book, Motivation and Personality (1954). Maslow defined self-actualisation as ‘the desire for self-fulfilment, namely, the tendency for him (the individual) to become actualised in what he is potentially…to become everything one is capable of becoming’. A simple textbook definition is ‘the full realisation of one’s potential’.

The purpose of this piece is not to discuss the theory and details of human motivation as expounded by Abraham Maslow and other renowned scholars but to briefly examine the route that pharmacists (and in fact, all young Nigerians) can take to self-actualisation. However, we will be relying on the writings of Abraham Maslow and other motivational personalities like Prof. Fola Tayo (Designed for Success, Engineered for Accomplishment, 2013) to chart the way forward.

 

Essence of education

According to Maslow, ‘What a man can be, he must be’. Simply put, if you are capable of scoring 90 per cent in an examination, you should not be satisfied with 70 per cent mark! Education is best defined as ‘the training of mind and character’. As a pharmacist, your mind and character have been trained and prepared to take on the world before you and be the best you can be. You are expected to make the full use (exploitation) of your talents, capacities and potentialities – your environment of operation notwithstanding.

Maslow also told us that ‘the story of the human race is the story of men and women selling themselves short’. With experience, we are almost giving credence to this assertion such that it can be said that the story of pharmacists in Nigeria is the story of men and women selling themselves short! We are challenged in all the areas of practice and we are desperately in need of self-actualisers to serve as role models.

A self-actualiser is a person living creatively and fully using his or her potentials. I will urge all to read more about the 13 characteristics of self-actualisers as written down by Abraham Maslow. This knowledge will help you to stay above your environment.

 

Excellence despite environment

The time is now to stop talking about the limitation of our environment. The attention should now be focused on the individuals and his or her desire to be self-actualised.

According to Abraham Maslow, ‘what is necessary to change a person is to change his awareness of himself’. Since you left school, have you taken a self-examination about who you are and what you have achieved so far? What is stopping you from getting to highest point of the ‘life ladder’, i.e. a higher purpose of human existence?? This self-examination includes answering several questions about yourself and your life journey:

  1. What do you want in life?
  2. If you do not GO after what you want or desire, you will NEVER have it.
  3. If you do not ASK, the answer will always sound like a NO.
  4. If you do not step FORWARD, you will ALWAYS be in the same place.
  5. If you REMAIN in the same place, you will NEVER SEE what lies ahead of you.
  6. If you DO NOT KNOW what lies ahead of you, you will never ASPIRE.
  7. Do you really know yourself?
  8. Who are you (talents, competencies, skills, knowledge, contacts, strengths, weaknesses, aspirations, etc.)?
  9. Why are you here (or what are you doing here): in the profession, work, societies, church/mosques, etc.?
  10. What is so special about me that I am chosen to perform this task? Are others not available?
  11. What is your destination?
  12. What can you make of your stay here?
  13. Do you have a plan for success?
  14. Where are you now? A situation analysis: defining life’s journey, successes, failures and opportunities.
  15. Where do you want to be? Statement of intent describing the expected output of a plan. Mission, goals, objectives, targets.
  16. How will you get there? Implementation strategy, activities or tasks, etc.
  17. How will you that you have arrived? Measurement, discipline, monitoring and evaluation.
  18. A plan is your vision embodied. Seeing what others are not seeing and communicating between the present and the future. It is an evidence of hope, an expression of aspiration which prepares the planner for a journey into an unseen reality. It is an essential ingredient of success without which self-actualisation may be impossible to attain.
  19. Are you aware of the Do’s and Don’ts?
  20. Never undertake any task that was not planned (Failure is built in already)
  21. Never take NO for an answer.
  22. Do not underestimate or overestimate yourself.
  23. Always expect accomplishment and success.
  24. Do not enter into the train of procrastination.
  25. Live everyday conscious of who you are.
  26. Time is a precious gift that can never be regained when lost. Run away from time devourers.
  27. Don’t make friends with ‘planless’ people.
  28. Be focussed and remain diligent even in adversity.
  29. Document all your activities, thoughts and plans

Expanding your horizon

We may not be able to exhaust the list of things to know or to be done in a single piece. What is important is that you change the awareness of yourself and this could lead to a permanent change in your life. We will give more attention to planning in this column in the nearest future.

There is something you should always remember: ‘If the only tool that you have is a hammer, you tend to see every problem as a nail’ (Abraham Maslow). It is therefore important for you to constantly update your knowledge base, developing skills and competencies and stay above your environment. Surely and steadily, you will get there.

HealthPlus to open 48 branches in 2015

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 – As JNC International boss canvasses harmony in health sector

Managing Director and Chief Executive Officer of the HealthPlus Group, Pharm. Bukky George, has announced that the company, rated as the fastest growing pharmacy chain in West Africa, would add 48 new branches to the existing ones in 2015.

HealthPlus
L-R: Pharm. Bolanle Adekoya, head of pharmacy department, Lagos University Teaching Hospital (LUTH); Pharm. Lekan Asuni, managing director of GlaxoSmithKline; Pharm. Bukky George, MD/CEO of HealthPlus Group; Pharm. Lolu Ojo, former chairman, National Association of Industrial Pharmacists (NAIP); and Pharm. Clare Omatseye, founder and Managing Director of JNC International Nigeria Limited.

 Speaking at the 7th annual thanksgiving dinner and awards ceremony which coincided with the company’s 15th anniversary, held at the Civic Centre, Victoria Island, Lagos on 15 December, 2014, the pharmacist remarked that she was happy that HealthPlus, Nigeria’s first integrative pharmacy store, had become the pride of Pharmacy.

“15 years is a major milestone for us,” Pharm. George recalled. “I still remember how we started from the 18 square-metre room in Ikeja, GRA, with three staff. We ensured that there was a pharmacist always on duty. We never paid lip service and, in 2011, we opened our first branch outside Lagos in Abuja. Today, with 40 branches nationwide, HealthPlus has become the pride of Pharmacy and the beauty industry.”

While crediting the success of the chain to her ‘people’ (the staff), the pharmacist said she was proud that HealthPlus was no longer about herself alone, adding that with the company’s current growth rate, past successes would seem insignificant in comparison with future prospects.

“We have a target to start 48 new branches next year [2015]. That is, 12 branches every quarter. It is going to be a challenge but it is achievable as we trust God for everything. It might also interest you to know that we have finally signed an agreement with International Financial Corporation (IFC),” she disclosed.

Lamenting the incessant conflicts besetting the health care sector, George said the time had come for health practitioners to stop fighting each other and work in the best interest of the patient.

She added: “On our part, we will continue to contribute our own quota. Just yesterday, we opened a new branch at Magboro along Lagos-Ibadan expressway. From next year, we will also target areas like Akowonjo, Tejuosho, Agege and several others.”

While delivering the keynote address for the occasion, Pharm. Clare Omatseye, founder and Managing Director of JNC International Nigeria Limited, disclosed that she almost screamed when she heard that HealthPlus was planning to open 48 additional branches in just one year.

“But knowing Bukky for who she is, a woman full of passion and vision, I believe she can achieve it,” she enthused.

The seasoned pharmacist with years of pharmaceutical, public health and medical device experience, recounted the sad event of an asthmatic young man who relapsed while driving along the Lagos-Ibadan expressway.

“All efforts made to get a quality patent medicine store, let alone a pharmacy, proved abortive. In the end, the young man died. Today I am happy somebody like Bukky George has taken care of that problem by opening a HealthPlus branch along the express,” she noted.

Omatseye also called on healthcare practitioners to put their differences aside and work in the collective interest of the patient. According to her, hospitals and doctors cannot make everything happen by themselves. What makes things happen is harmonisation, if the health sector is ever to break free from its vicious cycle.

“We cannot continue to do the same thing in the same way, day in, day out. We need to start creating new frontiers,” she said.

Also at the event were Pharm. Bolanle Adekoya, head of pharmacy department, Lagos University Teaching Hospital (LUTH); Pharm. Ike Onyechi, managing director of Alpha Pharmacy; Pharm. Lekan Asuni, managing director of GlaxoSmithKline; Pharm. Femi Soremekun, chairman of Biofem Pharmaceuticals; and Dr Lolu Ojo, former chairman of National Association of Industrial Pharmacists (NAIP).

Commenting on the thanksgiving dinner and award ceremony, Dr Lolu Ojo described it as laudable.

“Bukky is somebody one can describe as the best of the best. I think she has succeeded in bringing what we (pharmacists) dream about to reality,” he remarked.

On whether the HealthPlus boss could achieve the target of 48 new branches, the immediate past NAIP chairman was optimistic, citing Pharm. George past records.

“Although it is a very big and expansive ambition, she has the commitment to do it. Just as she vowed to increase HealthPlus Pharmacy from 17 to 40 branches in the past, this won’t be an exception. Don’t forget she just signed an agreement with the IFC,” he said.

Corroborating Dr Lolu Ojo’s view was Pharm. Chukwuemeka Obi, operations manager of PharmacyPlus Nigeria Limited, who said Bukky George had succeeded in revolutionising retail pharmacy in the country.

Obi disclosed that he knew the enterprising pharmacist way back when she left GSK and pitched tent with London’s popular pharmacy – John Bell and Croyden – to learn the ropes of managing a retail chain. He described her as a focussed pharmacist and go-getter.

Towards the end of the programme, some of the company’s staff were given awards and special recognition for their commitment over the years. They included Adebimpe Odesanya (2014 Outstanding Manager), Sandy Augustina (2014 Outstanding CasaBella Beauty Manager) and Sola Subair (Long Service Award).

HealthPlus was incorporated in 1996 four years after Pharm. Bukky George graduated from the School of Pharmacy, University of Lagos as the best student of the college. It officially started operations in May 1999 and CasaBella Beauty, a retail beauty business, was incorporated into the chain soon after.

 

MAS at five: Biofem, Sproxil celebrate

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Biofem
L-R, Mr Chinedu Chidioke, managing director, Sproxil; Mrs Abiodun Soremekun, executive director, Biofem Group; Mr Femi Soremekun, managing director, Biofem Group; and Pharm. Austin Osifo, head of marketing, Biofem Group, at the event.

It was celebration galore as Biofem Pharmaceuticals, a subsidiary of Biofem Group, marked five years of Mobile Authentication Service (MAS) in Nigeria.

MAS, which was advocated by the National Agency for Food and Drug Administration and Control (NAFDAC), in response to the spate of fake drugs sold in the country, is a technology-based service which allows individuals with mobile phones to verify the genuineness of a drug, without direct contact with the manufacturer. It was launched in Nigeria on 2 February, 2010, by Biofem Pharmaceuticals Ltd.

Speaking at the event, which took place within the company’s premises in WEMABOD Estate, Ikeja, Lagos last December, Managing Director of Biofem Group, Mr Femi Soremekun, disclosed that the decision taken by Biofem to be the first company in Nigeria to adopt MAS on its Type 2 Diabetes drug, Glucophage, was a bold move. He noted that prior to the adoption of MAS by Biofem, many pharmaceutical companies were reluctant to test the technology on their drugs.

“Our sincere appreciation goes to Sproxil for bringing MAS to Biofem at the time they did. We all know that it takes two to tango. Right from the day we started, it was like a risk. Actually, what we had in mind was that if it didn’t work at the end of the day, we would walk away, but if it worked, we would stay on it and do our best with it. Thank God, today, the success story after five years is here for all to see,” he said.

Corroborating the MD, Biofem’s Executive Director, Mrs. Abiodun Soremekun disclosed that Sproxil came to the company at a time when the company was in dire need of a lifeline from grasp of counterfeiters.

“Although it was highly challenging at the initial stage as so many consumers thought that by scratching the panel they were going to win prizes, we took time to explain to them, coupled with series of campaigns in the media. Gradually, they were able to realise that it was all for their good. We have every reason to thank God because, as at today, I don’t think there is any pharmaceutical company in the country that has as many as 23 of their products covered by MAS like we have in Biofem,” she said.

Also presenting a speech at the event, Mr Chinedu Chidioke, managing director of Sproxil, said MAS was developed by Sproxil in order to tackle the menace of drug counterfeiting in the country. He said Sproxil decided to develop a simple, efficient and cost-effective of helping consumers to verify the genuineness of their products prior to purchasing them.

“Our appreciation goes to Biofem for believing in MAS and for working with Sproxil in making MAS acceptable by all in the fight against counterfeiting and faking in the country and beyond,” The Sproxil boss said, adding that “relief has come the way of consumers now because all that is required of a buyer is to scratch off the label revealing a pin and then text the pin to a certain code for free. This gives an individual the power to authenticate what he or she is buying and also leads to customer satisfaction.”

Emzor marks thanksgiving dinner in style

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 – As GMD marks 70th birthday anniversary

It was a grand spectacle as hundreds of top government functionaries, pharmacists, captains of industry, technocrats and professionals from all walks of life gathered to mark the 2014 edition of Emzor Pharmaceuticals’ annual thanksgiving dinner.

Emzor
L-R. Head, Sales, Marketing & Strategy, Gerald Oputa; National Sales Manager, Folorunsho Alaran; Mrs Chinelo Umeh, Regulatory Affairs Manager; MAXWELL, the Wellocrat; GMD/CEO,Dr Stella Okoli; ED, General Duties/ Finance; Muyiwa Kayode, MD USP Brand Management.

The colourful event which took place at the Muson Centre, Onikan, Lagos, also had in attendance, Dr Alex Ekwueme, former vice president of Nigeria; Lady Onyeka Onwenu, representative of the Nigerian First Lady, Dame Patience Jonathan; Princess Adejoke Orelope-Adefulire, deputy governor of Lagos; Dame Abimbola Fashola, wife of Lagos State governor, Babatunde Fashola; and Dr Alex Otti, former chief executive officer of Diamond Bank.

While giving the opening address, Otti, who was also chairman of the occasion explained that Emzor had continued to demonstrate what leadership is all about. According to him, the 2014 edition of the annual thanksgiving was the 10th year.

“Sometimes we wonder what makes some people different from others. The reason is not far-fetched. To say “thank you” is something we humans find quite difficult to do.

He continued, “You remember the biblical story of the 10 lepers, where only one returned to show appreciation? The same is happening here. Since Dr Stella Okoli has decided to come back and say “thank you”, things will always turn out right for her.”

Corroborating Otti’s remarks, Pharm. Nnamdi Obi, managing director of Embassy Pharma stated that Emzor had excelled in the industry.

“In fact, there is no way the history of Nigerian pharmaceuticals would be narrated and Emzor would not be mentioned. I join every pharmacist to wish Dr Okoli more wonderful years ahead,” he said.

Appreciating the accolades, Emzor’s founder and Group Managing Director, Pharm Okoli noted that Emzor’s success story had divine backing, adding that the company strives to take a giant stride every year.

“That is why today we have over a hundred new products. We all know that the Nigerian pharma industry is quite unpredictable. But we serve a great God, a mighty one indeed. That is why we want to declare his unfaithfulness publicly each year,” she emphasised.

Towards the end of the programme, a handful of guests also used the opportunity to congratulate the Emzor’s GM Don her 70th birthday.

The company’s management equally used the occasion to unveil Wellocracy, the company’s vision of a new world where unlimited wellness would be available and affordablefor everyone.

Emzor Pharmaceutical Industries Limited is a wholly indigenous pharmaceutical manufacturing group founded by Dr Stella C. Okoli, OON, in 1984 and starting 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 colourful event which took place at the Muson Centre, Onikan, Lagos also has Dr Alex Otti, former chief executive officer of Diamond Bank; Princess Adejoke Orelope-Adefulire, deputy governor of Lagos; Dame Abimbola Fashola, wife of Lagos State governor; Dr Alex Ekwueme, former vice president of Nigeria; Dr (Mrs) Stella Okoli, founder/group managing director of Emzor Pharma and Lady Onyeka Onwenu, representative of the First Lady in attendance.

Also in attendance were Pharm. Bukky George, managing director of HealthPlus Group; Mrs Taiwo Taiwo, managing director of Shonny Properties Limited; Mrs Olufunke Amosun, first lady of Ogun State; Prof. Boniface Egboka, vice chancellor, Nnamdi Azikwe University, Awka and Dr Emmanuel Egbogah, former special adviser to the president on petroleum matters

 

 

 

Avian Influenza:Nigeria’s Agriculture Ministry introduces preventive measures

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bird flu

Following the re-emergence of the Avian Influenza popularly known as Bird Flu in some parts of Lagos and Kano last week, the Nigeria’s Ministry of Agriculture and Rural Development had taken some initial steps to curb the spread by quarantining the infected premises as well as placed restriction of movement of poultry and poultry products into and out of areas around infected premises.

For proper implementation of this, all state directors of veterinary services and the Federal Capital Territory, Poultry Association of Nigeria and other stakeholders have been informed and advised to be on alert with intensified bio-security measures to avert possible spread of the disease to other states.

Addressing journalists on the development at the weekend, the Lagos State commissioner for Agriculture and Cooperatives, Mr. Gbolahan Lawal, confirmed the resurgence of the epidemic in Badore- Ajah axis of the state, as a Zoological Park in Victoria Garden City is on the watch list following high mortality of wild birds.

The commissioner further stated that investigations revealed that the bird flu outbreak in the state might not be unconnected with birds transported from the North during the yuletide season.

However, citizens have been cautioned on the consumption on birds, ensuring that their chickens are well boiled before consumptions.

 

 

 

 

Abalaka, ready to offer his vaccine to FG on conditions

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HIV Vaccine

In what sounds like good news to HIV/AIDS patients in Nigeria, Dr. Jeremiah Abalaka, a surgeon cum researcher, who claimed to have developed a vaccine for the treatment and prevention of Human Immunodeficiency Virus (HIV), has agreed to release the product of his brain child to the Federal Government of Nigeria, but not without terms of agreement.

Abalaka who had rejected a partnership with the government over the breakthrough last year, due to some illegal actions that welcomed the innovation from different quarters, said “when the FG discovered that the vaccines were potent, it sent agents to me with the sum of N10million for the breakthrough to be announced in Atlanta Georgia, USA, but I refused”.

However, while fielding questions from journalists at the weekend, Abalaka disclosed his willingness to now partner with various interested government agencies, in order to ensure the effective use of the vaccine, on negotiation with the government.

His vaccine recipe, he said, will be released to a chosen representative of the Nigerian government – a person of relevant profession for whom he will organize a workshop with practical sessions, while the workshop will focus on the production, storage and administration of the vaccines.

Recounting his ordeal over the development of the vaccine for the past 16 years of legal hurdles and tussles, he said although he feels pained that millions of people should have benefitted from his discovery before now, but it’s never late.

He said his attempt at finding a way forward in fighting the HIV pandemic came after attending a World Health Organization-sponsored workshop in 1974 in Geneva.

The WHO workshop formed a solid foundation of the conception of his innovation for safe and effective HIV vaccines.

He recommended that a national or state emergency vaccination programme for HIV control be created. He said the agency must be completely independent directly under the presidency or the state governor. The agency, he said, should also be funded by the Nigeria government in collaboration with private sector contributors.

It will be recalled that in 2000, the Olusegun Obasanjo administration suspended the use of all drugs or vaccines claimed to be used for the prevention, cure or treatment of HIV/AIDS until proper guidelines are approved for the assessing and verification of the claims.

However, a Federal High Court in Makurdi in November 2014 ruled against the ban on the controversial HIV vaccine developed by Mr. Abalaka.The judge ruled that the Federal Government was wrong to have banned Mr. Abalaka’s vaccine.

The court in its ruling then said there was no evidence that such guidelines were put in place after 15 years. It said the ban on Mr. Abalaka’s vaccine was done arbitrarily and therefore illegal, null and void.

However, it said Mr. Abalaka could only administer his vaccine with patient’s consent.

 

 

 

 

 

 

 

 

Why People Buy Garcinia Cambogia

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HCA is actually mostly in charge of corroding fatty tissue, which supplies the system along with energy to sustain it. These items are actually marketing like hot bread. Dietary supplements – Ipads or even pills along with or even without various other active ingredients.

There are actually a lot of ways to decrease as well as control the body weight. For some it is actually longings for unhealthy as well as sugar rich meals and also for others that is actually merely a slow metabolic rate. However, what subject extra is your big problem and also approach in the direction of these solutions as most of all of them end up phony.

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Reports, as to be actually anticipated, have actually mixed evaluations. To start with, that works through decreasing hunger as well as restricting hunger pangs. If you’ve never ever found garcinia cambogia previously, that resembles a little fruit. There are actually a lot of weight reduction supplements that detail it as an active ingredient.

If you are actually planning to decrease body weight, you have likely know Garcinia cambogia Cambogia – everyone in the excess weight management globe is discussing that. Whenever you check out http://puregarciniashop.com/the-shocking-secrets-behind-garcinia-cambogia.html/ you can definitely find your self overwhelmed by simply garcinia cambogia details. In a lot of overall health researches conducted typical natural and organic supplements are actually claimed to become to have potentials in managing obesity. Hoodia gordonii eating plan tablets doesn’t possess dairy products, peanut, shellfish or even wheat that can produce allergy symptom for some folks.

Effectively, do certainly not have exactly what the media must claim about that, neither have just what the ads state. Hydroxycitric acid, the chemical drawn out from this fruit, is actually believed to function as a weight-loss supplement. And often, you don’t also have to create it.

It also helps minimize the body fat and cholesterol amounts in your blood, which hinders the system coming from keeping a lot of excess fat. Do not rush off to get hoodia gordonii plus yet, considering that for a minimal time, you could acquire a cost-free trying time. Several of them merely quit as well as a handful of would go for cosmetic surgical operation simply to appear healthy.

Aasonn Buyer Profile – Alexion Prescription drugs

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Lissa Legislation, Affiliate Director of HR Methods for Alexion Prescription drugs shares why she loves Aasonn’s MyConsultant Plan.

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SAP Provide Chain Integrity Options for Prescription drugs

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Pharma corporations face many challenges regarding Provide Chain Administration: They have to management globally distributed manufacturing websites in addition to numerous distribution channels. They’ve to observe your cold-chain and guarantee protected transport of narcotics and medicines and now additionally must take care of much more new legal guidelines and laws round serialization and monitor & hint. Study on this video how SAP options might help pharma corporations securely overcome all these challenges and obtain compliance effectively.

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Bulama tasks practitioners on harnessing herbs for economic development

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          … As Bioresources holds Herbfest 2014

For economic development to be a reality in the country, researchers, entrepreneurs, traditional medicine practitioners, and other stakeholders in the health sector, must strive to promote and improve on our indigenous bioresources, natural medicine knowledge, natural products resources as well as initiate means of connecting these resources for the wellbeing of the citizens, Dr. Abdul Bulama, minister of science and technology has said.

The minister, who was also the chairman at the Herbfest 2014, made this submission while addressing the audience at the opening ceremony of the 3-day international symposium, which took place at the Nigeria Natural Medicine Development Agency (NNMDA), Vitoria Island Lagos, on November 25, 2014.

Speaking on the theme of the workshop titled : “Herbs, health foods, herbal and natural products: shifting the boundaries of health care”, he said it is very relevant at such a time as this, when the government is aiming at using all available resources of the nation to improve on the welfare of citizens.

He described Herbfest as a laudable initiative which has potentials to promote the production of healthy indigenous foods and herbal therapies that will assist in addressing local and global food nutrition and health challenges, encourage sustainable utilization of our vast biological resources, facilitate conservation of our environment and assist the creation of job and wealth creation to the nation through industrial expansion, commerce, science, technology and innovation development.

Bulama, who was represented by Dr. Menesa Gwoza noted that Nigeria possesses about 40 per cent of medicinal plants and assured that the Federal Ministry of Science and Technology will continue to provide a credible platform for the development of these natural resources as well as support innovative research to assist in developing these herbal resources research and development outputs which will indeed contribute to create jobs, wealth and improve the lives of the people.

In his own contribution, Director General of NNMDA, Dr TF Okujagu, who is a co-host of the event, said the overall goal of Herbfest is to showcase the rich biodiversity and investment opportunities of Nigeria and the West African sub-region in general to the world and enhance the patronage /recognition, productive capacity and income status of small producers of herbal and other natural products through a combination of market promotion, enterprise development, scientific session and training and simultaneously promote trade and investment in the bio-business sector.

He emphasised the uniqueness of Herbfest 2014, stating that it is targeted on bridging the health gaps created by inefficient use of natural products, showcasing research and products used from nutrition to health and promoting the activities of traditional practitioners and community health workers as well as stimulate investment in the herbal, natural products field and contribute to transforming the country by improving healthcare delivery, creating jobs, wealth and contributing to national socio-economic growth and development.

The main host of the programme, Dr Maurice Iwu explained the essence of Herbfest, as an initiative to bridge the gap between the production of medicinal herbs and pharmaceutical products manufacturing. He acknowledged the fact that many researches have been done, but they are insufficient in quantity and quality to break the barrier frontiers, as there is no integration of scientific components to empirical information available.

The renowned scientist who spoke to pharmanews in an exclusive chat during the conference further said the other challenging aspect of natural medicine is the business component, as there are no many success stories of people making money from medicinal plants, thus there are no industry drivers. “This is why Herbfest now holds annually to motivate and drive inventors into the vast bioresources of our nation, thereby initiating economic growth through plants”.

On the issue of substandard herbal products in circulation, he said NAFDAC is doing a lot to check the activities of these unscrupulous men, by insisting that they submit their products for verification before they circulate in the market.

 

 

 

Shocker: 5,000 Nigerians travel abroad for treatment monthly – WWCVL boss

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Managing director of World Wide Commercial Ventures Limited (WWCVL), Anant Narayan, has said that no fewer than 5,000 Nigerians travel abroad for medical attention every month.

Speaking during the opening ceremony of the Annual National Conference of the Pharmaceutical Society of Nigeria (PSN) in Uyo, Akwa Ibom State capital, the Indian technocrat lamented that seeking treatment in foreign countries comes at a huge cost.

While observing that renal problems and cancer top the list of illnesses prompting foreign medical trips, Narayan added that such trips gulp an estimated $5 billion (N80 billion) annually.

He further remarked that 80 per cent of renal problems in the country were related to counterfeit products usage.

“It is pertinent to note that at the point of medical advice; only 23 per cent of patients use government hospitals. While 15 per cent turn to pharmacists for assistance; 13 per cent make use of private clinics, 43 per cent resort to use of chemists/traditional medicine vendors/self medication and 6 per cent do not seek medication at all,” he stressed.

According to the WWCVL boss, for every 4,000 people there is only one physician in Nigeria as against 10 in the United Kingdom and America.

Narayan however noted that prevalence of fake drugs was a global phenomenon, adding that the World Health Organisation (WHO) estimates eight per cent of drugs sold around the world are counterfeits.

“Some African, South-East Asian and Latin countries have as high as 50 percent fakes in the market just as global counterfeit market estimates equally vary from $50 – $70 billion,” he noted.

The WWCVL MD also took a swipe at the chaotic nature of the drug distribution channel in the country.

“The present distribution system is modelled on a disorganised structure where an importer/manufacturer deals directly with wholesalers, semi wholesalers, retailers, hospitals and clinics,” he said.

The health expert remarked that the resultant implication of such arrangement is that it gives pharmacies very high investment but the running cost gives low return on investment.

“Secondly, it leads to variable prices of products in the same locality as well as compels all pharmacies to start stocking non-pharmaceuticals to attract customers and make ends meet,” he added.

Narayan also expressed concern that if the importer-retailer chaotic distribution system is not curbed in time, it could either lead to depressed margins and distress sales (often termed ‘The Flood’), or overpricing, otherwise known as ‘The Famine.’

He was however optimistic that the new distribution chain proposed in the National Drug Distribution Guidelines would take care of the existing chaotic system.

“The new chain will see manufacturer/importer deal with Mega Drug Distribution Channel (MDDC), State Drug Distribution Channel (SDDC), and National Health Programme. The MDDC & SDDC, in turn will service the wholesale chain, which in turn will attend to community pharmacies, primary health care and PVT health institutions,” he emphasised.

The expert opined that Nigeria is a geographically diverse country with extreme climates that make distribution a critical function.

He further added that the long channel of distribution and high incidence of brand substitution makes it mandatory for a company to make all its stock keeping units (SKUs) available at all channels at all times which also ensures stable prices.

The WWCVL boss lauded the collective efforts of the PSN, federal ministry of health, Pharmacists Council of Nigeria (PCN) and the National Agency for Food and Drug Administration and Control (NAFDAC) at sanitising the health and pharmaceutical industry in Nigeria.

WWCVL, a subsidiary of Eco Health Limited, has, since inception in Nigeria, partnered with over 16 multi-national companies, maintaining 10 strategic distribution hubs scattered across the six geo-political zones, as well as servicing 144 wholesalers and depots nationwide.

Aside being a licensed vendor to all major healthcare providers in the country, it has also been described as a one-stop solution for warehousing, pharma marketing, supply chain, leads, delivery and sales, regulatory and port clearance, transportation logistics and inventory management.

Its consistency over the years has facilitated its success with great companies such as GSK, AstraZeneca, Bayer, Novartis, Johnson & Johnson, Abbot Nutrition, Sanofi, Pfizer, MSD, Novo Nordist, Himalaya, Boehringer Ingelheim, Janssen, Allergan, 3M and Roche.

 

 

And the 2014 May & Baker Professional Service Award goes to…Pharm. Obono!

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May & Baker 2014 Award

Assistant Director and Head of pharmacy department, National Orthopaedic Hospital, Igbobi, Lagos, Pharm. (Mrs) Margaret O. Obono, has won the 10th edition of the prestigious May & Baker Professional Service Award in Pharmacy.

Mrs Obono was announced winner of the award at the opening ceremony of the 87th PSN Conference held at Ibom Hall, Uyo, Akwa Ibom State, on 4 November, 2014 and was also presented with the plaque, certificate and a dummy cheque of N250, 000.

Mrs Obono hails from Idomi, Yakur Local Government Area of Cross River State and had her education at Saint Michael’s Primary School, Kaduna; Federal Government Girls College, Calabar; University of Nigeria, Nsukka and the West African Postgraduate College of Pharmacists (WAPCP).

She has won other various awards, including the Merit Award from the Association of Lady Pharmacists (2007); Merit Award from the Women’s Wing of Christian Association of Nigeria (WOMICAN) – 2001; Pharmaceutical Society of Nigeria (PSN), President’s Award 2006; Young Pharmaceutical Forum Gold Mentor Award (2008); Merit Award, PSN, Lagos (2009); and the Pharmaceutical Association of Nigeria Students (PANS) Award (2009).

She is a Fellow of the West African Postgraduate College of Pharmacists and member of the International Pharmaceutical Federation.

Why PharmD should be minimum qualification for pharmacy graduates – Pharm. Bob-Manuel

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When young Elizabeth Boma Bob-Manuel announced her intention to study Pharmacy in the university, nobody in her family saw it as a big surprise. For someone born of a revered pharmacist father and a mother whose nursing practice was well appreciated in the community, she must have been impressed by the influential synergy exhibited by the commitment of both parents. But in following her parents’ footsteps, the veteran pharmacist resolved not to be a mere “also-ran”; she worked hard to distinguish herself in the profession, until her retirement in 2009 as Rivers State Director of Pharmaceutical Services. In this interview with Adebayo Folorunsho-Francis, the 64-year-old native of Abonnema, Akuku Toru LGA of Rivers State, recalled some notable milestones in the growth of pharmacy practice in Nigeria and reveals why she thinks Pharm.D degree should be the minimum qualification for pharmacy graduates. Excerpts:

How did having a pharmacist father affect your upbringing?

Recalling my growing up years brings back fond memories. I am the eldest in a family of 12 children. My parents ensured that we were well catered for, even though my father was a strict disciplinarian and instilled in us the right moral principles. He worked with big pharmaceutical companies like Pfizer and Eli Lilly, detailing drugs. I was always awed by the type of confidence he exuded whenever he talked, especially about drugs. This contributed to my decision to study Pharmacy in the university. Good education was of utmost importance to my parents; so they ensured that every one of us was well educated. We were also taught the fear of God. We remain a close knit family and I thank God for His numerous blessings.

What about your work experience as a pharmacist?

After I left the University of Ife (now Obafemi Awolowo University), Ile-Ife, I started work as an intern pharmacist in 1974 at the General Hospital,Port Harcourt,and later went to Sokoto for my National Youth Service. On return to Rivers State, I worked in a couple of hospitals and later decided to leave hospital practice. I thereafter proceeded to the UK for a one-year Industrial training programme in drug production at Regent Laboratories,through the sponsorship of the Rivers State Government. This exposed me to Good Manufacturing Practice and, when I resumed duties after my training, I was posted to the Rivers State Pharmaceutical Manufacturing Laboratory, which was responsible for producing drugs for government-owned hospitals.

I was in charge of this establishment till 1994 when I was deployed to the Hospitals Management Board as Director of Pharmaceutical Services. In 1997, I returned to the Ministry of Health and was made the Rivers State Director of Pharmaceutical Services; a position I occupied until my retirement in 2009.

 

Can you confidently say that studying Pharmacy was a good decision for you?

Oh yes, there is no doubt in my mind that I made the right decision. If I were to choose all over again, I would still go for Pharmacy. It is a profession that remains relevant all through one’s life.

 

A veteran pharmacist like you must have gone through a lot. How would you compare Pharmacy in your day to today?

There was more sanity in the practice in my day. This was probably due to the fact that we as Nigerians then had our values right. There was more sanity in the country. People had more respect for the law, unlike what is happening today; so much lawlessness and love of money. Nowadays, people do whatever they like and get away with it. Honesty and integrity have been thrown to the dogs. We cannot isolate Pharmacy practice from the larger society because the profession is practised in this country by Nigerians.

 

Could you explain this further?

Yes. During my time, a young pharmacy graduate had no problem getting a job because there were so many openings, and we as a country placed premium on education and merit. We were comfortable with what we earned and so had no need to be lawless. However, I must admit that Pharmacy as a profession has come a long way from my time. The curriculum in the schools is better and the general populace is more aware of who a pharmacist is. Today, patient counseling is also commonplace.

 

Were there no instances of controversies and scandals during your time?

Well, not really. As young pharmacists, we did not have too many controversies because there was mutual respect amongst the different health professionals and we also saw our elders in the profession as role models. However, as the years went by, I started observing so much turmoil in the pharmacy profession. This mainly had to do with patent medicine licensing. Trading in drugs suddenly became everybody’s wish and there was the proliferation of drug stores, both legal and illegal. Many court cases and injunctions emanated from licensing issues and this incapacitated our regulatory body, the Pharmacists Council of Nigeria (PCN). It became a free-for-all affair and pharmacists blamed the Directors of Pharmaceutical Services for their woes since they represented the Council in the states. This led to a lot of distrust between the pharmacists who were the regulated and the DPSs who were the regulators. Our profession suffered a huge setback during this period.

 

In what ways?

Two major controversies which I cannot forget had to do with problems between the PSN and the PCN – first in 1997, when I first became DPS, and the in 2010. Incidentally, I was made the chairman of the Peace Committee which was set up by the PSN to try and resolve the 2010 issues that concerned PSN representatives in the governing board of the Council. Unfortunately, we did not succeed as there were court cases involved and this really saddened me because it set the practice backwards. Regulatory activities were almost at a standstill as there was no functional investigating panel and disciplinary tribunal. I am happy that things seem to have settled now with the appointment of the new registrar.

 

How best do you think some of the numerous challenges facing pharmacy practice in Nigeria can be curbed?

The challenges are enormous because they come from within and outside. The biggest challenge, as far as I am concerned, is the inability of the government to deal with the problem of drug proliferation and the open drug markets that are all over the place. I am yet to see any country in the world that compares with Nigeria in illegal sale of drugs. There seems to be no political will to address the problem.

One way Pharmacy practice can be improved is if the National Drug Distribution Guidelines (NDDG) can come into effect; but, unfortunately, we are nowhere near implementation. I don’t even know whether many pharmacists know what it is all about. Many have never seen the document and most states are not ready. The appropriate implementation of the National Health Insurance Scheme at all levels will also improve our practice. Luckily, a pharmacist is now the chairman of the Board. I am hoping for improvement.

 

Is that all?

Another way improvement can come is if pharmacists get more involved in pharmaceutical care and less in trading, as this will distinguish the pharmacist from the quack. This is why the Pharm.D degree should be the minimum qualification for the pharmacy graduate of today. I am a strong advocate of this programme. I think it gives the pharmacist more confidence whether in the hospital or the community.Pharmacists should also get involved in politics so that they can influence policies.

 

What about the influx of fake and counterfeit drugs into the country?

This problem can be curbed if it is given the seriousness it deserves in this country. The drug markets must be addressed. We cannot have every Tom, Dick and Harry trading in drugs because he can afford it or he seems to feel it is his birthright. We endanger the lives of our people when we ignore this monster. There must be very stiff penalties for violations; those who are caught must be prosecuted. The regulatory bodies concerned should be adequately empowered. How can you address the issue of inspections when there are no vehicles for surveillance, inadequate protection for inspectors and gross underfunding?We can all see that if there is political will we can achieve a lot in this country. The containment of the Ebola Virus Disease in Nigeria is a good attestation to this fact.

 

Has any PSN president made a lasting impression on you over the years?

The answer is yes. Lady Eme Ufot Ekaette made a lasting impression on me. She was the very first female president the PSN had and she took over at a time when the DPSs and the PSN were at loggerheads. The PPMVL (Patent & Proprietary Medicines Vendors Licence) problem was also rife then and she had a lot of challenges; but she did creditably well. The year she took over the mantle of leadership was also the year I became the DPS of my state and it was also during her tenure that I was made a Fellow of the PSN.

 

How active are you in pharmaceutical activities?

I have always been fully involved in pharmaceutical activities, especially in my state. Having served as DPS for 12 years, it was inevitable that I got involved as I was the number one pharmacist in the state all those years. It was a big responsibility because the pharmacists looked up to me as the chief implementer of the drug laws. As a Fellow, I give all the support in every way I can to the PSN in the state whenever the need arises and I take part in the activities of the Society.

 

Were there some major laurels given to you in recognition of your selfless service?

Yes. I had several awards while serving in the Pharmacists Council. I also had Merit Awards from the Association of Lady Pharmacists and NAHAP. There was one from ACPN for being a friend of the Association. I appreciate them all.

 

How do you see the annual PSN conferences?

I think too many activities are fixed for each day. We do not seem to get the full benefits of the conference because of this since various programmes take place concurrently. Another thing is that many pharmacists just go there to buy drugs and so you find the drug stands very busy while lectures and other programmes are going on in the halls. Apart from these, the conferences are enriching.

 

If you were not to be a pharmacist, what other profession would you have opted for?

I would have opted for Law because I hate injustice.

 

Is there any particular age an active pharmacist should retire?

I don’t think so. It all depends on the sort of work the pharmacist does and the health status. Some jobs are more strenuous than others. After active service, one could get involved in some part time work in any area of interest. We all know that a sedentary lifestyle is not good for the health.

 

As an elder in the profession, what is your advice to young pharmacists?

My advice to young pharmacists is that they should know that they have a highly valuable profession into which only brilliant minds graduate and so they should be confident of themselves. A pharmacist’s job affects the lives of people which, therefore, means that the licence should be jealously guarded. Despite the unfriendly environment, any hardworking pharmacist who knows his stuff will succeed. Finally, they should remember that a good name is better than riches.

 

 

UNIZIK Ebola research team announces seven potential cures

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In what seems to be a major breakthrough in the fight against Ebola, a team of investigators and research assistants sponsored by the Nnamdi Azikiwe University (UNIZIK)’s Faculty of Pharmaceutical Sciences has affirmed the discovery of seven drugs that can be used in the treatment of the dreaded disease.

Speaking at the 2014 Faculty of Pharmaceutical Sciences Research Fair and Luncheon, held at the Juhel auditorium of UNIZIK, Awka, Anambra State on 9 October, 2014, acting dean of the faculty and principal investigator of the UNIZIK-Nigerian Young Academy Ebola Drug Discovery Project Team, Dr Ikemefuna C. Uzochukwu, disclosed that the project team was willing to share the identities of these drugs with interested partners for further studies.

“The Ebola drug discovery project, which commenced on 1 September, has presently identified seven approved drugs with concurrent strong binding affinities for four different Ebola viral molecular targets (VP24, VP30, VP35 and VP40),” Uzochukwu said.

The principal investigator revealed that the team used two approaches – Computer-Aided Drug Design (CADD) and Drug Repurposing (DR) – to achieve the promising results.

On the issue of funding, the acting dean noted, with a sense of gratitude, that UNIZIK Vice Chancellor, Prof Joseph Ahaneku, had approved two million naira for computational resources for the project, adding that the fund was being processed with TETFUND.

Also speaking at the luncheon, UNIZIK’s DVC, Prof. Charles Esimone,who represented the VC, announced to the delight of the audience that the school management was in full support of academic researches that would not only end up as published papers but also benefit the general public.

He revealed that the VC’s vision for UNIZIK was to make it a research-based institution where the resulting products would generate appreciable income.

Towards the end of the programme, some forms were distributed to the dignitaries, especially representatives of industries and organisations, to express interest if they wished to collaborate with the project team. One of the participants, Dr Harry Obi-Nwosu, expressed his readiness to support the project by pledging N100,000.

Others notables at the event include Dr Joe Akabuike, Anambra State Commissioner for Health; Prof. Emeka Ezeonu, UNIZIK’s Director of Innovations; and Dr Ifeanyi Okoye, chairman of the event.

The PSN conference and the burden of extension

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Prior to the opening ceremony of the 87th Annual National Conference of the Pharmaceutical Society of Nigeria (PSN), held in Uyo, Akwa Ibom State, from 3 to 8 November, expectations were high among pharmacists as they looked forward to a rewarding and exciting experience.

The PSN conference has, over the years, evolved to become a quintessential model of pragmatic planning for organisers of other conferences. This is because the PSN, which is arguably the oldest professional body in Nigeria, has always endeavoured to improve all facets of the annual gathering of pharmacists from all over the country and beyond.

From all indications, participants at the Uyo conference were not disappointed in their expectations, as many recall being thoroughly enlightened and empowered, with some even ranking it the best conference so far.

However, as we congratulate the leadership of the PSN on the success of the 87th PSN conference, tagged, “Transforming Pharmacy Practice for Better Outcomes,” we also wish to task the leadership not to rest on its oars, not only in replicating the successes recorded at the event but also in correcting lapses that were observed.

To begin with, the turnout of pharmacists at the just-concluded conference was spectacular. Considering the current level of tension and apprehension in the country, it is to the abiding credit of the PSN that attendance at the gathering was that impressive. Throughout the opening ceremony and virtually all the parallel sessions, the Ibom Hall venue of the conference was always full to capacity, while pharmacists participated actively in all the programmes lined up at the event.

The opening ceremony of the event was also quite glamorous in line with the PSN conference traditions, especially with the presence of the deputy governor of Akwa Ibom State, Lady Valerie Ebe, who represented the governor; as well as the gracing of the occasion by five past PSN presidents – Senator (Lady) Eme Ufot Ekaette, Pharm. (Alh) Yaro Budah, Pharm. (Dr) U.N.O. Uwaga, Pharm. (Sir) Anthony Akhimien, and Pharm. Azubike Okwor – aside other eminent Nigerians.

Perhaps, what may be described as the “icing on the cake” of the event actually came from the various speakers, starting from the keynote speaker, Pharm. Lere Baale, who delivered well-researched and thought-provoking papers to the delight of the participants.

The PSN must also be commended for giving awards of “Ambassadors of the Health Sector” to four distinguished Nigerians, who were non-pharmacists. This award is significant, as it is a proactive step in courting and building important relationships for the pharmacy profession in Nigeria.

However, despite these positives, there were certain aspects of the 87th PSN conference that were not impressive and should be avoided in subsequent editions of the event. Topping the list of drawbacks was the extainsion of the conference period by one day. The additional cost of the extension in terms of finance and time was not in any way justified. Participants demonstrated just how unpopular the decision was by largely shunning the closing banquet on Friday night. Many had left before the event and some who remained to take part in the AGM did not hide their lack of interst in the banquet. While it is commendable that the PSN has introduced more events, we believe that all the activities could be accommodated within the four-day period through judicious planning.

Also besmirching the memory of the conference was the choice of an open field for the exhibition. It is our view that the heavy downpour that disrupted much of the exhibition could have been envisaged and a better location provided to accommodate exhibitors. The inability of the exhibitors to carry out their businesses in a conducive environment led to the chaotic atmosphere that saw the conference venue turning to an open market for all sorts of traders.

In addition, the Ibom Hall venue was not spacious enough to accommodate participants, especially during the opening ceremony, with some pharmacists standing during the session because they had nowhere to sit. A very important precondition the Local Organising Committee (LOC) must guarantee when given the hosting right for the PSN conference in future is the provision of a decent a hall that can adequately accommodate participants.

The task facing the PSN is to ensure the 2015 conference in Abuja is an improvement on the last edition. and the best way to start is by ensuring the lapses observed are reviewed and prevented from recurring.

 

Professional character and integrity in pharmacy practice

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(By Dr Lolu Ojo)

Let’s be blunt. Customers are the best judges of professionalism, not academic qualifications or certifying boards. Not everyone who practises a profession will be called a professional by the customers. And, while we may not all agree on who qualifies as a “professional”, most people know when they’ve been served by one. They also know when the person serving them, no matter the level of training and certification, is being less than ‘professional’ in their performance.

So, here’s a question for the pharmacist reading this article: Are you a true professional or just someone who has undergone the rigorous training and obtained the certifications to practice in this field? This is an important question with implications for the future of the pharmaceutical profession and other professional fields in Nigeria. My hope is that, as a society, we can start exploring, defining and re-discovering all the important attributes of a professional and injecting these back into all jobs.

A professional is more than someone ‘paid to undertake a specialized set of tasks’. He or she is,additionally, an expert with specialised knowledge base; a person with high standard of professional ethics, behaviour and work activities and; above all, an individual ‘who willingly adopts and consistently applies the knowledge, skills and values of a chosen profession’. The quality of being a professional, therefore, combines the basic knowledge in the chosen field with the attitudinal attributes of the person involved.

Character is the combination of qualities or features that distinguish an individual. It is the moral or ethical strength that defines the capacity, position or status or reputation of the person. It is the characteristic property that describes the apparent individual nature of something.

Integrity refers to the consistency of actions, values, methods, measures, principles, expectations and outcomes. It is the inner sense of wholeness, the honesty and truthfulness or accuracy of action. Honesty is ‘telling the truth to other people’ while INTEGRITY is ‘telling yourself the truth’.

With the definitions above, how do we discuss PROFESSIONAL CHARACTER AND INTEGRITY in Pharmacy? Are we true professionals who have willingly adopted and consistently applied the knowledge, skills and values of the pharmacy profession? What are we getting paid for: carrying out a specialised set of tasks with character and integrity OR simply for having a degree in Pharmacy?

The questions must also be directed to each of the technical groups or practice area in order for us to have a very clear view of the profession’s current situation:

  1. Academics:
  2. What do we teach and how is the knowledge measured?
  3. What tools are we using to teach and under what environment is the teaching taking place?
  4. Who are the teachers in terms of quality and quantity?
  5. What is the quality of the university products? What kind of feedback are we getting?Do we even care for the feedbacks?
  6. Is academic pharmacy only about teaching? Do we still do research?If yes, what research? To what purpose?
  7. Are we really contributing to the world body of knowledge on drugs and their application?
  8. Where is the Professional Character and Integrity in our practice?
  1. Hospital and Administration:
  • What do we do and how relevant are we to the hospital system?
  • What will the system miss if we are not there?
  • Which specialised set of tasks do we undertake?
  • Do we seek new way(s) to do the job better?
  • Can our job functions and duties pass the Professional Character and Integrity test?
  1. Community:
  • Are we community pharmacists or shop owners?
  • Even as shop owners, what manner of service do we provide?
  • When we work for non-pharmacists, what do we do?
  • What work do we really do? Are we princes or servants in our father’s palace?
  • Can our job functions and duties pass the Professional Character and Integrity test?
  1. Industry:
  • Industry, what industry? Do we exist in the world’s pharmaceutical map?
  • What is our contribution to the national GDP?
  • Who are the major players?
  • Who is a superintendent pharmacist and what does he do?
  • The market is so attractive but WHO are the beneficiaries?
  • Who are the regulators and what is the direction of regulation?
  • Can our job functions and duties pass the Professional Character and Integrity test?
  • To move forward and become true professionals with character and integrity, we must get excellent at the basics:
    1. Ask yourself the right questions and be honest about your answers.
    2. Resolve to be a professional, a pharmacistwith character and integrity in whatever area of practice you find yourself.
    3. Refuse to be assimilated by a stagnating, deteriorating and decaying system.
    4. Stay above your environment. Update your knowledge, experience and exposure base.
    5. STOP comparing yourself to others as we easily do. It is a defeatist approach.
    6. Reach out to the young pharmacists to renew their faith and refresh the profession.
    7. Collectively, we must kill ‘REGISTER AND GO’ through a deep understanding of the concept, fishing out the people involved, rehabilitating them where applicable and applying the right disciplinary measures.

We are certainly on the right track and we will get there: Building a pharmacy profession with character and integrity in Nigeria.

God bless Pharmacy in Nigeria!

 

Speed up Ebola vaccine production, Pearson tells multinationals

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Managing director of Africess Nigeria Ltd and organiser of the Medic West Africa Exhibition, Mr Bryan Pearson, has called on multinational organisations to fast-track the research processes in developing an effective vaccine for the disease.

Pearson who spoke to Pharmanews in an exclusive interview during the Medic West Africa Exhibition held recently at the Eko Hotels, Lagos, said funding and producing usable vaccines to fight Ebola was a tall order for individual pharmaceutical companies, due to the capital intensive nature of R&D, as well as the lengthy process it required.

“Until this epidemic, there was no economic reason for an independent pharmaceutical company to be financially responsible for the vaccine, but that doesn’t mean multinational organisations shouldn’t have embarked on research on the disease 20 years back,” he explained. “However, that is the benefit of hindsight, because no one ever thought this could happen.”

Pearson noted that since the disease had continued to ravage parts of the continent, it was pertinent for multinationals to synergise and develop validated vaccine for the disease, adding that Ebola was not a complex virus like HIV.

Speaking on the exhibition, Pearson said it was a good platform for health care professionals who wished to acquaint themselves with the latest technology in the industry, adding that Nigeria and Kenya were the biggest economies and regional hubs for the annual event.

He noted that though the fear of Ebola kept some exhibitors away this year, the event was still very successful. While admitting that the exhibition was a profit-making venture, Pearson said his team in the UK and Dubai worked tirelessly to ensure the success of the fair.

A co-organiser of the event in Nigeria, Dr Adewale Balogun, further explained that the organisers run a continuous educational seminar for practitioners alongside the exhibition, with the aim of sharpening their skills.

“SME (the training module) is supposed to expose practitioners to current practices in laboratory management. It runs concurrently with the exhibition, for a full day. Though the Continuing Professional development (CPD) point for the medical laboratory scientists is 3 CPD points, other professions’ is 5 CPD points. Depending on the registration criteria for the council, for the medical council, 10 CPD points will qualify a participant for a re-registration, while participants; CPD hours must be related to their professional programmes”, he explained.

 

What I learnt from Miami lakes

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When I was young, in the village, some places had no easy access to streams or spring water and, therefore, the people had to collect flood water during rainy season. A shallow trench was dug beside the house and, whenever it rained, water from the compound flowed into the trench. The water was then scooped into clay pots and left for the particulate matters to settle down. This water was then used for domestic purposes and drinking.

The reservoir for the collected water harboured various microorganisms, which we knew nothing about. Tadpoles, which we often saw in the water, were believed to purify it. At that time, we had no idea of water-borne diseases. It was indeed by God’s grace that the children, in particular, did not suffer from various diseases as a result of drinking such polluted water. Ironically, those who drank the water seemed relatively healthy. It was even believed that the water made people to be kind-hearted and generous

Let me compare these memories with what I observed during my recent visit to Miami, a city in Florida State of the USA. One main feature of Miami is the large number of lakes and canals. The lakes are man-made, to beautify the environment and promote air quality. Some canals are chanelled to run alongside the beautiful and spacious roads. Many residential estates are provided with lakes for fresh air and aesthetics. A clear notice at the lakes reads:”No swimming, no fishing, no boating”. Provisions are made for these activities elsewhere.

While in Miami, I watched the construction of a lake as heavy equipment was used to excavate and carry away sand and debris. The process was reminiscent of the way we dug shallow ditches with hoes to collect flood water those days in my village. The principle is the same – but more importantly, the process contains some vital spiritual lessons that can improve our lives.

Firstly, to collect and retain water, we must create a lower level; we must dig a trench. Spiritually speaking, this implies that you must bring yourself low – you must humble yourself -in order to receive from God. Just as hills cannot retain water, you cannot receive anything from God if you are full of yourself. Hebrews 4:6 says “…God resists the proud, but gives grace to the humble.

Secondly, just as machines are used to dig and remove sand in order to create a lake, so also must we clear our hearts of injurious ideas, philosophies and prejudices in order to gainfully receive the Word of God. Ditches must be emptied to receive much water. Similarly, you must not allow the enemy to fill up the ditch of your mind with rubbish. The Bible reveals that Isaac once inherited some wells dug by his father, Abraham. But some Philistines, who were envious of Isaac because of God’s blessings on him, filled the wells with sand. Therefore, Isaac had to move to Gerar, where he dug a new well and found spring water.

Thirdly, the notice at the Miami lakes says, “No swimming, no fishing, no boating.” The reason is because, if allowed, these activities would disturb the serenity and beauty of the lakes and introduce some environmental hazards. In the spiritual sense, allowing hazardous elements like hatred, envy, bitterness, malice, fear, falsehood and dishonesty can affect the tranquillity of the mind. Such a mind cannot receive and retain the Word of God.

Also, the lakes were of various sizes and shapes. The larger the surface area and depth, the more water it can contain and, therefore, more fresh air and more aesthetics with a panoramic view. It is the same in the spiritual. When God wanted to bless a certain needy woman with financial resources, Elisha told her, “Go, borrow empty vessels abroad of all thy neighbours, even empty vessels; borrow not a few.” God caused all the empty vessels to be filled with oil, which the woman sold to pay her creditors and cater for her family (2 Kings 4). We, too, must present ourselves as large empty vessels to be filled with the Holy Spirit of God.

Lastly, water symbolises the Word of God, which gives life. Ephesians 5:25-26 (KJV) says, “Husbands, love your wives, even as Christ also loved the church, and gave himself for it; that he might sanctify and cleanse it with the washing of water by the word.

God’s Word is the water that cleanses our heart from impure thoughts and unhealthy emotions. Jesus emphasised this cleansing power of the Word, when He told His disciples in John 15:3, “Now ye are clean through the word which I have spoken unto you.”Our world is filled with sights and sounds that have the tendency to defile our hearts and imaginations. Daily, we are bombarded with images and ideologies that are unwholesome for our spiritual growth and development. However, as we daily study and meditate on God’s Word, our hearts are constantly purified and preserved from all corrupting infiltrations.