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How some pharmacists impede the drug distribution network- Pharm. Nwabunike

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(By Adebayo Folorunsho-Francis)

Pharm emmanuel

In this interview with Adebayo Folorunsho-Francis, Pharm. Emmanuel Chukwuemeka Nwabunike, managing director of Fontana Chemists, Surulere, Lagos, and two-time chairman of Nigerian Association of General Practice Pharmacists (now ACPN), evaluates pharmacy practice in Nigeria today, highlighting its achievements and suggesting solutions to some of its challenges. Excerpts:

 

Tell us a little about yourself

I was born on 23 November, 1930, in the town of  Nnewi, Anambra State. I had my early education at CMS Central School, Nnewi, and finished in December 1945. From there, I went to Dennis Memorial Grammar School, one of the best institutions in Nigeria. Since it was a five-year course, I passed with Grade 1 in 1950. Unlike now, what we had during my time was Cambridge education. In all, we had 31 Grade 1 results out of about 50-something students.

 

What was your first official assignment like?

Well, it is worthy to note that after my Cambridge exams, I worked for a year; after which I applied for admission in Yaba School of Pharmacy in 1951. In those days, there was serious competition among students. When I eventually qualified as a pharmacist, I got an appointment with Kingsway Chemist, a branch of UAC, in 1955. After a brief stint, I left and teamed up with Evans Medical where I worked for several years before I started nursing the idea of starting something on my own.

 

What made you think you had garnered enough experience to stand on your own?

To be frank, I had learnt a lot about the business of retail pharmacy while working at Kingsway and also more on wholesale in the course of my assignment as pharmacist with Evans Medical. Therefore, as a young man still bubbling with energy and zeal, I tendered my resignation letter to the then Managing Director, Mr. D. W. Martin. In fact, I still have the original letter, Mr. Martin’s reply and the letter of commendation he gave me in a file in my office. That should tell you that I left on a friendly note as I don’t like the idea of people resigning from work in a contentious manner.

 

So it wasn’t because you got a better offer that you resigned?

No, I actually resigned because I planned to start running my own retail pharmacy. Fontana Chemists was opened in April 1958 at Ojuelegba which was such a nice place to site such business then.

 

There are speculations that perennial violence by hoodlums compelled you to move from Ojuelegba to your present site. How true is this?

I wonder why people today often refer to Ojuelegba as a notorious area. That statement is not true. As earlier mentioned, I started Fontana Chemists in 1958. But the coming of the Nigerian civil war in 1967 made me close down the store as many of us from the East had to run home. On my return after the war, I discovered that the outlet had been taken over by another business. That was how I started the search for a new outlet until I got the one I presently occupy.

 

How did your old customers feel when they saw you after the war?

They quite understood my plight and even empathised with me. Besides, since the distance from my former store is not that far, they still patronise me to date.

 

In retrospect, can you confidently say studying Pharmacy was a good decision for you?

Well, I will say Pharmacy was a good course for me because it exposed me to the business aspect of life.

 

What was the profession like in your day compared to today’s practice?

There is a remarkable improvement in modern pharmacy practice as far as packaging and prescription are concerned. We no longer have to measure liquid and oral suspension in millimetre. Retail pharmacy too has undergone a lot of changes in recent times. I have observed it is being pitched together with supermarket to bring in additional income, unlike our own time when we focused only on medicines to make a living.

 

Was quackery rampant in your time too?

Well, I cannot really say no. But quackery was not as rampant as it is today. Even the issue of doctors refusing to allow pharmacists on ward round did not just start today. Doctors are not trained in drug administration but we had to allow them do it anyway. Having said that, we have to come to terms with the fact that the problem of quackery and mediocrity goes beyond Pharmacy, as every other profession has its share.

 

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

I think it is the problem of distribution network. Back in my time, it was not as chaotic as it is presently. What we had were large companies delivering to pharmacies. Unfortunately, pharmaceutical companies don’t do that anymore because of the clamour for local manufacturing. Before, only top multinationals such as Kingsway, Glaxo, Wellcome and the likes, undertook such delivery and the drugs were genuine.

The sad thing about this chaotic distribution is that our colleagues are the ones abetting traders who have no business in Pharmacy to use their licence. It is quite unethical! If only we can speak with one voice, the better. This has further worsened the influx of fake drugs into the country.

 

How active were you in the area of contributing to the growth of pharmacy practice?

Well, I did my best. I was a two-time chairman of Nigerian Association of General Practice Pharmacists (NAGPP), which is presently known as Association of Community Pharmacists of Nigeria (ACPN), Lagos branch.

 

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

I would have become a doctor. It is about the only thing else I could think about aside Pharmacy. My second daughter is a paediatrician and I have another working with NAFDAC. Interestingly, I also have a brother who is a medical doctor.

 

Is there any particular age that an active pharmacist should retire?

I belong to the class of pharmacists who say, “If your body is still functioning well, why bother to retire?”After all, I am now 83 years and still strong. But truth be told, I don’t come everyday.

 

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

I believe so much in cooperation. If they can tell themselves the truth, they can progress because the profession is big enough to accommodate everybody.

 

 

Strike actions by health professionals unethical – Dr. Ovu

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Dr. Steve Ovu is a medical officer at the A&M Health Science Centre, Texas, United States. When Adebayo Folorunsho-Francis met him at a recent health event held in the country, the enterprising doctor gave a candid assessment of the Nigerian health sector, with particular emphasis on some nagging issues hampering its growth. He also suggested ways of resolving the issues. Excerpts:

 

Tell us about yourself, especially your educational background

 

I attended Birrel Avenue High School, Yaba, and obtained a BSc. with Honours from Prairie View A&M University, Texas, United States. I also had both Doctor of Medicine (MD) and Master of Public Health (MPH) degrees from Texas A&M University in College Station, Texas.

 

Why did you decide to study medicine?

I decided to pursue medicine after a successful surgical intervention to remove my infected appendix at the Eko Hospital in Ikeja. The feeling of relief overwhelmed me that I wanted to do the same for others in some way.

 

At a recent event, you talked about the problem of wrong diagnosis and how it is claiming lives in Nigeria. Give us your experience on this.

Please permit me to relate only on what I have experienced– poor medical management.

 

Tell us about poor medical management in Nigeria then.

There are quite a few issues that come to mind such as lack of “bedside oxygen” at the emergency rooms or no oxygen at all; patients having to provide their own medical supplies such as gloves, syringes, saline, laboratory diagnostic kit etc; absence of in-hospital imaging machines (CT scanners, MRIs); unavailable stat labs for quick assessment of patient haemodynamic; absence of electronic documentation of patient data, and so on. These aresome of the disturbing findings in our local hospitals.

All these factors constitute poor management,which greatly affect efficiency of care; this often translates to poor quality of care and loss of life in severe cases. These are provider-services issues, not considering whether the patients can or cannot afford these services.

 

What is your take on fight against counterfeit medicine in the health sector?

I am not familiar with the statistics of this issue but I can see this being plausible, given the significant physician-patient ratio in a rapidly expanding population. The difficulties students face getting into medical school, graduating from medical school and progressing to become consultants are factors that could fuel the promotion of incompetent/quack care givers because they have to “make it”. Not considering those who impersonate doctors for the purpose of fraudulent activities.

 

As a medical practitioner, what is your assessment of the state of health care in Nigeria?

My perspective on this issue is a culmination of my experiences in volunteering at one of the federal hospitals in Lagos, visiting family members at our public hospitals, prison medical missions and subjective reports from patients treated in the country. An overview of our health care is analogous to visualising an oak tree with many branches.The stalk represents provider services, in dire need of “available resources” (financial and human resources) to drive the business of healthcare. From the perspective of population medicine, healthcare should be structured to meet the health demands of the people and help avert undesirable health outcomes.

We need fully-equipped hospitals (which have functional emergency room services, intensive care units, general/specialised wards, trauma divisions, etc) that can accommodate acute issues concerning airway management, cardiovascular-related insults, pregnancy-related emergencies, fractures from high rate of motor vehicle accidents, manage infectious and chronic diseases, and provide medical technology for efficiency. We are talking about hospitals that will not demand the patients to go buy the accessories they need for adequate care. Time is life oftentimes, especially in emergency crises; and we have to equip our hospitals to provide all necessary devices to render competent care at a reasonable cost. The people don’t need a charitable non-functional health centre but health institutions that can fix them up with billing fees at the end of the rendered service. This will open up concerns for health insurance, which is fundamental for operations.

 

What about the branches?

The branches are the issues that have to do with patient expectations/management, such as respect for persons. Patients want to be treated humanely and not bashed when seen at a healthcare institution. Next is affordability of care. This tops the priority list for most patients over quality of care. Location of institution, accommodation (that will take care of the question: “Will they have beds for us?”), the list is endless.

 

What is the way forward, if we are to have a vibrant health sector?

Firstly, I will say significantly increasing revenues allotted to the health ministry to equip, build and restructure health institutions. Secondly, training more care providers to improve quantity and quality in the health sector. Thirdly, there should be preventive care –going after the root causes of morbidity and mortality (bad roads, water/waste hygiene, nutrition choices, vaccination and maternal care).

 

There are several primary health centres in the state, yet most Nigerians don’t access them for treatment. Why is this so?

They were not cutout to meet the teeming population of Nigeria, and I am yet to see a health centre that is not already congested with patients. This makes it difficult for anyone to want to go and spend the entire day in such place.

 

Is strike action really a good way to press home the demands of health officials or are there other means to draw government’s attention?

Strike by health professionals is unethical. But in a country like ours, where little or nothing happens until extreme measures are taken, one can understand but need not condone the strike actions. We need to get the healthcare professionals (doctors, nurses, pharmacists,etc) on board legislative issues because these people know where it hurts and are in better positions to make informed decisions on care governance in the country than the types of people on the cabinet.

 

 

Pharmaceuticals sell better with quality packaging, says Ituah

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…As Interpack trade fair holds in May

(By Adebayo Oladejo)

Pharmaceutical companies in Nigeria have been advised to improve their products’ packaging as this affects how consumers perceive and purchase the products.

The counsel was given by the regional representative of Trade Fair Services Limited (the West African representative of Messe Dusseldorf, Germany), Mr Akhigbe Itua, while unveiling plans for this year’s edition of Interpack Processes and Packaging Trade Fair, scheduled to hold between 8 and 14 May in Germany.

Mr. Ituah, who spoke at a press briefing organised to review the upcoming trade fair at the Sheraton Hotel, Ikeja, Lagos in February, noted that as the purchasing power of  Nigerian consumers continues to grow, the demand for quality packaging becomes the “core differentiator” on the store shelf.

“Packaging is very important to the pharmaceutical manufacturers and others because it is the last step the manufacturing companies take before they get to the consumers, and the way a product is packaged plays a prominent role in deciding its acceptability or otherwise,” Ituah noted.

He also added that “in terms of curbing the menace of counterfeiting which has ravaged our pharmaceutical markets, packaging and proper labeling can be used conveniently to differentiate between a genuine product and the fake one. There is no way one could imitate a genuine and well packaged product that will make it look like the original.”

Providing more information on the forthcoming trade fair, Ituah said the event would have about 2,700 exhibitors from over 60 countries who would present the future direction of packaging technology to 166,000 visitors in Dusseldorf, Germany. He added that Trade Fair Services Limited, which had been in existence for over 30 years, would provide consular, travel, accommodation and on-site support to Nigerians who would be travelling for the event.

He explained further that the scope of business interests that would be covered at the trade fair would include processes and machinery for food and beverages, pharmaceuticals and cosmetics, consumer goods (non-food), industrial goods, packaging materials as well as services for the confectionary and bakery industries.

Advising pharmaceutical manufacturers on the benefits of the fair, Ituah said,”My advice to them is that they should try as much as possible to be part of this year’s edition as it is the biggest platform for manufacturers all over the world. It is also going to be a platform that will afford them opportunity to meet other manufacturers, speak to machine manufacturers, makers of consumables, make them know the direction where technology is going, understand the basis for knowledge transfer, get inputs from much more established companies with regards to how they can improve their own manufacturing businesses here in Nigeria and many other benefits. So, it’s definitely going to be a worthwhile experience for them.”

Speaking further, Mr Ituah said those who are already familiar with Interpack know that the trade fair, which is held every three years, is the biggest international summit of an extremely dynamic sector, where the latest innovations in packaging products and associated process technology can be seen firsthand. He added that the fair is the leading and largest global platform for packaging and related processes technology.

Speaking on the unique features and opportunities that abound in Germany, Sophia Stefan from the German consulate used the platform to highlight the global attraction of Germany as a business destination, noting that those travelling to Germany are open to an avalanche of opportunities. According to her, Germany offers high level of productivity, innovation and quality of life to its citizens and visitors, while the government places a top priority on education and infrastructural development.

PMG-MAN alarmed over rate of drug importation

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(By Temitope Obayendo)

pmg_man

 

Chairman of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), Chief Bunmi Olaopa, has disclosed that for local manufacturing of drugs in Nigeria to meet the National Health Policy ratio of 70 per cent, as opposed to the 30 per cent for imported drugs, there is need for a deliberate policy of government to encourage patronage of locally produced medicines.

Olaopa, who spoke to Pharmanews in an exclusive chat, condemned the imbalance in the ratio of imported drugs over indigenously produced ones, adding that, except a drastic step is taken by the government to intervene; the objectives of the National Health Policy would continue to be a mirage.

The PMG-MAN boss also bemoaned the influx of foreign companies into the country’s drug market, noting that the trend could be detrimental to the development of local manufacturers who play crucial roles in fostering self-sufficiency in drug production.

“The influx is not restricted to Indian companies alone; all the European and American companies that left in the 1980s are all back. The South African companies are not left out of the scramble for the lucrative Nigerian market. Local drug manufacture, like food production, should be seen from the security perspective”, he asserted.

Speaking on the need for PMG-MAN members and research institutions to collaborate on herbal studies, he said it had been estimated by WHO that by the year 2030, Nigeria would host about 60 million patients with hypertension as well as 18.6 million with diabetes, in addition to the about one million cancer cases recorded annually, adding that the only key to overcoming the high disease burden is investment in herbal medicines.

“It is high time we challenged our universities and research institutions like NIPRD to collaborate with Nigerian drug manufacturers to focus on this area,” he stressed. “However we must realise that the cost of pharmaceutical research is high and it may cost hundreds of millions of naira to get a drug into the market.”

When asked about PMG-MAN’s efforts to curb the activities of drug counterfeiters, Olaopa noted that the group is self-regulating as prospective members are subjected to the Good Manufacturing Practice Audit before they are admitted. He also added that periodic audits for compliance are regularly carried out to ensure that standards are maintained.

He further hinted on the cordial relationship between NAFDAC and PMG-MAN, which ensures that a manufacturer must belong to the umbrella association before his locally manufactured products can be registered.

He maintained that it is also the duty of members to be whistle-blowers by reporting fake drug manufacturers to NAFDAC which is empowered to enforce applicable laws and prosecute violators.

Defining executive priorities

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 (By Pharm. Nelson Okwonna)

 

In August 1939, Albert Einstein, who had fled Nazi Germany some years earlier, wrote a letter to President Franklin D. Roosevelt informing him of his concerns about Germany’s capacity to develop an atomic weapon and made suggestions on how America could so same.. In response, Roosevelt set up the Manhattan project, to work on developing an atomic bomb.The project was successful and resulted in the historical bombing of Hiroshima and, a few days later, of Nagasaki in August 1945.

Afterwards, the world would never remain the same. We’ve developed a relatively cheap way to annihilate humans. Following a thoughtful consideration of the damage done and the implications for the future, Albert Einstein spent the latter part of his life canvassing for an end to armed conflict.It was no longer a reasonable proposition for countries with nuclear capacities to engage in wars.

Einstein understood that technology, left in the hands of the wrong kinds of men, could wipe us out.In his words, “the human spirit must once again prevail over technology.”

In 2013, Pope Francis generated quite a controversy when he attacked unfettered capitalism as “a new tyranny”, urging global leaders to fight poverty and growing inequality. The crux of the Pope’s message was that, if left unchecked, the present exclusive culture that prevails in the marketplace, which extols money as king, would not help the society in the long term.

To me, the Pope was simply saying that the technology of enterprise, if left in the hands of the wrong kinds of men, could wipe us out as easily as the nuclear weapons could.

Both men are right. The aim of this article, however, is not just to prove the veracity of their assertions but rather to raise some pertinent issues within our unique context.

 

What is the goal?

This question is not just for the market arena where the CEO reigns but also for the serene academic institution, the health care service centres and the research community.

What really is the goal of the organisation?  Why do we exist?

This question should be answered in the light of the present societal environment, where the gaps between private and public organisations are fast disappearing. Globally, universities and research organisations that do not cultivate private sector influence and collaboration gradually become irrelevant.

All over the world, the health care sector is increasingly being private-driven and in Nigeria, the emergence of Managed Health Care led by Health Management Organisations is an indicator to the nature of the future. In India for example, the growth of huge private hospitals and the accompanying decline in the quality and funding of public health facilities give a pointer to the likely possibilities for us in Africa if we do not arrive at good answers to this question.

 

The Triple Helix

The concept of the Triple Helix of university-industry-government relationships, which was initiated in the 1990s,describes the shift from a dominating industry-government dyad in the industrial society to a growing triadic relationship involving the university, the industry and the government in the knowledge society.

The Triple Helix hypothesis is that the potential for innovation and economic development in a knowledge society lies in a more prominent role for the university and in the hybridisation of elements from the university, the industry and the government to generate new institutional and social formats for the production, transfer and application of knowledge.

The point is that the long legs of the industry have entered the hallowed chambers of the university and many other public service utilities, hence leaders in universities and other public organisations would need to answer questions they have not asked before. Questions like, “what really is the goal in light of scarce resources and competition?”

It is noteworthy therefore that in this brave new world of ours aptly called a knowledge society, the goal of the individual or individuals that lead this innovation environment is going to affect every one of us. A case in point is the efforts of Bill Gates with the Bill Gates and Melinda Gates Foundation; his personal answer to the question raised in this article is making a lot of difference even here in Africa.

 

 

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 Figure 1: Triple Helix

Corporate goals: What business schools teach

One of the introductory remarks one would get in any self-respecting business school is on the goal of the enterprise. The general answer is to “maximise shareholders’ wealth”; and, frankly, in the past half a century, business managers have done a great job of this. Figure 2 is a graph of corporate profitsvs. wages in the United States over a couple of years.

 

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Figure 2: Corporate Profits vs. Wages as percentage of GDP

The point to note from the above is that though the American economy is not getting any better, corporate profits are at their highest and there is almost an inverse relationship between profitability and wages. Though there are lots of arguments right now for the breaching of income inequality in most parts of the world, it is clear that business managers are doing a good job of achieving the goal of business – to maximise shareholders’ wealth.

Given the difference in knowledge base and the resources at the disposal of the operators of the machineries of trade, we do not expect the observed scenario to change much except when the conditions become quite intolerable.

 

Nations: Global competition

Recently, the Prime Minister of the United Kingdom, David Cameron, defending his visit to Kazakhstan, a nation with a rather bad reputation for human rights abuses, noted that “in the global race for jobs and employment”, some certain actions were necessary. The Prime Minister, I must say, is not at all squeamish about the way he has gone about driving national development, the latest of which is the planned “Islamic bond” that will make UK the first non-Muslim country to sell a bond that can be bought by Islamic investors. His aim is simple: to encourage massive investment. That said, we must bear in mind that other nations are making trade-offs to increase their aggregate productivities and it is with these nations that we are competing.

 

Implications for Africa

Given global trade dynamics and the current state of our economies, maximising shareholders’ wealth when adopted as the goal of the enterprise would not bring the majority of our people out of poverty because the wealth of a nation is measured in the aggregate productivity of her citizens and not in the number of billionaires she has (this is a question of wealth distribution); hence outcomes that increase aggregate productivity will go a long way to ensure long term prosperity.

 

Maximising aggregate productivity vs. maximising shareholders’ wealth

Many times, these are not the same thing and in developing economies like ours, they are definitely not the same. To maximise aggregate productivity, one has to own the factors of production and, sometimes, it is not immediately profitable to own the factors of production.

Consider the fact that it could be more profitable for a Nigerian trained doctor to practise in the UK rather than Nigeria.Though aggregate productivity has been reduced on the long term, maximum profitability has been achieved on the short term. The same applies to the cost of medications and other considerations. Hence, though maximising shareholders’ wealth could be a good goal for any particular company in Africa, for a whole industry it is not, especially as it is currently defined.

 

Can the human spirit prevail?

Einstein believed that the human spirit must once again prevail over technology; the Pope, in his address, sought to inspire the human spirit to prevail over the technologies of trade and, for Africa, that plea is timely. The best decisions that need to be taken in the Health Care Sectors of most African countries will most likely not be the most profitable decisions;yet they are the ones that will increase aggregate productivity.

This context, as said earlier, is important considering the increasing influence of the private sector. In pharmaceutical research and development, we know some diseases will never find funding until someone with a different goal comes around. Some health care training institutions will not be built, some products will be dropped from the product line and some indigenous research projects cancelled for competing engagements that are more profiting.

These ideals cannot be legislated (Marxism has tried); they can only be preached. Albert Einstein, Pope Francis and, now, my humble self, lend our voices to that cry – that the human spirit can prevail over the technologies of war and trade.

For Africa, we must think in terms of the aggregate productiveness of our industries – the ownership of the factors of production, human capacity development and retention, adequate technology integration and the right application of capital. Considering our current predicament, our challenges are great but so are our spirits.

 

Securing the Pharmaceutical Provide Chain – Interview with Henry Moran, Napp Prescription drugs

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As provide chains develop bigger and extra complicated added strain is placed on provide chain integrity. On this interview Henry Moran, UK and Worldwide Provides Supervisor at Napp Prescription drugs, speaks to Andrea Charles from Chilly Chain IQ about implementing new provide chain safety initiatives and mitigating threat.

For extra info go to http://www.coldchainiq.com/

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Pharmacists tasked on right attitude towards clients – as lady pharmacists mark 2013 end –of-year party

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Lady Pharmacy Association

 

 

 

 

 

 

 

By Adebay Oladejo –

Pharmacists in Lagos State have been advised to be mindful of their attitude towards their clients, as this plays an important role in their productivity and contributes significantly to their occupational success.

The counsel was given by Pharm. Modupe Oyawole, assistant director of pharmacy, Lagos State University Teaching Hospital (LASUTH), while delivering her keynote address at the Association of Lady Pharmacists, Lagos State Chapter’s end-of-year party and bi-monthly meeting, held at the Pharmaceutical Society of Nigeria (PSN) secretariat in Ojota, Lagos last December.

Addressing the audience, the lecturer who hinted that she was happy to be identified with the association, being a woman herself, spoke on the topic “Attitudinal Change for Professional Excellence”.

She revealed that a truly successful life requires that one pays special attention to the areas that could have the greatest positive impact on quality of life and overall success, adding that a person with relevant knowledge and skills but demonstrating wrong attitude would not be able to contribute much to his or her organisation and community. “Moreover, the higher the skills and knowledge of a person, the greater damage they can do to the organisation, if their attitude is flawed,” she noted.

Continuing, she said, “We have two types of clients internal and external. While the internal clients are the various people who work for your organisation in other departments and locations and depend on you to enable them complete their work to serve the customer, the external clients are people who buy and need services from your organisation.”

Speaking on the skills needed for attitudinal change, Pharm. Oyawole listed patience as paramount, saying it is not only important to clients, who often reach out for support when they are confused and frustrated, but also to the business at large.

She added also that, “the ability to really listen to clients is so crucial for providing great service for a number of reasons. Not only is it important to pay attention to individual client interactions, watching the language and terms that they use to describe their problems, but it’s also important to be mindful and attentive to the feedback that you receive.”

Meanwhile, speaking earlier with Pharmanews, Pharm. ModupeOlogunagba, chairperson, ALPs, Lagos State Branch, had said that the purpose of the programme, apart from being a day for their bi-monthly meeting, was to appreciate God for his mercies over the association and to prepare her members for the challenges ahead in 2014.

“The year 2013 was a great year but it was full of challenges for me and the association,” she said with hindsight. “Our major challenge is membership attendance at our activities. Presently, we have over 300 registered and practicing lady pharmacists in Lagos State, but it is worrisome that the active ones are not more than 60. Meanwhile, we have been able to strategise to reach out to some key persons in the practice, so that as soon as we are able to reach them, we will be able to mobilise more members and we are hopeful that the strategy will work.

She also urged all pharmacists in the state to join the association, promising that the association would offer them a platform to associate and explore into other areas. “Being an interest group of the PSN, we are promising that we would offer them a platform for expansion. We would also offer a platform of love, which is a mandate of God to humanity; therefore they should all endeavour to join us and be part of the family,” she said.

Effective leadership in health care delivery

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Pharmanews Training

Target Participants: Doctors, Pharmacists, Nurses, Medical Laboratory Scientists and other clinical, administrative, management and technical personnel in the health care and pharmaceutical sector.

COURSE :         EFFECTIVE LEADERSHIP IN HEALTH CARE DELIVERY

 Date:                  Tuesday 20 – Thursday 22 May, 2014

Time:                  9:00am – 4:00pm

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

  Course Contents:

  • Fundamentals of Clinical Leadership
  • Leadership and Effective Advocacy in Health Care Delivery
  • Economics of Disease Management
  • Fundamentals of Health Care Financing
  • Public – Private Partnerships in Health Care Delivery
  • Stress Management for Executives

 Course Objectives:

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

  • Understand the relevance, rudiments and postures for delivering clinical leadership.
  • Effectively provide leadership in championing advocacy goals for optimum care delivery.
  • Understand economic implications and future developments in the effective management of diseases in Nigeria.
  • Understand global health care financing models, the Nigerian Health Insurance Scheme and modalities for national and community health care financing.
  • Comprehend best practices and current management approaches and strategies for achieving effective public-private partnerships.
  • Learn effective stress management techniques.

Registration:

Registration fee is N 70,000 per participant before 20/04/2014 and N 75,000 after. On-site registration of  N 75,000 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 more information, contact:

Cyril Mbata                       – 0706 812 9728

Nelson Okwonna              – 0803 956 9184

Elizabeth Amuneke        – 0805 723 5128

 

 

 

Community pharmacists get insurance policy

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(By Adebayo Oladejo)

The Association of Community Pharmacists of Nigeria (ACPN) has signed on to a Professional Indemnity Insurance Policy Scheme for its members.

Speaking on the decision, national chairman of ACPN, Pharm. (Alh.)Olufemi Ismail Adebayo, said the signing of the policy was born of the goal of the association to ensure that its members are protected in the course of carrying out their professional duties, and to ensure that the standard of the profession is raised to meet up with what is obtainable in the developed world.

“As an association, we know what is good for our members and it is our desire that all our members operate with peace of mind in their environments and to also add value to their practice,” Adebayo said. “We decided to sign on the scheme because we know in the recent past, we have had some unsavoury incidents that have brought the profession to disrepute, with the most recent being the Cynthia Osokogu murder case.”

In his own words, Pharm. AdeshinaOpanubi, project manager of Pharmalliance Consulting, whose company is responsible for managing the scheme, noted that the policy has positioned ACPN as one of the leading professional associations which hold their members in high esteem.

Stating the benefit of the policy, Opanubi said, “For just a fee of N3000 per pharmacist, every pharmacist who subscribes has access to the N100 million indemnity cover that the association bought. This money can be accessed to offset the bills incurred either for legal costs or damages awarded. In the absence of the policy, the affected pharmacist would have to pay out of pocket in the case of any unfortunate incident.”

While commending the executive and national membership of ACPN for buying into the scheme, Opanubi advised other technical arms, especially those in hospital practice and those in industrial practice to also subscribe to the policy.

Revisiting OBJ’s 75 per cent Nigerian drug policy

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 (By Pharm. Ayodele Adedipe)

 

During the 2008 annual conference of the Pharmaceutical Society of Nigeria (PSN) held in Abuja, former Head of State, Chief Olusegun Obasanjo, gave a directive to a committee to come up with a plan to produce 75 per cent of Nigerian drug requirement by 2010.

Sadly, since that directive was given some years ago, not much has been heard of the issue in terms of progress or development.

This matter has been discussed at various levels in the private sector of the pharmaceutical industry in Nigeria. The general feeling is that the OBJ directive is too important to be allowed to die. Maybe a report has been submitted; but, by now, Nigerians should have been fully informed of the intention of the government on this very important matter. But if there is nothing positive on ground, it is not too late to revive the whole exercise. This kind of exercise is not entirely new.

Sometime in 1960, the Ford Foundation sent a consultant to evaluate the state of the pharmaceutical business in Nigeria. It happened that I was privileged to work with this team in Lagos and Port Harcourt to evaluate the statistics of imports to Nigeria by extracting useful information from Custom documents.

A report was produced which I believe can still be accessed from The Ford Foundation. But what is of interest is that it is very doubtful if such exercise has been repeated since then. The point I am trying to make is that for a programme of this magnitude, there must be a statistical basis to work on.

Be that as it may, this should not be a handicap. Therefore, I will like to make the following suggestions to kick-start this very important directive whatever the stage the study has reached at the moment.

Statistical survey of drug purchases and consumption at the federal, state and local government levels for the past five years

Since Government at the three tiers are responsible for about 65 per cent of the drug business in Nigeria, it is possible to make a projection for the total drug business for the whole country from whatever information is accessed from the above exercise.

With this statistics in place, one can then start planning the strategy to adopt for the present and future needs of the Nation.

 

Strategy

It is instructive to note that other countries in the past have adopted this kind of strategy to jumpstart the pharmaceutical industry. These include Indonesia and Brazil. In other words, the study we are embarking on is not new, and so we should learn from what other countries have done in the past in order to make a quantum leap.

 

Going from the known to the unknown

NAFDAC has a data bank of approved pharmaceutical industries in Nigeria. But for the kind of information required for the exercise we have in mind, we require much more than a list of products these approved industries manufacture at the moment.

There is the need to know:

·        What product groups are now manufactured in Nigeria.

·        The capacity available for each product group.

·        The capacity utilization for each product group based on current statistics.

·        The technical manpower available.

It is only when these pieces of information are available that one can make a meaningful projection for the future. Hopefully, with the recent capitalisation of banks in Nigeria, the issue of funding should not be a handicap.

Both local and foreign investors will be better encouraged to come into the sectors if current and credible information is available.

 

Comments and observations

No doubt, there are lots of base studies that have to be done. Still, the little information available shows that the pharmaceutical business in Nigeria is a big and thriving one, capable of creating more jobs at all levels and contributing substantially to the Gross Domestic Products (GDP) of the Nation.

It is instructive to note that the following allied areas of the industry have not been touched in the country at the moment:

·        Drugs for the veterinary industry;

·        Drugs for the agro-allied Industry

·        Medical diagnostic and allied products.

·        Drugs and chemical for the environmental sector.

·        Production of raw materials in which Nigeria has a comparable advantage for both home consumption and export, e.g. starch, glucose, ethanol from cassava.

I hope from all what has been said above, some progress in this all-important assignment can be realised.

 

Pharm. Ayodele Adedipe is the chairman of Drugfield Pharmaceutical Industry, Ota

 

Proofs of rapid cell regeneration

4

(By  Pharm. Kabiru  Abubakar  Gulma)

 

The title of this article was inspired by an event that occurred three years ago. As an intern at a clinic, night calls were usually occupied with watching channels on the satellite and, occasionally, movies that were thought-provoking because the patient influx was usually minimal.

A medical colleague in the same institution, who normally popped into my office at free times, once wooed me into copying a movie from his flash disk. In the process, I ran into a movie titled ‘Exam’.  It turned out to be a highly engaging movie, with many lessons especially for job-seekers. But what really caught my attention the most was a pill (capsule) used by the invigilator in the movie to promptly heal a candidate with gunshot wound. The invigilator exclaimed: “While searching for the cure, we stumbled upon something far more powerful – Rapid Cell Regeneration (in a pill). It eradicates the virus and other stubborn mutations…”

Over the years, I have deeply thought of how damaged cells could be rapidly healed by a pill.  Recently, I stumbled on an article on “Cellular Regeneration and Rapid Healing” which explains how a marine food augments cellular regeneration and rapid healing. This marine food is the phytoplankton, a single-celled aquatic organism, or microscopic algae (micro-algae). There exist an estimated 200,000 to 800,000 species of micro-algae, of which about 40,000 species have been described. Most people are familiar with micro-algae such as spirulina, chlorella, blue-green algae and astaxanthin, which have become popular health supplements in the last few decades.

After over 10 years of research, and millions of dollars invested, a team of European doctors, microbiologists and botanists discovered one amazing strain of marine phytoplankton that contains the highest nutritional values for human consumption. The strain was named Nannochloropsis gaditana. It is extremely tiny, 9 times smaller than a red blood cell. There is no known food which is smaller in size — yet, there is so much life energy stored in this single cell. It has the ability to multiply and proliferate exponentially, producing trillions of healthy cells that humans need to maintain and restore health.

This unique micro-algae contains over 65 nutritional properties including all the amino acids, all the essential fats, vitamins, key minerals and trace elements, rare anti-oxidants, phospholipids, electrolytes, nucleic acids, enzymes and co-enzymes.( It is this rare combination and proportion of elements and nutrients that makes this strain of marine phytoplankton distinctive and highly effective in enabling cellular regeneration and healing. People get healed of chronic diseases within days by this way of treatment.

Another very important feature that makes it a profoundly powerful and effective healing substance is that it is composed of single cells that bypass the liver and digestive system. It goes straight to your liver and directly into your bloodstream. Because of its ultra-microscopic size, a single cell is able to go right into the human cell and feed it at a mitochondrial level.

This is one reason Dr. Jerry Tennant, founder and director of the Tennant Institute of Integrative Medicine, who has treated thousands of people with chronic diseases, believes results have been so rapid — particularly among critical and chronically ill patients whose livers were in poor condition. Whereas other products took months to see noticeable benefits, significant results were being achieved within days of taking this particular strain of marine phytoplankton.

“With people who are extremely ill…you can’t get their system to absorb the raw materials needed to make neurochemicals,” states Dr. Tennant. “The marine phytoplankton are microscopic plants …. Because they are so microscopic, they go right through a sick digestive system and a sick liver, and you’ll be able to start restoring neurochemicals and minerals even in somebody who’s critically ill. Nothing else I know of will do that.”

Many nutritional experts – and even doctors- agree that if you were to consume this strain of marine phytoplankton daily, your health would actually improve as you get older!

Nannochloropsis gaditana is the world’s top level resource of DHA (Docosahexaenoic acid), an omega-3 fatty acid that Dr. Mehmet Oz (also known as “America’s Doctor”) recently declared the most important food supplement you can take.( (

DHA is the most abundant omega-3 fatty acid in the brain and retina. Sufficient levels of DHA makes your brain function more efficiently. In fact, 60 per cent of the fats in your brain are composed of DHA as are the nerve fibres of your heart.

Nannochloropsis gaditana is also incredibly rich in yet another fatty acid, namely EPA (Eicosapentaenoic acid). EPA works in concert with DHA to produce nearly every nutrient your body requires! As such, nutritional supplementation with this microscopic green food could single-handedly fill all your nutritional deficiencies. (

Its high chlorophyll content also boosts your immune system, produces cancer-fighting carotenoids, and protects the body against free radicals in the air, water and food we consume.

Most people know that certain nutritional products that contain medicinal properties are only effective for some people, but not for others. Dr. Tennant believes this is because the body needs all the raw materials and critical components at the same time. The problem is that we need ALL of them at the same time for things to work.

The idea of rapid cell regeneration is, indeed, a reality. It is not as fictional as it appears in the movies.

 

How to cure skin infections

97

 ring worm

A skin infection is an infection that affects the skin. Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation. Skin inflammation due to skin infection is called infective dermatitis.

 Categories of skin infections

1.      Bacterial

Bacterial skin infections include:

·        Impetigo – a highly contagious bacterial skin infection most common among pre-school children. It is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes.

·        Erysipelas – an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.

·        Cellulitis– a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, intravenous drug injection or sites of intravenous catheter insertion. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body.

2.      Fungal

Fungal skin infections may present as either a superficial or deep infection of the skin, hair, and/or nails. They affect as of 2010 about one billion people globally.

3.      Parasitic infestations, stings, and bites

Parasitic infestations, stings, and bites in humans are caused by several groups of organisms belonging to the following phyla: Annelida, Arthropoda, Bryozoa, Chordata, Cnidaria, Cyanobacteria, Echinodermata, Nemathelminthes, Platyhelminthes, and Protozoa.

4.      Viral

Virus-related cutaneous conditions are caused by two main groups of viruses–DNA and RNA types–both of which are obligatory intracellular parasites.

Athlete’s foot

Athlete’s foot is a very common infection. The fungus grows best in a warm, moist environment such as shoes, socks, swimming pools, locker rooms, and the floors of public showers. It is most common in the summer and in warm, humid climates. It occurs more often in people who wear tight shoes and who use community baths and pools.

What causes athlete’s foot?

Athlete’s foot is caused by a microscopic fungus that lives on dead tissue of the hair, toenails, and outer skin layers. There are at least four kinds of fungi that can cause athlete’s foot. The most common of these fungi is trichophytonrubrum.

What are the symptoms of athlete’s foot?

Signs and symptoms of athlete’s foot vary from person to person. However, common symptoms include:

·        Peeling, cracking, and scaling of the feet

·        Redness, blisters, or softening and breaking down of the skin

·        Itching, burning, or both

 

Types of athlete’s foot

·        Interdigital: Also called toe web infection, this is the most common kind of athlete’s foot. It usually occurs between the two smallest toes. This form of athlete’s foot can cause itching, burning, and scaling and the infection can spread to the sole of the foot.

·        Moccasin: A moccasin-type infection of athlete’s foot can begin with a minor irritation, dryness, itching, or scaly skin. As it develops, the skin may thicken and crack. This infection can involve the entire sole of the foot and extend onto the sides of the foot.

·        Vesicular: This is the least common kind of athlete’s foot. The condition usually begins with a sudden outbreak of fluid-filled blisters under the skin. Most often, the blisters develop on the underside of the foot. However, they also can appear between the toes, on the heel, or on the top of the foot.

How is athlete’s foot diagnosed?

Not all itchy, scaly feet have athlete’s foot. The best way to diagnose the infection is to have your doctor scrape the skin and examine the scales under a microscope for evidence of fungus.

skin_018

How is athlete’s foot treated?

Athlete’s foot is treated with topical antifungal medication (a drug placed directly on the skin) in most cases. Severe cases may require oral drugs (those taken by mouth). The feet must be kept clean and dry since the fungus thrives in moist environments. 

How is athlete’s foot prevented?

Steps to prevent athlete’s foot include wearing shower sandals in public showering areas, wearing shoes that allow the feet to breathe, and daily washing of the feet with soap and water. Drying the feet thoroughly and using a quality foot powder can also help prevent athlete’s foot.

Jock itch

Jock itch, also called tineacruris, is a common skin infection that is caused by a type of fungus called tinea. The fungus thrives in warm, moist areas of the body and as a result, infection can affect the genitals, inner thighs, and buttocks. Infections occur more frequently in the summer or in warm, wet climates. Jock itch appears as a red, itchy rash that is often ring-shaped.

Is jock itch contagious?

Jock itch is only mildly contagious. The condition can be spread from person to person through direct contact or indirectly from objects carrying the fungus.

 

What are the symptoms of jock itch?

·        Itching, chafing, or burning in the groin or thigh

·        A circular, red, raised rash with elevated edges

·        Redness in the groin or thigh

·        Flaking, peeling, or cracking skin

How is jock itch diagnosed?

In most cases, jock itch can be diagnosed based on the appearance and location of the rash. If you are not certain that the condition is jock itch, contact your doctor. The doctor will ask about your symptoms and medical history, and will perform a physical exam. A microscopic exam of the scales of skin can confirm the diagnosis.

How is jock itch treated?

In most cases, treatment of jock itch involves keeping the affected area clean and dry and applying topical antifungal medications. Jock itch usually responds to over-the-counter antifungal creams and sprays. However, prescription antifungal creams are sometimes necessary. During treatment of jock itch, be sure to:

·        Wash and dry the affected area with a clean towel

·        Apply the antifungal cream, powder, or spray as directed

·        Change clothes – especially underwear – everyday 

Ringworm

Ringworm, also called tineacorporis, is not a worm, but a fungal infection of the skin. It can appear anywhere on the body and it looks like a circular, red, flat sore. It is often accompanied by scaly skin. The outer part of the sore can be raised while the skin in the middle appears normal. Ringworm can be unsightly, but it is usually not a serious condition.

 Is ringworm contagious?

Ringworm can spread by direct contact with infected people or animals. It also may be spread on clothing or furniture. Heat and humidity may help to spread the infection.

What are the symptoms of ringworm?

Ringworm appears as a red, circular, flat sore that is sometimes accompanied by scaly skin. There may be more than one patch of ringworm on the skin, and patches or red rings of rash may overlap. It is possible to have ringworm without having the common red ring of rash. 

How is ringworm diagnosed?

A doctor can diagnose ringworm based on the appearance of the rash or reported symptoms. He or she will ask about possible exposure to people or animals with ringworm. The doctor may take skin scrapings or samples from the infected area and look at them under a microscope to confirm the diagnosis.

Boils

A boil is a skin infection that starts in a hair follicle or oil gland. At first, the skin turns red in the area of the infection, and a tender lump develops. After four to seven days, the lump starts turning white as pus collects under the skin.

The most common places for boils to appear are on the face, neck, armpits, shoulders, and buttocks. When one forms on the eyelid, it is called a sty.If several boils appear in a group, this is a more serious type of infection called a carbuncle.

Causes of boils

Most boils are caused by a germ (staphylococcal bacteria). This germ enters the body through tiny nicks or cuts in the skin or can travel down the hair to the follicle.

The following health problems make people more susceptible to skin infections:

·        Diabetes

·        Problems with the immune system

·        Poor nutrition

·        Poor hygiene

·        Exposure to harsh chemicals that irritate the skin

Symptoms of boils

A boil starts as a hard, red, painful lump usually about half an inch in size. Over the next few days, the lump becomes softer, larger, and more painful. Soon a pocket of pus forms on the top of the boil. These are the signs of a severe infection:

·        The skin around the boil becomes infected. It turns red, painful, warm, and swollen.

·        More boils may appear around the original one.

·        A fever may develop.

·        Lymph nodes may become swollen.

When to seek medical care:

·        You start running a fever.

·        You have swollen lymph nodes.

·        The skin around the boil turns red or red streaks appear.

·        The pain becomes severe.

·        The boil does not drain.

·        A second boil appears.

You have a heart murmur, diabetes, any problem with your immune system, or use immune suppressing drugs (for example, corticosteroids or chemotherapy) and you develop a boil.

Boils usually do not need immediate emergency attention. If you are in poor health and you develop high fever and chills along with the infection, a trip to a hospital’s emergency room is needed.

Exams and tests

Your doctor can make the diagnosis with a physical exam. Many parts of the body may be affected by this skin infection, so some of the questions or exam may be about other parts of your body.

Boils treatment – home remedies

·        Apply warm compresses and soak the boil in warm water. This will decrease the pain and help draw the pus to the surface. Once the boil comes to a head, it will burst with repeated soakings. This usually occurs within 10 days of its appearance. You can make a warm compress by soaking a wash cloth in warm water and squeezing out the excess moisture.

·        When the boil starts draining, wash it with an antibacterial soap until all the pus is gone. Apply a medicated ointment and a bandage. Continue to wash the infected area two to three times a day and to use warm compresses until the wound heals.

·        Do not pop the boil with a needle. This could make the infection worse.

Leprosy

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs. The disease has been around since the beginning of time, often surrounded by terrifying, negative stigma and tales of leprosy patients being shunned as outcasts. At one time or another, outbreaks of leprosy have affected, and panicked, people on every continent. The oldest civilizations of China, Egypt, and India feared leprosy was an incurable, mutilating, and contagious disease.

However, leprosy is actually not highly contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated, severe leprosy. Children are more likely to get leprosy than adults.

Today, more than 200,000 people worldwide are infected with leprosy, according to the World Health Organisation, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U.S. territories.

What causes leprosy?

Leprosy is caused by a slow-growing type of bacteria called Mycobacteriumleprae (M. leprae).Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

What are the symptoms of leprosy?

Leprosy primarily affects the skin and the nerves outside the brain and spinal cord, called the peripheral nerves. It may also strike the eyes and the thin tissue lining the inside of the nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-coloured.

Nerve damage can lead to:

·        Loss of feeling in the arms and legs

·        Muscle weakness

It takes a very long time for symptoms to appear after coming into contact with the leprosy-causing bacteria. Some people do not develop symptoms until 20 or more years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period.  Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.

Forms of leprosy

Leprosy is characterised according to the number and type of skin sores you have. Specific symptoms and your treatment depend on the type of leprosy you have. The types are:

·        Tuberculoid: A mild, less severe form of leprosy. People with this type have only one or a few patches of flat, pale-coloured skin (paucibacillary leprosy). The affected area of skin may feel numb because of nerve damage underneath. Tuberculoid leprosy is less contagious than other forms.

·        Lepromatous: A more severe form of the disease. It involves widespread skin bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose, kidneys, and male reproductive organs may also be affected. It is more contagious than tuberculoid leprosy.

·        Borderline: People with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms.

skin infection

How is leprosy diagnosed?

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a lab to be examined. This is called a skin biopsy. A skin smear test may also be done. With paucibacillary leprosy, no bacteria will be detected. In contrast, bacteria are expected to be found on a skin smear test from a person with multibacillary leprosy.

How is leprosy treated?

Leprosy can be cured. In the last two decades, more than 14 million people with leprosy have been cured. The World Health Organisation provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. Antibiotics are used to treat the infection. Long-term treatment with two or more antibiotics is recommended, usually from six months to a year. People with severe leprosy may need to take antibiotics longer. However, antibiotics cannot reverse nerve damage.

Anti-inflammatory drugs are used to control swelling related to leprosy. This may include steroids, such as prednisone.

Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body’s immune system. It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by pregnant women.

Leprosy complications

Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Complications of leprosy can include:

·        Blindness or glaucoma.

·        Disfiguration of the face (including permanent swelling, bumps, and lumps).

·        Erectile dysfunction and infertility in men.

·        Kidney failure.

·        Muscle weakness that leads to claw-like hands or an inability to flex the feet.

·        Permanent damage to the inside of the nose, which can lead to nosebleeds and a chronic, stuffy nose.

·        Permanent damage to the peripheral nerves, the nerves outside the brain and spinal cord, including those in your arms, legs, and feet.

Nerve damage can lead to a dangerous loss of feeling. A person with leprosy-related nerve damage may not feel pain when the hands, legs, or feet are cut, burned, or otherwise injured.

Approximately 1 to 2 million people worldwide are permanently disabled because of leprosy.

Carbuncles

A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin. A boil (or furuncle) is an infection of a hair follicle that has a small collection of pus (called an abscess) under the skin. Usually single, a carbuncle is most likely to occur on a hairy area of the body such as the back or nape of the neck. But a carbuncle also can develop in other areas of the body such as the buttocks, thighs, groin, and armpits. 

Cause

Most carbuncles are caused by Staphylococcus aureus bacteria, which inhabit the skin surface, throat, and nasal passages. These bacteria can cause infection by entering the skin through a hair follicle, small scrape, or puncture, although sometimes there is no obvious point of entry.

Filled with pus – a mixture of old and white blood cells, bacteria, and dead skin cells — carbuncles must drain before they’re able to heal. Carbuncles are more likely than boils to leave scars.

An active boil or carbuncle is contagious: the infection can spread to other parts of the person’s body or to other people through skin-to-skin contact or the sharing of personal items. So it’s important to practice appropriate self-care measures, like keeping the area clean and covered, until the carbuncle drains and heals.

Carbuncles require medical treatment to prevent or manage complications, promote healing, and minimize scarring. Contact your doctor if you have a boil or boils that have persisted for more than a few days.

Risk factors for carbuncles

Old age, obesity, poor hygiene, and poor overall health are associated with carbuncles. Other risk factors for carbuncles include:

·        Chronic skin conditions, which damage the skin’s protective barrier

·        Diabetes

·        Kidney disease

·        Liver disease

·        Any condition or treatment that weakens the immune system

Carbuncles also can occur in otherwise healthy, fit, younger people, especially those who live together in group settings such as college dorms and share items such as bed linens, towels, or clothing. In addition, people of any age can develop carbuncles from irritations or abrasions to the skin surface caused by tight clothing, shaving, or insect bites, especially in body areas with heavy perspiration. 

Symptoms of Carbuncles

The boils that collect to form carbuncles usually start as red, painful bumps. The carbuncle fills with pus and develops white or yellow tips that weep, ooze, or crust. Over a period of several days, many untreated carbuncles rupture, discharging a creamy white or pink fluid.

Superficial carbuncles – which have multiple openings on the skin’s surface – are less likely to leave a deep scar. Deep carbuncles are more likely to cause significant scarring.

Other carbuncle symptoms include fever, fatigue, and a feeling of general sickness. Swelling may occur in nearby tissue and lymph nodes, especially lymph nodes in the neck, armpit, or groin. 

Complications of Carbuncles

Sometimes, carbuncles are caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteria, and require treatment with potent prescription antibiotics if the lesions are not drained properly.

In rare cases, bacteria from a carbuncle can escape into the bloodstream and cause serious complications, including sepsis and infections in other parts of the body such as the lung, bones, joints, heart, blood, and central nervous system.

Sepsis is an overwhelming infection of the body that is a medical emergency and can be fatal if left untreated. Symptoms include chills, a spiking fever, rapid heart rate, and a feeling of being extremely ill.

Home treatment for carbuncles

The cardinal rule is to avoid squeezing or irritating a carbuncle, which increases the risk of complications and severe scarring.

Warm compresses may promote the drainage and healing of carbuncles. Gently soak the carbuncle in warm water, or apply a clean, warm, moist washcloth for 20 minutes several times per day. Similar strategies include covering the carbuncle with a clean, dry cloth and gently applying a heating pad or hot water bottle for 20 minutes several times per day. After each use, washcloths or cloths should be washed in hot water and dried at a high temperature.

Washing the carbuncle and covering the area with a sterile bandage also may promote drainage and healing and help prevent the infection from spreading. Over-the-counter medications such as acetaminophen or ibuprofen can help relieve the pain of an inflamed carbuncle.

It’s important to thoroughly wash your hands after touching a carbuncle. Launder any clothing, bedding, and towels that have touched a carbuncle and avoid sharing bedding, clothing, or other personal items.

Medical treatments for carbuncles

See your doctor if a boil or boils do not drain and heal after a few days of home treatment or if you suspect you have a carbuncle. Also, seek medical evaluation for a carbuncle that develops on your face, near your eyes or nose, or on your spine. Also see a doctor for a carbuncle that becomes very large or painful.

Your doctor may cut and drain the carbuncle, and ensure that all the pus has been removed by washing the area with a sterile solution. Some of the pus can be collected and sent to a lab to identify the bacteria causing the infection and check for susceptibility to antibiotics.

If the carbuncle is completely drained, antibiotics are usually unnecessary. But treatment with antibiotics may be necessary in cases such as:

·        When MRSA is involved and drainage is incomplete

·        There is surrounding soft-tissue infection (cellulitis)

·        A person has a weakened immune system

·        An infection has spread to other parts of the body

Depending on severity, most carbuncles heal within two to three weeks after medical treatment.

Impetigo

Impetigo is a highly contagious bacterial skin infection. It can appear anywhere on the body but usually attacks exposed areas. Children tend to get it on the face, especially around the nose and mouth, and sometimes on the arms or legs. The infected areas appear in plaques ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, a deeper form of the disease. Ecthyma forms small, pus-filled bumps with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the sores may cause permanent scars and pigment changes.

The gravest potential complication of impetigo is post-streptococcal glomerulonephritis, a severe kidney disease that occurs following a strep infection in less than 1 per cent of cases, mainly in children. The most common cause of impetigo is Staphylococcus aureus. However, another bacteria source is group A streptococcus. These bacteria lurk everywhere. It is easier for a child with an open wound or fresh scratch to contract impetigo. Other skin-related problems, such as eczema, body lice, insect bites, fungal infections, and various other forms of dermatitis can make a person susceptible to impetigo.

Most people get this highly infectious disease through physical contact with someone who has it, or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo.

Pilonidal cyst

A pilonidal cyst occurs at the bottom of the tailbone (coccyx) and can become infected and filled with pus. Once infected, the technical term is pilonidal abscess. Pilonidal abscesses look like a large pimple at the bottom of the tailbone, just above the crack of the buttocks. It is more common in men than in women. It usually happens in young people up into the fourth decade of life.

Causes

Most doctors think that ingrown hairs cause pilonidal cysts. Pilonidal means “nest of hair.” It is common to find hair follicles inside the cyst.Another theory is that pilonidal cysts appear after trauma to that region of the body. During World War II, more than 80,000 soldiers developed pilonidal cysts that required a hospital stay. People thought the cysts were due to irritation from riding in bumpy Jeeps. For a while, the condition was actually called “Jeep disease.”

Symptoms

The symptoms of a pilonidal cyst include:

·        Pain at the bottom of the spine

·        Swelling at the bottom of the spine

·        Redness at the bottom of the spine

·        Draining pus

·        Fever

When to seek medical care for a pilonidal cyst

A pilonidal cyst is an abscess or boil that needs to be drained or lanced, to improve. Like other boils, it does not improve with antibiotics. If any of the above symptoms occur, consult a doctor. 

Exams and tests

A doctor can diagnose a pilonidal cyst by taking a history (asking about the patient’s history and symptoms regarding the cyst) and performing a physical exam. The doctor may find the following conditions:

·        Tenderness, redness, and swelling between the cheeks of the buttocks just above the anus

·        Fever

·        Increased white blood cells on a blood sample (not always taken)

·        Inflammation of the surrounding skin

Home remedies

Early in an infection of a pilonidal cyst, the redness, swelling, and pain may be minimal. Sitting in a warm tub may decrease the pain and may decrease the chance that the cyst will develop to the point of requiring incision and drainage.

Medical treatment for a pilonidal cyst

Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.

·        The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles and packing the cavity with gauze. (Advantage- simple procedure done under local anaesthesia; disadvantage – frequent changing of gauze packing until the cyst heals, sometimes up to three weeks).

 

·        Marsupialisation – This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch. (Advantages – outpatient surgery under local anaesthesia; minimizes the size and depth of the wound without the need to pack gauze in the wound; Disadvantages – requires about six weeks to heal; needs a doctor trained in the technique.)

·        Another option is incision and drainage with immediate closing of the wound. (Advantage – wound completely closed immediately following surgery without need for gauze; Disadvantages – High rate of recurrence (it is hard to remove the entire cyst, which might come back; typically performed in an operating room, it requires a specially trained surgeon).

 

Skin and molluscumcontagiosum

Molluscumcontagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin. It is a chronic infection, and lesions may persist from a few months to a few years. However, most cases resolve in six to nine months.

Causes

Molluscumcontagiosum is caused by a virus (the molluscumcontagiosum virus) that is part of the pox virus family. The virus is contagious through direct contact and is more common in children. However, the virus also can be spread by sexual contact and can occur in people with compromised immune systems. Molluscumcontagiosum can spread on a single individual through scratching and rubbing.

Symptoms

Common locations for the molluscumcontagiosum papules are on the face, trunk, and limbs of children and on the genitals, abdomens, and inner thighs of adults. The condition usually results in papules that:

·        Are generally painless, but can itch

·        Are small (2 to 5 millimetre diameter)

·        Have a dimple in the centre

·        Are initially firm, dome-shaped, and flesh-coloured

·        Become softer with time

·        May turn red and drain over time

·        Have a central core of white, waxy material

Molluscumcontagiosum usually disappears spontaneously over a period of months to years in people who have normal immune systems. In people who have AIDS or other conditions that affect the immune system, the lesions associated with molluscumcontagiosum can be extensive and especially chronic

Diagnosis

Diagnosis of molluscumcontagiosum is based on the distinctive appearance of the lesion. If the diagnosis is in question, a doctor can confirm the diagnosis with a skin biopsy — the removal of a portion of skin for closer examination. If there is any concern about related health problems, a doctor can check for underlying disorders.

Treatment

Molluscumcontagiosum is usually self-limited, so treatment is not always necessary. However, individual lesions may be removed by scraping or freezing. Topical medications, such as those used to remove warts, may also be helpful in lesion removal.

Note: The surgical removal of individual lesions may result in scarring.

Prevention

To prevent molluscumcontagiosum, follow these tips:

·        Avoid direct contact with anyone who may have the condition.

·        Treat underlying eczema in children.

·        Remain sexually abstinent or have a monogamous sexual relationship with an uninfected individual. (Male and female condoms cannot offer full protection as the virus can be found on areas not covered by the condom.)

Shingles

Shingles (herpes zoster) results from a reactivation of the virus that also causes chickenpox. With shingles, the first thing you may notice is a tingling sensation or pain on one side of your body or face. Painful skin blisters then erupt on only one side of your face or body along the distribution of nerves on the skin. Typically, this occurs along your chest, abdomen, back, or face, but it may also affect your neck, limbs, or lower back. The area can be very painful, itchy, and tender. After one to two weeks, the blisters heal and form scabs, although the pain often continues.

The deep pain that follows after the infection has run its course is known as postherpetic neuralgia. It can continue for months or even years, especially in older people. The incidence of shingles and of postherpetic neuralgia rises with increasing age. More than 50 per cent of cases occur in people over 60. Shingles usually occurs only once, although it has been known to recur in some people.

What causes shingles?

Shingles arises from varicella-zoster, the same virus that causes chickenpox. Following a bout of chickenpox, the virus lies dormant in the spinal nerve cells. But it can be reactivated years later when the immune system is suppressed by:

·        Physical or emotional trauma

·        A serious illness

·        Certain medications

Medical science doesn’t understand why the virus becomes reactivated in some people and not in others.

Chickenpox

Chickenpox (varicella), a viral illness characterised by a very itchy red rash, is one of the most common infectious diseases of childhood. It is usually mild in children, but adults run the risk of serious complications, such as bacterial pneumonia.

People who have had chickenpox almost always develop lifetime immunity (meaning you can’t get it again). However, the virus remains dormant in the body, and it can reactivate later in life and cause shingles.

Because the chickenpox virus can pass from a pregnant woman to her unborn child, possibly causing birth defects, doctors often advise women considering pregnancy to confirm their immunity with a blood test.

What causes chickenpox?

Chickenpox is caused by the herpes zoster virus, also known as the varicella zoster virus. It is spread by droplets from a sneeze or cough, or by contact with the clothing, bed linens, or oozing blisters of an infected person. The onset of symptoms is seven to 21 days after exposure. The disease is most contagious a day before the rash appears and up to seven days after, or until the rash is completely dry and scabbed.

Reports compiled by Adebayo Folorunsho-Francis with additional information from webmd.com/skin-problems-and-treatments and wikipedia.org/wiki/Skin_infection

 

Community Pharmacy is profitable – Solaris MD

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(By Adebayo Oladejo)

 

Pharm. Olasunkanmi Ademola Adewuyi is the managing director, Solaris Pharmaceuticals Limited, Osogbo, Osun State. In this interview with Pharmanews, the Osun State based pharmacist spoke on pertinent issues relating to community pharmacy practice, especially in Osun State.

 EXCERPTS:

How would you assess community pharmacy practice in this part of the country?

Community pharmacy practice in this part of the country is interesting and, at the same time, challenging. Interesting in the sense that community pharmacists are well-recognised by the general public as healthcare providers, who they can approach for their health needs, and this gives us satisfaction, as practitioners. Meanwhile, it is challenging in the sense that setting up and maintaining a good community pharmacy is capital-intensive and, sometimes, a lot of resilience, patience and hard work are required to succeed in the practice.

 

Tell us about some of the challenges you have faced in your practice and how they were surmounted.

One of the challenges I faced was getting enough capital to start and maintain a standard community practice. Though I still contend with that, I have made considerable progress by resorting to bank loans, cooperative societies, selling business ideas to acquaintances who invest their money in the business, etc.

Another challenge I faced was change in government policies,which affectedthe business environment generally. Due to government policy change, we had to relocate our businesses to an entirely new community, and that means we were starting almost all over again.But we were able to overcome that by deploying the principle of reproducibility, that is what has been done before can be done again and again by following the former principles. So, we thank God today that we are doing well in the business.

 

How lucrative is community pharmacy practice business in Osun State?

Lucrative? Well, community practice is very lucrative here in Osun State, provided the pharmacist is ready to pay the price. What I mean by that is that, here, in Osun State, community practice is well-regulated, and if one is ready to play by the rules, there will be no problem, but if not, there will be problems. Also, there is need to pay the price of patience, hard work, resilience and determination, which we have paid in the past. To God be the glory, we are doing fine.

 

Do you think ACPN, OsunState, is living up to expectations, as the umbrella body for community pharmacists in the state?

I think ACPN in Osun State is really living up to expectations because, through its activities, members have gota sense of belonging. ACPN gives maximum support to its members, when necessary, and in collaboration with PCN, NAFDAC and other regulatory agencies, community practice is being well regulated in Osun State and is doing well.

 

What are the most common health conditions patients in this area come to the pharmacy for, and why is this so?

One of the most common health problems patients suffer from is malaria, and the reason is not far-fetched. From the nature of our environment, which is creating a fertile ground for the malaria parasite to thrive, because these parasites can only survive in an unfriendly environment. Other common healthcare problems include typhoid, sexually transmitted diseases and so on.

 

If you were not a community pharmacist, which other areas of practice in Pharmacy would you have considered, and why?

If I were not a community pharmacist, I would have loved to remain in the pharmaceutical industry. The reason is that I love the business aspect of pharmacy practice.

 

How do you see the war on fake drugs and what other strategies can be adapted to effectively tackle this menace?

I want to believe the government, through its various regulatory bodies, is trying its best to curb the menace. One way I believe fake drugs can better be curbed is to allow the institution of mega drug depots in each state, where all manufacturers and importers of drugs will be able to supply their drugs directly, while wholesalers will go there to source their drugs. Meanwhile, those mega depots should be managed by the government, though private business owner which could be the major investors.

Personality of the Month

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Pharm. Charles A. Akinsete is a graduate of the prestigious Faculty of Pharmacy, Obafemi Awolowo University (OAU),Ile-Ife. It was also at OAU that he obtained his Master’s in Business Administration degree, with specialty in marketing.

Akinsete has had about two decades of experience in industry pharmacy practice, covering the key sectors of business development, sales and marketing, regulatory, administration, human capital management and finance.

As an active member of the Pharmaceutical Society of Nigeria (PSN), Akinsete has served the society at various levels, recently earning him a merit award of its Lagos State branch. He was also at different times chairman of the PSN Lagos State Pharmacy Week Planning Committee. He equally served as a member of the Conference Planning Committee of the PSN, Taraba 2011 and Kwara 2013.

An astute public speaker and presenter, Pharm. Akinsete has featured as a guest speaker at various forums. He was the first publicity secretary of the Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM), as well as various stakeholders’ forums on NAFDAC regulated products.

He is the immediate past 1st vice-chairman of the Association of Industrial Pharmacists of Nigeria (NAIP), where he has served at various capacities for about 15 years. He is also a member of the Board of Trustees of the Association.

Aside from his relevance in the profession, Akinsete has also extended his versatility to the needy on the mission field by being a member of the Board of Trustees of Heal the World Mission Inc., a non-governmental Christian charity organisation, providing help to the needy in the society. He is also the chairman, Parents Teachers Association (PTA) of the Ambassadors Nursery and Primary School, Ota, Ogun State.

A fervent optimist and great achiever, Akinsete has demonstrated capacity to deliver with minimal resources. He is a good Christian and community man.

Pharm. Akinsete is happily married to Mrs Mojisade Akinsete, and the union is blessed with three boys.

 

Accolades as Pharmacy Faculty, OAU, celebrates Golden Jubilee …Atueyi, Akintayo, Adeluyi, others awarded

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(By Adebayo Oladejo)

It was a moment of joyous reunion, pleasant reminiscences and fitting recognitions as the Faculty of Pharmacy, Obafemi Awolowo University (OAU), Ile-Ife, Osun State, held its 50th anniversary and alumni reunion programme.

The event which took place from 27 February to 2 March in the university campus also featured presentation of awards to selected alumni who have distinguished themselves in various fields of endeavour, as well as other individuals and corporate bodies who have contributed significantly to the development of the prestigious faculty.

The dinner and awards ceremony which was held at the Chris Ogunbanjo Hall, OAU, under the chairmanship of Pharm. Bruno Nwankwo, chairman, Pharmacists Council of Nigeria (PCN), had in attendance several eminent personalities, including Prof Festus Adio Ogunbona, former chairman, PCN, and former deputy vice-chancellor (Administration), OAU; Prof G.O Onawunmi, dean, Faculty of Pharmacy, OAU; Pharm. (Sir) Ifeanyi Atueyi, publisher, Pharmanews; Pharm. Chief Bunmi Olaopa, managing director, Evans Medical Plc. and chairman, Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN); Pharm. (Alh) Adebayo Ismail Olufemi, national chairman, Association of Community Pharmacists of Nigeria (ACPN); Prof Kolawole T. Jaiyeoba, vice-chancellor, Bishop Ajayi Crowther University, Oyo; Prof Saburi Adesanya, vice-chancellor, Olabisi Onabanjo University, Ago-Iwoye, Ogun State; Pharm. Lekan  Asuni, managing director, GSK Nigeria; and Pharm Olakunle Ekundayo, managing director, Drugfield Pharmaceuticals Limited.

Beaming with smiles, Prof Onawunmi expressed her delight at being privileged to witness such an historic occasion in her lifetime, noting that it was a great honour to be in the midst of alumni of the faculty who had become movers and shakers of Pharmacy practice in Nigeria and in Diaspora.

“We feel honoured and privileged to have our senior citizens in our midst tonight and we are also using this opportunity to appreciate their constant support and assistance in various categories to their alma mater,” she said.

Chairman of the event, Pharm. Bruno Nwankwo, observed that gone were the days when Pharmacy and pharmacists were not recognised or acknowledged in the nation, adding that the profession had fought very hard to be reckoned with in the health sector. He also used the occasion to further challenge fellow pharmacists.

“We need to know why we are in this profession because pharmacy profession is evolving as it has moved from being product-based to being patient-based and, as such, we should endeavour to practise professionally and always remember who we are and where we are coming from,” he counselled.

The highpoint of the event was the presentation of awards in different categories to distinguished alumni of the faculty.

Prof. Irukaku Okeke was awarded in the category of “OAU Pharmacy Ambassador in Diaspora”; “Prince Julius Adelusi-Adeluyi, former minister of health and chairman, Juli Plc.,was awarded in the category of “Alumnus with Distinguished Community Practice as Pacesetter and Role Model”; while Profs. Cyprian Onyeji, Kolawole Jaiyeoba and Saburi Adesanya were awarded in the category of “OAU Pharmacy Alumni with Distinguished Academic Practice as Pacesetters/Role Models”.

In the category of “Distinguished OAU Pharmacy Alumni in Sectors of Economy Beyond Pharmacy” Pharm. (Sir) IfeanyiAtueyi;Pharm. Joseph Odumodu, DG, Standards Organisation of Nigeria; Pharm. Gbolagade Osibodu; Pharm. Olu Akanmu; Pharm. Sam Nda-Isaiah, publisher, Leadership Newspapers; and Pharm. Ayo Otuyalo were honoured with awards.

Other award recipients and their respective categories were: Pharm. Olumide Akintayo, Pharm. (Lady) Eme Ufot Ekaete and Pharm. (Sir) Samuel Agboifo (“Alumni of the Faculty Who Have Provided Leadership to the Pharmaceutical Society of Nigeria); Prof Festus Adio Ogunbona and Pharm. Adebayo Lamikanra (“OAU Pharmacy Alumni with Distinguished Academic Service to Alma Mater”); Pharm. Rufus Omotayo (“OAU Pharmacy Alumnus with Distinguished Practice in Hospital/Administration as Pacesetter/Role Model”); Pharm. Olakunle Ekundayo (OAU Pharmacy Alumni with Distinguished Industrial Practice as Pacesetters/Role Models); Ifeanyi Okoye and Pharm. (Chief) Bunmi Olaopa and Pharm. Charles Akinsete (“OAU Alumni with Distinguished Support to Alma Mater in Various Forms”);Pharm. Samuel Ohuabunwa and Pharm. Ayo Otuyalo (“OAU Pharmacy Alumni with Distinguished Financial Support to Alma Mater”); and Profs Olanrewaju Ogunlana, Abayomi Sofowora and AjibolaOlaniyi (“Foundation Teachers”).

Faculty of Pharmacy, OAU, was founded in 1962 as Department of Pharmacy under the Faculty of Sciences, making it the premier institution to provide pharmacy education in Nigeria. The department was upgraded to a full-fledged faculty in 1969, with four main departments: Pharmaceutical Chemistry, Pharmacology, Pharmacognosy, and Pharmaceutics. However, as the faculty grew in vision and status over the years, a Drug Research and Production Unit, and an additional department, Clinical Pharmacy and Pharmacy Administration, were established to consolidate the various efforts on teaching, research and service.

When your comfort zone becomes a danger zone

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“Unless you try to do something beyond what you have already mastered, you will never grow.” – Ralph Waldo Emerson

 

Life is for those who take risks. Those who do not take any risks take the greatest risk of all. The greatest risk in life is to wait for and depend upon others for your security and the greatest security is to plan and act, and to take the risks necessary that will make you independent, joyful and fulfilled. It feels nice to be comfortable, but if we are comfortable all the time, we miss the chance to stretch and grow. A ship is safe in a harbour, but that is not what ships are for. Helen Keller said, “Security is mostly a superstition. It does not exist in nature. Life is either a daring adventure or it’s nothing at all.”

Albert Einstein once said, “Without mystery, life is as meaningless as a snuffed out candle.” Mystery, by definition, resides in the unknown, which of course, in turn, resides outside our comfort zones.

It is difficult for some people to resist the temptation to force themselves into the pattern of being average. One needs only to remember that a groove may be safe – but as one wears away at it, the groove becomes first a rut, and then finally a grave. John Whittier, a popular New England 19th century poet, wrote an often quoted poem describing a life in which one does not break out of their comfort zones and realise their dreams:

 

Maud Muller

Alas for maiden, alas for judge,

For rich repriner and household drudge!

God pity them both! And pity us all,

Who vainly the dreams of youth recall:

For of all sad words of tongue or pen

The saddest are these, it might have been!

If you ask Steven Hawking, the world’s foremost physicist, about the universe, he will respond by saying, “It has no beginning in time, no ending in time, and no edges in space, and nothing for a creator to do.” If you think about this, it is impossible to comprehend. The secret to perpetual growth is to develop the habit to live outside of your comfort zone. As a prominent scientist from the early part of the 20th century once said, “The universe is not only stranger than we think; it is stranger than we can think.”

The reason why functioning within your comfort zone is the norm, rather than the exception, is that it tends to regulate our life and, on the surface, seems to make things easier. Within that comfort zone, we develop a pattern of successfully caring for our basic needs. The problem is that remaining in the comfort zone also causes us to underachieve. So, let me ask you a direct question: Is your comfort zone holding you back from reaching you potential? Is it holding you back from living your purpose or setting and reaching worthy goals?

The most effective way to break out of your comfort zone is to set higher goals and create an ACTION PLAN. This action plan will clarify your purpose and help you to identify the internal barriers that may be in your way. Your action steps must take some risk. You simply must live outside your comfort zone, in order to grow.

It is critical for you to focus on the habit of comfort zone EXPANSION. This literally means PERPETUAL GROWTH. The Roman Empire flourished and dominated the world for over 1,000 years; yet when its primary focus of planning, building and economic expansion was replaced with luxury and pleasure, the empire crumbled, and it crumbled from within. Luxury and pleasure are wonderful, but they will be your downfall, unless they are combined with planning and commitment for achievement. In fact, your upkeep will become your downfall, if your outgo exceeds your income.

When we find ourselves settling for security and stability, at the expense of transformation, transition and growth, we are making a big mistake. Emerson put it this way, “Unless you try to do something beyond what you have already mastered, you will never grow.”

Most people are inhibited by the fear of committing themselves to action. They do not understand that to risk is to exceed one’s usual limits in reaching for any goal, and that uncertainty and danger are simply part of the territory. To get profit without risk, experience without danger, and reward without work, is as impossible as it is to live without being born.

Children who are cared for by parents who are inconsistent in nurturing or who are emotionally absent or unaffectionate or passive, produce, in their turn, children who become adults with one overriding need: to limit any potential loss of love in their lives.

Feelings follow a predictable, invariable pattern. When a loss threatens you, you feel anxious. When a loss occurs, you feel hurt. When hurt is unresolved, it becomes anger. When anger is held back, it creates guilt. When guilt is unrelieved, depression occurs. If you take care of your fear, hurt, and anger, guilt and depression cannot happen.

The primary reason we are uncomfortable with comfort zone expansion is fear, which can be defined as False Evidence Appearing Real. Avoiding risk, staying with a limited belief system, will guarantee failure and self-imposed bondage.

People who stay within their comfort zones are risk-adverse. They are stuck in mediocrity. Those who choose caution over challenge and opportunity do well to listen to Germane Green who said, “Security is when everything is settled, when nothing can happen to you; security is denial of life.” Earle Nightingale, who is called the Dean of Human Achievement, said simply, “Security? There is no security! There is only opportunity.”

The future belongs to those rare few men and women who dare to move out of their comfort zones, into the area of uncertainty or challenge. Remember the words of the great German philosopher, Goethe, who said, “Act boldly and unseen forces will come to your aid.”

Culled from SUCCESS TO SIGNIFICANCE by RICHARD CARSWELL

 

How to plan for your future

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To some people, this topic sounds almost sacrilegious. When I say, “Do you have a good plan for your financial future?” they look at me as if to say, ‘’I’m spiritual; I don’t need a plan. I walk by faith, not by plans.”

Look at Proverbs 24:3-4: “Any enterprise is built by wise planning, becomes strong through common sense, and profits wonderfully by keeping abreast of the facts” (TLS). Earlier in Proverbs, we read: “We should make plans-counting on God to direct us” (16:9, TLS).

Many people I meet seem to feel that God is just going to rain down on them what they need, without any effort or thought on their part. It is as if they expect to go outside and look at trees in their backyards, and find 100-dollar bills growing on them.

You will never get ahead with that kind of thinking. Not now. Not five years from now. Not ever. Because it is not the wisdom of God.

You must make a plan for your future. Let me share a plan I instituted, as we began the Church on the Rock in 1980. We kept that plan in place until we embarked on a massive building project, and last year we reinstituted it. Apart from the time when we were involved in building our 10-million-dollar facility, we operated that plan when we had a little bit–interms of financial resources – and when we had a lot.

This is also the plan that Melva Jo and I have lived by since we were married in 1974. I heartily recommend it to you for your own family and personal finances, and I recommend it from personal experience.

I call the plan the 8-1-1 plan. What are the basics of this plan? The first premise is that you will be faithful in giving to God. The second premise is that you will save regularly. And the third premise is that you will live on only 80 percent of what you earn.

The plan is based on the idea that your total income is represented by the number 10. Here’s how it breaks down.

Give one-tenth of your income to God’s work. That’s the tithe. It’s the biblical standard for giving. It’s a commandment of God. You need to do that for “heart” reasons before God–to show God that your heart is in the right place with regard to your finances.

Save one-tenth. Be faithful in doing this. Make the first cheque you write–from every amount of money you receive–a cheque for one-tenth to God’s work. But make the second cheque you write a deposit into your own savings account.

Live on the rest – 80 per cent. Now, this is contrary to the way most people in the United States of America live today. Most people I encounter are making ten apples and trying to live off 14! They have overextended themselves on credit, to live a lifestyle that they wished they had but that, in reality, they will never have because of their overspending. Living beyond your means or even living to the level of your means–making ten apples and spending all ten–is a sure-fire way never to get ahead.

Make this a starting point. Soon you may be able to live on 70 percent, give 20 percent to God’s work and save 10 percent. You may be able to reduce your living even more and raise your giving even higher, as time passes. In fact, I believe that you WILL be able to do that, because that is what God’s cycle of blessing describes. The Hebrew approach to prosperity was more and more resources, so you can be a greater and greater blessing; only the Christian church has interpreted God’s Word to mean that you should have less and less (which means you are forced to give less and less)!

Now, why should you save? A number of people say to me, “Isn’t saving money contrary to believing that Jesus is coming soon?” We don’t know when Jesus is coming. But we do know that He told us to occupy until He does come. He told us that the rain falls on the just and the unjust; in other words, calamities and hard times come to everyone. At times, all of us need extra money for one reason or another, and that is where a savings account comes in.

“Well,” you say, “show me a verse of scripture that talks about savings”. I’ll show you two of them. “The wise man saves for the future, but the foolish man spends whatever he gets” (Proverbs 21:20, TLB).

Houses and riches are an inheritance from fathers” (Proverbs 19:14). Now you can’t leave an inheritance of houses and riches to your children, unless you have a good investment plan for your life. If you are spending the full amount you earn on consumable living items, then you will never be able to accumulate an estate to pass along to your children. “Well,” you say, “I’m leaving my children a godly inheritance. I’m leaving them an inheritance of faith in God.”

There is nothing more important that you can do. But the Bible also encourages you to leave your children something of tangible means in this world.

 

Culled from WISDOM:DON’T LIVE LIFE WITHOUT IT by LARRY LEA

Artcop-DS will help reduce malaria deaths – Pharm. Onasanya

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(By Adebayo Oladejo)

 A researcher and malaria expert, Pharm. Seun Onasanya, recently disclosed to Pharmanews, in an exclusive interview that dealing with the scourge of malaria in Sub-Saharan Africa would require an antimalarial drug that is both effective and affordable.

“Successful malaria control depends greatly on treatment with efficacious anti-malarial drugs” he said.“And when we are talking about antimalarial drug that has potency and that is cost effective, I will recommend Artcop-DS.”

Shedding more light on the unique features of Artcop-DS, Onasanya, who is also a member of Malaria World, the world’s largest scientific and social malaria network for malaria professionals, said the product is a fixed dose artemisinin-based combination therapy and each tablet contains artemisinin 62.5 milligram and piperaquine 375 milligram.”

He added that the drug is effective against the drug resistant P.Falciparummalaria, stressing that it is well-tolerated and has rapid action, low toxicity and offers a short-course treatment.

“Artemisinin in Artcop-DS tablets has powerful and quick parasiticidal effect on those parasites in intraerythrocyte stage. Moreover, its efficacy is much quicker”, he stated.

He further added thatArtcop-DS is a four-tablet dose that would be taken within 24 hours. According to him, within those hours, “over 97 percent of the malaria parasites will be cleared off from the system.”

 

The appointment of a Surgeon General of the Federation

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In January this year, the Nigerian Medical Association (NMA) threatened to commence an indefinite strike action, if the federal government failed to meet its demands, among which is the appointment of a medical doctor as Surgeon General of the Federation.

The strike action, which was scheduled to commence on 6 January, was however suspended, following the agreement between the NMA and the government to allow for the implementation of the MoU reached, after a series of meetings.

However, since the suspension of the proposed strike, following the pledge by the Federal Government to implement the MoU reached with the NMA, the planned appointment of the Surgeon General of the Federation has become more contentious and controversial.

The Assembly of Healthcare Professional Associations (AHPA)and Joint Health Sector Unions (JOHESU), whose members are health workers, other than medical doctors, have questioned the justification for the position of a Surgeon General in Nigeria.

In a recent open letter to President Goodluck Jonathan, signed by the President of the Pharmaceutical Society of Nigeria (PSN), Pharm. OlumideAkintayo; President of the National Association of Nigeria Nurses and Midwives (NANNM), MrAbdulrafiuAdeniji; Chairman of the Joint Health Sector Unions, Comrade WabbaAyuba;  Chairman ofthe Assembly of Healthcare Professional Associations (AHPA), Dr. G. C. Okara; President of the Nigeria Society of Physiotherapy (NSP), MrTaiwo-Oyewumi; President of the Association of Radiographers of Nigeria (ARN), Dr. Mark Okeji; and President ofHealth Information Managers Association of Nigeria (HIMAN), MrWoleAjayi, the health workers argued that therationale given for creating the post of the Surgeon General was not compelling enough to warrant its implementation, with the result ant wastage of scarce publicfunds.

They argued further that the office of the Surgeon General would mean an unnecessary duplication of functions which are presently being carried out by the offices of the minister of health and the minister of state for health, with several directors, deputy directors and assistant directors.

It must first be emphasised that ensuring industrial harmony in a multi-disciplinary sector like health is a sine qua non for its progress and development.  The sector depends on the collective efforts of different professionals to function optimally.Therefore, the first consideration in any policy formulation and implementation in the sector must be the potential impact on its continued harmony.The health sector cannot prosper where there is no unity among the different categories of professionals.

It must also be emphasised that the nation is better off devising ways of solving the numerous problems currently confronting the health sector.  Creating a new position, just for the sake of it, would only lead to further complications and aggravations.

Moreover, a glance at all the listed duties of the Surgeon General shows clearly that most of them are already within the portfolios of the minister of health and the minister of state for health. Why do we want to create an additional office and waste resources that could be put to better use through the provision of essential, comprehensive and pressing health care needs?

The Nigerian government must learn not to copy concepts just because they are operational in some advanced nations of the world, without consideration for their local relevance, adaptability and benefits.

It is our view that having a Surgeon General of the Federation is neither the most pressing nor the most important need of the Nigerian health sector right now. In fact, it poses the risk of creating more tension, crisis and conflicts in an already beleaguered sector of the nation.

 

 

 

 

 

Deciding your real age

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This may sound ridiculous, but the majority of people do not actually know their real age. I have personally observed that many, especially the elderly ones, manifest three ages. The first is the chronological or calendar age. This is the real date of birth. Old people who were born in enlightened families have accurate records of their births. In the villages, there were no birth certificates, as deliveries were done by traditional birth attendants in homes, and not hospitals and maternities. For Christians, infant baptismal certificates had information on the dates of birth. Sometimes, the actual date may not be known and certain assumptions are made to fix an arbitrary one. This is acceptable, since a date must be adopted for record purposes.

The second age is the official one. It is the age used for public records. Many reduce their official age for the purpose of employment and retirement. They do so to stay long in service and delay retirement. The normal retirement age in Nigeria is 60/65, but clergymen, judicial officers and university professors retire at 70.  Civil servants are widely known to reduce their ages. The process is easy. Just swear an affidavit to effect the change.  This declaration of so-called official age is taken for granted but, really, it is falsification. A person of integrity would not falsify his biodata to be in employment.

The third one is the biological age. Our body systems to grow old at different rates. This is why a man of 50 years may look like someone of 60, while a 65-year-old woman may look just 55. The biological age depends on several factors, including genetics, ‘ageing clock’, diet, physical activities and attitude to life.

Usually, nobody wants to look older than their age. Women, in particular, make serious efforts to look younger and remain beautiful. Sometimes, in the process of achieving this, some apply noxious preparations to their skins.

Medical science has recently discovered how we age biologically. Nutrition experts have found out that advanced glycation end-products (AGEs) are responsible for speeding up the ageing process. The body forms AGEs and we also consume them in certain foods.

When the quantity of AGEs in the body gets high, they can cause wrinkles, sagging skin, kidney and nervous system damage, clogged arteries, diabetes, cataracts, inflammation and other age-related diseases, and eventually, death.

AGEs are formed in the body when sugars combine with amino acids. High blood sugar, therefore, can trigger formation of AGEs.

Research has shown that foods of animal origin such as meat, poultry, fish and cheese have high levels of AGEs. Levels of AGEs rise when foods are cooked. The higher the cooking temperature, the more AGEs are produced. Therefore, frying, grilling and roasting increase the rate of AGEs formation.

Foods of plant origin –fresh fruits, nuts, vegetables and grains are lowest in AGEs. It has been shown that Noni juice, which contains a high quantity of iridoids, effectively reduces AGEs in the body.  Potatoes are expectedly low in AGEs but, when they are prepared as French fries, the levels of AGEs increase by 89 fold. Fried bacon and fried chicken are very high in AGEs.

People who regularly consume a high AGE diet have significantly higher levels of AGEs in their blood. When they are placed on a low AGE diet, the levels of AGEs fall and the rate of ageing declines also.

Limiting sugar in your diet is a key to longevity because sugar molecules inflict damage to the body. Fructose, in particular, is an extremely potent pro-inflammatory agent that creates AGEs and speeds up the ageing process.

Consumption of foods such as white bread, pastries, cookies and candy increase the sugar in the body and add to the havoc. Heavy consumers of soft drinks and fruit juices add excess of sugar to their bodies.

High-sugar diets lead to obesity. Carbohydrates like fructose and other sugars destroy your insulin sensitivity which, in turn, causes your cells to accumulate more fat. This makes it more difficult to get rid of the extra weight, as well. Therefore, if you want to look and feel younger, drastically reduce all forms of sugar in your diet.

By now, you should have determined your true age. It is not your calendar age, which can be real or falsified. It is not your official age, which is usually below the calendar age. We usually celebrate these ages and, many a time, mark them with expensive parties. But the most important age, the biological age, which indicates the real rate of ageing and eventual death, we tend to ignore.

Today, machines are available to enable you determine the level of AGEs in your body. If the level is high, you have to take the appropriate steps to reduce it and extend your lifespan in good health.

 

 

 

 

NAIP ready to support new drug distribution guidelines – Falabi

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 (By Yusuff Moshood)

The Association of Industrial Pharmacists of Nigeria (NAIP) has pledged to work with other stakeholders in the pharmaceutical sector to ensure successful implementation of the new National Drug Distribution Guidelines, which is expected to take effect from 30 June.

Chairman of NAIP, Pharm. Gbenga Falabi, stated this while giving his opening remarks at the first bi-monthly meeting/seminar of the association for the year.

At the gathering, which held at NAIP secretariat, Ikeja, last month, Falabi disclosed that, among other things, the birth of the Pharma Industry Stakeholders Forum was to help ensure the successful implementation of the new drug distribution guidelines, while also protecting the interest of stakeholders and ensuring professionalism.

Falabi also noted that the stakeholders, comprising Association of Pharmaceutical Importers of Nigeria (APIN), Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM), Pharmaceutical Manufacturing Group of the Manufacturers Association of Nigeria (PMG-MAN), Indian Pharmaceutical Manufacturers and Importers in Nigeria (IPMIN) and NAIP, are scheduled to meet to discuss the grey areas in the new guidelines and come up with a position.

In his own remarks at the occasion, the Managing Director/CEO of Embassy Pharmaceutical & Chemicals Limited, Pharm. (Sir) Nnamdi Obi, urged pharmacists to embrace collaboration with non-pharmacist entrepreneurs.

Obi noted that one of the best ways to transform the pharmaceutical sector is to work with entrepreneurs who are not pharmacists but are desirous of investing in the sector, adding that this would help take the sector to the next level.

The well-attended NAIP event was also graced by Pharm. Ade Popoola, chairman of PSN Board of Fellows.

Meet a CSIR chemical engineer who specialises in pharmaceutical and meals/feed merchandise

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A wholesome dose of curiosity appears to be the recurring theme for these desirous to turn into chemical engineers. A minimum of, that’s what Kersch Naidoo, a chemical engineer on the CSIR, believes.

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Latest developments in glaucoma therapy

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 (By Pharm. Harrison Kofi Abutiate)

Glaucoma has recently been reclassified as a “progressive optic neuropathy characterised by a specific pattern of optic nerve head and visual field damage.”

   Now known to occur with or without elevated intraocular pressure, the updated definition of this group of irreversibly blinding disorders does not include the words intraocular pressure. Glaucomatous optic nerve damage should be seen as representing a final common pathway resulting from a number of diseases which affect the eye, similar to end-stage kidney or liver failure.

Glaucoma may therefore be regarded as an ocular manifestation of a systemic disease. We are still faced with problems in diagnosis, workup, and treatment, since we have not elucidated all of the additional risk factors and how they impact the development and progression of glaucoma. We are therefore still limited primarily to treatment oriented at lowering IOP.

Risk factor management and directed therapy, such as evidenced in cardiologists’ approach to heart disease, including management of diet, weight, stress, smoking, exercise and cholesterol levels, must be emphasised in our future management of glaucoma.

Systemic risk factors may consist of a variety of disorders, including cardiovascular abnormalities, serum viscosity and platelet abnormalities and a wide variety of as yet poorly defined molecular, immune, and genetic disorders, including factors common to neurodegenerative disease in general, such as oxidative damage and low grade inflammation.

Recently, an increasing number of reports have associated sleep apnea and low cerebrospinal fluid pressure with glaucoma. It has been conjectured that much of glaucomatous damage due to risk factors other than IOP occurs at night. Newer studies are looking at ocular perfusion pressure in relation to blood pressure, which typically is lowest in the early morning hours during sleep, when IOP is highest.

A combination of higher IOP, low blood pressure (and CSF pressure), and sleep apnea may be particularly dangerous, leading to a significant decrease in ocular perfusion pressure.  Increasing IOP by sleeping with the eye pressed against the hand or pillow is another potential nocturnal risk factor for progression of glaucoma.  Some yoga philosophies advocate that individuals must assume different kinds of inverted positions for some time, in order to give the brain a better blood supply. When in the inverted posture, the intraocular pressure (IOP) rises immediately and remains elevated as long as the position is maintained, going back to normal when the upright position is reassumed. It is possible that this transitory spike of intraocular pressure, practised every day and for many years, can lead to damage to the optic.

Therapy directed toward risk factors other than IOP for glaucoma, although still in its infancy, will hopefully develop into an important part of our armamentarium in future years.

 

Traditional glaucoma therapy

Prostaglandin Analogues

Latanoprost (Xalatan®), Travaprost (Travatan® and Travatan Z®) Bimatoprost (Lumigan®)

Function: This is the newest class of drugs and acts differently from other glaucoma drops. Pressure is lowered by the drug increasing the rate at which fluid flows out of the eye (uveoscleral outflow). The drug needs to be taken only once a day.

Beta-Blockers

Timolol Maleate (Timoptic®) or (Istalol®), Levobunalol (Betagan®), Carteolol (Ocupress®), Betaxolol (Betoptic®)

Function: Reduces aqueous humour production.

 

Alpha 2 adrenergic agonist

Brimonidine (Alphagan®) (Alphagan-P)

Function: This is a highly selective alpha2-adrenoceptor agonist. Reduces aqueous humour production and increases uveoscleral outflow.

 

·  Apraclonidine (Iopidine®)

Function: This drug is used at the time of laser treatment to prevent sudden IOP rises caused by the treatment.

·  Miotics

Pilocarpine (Isoptocarpine®, Pilocar ®)

Function: Drops which help open the eye’s drain and increase the rate of fluid flowing out of the eye.

·  Carbonic anhydrase inhibitors – drops

Dorzolamide (Trusopt®), Brinzolamide (Azopt®)

Function: These lessen the production of fluid in the eye.

 

Carbonic anhydrase inhibitors – pills/tablets

Acetazolamide (Diamox®), Methazolamide (Neptazane®)

 

Newer drug on the market

·  PilocarpineOcuserts-a tiny disc impregnated with pilocarpine and worn under the eyelid several days at a time, produces a steady flow of the drug while causing a minimal amount of side effects.

Combinations of some or all these products (Combigan, Azarga, Duotrav, Ganfort, Cosopt, Xalacom, Trusopt) are available to enhance patient compliance.

 

Future additions to glaucoma therapy

·  Marijuana 

This definitely does lower intraocular pressure. CANASOL, an eye drop created from tetrahydrocannabinol (THC), the active ingredient in marijuana, is available in Jamaica. Unfortunately, although many other derivatives of marijuana have been tested in the US over the last 15 years, none has been deemed sufficiently effective and sufficiently free of side effects to bring to market there for glaucoma treatment.

A number of states have decriminalised the substance to varying degrees; other states have created exemptions specifically for medical cannabis, and several have both decriminalisation and medical laws. Two states, Colorado and Washington, have legalised the recreational use of cannabis. In many of the United States, medical marijuana is available by prescription for patients with glaucoma who have had all other measures fail to control pressure. However, only a few patients are receiving government-provided marijuana cigarettes and a great deal of paperwork is necessary to get permission to receive them.

 

·  Calcium channel blockers

Calcium channel blockers, like nifedipine and verapamil, have been reported to increase blood flow to the eye and to stabilise the visual field. Thus, instead of lowering IOP (although they appear to do this also), calcium channel blockers increase the resistance of the eye to glaucomatous damage.

There are different types of calcium channel blockers. Some primarily affect the strength with which the heart contracts, while others affect peripheral blood vessels, making them dilate so that more blood can pass through. The calcium channel blockers used in the treatment of glaucoma ideally would be those which increase blood flow to the brain, since the eye and the brain share a common blood supply.

Calcium channel blockers can also lower blood pressure, and a low blood pressure predisposes to glaucomatous damage. Therefore, we do not use these drugs at the present time in patients who have low blood pressure, but only in those with normal or high blood pressure

 

·  Neuroprotectants

 

Memantine (taken orally as tablets) – appears to protect the nerve cells against glutamate, a messenger chemical released in excess amounts by cells damaged by certain neurological disorders.(1)

 

Resveratrol – a natural phytochemical found in grape skins, seeds, chocolate, peanuts, and berries.  A Duke Eye Centre-led study showed that resveratrol is associated with a significant lowering of inflammatory indicators, oxidative damage and age-related degenerative markers in trabecular meshwork cells. (2)

 

Turmeric/Curcumin – Turmeric is derived from the rhizomes (underground stems) of the plant Curcuma longa, a member of the ginger family. It is responsible for the yellow colour of Indian curry and American mustard. Curcumin, which has powerful antioxidant and anti-inflammatory properties, is the most active constituent of turmeric. Curcumin has shown possible beneficial effects in most of the mechanisms that are thought to be involved in the development and progression of glaucoma and which are the targets for pharmacological intervention including excitotoxic cell damage . (3)

 

1.   Arch Ophthalmol. 2006;124(2):217-225. doi:10.1001/archopht.124.2.217.

2.   Food ChemToxicol. 2009 Jan;47(1):198-204. doi: 10.1016/j.fct.2008.10.029. Epub 2008 Nov 6.

3.   Can J Ophthalmol. 2007 Jun;42(3):425-38

 

Pharm. Harrison Kofi Abutiate, FPCPharm, FCIMG, FPSGH is the managing director/CEO of Paracelsus Pharmacy & Marketing Company Ltd., and vice president of World Glaucoma Patients Association.

 

Nursing practice requires special calling – Okedo

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(By Temitope Obayendo)

 

Okedo

 

 

 

 

 

 

 

In this exclusive interview with Temitope Obayendo, the executive secretary of West African College of Nursing (WACN), Mrs. Henrietta Okedo, highlighted areas of advancement in nursing, and how nurses can cope with their daily schedules, without stress.

Excerpts:

Tell us a little about yourself

My name is Henrietta Okedo, a nurse and Fellow of the West African College of Nursing. I am happily married with children. I am from Nnewi in Nnewi North L.G.A. of Anambra State, Nigeria, and the immediate past director of nursing in Anambra State Ministry of Health.

 

How did you feel when appointed the new secretary of WACN?

Of course, I felt honoured and fulfilled. I also viewed it as a challenge and a call to duty to serve WACN in this capacity – moreso now that the college is going through a transition period.

 

What is your assessment of nursing practice in Nigeria?

Nursing practice in Nigeria cannot be said to have attained our dream height but it has evolved from a very humble beginning, over the years, to where it is today.It is still striving for perfection, despite the hostile environment.

 

What are your areas of concern for improvement in the profession?

A profession is recognised for its body of knowledge but with the dynamic nature of the society, new issues keep coming up.  However, in my opinion, the most crucial areas of improvement in the profession include: professional competence and evidence-based practice; client–centred care; interpersonal, intra-professional and inter-professional relationships; and technologically dynamic nursing practice.

On the part of employers of nurses, there should be adequate remuneration of the nursing workforce, to ensure commitment, dedication, service efficiency and quality assurance.

 

As the new secretary of WACN, is there a need for a curriculum change in the institution?

There is a standard curriculum in place in the college, which we are trying to implement. A change in the existing one will only come when it has been established that there is need for a change, which will definitely be done.

 

In what ways can Fellows and other nurses improve on their attitude?

Attitude is a complex state, involving beliefs, feelings, values and dispositions to act in certain ways. Nurses typically work long shifts that require utmost attention and dedication. This is often a tiresome and draining profession; it takes an individual with a special calling to be a nurse. But the satisfaction in nursing comes from the knowledge that one has made a positive impact in another person’s life.

Nursing strategies and outlooks have affected and will continue to affect patients’wellbeing. Therefore it is wise for a nurse to be conscientious in his or her outlook and behaviour in the workplace.

 

Ignite holds summit on coffee and health

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(By Yusuff Moshood)

Ignite, a Pan-African educational programme coordinated by medical consultants and researchers with interests in the nutritional and health benefits of coffee, recently held a stakeholders’ parley on the latest clinical findings of the health benefits of coffee.

The event, themed: “Coffee and Health: Current Scientific Findings” and held at De Renaissance Hotel, Alausa, Ikeja, Lagos, was attended by Ignite Scientific Committee members and other top health practitioners.

A member of the Ignite scientific committee, Dr. Bartholomew I. C. Brai, a research fellow from the Nigerian Institute of Medical Research (NIMR), while speaking on the topic, “Coffee: A Beverage Full of Goodness”, said coffee is the most pleasurable hot beverage in the world and the second most drunk beverage, after water.

He noted that coffee is naturally rich in antioxidants, mainly polyphenols from the chlorogenic acid family, adding that the antioxidants represent about 25 per cent coffee solids in instant coffee.

Dr. Brai stated that research has shown that coffee enhances mental and physical performance, while also helping to lower the risk of colon cancer, type 2 diabetes, hepatic diseases, Alzheimer’s disease, Parkinson’s disease, inflammation and cavities.

In his presentation, another member of the Ignite Scientific Committee, Dr. Akinsanya Olusegun-Joseph, a consultant cardiologist from Lagos University Teaching Hospital (LUTH), said while coffee is the most pleasurable hot beverage in the world, it is also the most controversial beverage globally.

Dr. Akinsanya, who spoke on the topic, “Coffee and Health: Current Scientific Findings,”observed that earlier studies on coffee did not always take into account that known high-risk behaviours, such as smoking and physical inactivity, tended to be more common among heavy drinkers of coffee at that time, adding that recent articles, however, point to coffee as being cardioprotective.

The cardiologist noted that coffee has natural bioactive compounds with beneficial properties. These include: caffeine, fibre, antioxidants, micronutrients and polyphenols.

He stated further that a 2008 study of 459 Japanese women revealed a significant, independent, inverse correlation between coffee consumption and serum C-reactive protein (CRP) levels, adding that the antioxidant effect of coffee is becoming increasingly known.

Coffee compounds, he said also raise the levels of detoxifying enzymes that protect against DNA damage, which partly explains how coffee further helps lowers the incidence of related disease such as cancer.

He also disclosed that a 2009 prospective study in Japan, following nearly 77,000 individuals aged 40 to 79, found that coffee consumption was associated with a reduced risk of dying from cardiovascular disease.

He noted that, while drinking coffee has been found to actually raise blood pressure briefly, right after consumption, due to the effect of caffeine, scientific studies, however show that coffee’s compounds lower blood pressure over the long term, decreasing the risk of cardiovascular disease. This, he said, is believed to be a result of the beneficial action of chlorogenic acids on the arteries.

He however warned that excessive coffee intake, like any other substance, can be harmful, saying that there have been complaints of restlessness, agitation, awareness of heartbeat in some very high coffee consumers (those who drank more than five cups of coffee per day).

He equally added that some people are sensitive to caffeine’s stimulating effects, counselling such to take coffee with caution or discontinue further intake. Coffee, he said, is also not intended to replace other healthy lifestyle behaviours like exercise, smoking cessation, as well as reduction in salt and fatty meals intake.

In her own presentation, Dr. Kemi Odukoya, a public health physician and lecturer at the Department of Community Health and Primary Care, College of Medicine, University of Lagos, said that more recent research is showing evidence that coffee has many benefits to human health.  Dr. Odukayo, also a member of the Ignite Scientific Committee, who spoke on the topic, “Coffee and Health: An Update on Research Findings” said that while coffee was initially thought to cause arrhythmias and raised blood pressure, recent evidence suggests that coffee, whether caffeinated or not, does not appear to cause arrhythmias in normal subjects.

She disclosed that extensive epidemiological studies have confirmed that there is no link between coffee consumption and hypertension, hyperlipidaemia and coronary artery disease (CAD), adding that moderate amounts of coffee consumption may play an important role in maintaining good health.

 

 

 

 

 

Pharmacists cannot do without non-pharmacist investors – Sir Obi

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(By Yusuff Moshood)

 

Sir Obi

 

 

 

 

 

 

In this first edition of our CEO of the Month series, we present Pharm. (Sir) Nnamdi Obi, MD/CEO of Embassy Pharmaceutical and Chemicals Limited who spoke on the importance of positive collaboration between pharmacists and non-pharmacists in the development of the pharmaceutical industry.

 Sir Obi, who is also president of the Association of Pharmaceutical Importers of Nigeria (APIN), in this recent interview with Pharmanews in Lagos, particularly urged pharmacists to embrace non-pharmacist entrepreneurs who are willing to invest in and transform the pharmaceutical sector. He also discussed the new National Drug Distribution Guidelines and other contemporary issues affecting pharmacy practice in Nigeria.

 

Excerpts:

At the first 2014 bi-monthly meeting/motivational seminar of industrial pharmacists, you spoke on the importance of collaboration in the development of the pharma sector. What steps can stakeholders take to make the initiative work?

The fact is that we have all agreed that the way pharmacy is practised in this country is not the best.  Besides, it is very clear that pharmacists cannot do it alone.  We need to work in concert with non-pharmacist entrepreneurs who can invest in our sector to take the practice to an enviable height.  It will be a win-win situation for everybody, if this is done.

 

Pharmacists don’t have to treat non-pharmacists interested in the pharmaceutical sub-sector of the economy with disdain.  So, what I am saying is that we should work with non-pharmacists and open up the industry.

 

Nothing stops a non-pharmacist from investing in a chain of drug distribution.  In fact, right now, how many pharmaceutical manufacturing outfits are even owned by pharmacists in this country?  Just a few. What I am saying is that we already have non-pharmacists who have invested their money in pharmaceutical manufacturing business. We should encourage this collaboration with non-pharmacist investors and open up the sector.

Our colleagues should forget about having a one -man show and embrace collaboration.  We owe it to ourselves and our profession.  Also, the teaming population of students graduating from our universities every year have to work. And where are they going to work, if we don’t open up all the sectors of our economy and embrace collaboration with investors?

 

Government of countries in Europe and Asia are said to be using policies to promote businesses in their countries.  Can Nigeria follow this path? Are there policies the Nigerian government can formulate to help transform the pharmaceutical industry?

 

Certainly we can and, indeed, should have such policies.  We should have tax incentive. For instance, there is no reason why the Nigerian government cannot say that any pharmaceutical company that can manufacture antiretroviral drugs, antihypertensive drugs and antidiabetic drugs in Nigeria for the use of Nigerians, should not import the raw materials for the drugs duty-free.

Also, our financial institutions are not helping matters.  Investors in the institutions are all for quick fixes and short-term investments.  This cannot work, if we want to grow and develop our industries.  A friend of mine has just established a pharmaceutical outfit in India.  With less than 500 thousand naira of his own money, he established an industry that is worth over 20 million dollars.  Can that happen in this clime? No.  Our investors will be unwilling to fund such a project.  There must be a conscious effort by all to grow our industries.

So, for the health sector, as a whole, to work, all stakeholders must contribute their bit, work together with other interested parties and do what is right always.

 

A major issue in the pharmaceutical sector right now is the National Drug Distribution Guidelines recently announced by the health ministry.  What are your thoughts on this initiative? Is it a step in the right direction?

 

Yes, it is a step in the right direction.  However, I also think the modalities for its implementation must be tinkered with because we have to take cognisance of our own peculiarities in this environment.  I don’t want to dwell much on it because I know the stakeholders are meeting and we shall discuss and fine-tune the grey areas.

 

Your company, Embassy, recently bagged a NAFDAC award as the most compliant to the agency’s regulatory requirements in the pharmaceutical sector. Tell us about this award and its significance to Nigerians.

It is a statement of fact by NAFDAC that we are working in strict compliance to the requirement of the law.  Nigerians are better off for it because they are getting genuine drugs from Embassy.  If we are bringing fake products into this country, we couldn’t have received such recognition from NAFDAC.  So, Nigerians are benefiting because we are bringing in quality pharmaceutical products at affordable rates.

I think the credit should go to our partners who supply the products and the Embassy team working with me, not to me alone, as an individual.

 

What usually informs the choice of products your company brings to the Nigerian market?

I am conscious of the fact that this is a clime where there are so many products needed that are not available and affordable.  So, it is not only commercial interest that drives the Embassy business.  It is not. I am a pharmacist and I consistently read to update myself on what is going on in the society and the environment where I am practising. We look at the needs of the environment and bring products to satisfy the needs of Nigerians who need these products. The principle is to always provide top quality products that Nigerians need at affordable prices.

Enjoying the benefits of CDDDP

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(By Yusuff Moshood)

In 2011, the University of Ibadan won a grant from the MacArthur Foundation’s Africa Higher Education Initiative and used it to establish a Centre for Drug Discovery Development and Production (CDDDP) in the Faculty of Pharmacy.

According to the Dean of the faculty, Professor Chinedum O. Babalola, the CDDDP was established to help improve the quality and availability of essential medicines in West Africa.

Professor Babalola, while speaking at a one-day workshop organised by the CDDDP in conjunction with BASF(a chemical company based in Europe) on 6 June, 2013, with the theme, “From Powder to Tablets”, said that there was need to build the capability and capacity to discover, develop, produce and adequately regulate medicines targeted to the needs of Africans.

The vision of CDDDP, she explained, was to have a centre of excellence in West Africa that would serve as a platform for world-class training in drug discovery, development and production, by building Africa’s capacity to make her own drugs in Africa, by Africans for Africa and the world.

To achieve its vision, the CDDDP, she said, would develop a curriculum and run postgraduate programmes in Drug Development, Industrial and Medicine Regulation; offer short courses in Good Manufacturing Practices for target groups; strengthen existing facilities for research and development (R&D) in drug discovery and production; develop pharmaceutical products from research findings; and establish a cGMP facility pre-qualifiable by WHO for pilot manufacturing and quality assurance of medicines circulating in the sub-region for service provision and bridging the gap between academia and industry.

Aside the aforementioned workshop held in Lagos, the CDDDP also organised a three-day international conference on “Medicine Regulation of Claims: From Concept to Launch” in collaboration with Reckitt Benckiser, UK.  The conference held at the University of Ibadan from 2 to 4 October, 2013 with over 150 participants, which included virtually all the stakeholders in the drug industry (regulators, industrial pharmacists, academia and consumers).

The CDDDP has also signed Memoranda of Understanding (MoU) with several institutions and agencies, among which are: National Agency for Food and Drug Administration and Control (NAFDAC), National Institute for Pharmaceutical Research and Development (NIPRD) Abuja, and the Kilimanjaro School of Pharmacy (KSP), Tanzania.

Highlights of services to be rendered by the CDDDP, according to Prof. Babalola, include: quality assurance of pharmaceuticals; food and cosmetics; anti-counterfeiting research, bioavailability/bioequivalence studies for registration of generics; evaluation of claims; clinical trials, contract manufacturing/API pilot manufacturing; formulation of herbal medicines; toxicity studies; and short-term courses in good pharmaceutical practices.

The CDDDP initiative is quite laudable and should be of tremendous help in building capacity for the provision of quality essential medicines for the teeming population of Nigeria and the sub-Sahara Africa region.

Pharmacy practice today is more chaotic – Pharm. Ezegbo

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In this interview with Adebayo Folorunsho-Francis, Chief (Sir) Rex Albert Obi Ezegbo, KSC, FPSN, managing director of Rex Chemists, Onitsha, takes a cursory look at the evolution of pharmacy practice from what it used to be during his day as a young pharmacist to the present time. Excerpts:

Pharm. Ezegbo

Tell us about your background

I attended CMS Central School, AkpakaogweOgidi, for my primary education and finished in 1949. Later, I gained admission into the prestigious Dennis Memorial Grammar School (DMGS), Onitsha (1950-1954))and passed the Senior Cambridge School Certificate Exam in Grade I in 1954.

 

How about your tertiary education?

I  gained  admission into (the then) Nigerian College of Arts Science and Technology, lbadan to do Advanced Level Physics, Chemistry and Zoology for two years, and Pharmacy for three years. I did the programmes on full federal government scholarship (covering board, tuition, books, pocket money and transport). I passed the London GCE Advanced Level and Cambridge Higher School Certificates Exams in 1957 in Physics Chemistry and Zoology, respectively.

 

When did you become a full-fledged pharmacist?

That was in 1960 when I graduated after I finished studying my Pharmacy course for three years.

 

Were you involved in any form of extra-curricular activities in the course of your study?

Not exactly. But way back in the college, I was one of the student leaders. Also, I was a distinguished sportsman in high jump and 220 yards both at Dennis Memorial Grammar School and Nigerian College of Arts Science and Technology. In fact, at a point I was honoured with the school colour in athletics (1954).

 

In retrospect, can you confidently say studying Pharmacy was a good decision for you?

Looking back, I cannot fully say I have regrets whatsoever to have studied Pharmacy. This is because I am one of the most successful pharmacists in Nigeria today and I enjoyed the practice of pharmacy throughout my active years.

 

Tell us about your work experience after your graduation

My journey as a pharmacist after graduation in 1960 was quite eventful. I recall joining Glaxo Pharmaceutical Company (Nig.) Limited. In fact, I was the first Nigerian medical representative with Glaxo in Nigeria as at 1961. Later, I was promoted as eastern regional manager of Glaxo in 1970. I continued in that capacity until 1976, when I founded my own company – Rex Chemists Limited. Meanwhile, in the midst of these, I had the privilege to attend courses in England on management, sales, field/sales control and training in 1973.

 

How do you see today’s practice compared to your day?

What more can I say? There is no way you will compare the two without seeing differences. Pharmacy practice today appears more chaotic than in the past. In the past, only pharmacists imported drugs and those in retail practice enjoyed fully their 331/3per cent professional margin and so on. Those working as medical representatives worked with samples of drugs and promotional gifts. But today, all those are history.

 

Tell us more about controversies, scandals and other disturbing issues plaguing the practice that tend to evoke memories of the past.

Controversies have always pervaded the practice from time. We have had controversy from conflicts with patent medicine dealers, with doctors, and sometimes silent illicit acquiescence of officials of the Ministry of Health.

 

Tell us about some challenges facing Pharmacy practice in Nigeria and how they can be surmounted

The challenges facing the practice of pharmacy today are indeed numerous. They include selling of drugs in the open market and along the streets. Another is the importation of drugs by non-pharmacists and drug merchants indiscriminately and proliferation of patent medicine shops.

 

How do we curb the problems?

To curb the trend, the only solution is that the federal government should summon the courage and determination to close all open markets for drugs and clear out all patent medicine sheds in the market because those are areas where unwholesome activities go on. Let them be resettled along the roads like pharmacists where their address can be traced and their shops can be inspected.

 

How about fake drugs?

That is not our problem alone; fake drugs now exist all over the world. However in Nigeria,I believe it can be curbed by the measures suggested earlier. That is, closure of markets and patent medicine shops where they are hidden and are hardly inspected. Secondly, involving the countries of origin to inspect and certify products before shipment to Nigeria. The country of origin will have to set up a machinery at a fee to Nigeria, but will be held responsible if the drug is found wanting.

 

Over the years, you must have seen many PSN Presidents come and go. Was there one who really left a lasting impression on you?

Indeed I have seen many PSN presidents come and go. To be candid, none has made any lasting impression on me.

 

Are you serious?

Yes. Perhaps Pharm. OlumideAkintayomightbe an exception. He has not been on the seat for too long and I have not met him face-to-face, but he gives me the impression that he is a go-getter and a lion for work. Why I say he is a lion for work is because of his ability to galvanise other arms of health workers – nurses, laboratory scientists, radiographers, etc. to present a formidable force to the government.

 

How active were you in pharmaceutical activities?

I was involved in several pharmaceutical activities in the past. For the record, I was once a First Deputy President of PSN (National). At the community level, I was also a national chairman of NAGPP (now ACPN). Other posts I held were PSN chairman (New Anambra State); chairman, Committee on Fake Drugs (old PSN, Anambra State Branch) and chairman, Committee on Review of Rules and Regulations (old Anambra State).

 

Are there some major awards given to you in recognition of your selfless service?

Quite a handful, I must admit. They include: Fellow of the Pharmaceutical Society of Nigeria (FPSN, 1991); Knight of St. Christopher in Anglican Communion(KSC) in 1992; Fellow of the Nigerian Institute of Sales management (FNISM) in 1996; and Honourary Life Vice-President of Onitsha Chambers of Commerce, Industries, Mines and Agriculture            (2001).

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

If I had failed to be a pharmacist which was my first choice, perhaps I would have striven to be a medical doctor or a mechanical engineer.

Is there any particular age when an active pharmacist should retire?

A pharmacist who wishes to start his own business should retire from whatever job of another person or organisation he is doing at the age of about 45 years when he is still left with reasonable energy. There is however no particular age when an active pharmacist should retire. His retirement age will be determined by the state of his health.

 

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

My candid advice to young pharmacists is to work very hard and be honest in whatever organisation they find themselves. Infact, they should work as if that job is theirs. By so doing, they will develop the culture of hard work and industry. If and when they decide to start their own businesses,they are bound to maintain the same tempo of industry.

Lessons local pharma companies can learn from foreign ones, by Novartis Vice President

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In this engaging interview with Adebayo Folorunsho-Francis, Dr Linus Igwemezie, the executive vice president and head of the Novartis Malaria Initiative, spoke on several pressing issues regarding the Nigerian pharmaceutical industry, including vital lessons local companies can learn from foreign ones. He also highlighted the challenges some companies face with the implementation of the Mobile Authentication Service (MAS) technology, as well as the reasons Novartis introduced an academy to train Nigerian pharmacists in the private sector.

 

EXCERPTS:

Tell us  about your background

       As a young Nigerian, I spent the better part of my primary and secondary education here in the country. I also did my B.Pharm. degree at the University of Ife (Now Faculty of Pharmacy, Obafemi Awolowo University). I then left for North America for my graduate studies and obtained both a Master’s and a Ph.D. in Pharmaceutical Sciences from the University of British Columbia, Vancouver, Canada. I also added an MBA from the Wharton Business School, University of  Pennsylvania, Philadelphia, USA.

 

Were there some local companies you worked with before opting for Novartis Pharma?

I started working for mega pharmaceutical companies like Merckin Montreal, Canada; then Bristol-Myers Squibb (BMS), New Jersey,USA,and Novartis Pharma, New Jersey, USA. I have had the good fortune of working on some of the most innovative new drugs that have been introduced in the last two decades. For example, I worked on HIV/AIDs programmes while I was at BMS and both Videx and Zerit came out of those programmes. At Novartis, we introduced several anti-cancer drugs, including Glivec, Zometa, Femara, Tasigna, Jakavi and Afinitor.These drugs are helping to improve outcomes, transforming  the lives of patients living with cancer around the world.

In January 2012, I was appointed Executive Vice President and Head of the Novartis Malaria Initiative.

 

What is it like for a Nigerian to be a vice president of global brands at Novartis?

Novartis is a very diverse company. You have to be at the top of your game and be able to deliver on your objectives; but the company is committed to investing in its people. The key for me is that, since I have a lot of training and experience, I am able to do the parts that are assigned to me, and more. The better you work, the more you are given.

Also, I have been lucky to work with a wonderful team of people over the years and to have mentors who have positively influenced my career.

 

What factors did you consider before joining Novartis?

When I completed my MBA in 2000, I was looking for an entrepreneurial environment. I actually considered going to work for a medium-sized biotech company where I could make a big impact, but Novartis was building the oncology business unit at the same time. The design was a small company that would operate like a biotech but with the backing of the big company. They told me they had what I was looking for and asked if I could join them.

I decided to join Novartis Oncology in 2001 and it has turned out great for me. What I have learnt in Novartis is how to develop drugs – what key information is needed, what structures and teams, the strategy and decision-making process in a very complex environment. These are invaluable experiences if you are going to be a leader in the pharma industry.

 

What is your assessment of the pharmaceutical industry in the Western world compared to the Nigerian situation?

Clearly, in the West, things are well organised. You know, they have been doing this for so many years, much longer than us. There are a number of issues I see in Nigeria. First, there is excessive fragmentation in the drug distribution system – too many players involved, some of whom are not qualified.  This clearly lends itself to infiltration of the system with substandard drugs, as well as counterfeits.  Second, in the Western countries, the drug regulations are better developed and there is strong regulatory enforcement. Third, in Nigeria,there is limited availability of human talent, technology, infrastructure (e.g. power) necessary to do the complex work of pharmaceutical R&D and manufacturing.  Finally, there is more restricted access to investment capital compared to Western countries.

 

How best do you think we can resolve these issues?

I think we can strengthen the regulatory oversight, including strong enforcement.  We need to continue to improve pharmaceutical and scientific education to ensure availability of necessary human talent.  We must invest in pharmaceutical R&D through the entire value chain – preclinical research, clinical research, product development and manufacturing.

I would suggest that local companies should pay attention to innovation and value-added activities. There is no point coming into the market as the thirtieth producer of Panadol; you will not be widely successful.

 

What measures is Novartis taking to ensure Coartem is not faked or cloned?

Novartis takes the issue of counterfeits and fake drugs seriously and we have a broad strategy in place to address this. We work closely with governments, donors, funders and law enforcement agencies to investigate any report of counterfeits or fake drugs.  We also have a product security team that carry out continuous surveillance so that any kind of report we get, we analyse it and pass on the information to the law enforcement agents. We use technology available to us, and we also educate our customers to ensure that they obtain Coartem through our designated supply chain.

We continue to be vigilant, constantly searching for new approaches and looking at all of the options available to us, so it is not just one solution but a number of activities that are designed to deter counterfeiters from faking Coartem.

 

The Mobile Authentication Service (MAS) has been suggested as an ideal anti-counterfeiting measure for drug manufacturers in Nigeria. Unfortunately, not many pharmaceutical companies are keen to embrace the technology. What is your take on this?

Well, we have agreed to use the MAS in Nigeria to meet the local regulatory requirements. But implementing this is not as easy as it sounds; there are many complexities to think about. For one, it is new and a lot of companies are not used to having an additional label on their packaging with information being controlled by somebody outside the company. This is the first time we are going to have such a thing on one of our brands.

There is also the concern that the MAS directive will not be enforced.Manycompanies worry about making the investment needed for the implementation of MAS, but if it is ultimately not imposed, it puts the company at a competitive disadvantage.

Also the added cost of including MAS in the packaging may be passed on to the consumer which would increase the price of drugs. Another reason is related to the issue of added complexity for the manufacturing plant.When you add the MAS for Nigerian products only, the plant would see this as a different packaging, thereby stopping the regular production and loading the Nigerian specific packaging, which slows things down.

 

In the face of stiff competition from other multinational companies, how does a company like Novartis manage to stay afloat?

Novartis’ success is driven by a number of factors.  As a company, we differentiate ourselves from our competitors through a strong focus on innovation. In 2012, we invested 21 per cent of pharmaceuticals net sales in R&D. We also have six divisions that offer a wide array of products, including novel pharmaceuticals, high quality generic products, vaccines, over-the-counter, animal health, and eye care products.  These divisions are leaders in their categories.For example, our generics division, Sandoz, is the second largest producer of generic drugs worldwide. In fact, Sandoz is well positioned to provide high quality, affordable generic drugs to the Nigerian market.

If you put all of these together, you are really building a brand that is known for innovation, quality and a diverse portfolio. These are some of the ingredients for success. It is more likely that Novartis will bring the next brilliant malaria drug into the market. That is what I am working on.

 

What lessons can local pharmaceutical companies learn from global brands like Novartis?

Again, I need to say this. The local guys (manufacturers) need to understand that to be successful, you cannot continue to be a local player. You have to be able to play at a quality standard that is international. Look at the Indian manufacturers.They are now major suppliers of generic products to Western countries. You have to be able to do some R&D and make investment in your people so you have the necessary talent pool.

 

We heard Novartis has launched its first academy for pharmacists in the private sector in Nigeria. What’s the essence of this?

The pharmacy academy is a value-added service for pharmacists who sell our antimalarial drug, Coartem, to strengthen their knowledge in the areas of prevention, diagnosis and testing, and treatment of malaria.  It is a pilot programme geared towards capacity building. Again, we believe that just selling drugs is not enough. You ought to teach people how to use itso that you can maximise the value.

 

Is it a programme you hope to sustain?

We piloted it to see whether people want it and the result was just overwhelming – extremely positive! So we will maintain and even expand it. You asked me earlier how Novartis succeeds;one of the ways is through innovative, value adding programmes such as this.

 

Drugfield working to improve Nigerians’ health – Pharm. Odediran

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(By Yusuff Moshood)

Pharm Odediran

Drugfield Pharmaceuticals is committed to providing products that will help improve the health of Nigerians, Pharm. Michael Odediran has said.

Odediran, who is the general manager (sales and marketing) for Drugfield, while speaking in an exclusive interview with Pharmanews in his office in Sango Ota, recently, noted that it is the desire to fulfil this sacred commitment that propels the company to constantly introduce new and beneficial products into the Nigerian pharmaceutical market.

According to him, it was the same motivation that prompted the company to introduce its own intravenous fluid products (infusion products) into the market last year, adding thatthe company also introduced Coflax with codeine,a cough syrup with codeine; Drupidox, a brand of sulfadoxine/pyrimethamine antimalarial, as well as Tramadol, a controlled analgesic.

Odediran stated further that, in keeping with the company’s vision, Drugfield would introduce other equally beneficial products into the market in 2014.Some of the scheduled products include:Betadone-N eye ointment, which is an addition to the Betadone-N eye/ear drops; and Chlorxy-G gel which will be a special product for neonates healthcare.

Drugfield, he added, also intends to increase its range of antihypertensives to further help Nigerians living with hypertension.

Odediran expressed his appreciation for the support of Drugfield customers and partner institutions in 2013, adding that the company was counting on their continued support and cooperation for better performance in 2014.

On the challenge of drug counterfeiting in Nigeria, Pharm. Odediran noted that the company relentlessly battled the perpetrators last year, adding that aside improving collaboration with other companies and institutions to fight drug fakers, Drugfield had also established a unit mandated to keep tracks of its products in the market to protect them from drug fakers.

 

UI Pharmacognosy Lecturer, wins women global award

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(By Temitope Obayendo)

Dr. Taiwo Olayemi-Elufioye, a lecturer and scientist from the department of Pharmacognosy, University of Ibadan, has won the 2014 Elsevier Foundation Awards for Early Career Women Scientist Award in Developing Countries.

Elufioye, being the only African among the five awardees, received the award for her research works on the treatment properties of native Nigerian plants, with particular bias on the effectiveness of different species in treating malaria, wounds, memory loss, leprosy and cancer.

The prizes were awarded by The Elsevier Foundation, the Organization for Women in Science for the Developing World (OWSD) and The World Academy of Sciences for the advancement of science in developing countries (TWAS), with the aim of building scientific strength and advancing scientific knowledge in developing countries. The winners received $5000 and all-expenses paid attendance at the American Association for the Advancement of Science (AAAS) Annual Meeting in Chicago, United States, where the ceremony was held.

The award winning researchers, representing five regions of the developing world, were from Indonesia, Jamaica, Nigeria, Uzbekistan and Yemen.

Reacting to the award, the Vice Chancellor, University of Ibadan, Prof. Isaac Adewole, described Dr Olayemi Elufioye as a pride of Nigeria and the African continent as a whole.

According to him, the feat recorded by the woman scientist would inspire other women in science.

He stated that the University of Ibadan would continue to provide the needed environment for her researchers to be able to compete and come out tops in global community of scholars.

Curbing incessant strikes in the health sector

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 Health workers under the umbrella of the Joint Health Sector Union (JOHESU), embarked on a three-day warning strike from Wednesday, 22 January to Friday, 24 January, 2014.  The action was in protest against the non-implementation of collective bargain agreement and Memorandum of Understanding (MoU) and the judgment of National Industrial Court of Nigeria by the Federal Government.

The health workers also condemned the planned appointment of Surgeon-General of the Federation being championed by members of the Nigerian Medical Association (NMA).

The spokesperson for JOHESU and president, Association of Medical Laboratory Scientists of Nigeria, Dr. Godswill Okara, during a press briefing held in Abuja, accused the federal government of insincerity and breach of agreement.

The three-day strike action of JOHESU paralysed activities in hospitals across the nation and brought untold hardship to patients and their loved ones. Many families are still counting their losses from the strike.

Incidentally, JOHESU’s work stoppage came shortly after the NMA had called off its planned indefinite strike action that was to commence on 6 January to press home its own demands. It would be recalled that members of the NMA had embarked on a five-day warning strike late last year (18 to 22 December) which equally brought suffering to millions of Nigerians.

It is high time all stakeholders in the health sector devised a lasting solution to the numerous contentious issues leading to incessant strikes in the sector.

If there is a sector that should not be engaging in strike actions, it is the health sector.  The difference, most times, between life and death in precarious emergency situations is the prompt intervention of health care professionals. Besides, most patients on admission require constant tending from health workers sometimes to stay alive and also to prevent further complications of their health conditions.

For such cadre of health professionals to abandon work is unacceptable.

It must be emphasised, however, that the government has a big role to play in this regard. Over the years, the Nigerian government has, by its actions and inactions, made strike the only effective recourse for workers in virtually all the sectors of the nation.  It is painful and worrisome that the government hardly acts in time to nip problems that could lead to strikes in the bud; it only tends to show interest in negotiating with aggrieved unions after they have downed tools.

Government must be more proactive in managing crisis especially when it affects the health sector. It must develop a new culture of promptly looking at the legitimate demands of health workers and acting on such demands quickly and fairly.

It is also our view that a major cause of the lingering unrest in the health sector, aside poor funding, is inter-professional wrangling. Thus, any effort aimed at taking the health sector out of its present doldrums must also focus on how to promote team spirit among the various practitioners.  The sector can only perform at its best in offering quality care to Nigerians when rivalry and unbridled competition is banished, and all the stakeholders work in harmony.

Most importantly, both the government and the health workers should know that when they allow disagreements to degenerate into strike actions, the Nigerian people are usually the victims.  Many people have died while some have been maimed for life as a result of incessant strike actions by health workers.

It is high time we put a stop to the disturbing trend. Health workers’ strike is an ill-wind that blows nobody any good. It is tantamount to an internecine war: there can never be a winner.

A closer look at the new national drug distribution guidelines

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(By Dr. Lolu Ojo, FPSN)                                      

        The second edition of the National Drug Distribution Guidelines was published by the Federal Ministry of Health in 2012. The implementation of the guidelines is expected to take off in July, 2014 since all structures are expected to be in place on or before 30 June, 2014. Overall, the guidelines seek “to establish a well-ordered drug distribution system for Nigeria”.  This noble goal is a desirable end-point for which all pharmacists, young and old, have been clamouring.

The clamour is not without basis as the current system of drug distribution in Nigeria is anything but dignifying for the profession of Pharmacy. Drugs are peddled by all sorts of characters: sane, insane, learned, ignorant, etc. It is a rat race, the consequences of which are weighty and destructive for the health care delivery system in the nation, as well as its economy.

The most notable fallout of the chaotic and unorganised distribution system is the unrestricted circulation of fake, substandard and adulterated pharmaceutical products. Like most other issues, we do not have statistics that will adequately describe the extent of faking or the proportion of fake products in circulation. We have had figures from different sources that state that 70 per cent, 50 per cent or 15 per cent of total drugs circulating in Nigeria are fake. Our concern will not be the veracity or otherwise of these figures but the fact that we have a problem and it is our joint responsibility to solve it. The fake drug incidence or prevalence should be zero!

Responsibilities 

In summary, the guidelines have erected pillars and clearly delineated channels of distribution with roles and responsibilities:

  1. The manufacturers and the importers are at the apex of the ladder and their role is to make the drugs available and sell ONLY to Mega Drug Distribution Centres (MDDC), State Drug Distribution Centres (SDDC) and National Health Programmes.
  2. The next layer is occupied by the MDDC and the SDDC. While the MDDC is private sector-driven, the SDDC is for the public sector at the state level. The SDDC will cater for all public health facilities in the state and is also allowed to sell to National Health Programmes (where indicated) and wholesalers. The MDDC is allowed to sell to wholesalers ONLY.
  3. The wholesalers occupy a pivotal role in the value chain. Purchases can be from MDDC or SDDC but NOT from the manufacturers or importers. The wholesaler is allowed to sell to community pharmacies, public/primary healthcare facilities and private health institutions. With this function clearly spelt out, there is really no need for a wholesaler to engage in retailing as it is now.
  4. At the bottom of the distribution ladder, we have community pharmacists and public/private health institutions who sell directly to the consumers. The community pharmacy is also allowed to sell to private health institutions.
  5. There other provisions which affect pharmacists directly:
    1. All drug retailing institutions, including private hospitals, local government clinics (a pharmacist is allowed to supervise four clinics) must be registered by the PCN. With this, more employment opportunities will open for pharmacists.
    2. Only pharmacists can register and operate a retail pharmacy. This is a clear departure from the current system.
    3. To be a superintendent pharmacist, you must have, at least, five years post qualification experience for retail and ten years for wholesale.
    4. The position and importance of pharmacists are well spelt-out in the structure and operation of the MDDC and the SDDC.
    5. The guidelines will be operated based on the existing PCN and NAFDAC laws.

It is important for everyone to have a copy of the guidelines and study it properly. Pharmacists must, working together, ensure that these guidelines are faithfully implemented.

Reservations

The PSN President, Pharm Olumide Akintayo FPSN, set up a committee headed by me early in March, 2013. The committee, made up of eminent and accomplished pharmacists, was to, among other things, fashion out what would be the appropriate response of Pharmacy House to the new guidelines. We have, since then, been working to get things moving.

From this vantage position, I have observed so many things:

  1. The level of awareness among pharmacists is, unfortunately, still very low, considering that this document has been in circulation for more than one year.
  2. People have some reservations on some of the provisions. The queries are:
    1. Why is the MDDC not restricted to pharmacist ownership?
    2. Some states already have a flawless drug supply system. Why do we want to rock the boat with this new system?
    3. What will happen to young pharmacists if the superintendent pharmacist’s position is reserved for experienced (5 years above) people?
    4. The PSN-promoted MDDC will suffer the same fate as CO-PHARM.  Why waste efforts on this venture??
    5. The drug market will still be operating. Why are we wasting time on these new guidelines?
    6. There are still many unresolved issues between the different cadres of pharmacists which may not augur well for the implementation of these guidelines.

 Recommendations

The committee, under my leadership, has made some recommendations to the President which have been accepted and endorsed at the last AGM of the PSN in Ilorin. One of the recommendations is the floating of a holding company which will belong to all of us and other investors, and will serve as Mega Drug Distribution Centre.

We have also made presentations at different fora on the need for pharmacists to know about and embrace the guidelines. We must all be involved. You must ask questions from your State PSN Chairman or the DPS on what is going on in your state. We must not be the ones to impede the progress of this new system. The document is already endorsed by the relevant authorities in government. Let us implement it as it is. There will be opportunities for amendment in future.

I am convinced that the implementation of these guidelines will move Pharmacy forward in Nigeria. It is our key to a more dignified practice. We can build on the momentum that will be generated in Pharmacy if drug distribution becomes well-organised.

Roles of the PCN

The PCN is the most important agency of government in the successful implementation of these guidelines. The value chain must be policed to ensure that there are no leakages and a parallel black market does not emerge. The existing drug markets must go, to allow for a smooth operation. The operators of the market can form their own MDDC. This should not be a problem to anybody. There is nowhere in the world where non-pharmacists do not play prominent roles in the business of Pharmacy. Our interest should remain that: the rules, as set up in the guidelines, must be followed.

The PCN registration must not be STATIC. PCN must feel the pulse of the organisations registered in order to curb the ‘register and go’ syndrome.  The chairman, registrar and other officials of the council must rise up to the challenge of creating a new Pharmacy. They must do more than what is expected of a government official. They must go the proverbial extra mile to deliver on commitments and expectations.

PCN will need our support in terms of resources to discharge her obligations under the guidelines. PSN must rise up to this challenge. No effort must be spared to get things moving. As pharmacists, we must be ready to make the necessary sacrifice when called upon to do so. I have created a question-and-answer package to throw more light on the implementation of the new guidelines particularly as it concerns the PSN-promoted MDDC. I urge the readers to go through carefully and make their contributions.

Dr. Lolu Ojo, FPSN, is the chairman/CEO, Merit Healthcare Limited and immediate past national chairman of AIPN.

 

NATIONAL DRUG DISTRIBUTION GUIDELINES

FREQUENTLY ASKED QUESTIONS

 

Q. WHAT ARE THE MAJOR OBJECTIVES OF THE NEW GUIDELINES?

 

A. i) To establish a well-ordered drug distribution system for Nigeria.

  • ii) To ensure efficient and effective drug supply management in the public and private sector
  • iii) To ensure availability of good quality, safe, efficacious and affordable drugs nationwide.

 

Q. WHAT ARE THE TARGET DATE(S) FOR IMPLEMENTATION?

A.  It is expected that by 30th June, 2014:

  1.                     i.            All state governments would have set up their STATE DRUG DISTRIBUTION CENTRES (SDDC)
  2.                   ii.            The private sector would have established the MEGA DRUG DISTRIBUTION CENTRES (MDDC) with operation in all the states of the federation or at least in six geo-political zones of the country.
  3.                 iii.            With the SDDC and MDDC in place, the guidelines become operational by 1st July, 2014.

 

Q. IS THERE AN ENABLING LAW TO GUARANTEE THE OPERATION OF THE GUIDELINES?

A. The guidelines are to be operated based on the existing PCN and NAFDAC laws. No new law specifically enacted for the guidelines is available for now. However, the guideline is a federal government document which has been endorsed by the relevant authority.

 

Q. WHY WILL A STATE GOVERNMENT ABANDON THE CURRENT DRUG DISTRIBUTION SYSTEM AND ADOPT THE NEW GUIDELINES?

 A. Drugs and all issues relating to drugs are in the exclusive legislative list. It is, therefore, the exclusive prerogative of the Federal Government to issue guidelines as appropriate. Besides, the state governments were carried along at the drafting stages.

Q.   WHAT ARE THE MAJOR DIFFERENCES THAT THE NEW GUIDELINES WILL BRING INTO THE DRUG DISTRIBUTION SYSTEM?

A.

  1.                       i.            The current distribution system is chaotic, lacks professionalism, breeds unethical practices, accommodates circulation of fake, substandard & adulterated drugs and is capable of undermining the total health care delivery system in the country.
  2.                     ii.            The new guidelines recognises specific and established channels of distribution:
    1. The Manufacturers and Importers at the top of the ladder. Their job is to manufacture or import the drugs as the case may be. They are to sell directly to three major outlets or channels:
      1.                                                                             i.      The Mega Drug Distribution Centres (MDDC),
      2.                                                                           ii.      The State Drug Distribution Centres (SDDC), and
      3.                                                                         iii.      The National Health Programmes.
      4. Next on the ladder and at the lateral level are the:
        1.                                                                             i.      MDDC: A private sector initiative which can sell to WHOLESALERS only.
        2.                                                                           ii.      SDDC: A public sector organisation which caters primarily for the state drug needs (public and primary health care) but can also sell to the wholesalers.
        3. Next on the ladder are the WHOLESALERS who are already existing and the new ones that will come up. They are allowed to sell to community pharmacists, private health institutions, PPMV holders and public health facilities.
        4. Community pharmacies, hospitals (public and private), PPMV holders are at the bottom of the ladder. They are the retailers who will sell to the consumers. The community pharmacy is also allowed to sell to private hospitals.
        5.                   iii.            There is a clear role sort and responsibilities along the value chain. There is a clear distinction between the role of a retailer and that of the wholesaler. The manufacturer and importer can no longer sell to directly to the hospitals, wholesalers and community pharmacies.

 

 

 Q. WHAT ARE THE IMPLICATIONS FOR PHARMACISTS IF AND WHEN THESE GUIDELINES BECOME OPERATIONAL?

  A.

  1.                       i.            The document is essentially a pro-Pharmacy document. Effective implementation will restore honour and dignity to the profession. The new system will promote professionalism.
  2.                     ii.            The key management and operational staff of both the MDDC and SDDC are, by the provision of the guidelines, pharmacists. Therefore, there will be gainful employment and empowerment for pharmacists.
  3.                   iii.            The guidelines clearly state that retail pharmacies are to be owned by pharmacists. There is no ambiguity in this provision.
  4.                    iv.            All retail channels for drugs including the private hospitals must be registered by the PCN. This certainly will give more control about drug affairs to the pharmacists.
  5.                      v.            A pharmacist is allowed to supervise drug use in up to four primary healthcare centres. Most states do not have pharmacists at this level right now.
  6.                    vi.            To work as a superintendent pharmacist, you must have at least:
    1. five-year post qualification experience for retail pharmacy.
    2. ten-year post qualification experience for wholesale pharmacy.
    3. ten-year post qualification experience for MDDC and also to be on the board of the distribution channel companies.

Q.  IS THE MDDC GOING TO OPERATE LIKE A CORPORATE DRUG MARKET AS WE HAVE IN ONITSHA, IDUMOTA, ETC, CURRENTLY?

A.

  1.           i.            NO. The MDDC is a limited liability company whose structure and operations are clearly spelt out in the guidelines. It is essentially drug distribution logistic organisation with mega warehouses, offices, distribution vans and personnel in all the states of the federation or, at least, nearly all. It is not a market!
  2.         ii.            Drug procurement by wholesalers will be streamlined by appropriate technology which will make physical travel for drug purchase unnecessary.

Q.  HOW MANY MDDC ARE WE GOING TO HAVE AND IS IT GOING TO BE FOR OR OWNED BY PHARMACISTS ONLY?

A.

  1.                        i.            The guidelines do not state that only pharmacists can set up MDDC. It is a private sector initiative and any investor, entrepreneur or venture capitalists, including the so called traders, can set up MDDC either as an individual or group.
  2.                      ii.            However, the guideline is very clear on the operation of the MDDC which must be run by pharmacists.
  3.                    iii.            There is no limit to the number of MDDC that can be set up. As many applications as are considered worthy of registration by PCN can become MDDC.

 

Q. WHAT WILL HAPPEN TO THE EXISTING OPEN DRUG MARKETS?

      A.  The open drug markets have no role to play in the new drug distribution guidelines. They will eventually fizzle out.

       Q.  WHAT IS THE GUARANTEE THAT THE PROVISIONS OF THESE GUIDELINES WILL BE ENFORCED GIVEN OUR CURRENT EXPERIENCE?

       A.

  1. The success of the new guidelines is a joint responsibility of all the stakeholders.
  2. We must all join hands to police the system. We must give maximum support to PCN and NAFDAC in the discharge of their statutory duties.
  3. The PSN and technical/interest groups must work in sync to ensure a seamless implementation of the guidelines.

Q. WHAT IS THE PSN DOING TO PROTECT THE INTEREST OF PHARMACY AND PHARMACISTS IN THE NEW DISPENSATION?

 A. PSN is doing a lot.

  1. A committee, under the leadership of Dr. Lolu Ojo FPSN, was set up to formulate the appropriate response of PSN to the new guidelines.
  2. The committee is working on:
    1. Generating more awareness about the guidelines among pharmacists through presentations, advocacy visits and other forms of communication.
    2. Liaising with state PSN chairmen and DPS on the setting up of SDDC in each state.
    3. Setting up of a MDDC which will belong to all Pharmacists.
    4. Doing everything possible to prevent a situation where the guidelines will be hijacked by a privileged few to the exclusion of the majority.

Q. HOW CAN I PARTICIPATE IN THE PSN-PROMOTED MDDC?                                                    

 A.

  1. Participation will be open to all pharmacists. Other interest groups will be called upon to invest as well.
  2. Minimum level of investment will be N100,000. Everyone will be encouraged to put in as much as he/she is capable of doing.
  3. A register of members of the company will be opened and will close within a specified period. Details will be communicated in due course.
  4. Our market research has shown that this is going to be a great business venture and everybody is encouraged to participate.

Q. WILL THE PSN-PROMOTED MDDC BE OPERATED LIKE THE CO-PHARM VENTURE?

A. NO. The PSN will not run the MDDC. The PSN is the promoter and will be a shareholder.

  1.         i.            The company will be run by a competent management team under the supervision of a Board of Directors whose membership will reflect the shareholding structure.
  2.       ii.            You can get a seat on the Board depending on your level of participation or shareholding.
  3.     iii.            The company will be run based on the world’s best business practices, ensuring there is a commensurate return to the investors.
  4.      iv.            It will also protect the interest of Pharmacy and the general public in the drug distribution system.
  5.        v.            A dedicated account has been opened for the purpose of the proposed MDDC
S/N ACCOUNT NAME BANK ACCÖUNT NUMBER
1 PHARMACEUTICAL SOCIETY OF NIGERIA (PSN) FCMB  2071515026

Q.  IS THERE A POSSIBILITY OF A PARALLEL DISTRIBUTION SYSTEM (BLACK MARKET) DEVELOPING WHEN THESE GUIDELINES TAKE OFF?

A. There are no specific guarantees that Nigerians and others will not try to circumvent the system. There is no absolutism in issues like this. However, we all must remain very vigilant and police the value chain effectively. We must work with PCN and NAFDAC to ensure compliance.

Q. HOW DO I GET A COPY OF THE GUIDELINES?

A. You can get a copy:

  1.           i.            Directly from the Food & Drug department of the Federal Ministry of Health. Mrs Joyce Ugwu is the project director.
  2.         ii.            From PCN offices nationwide and the Pharmacy Department of the State Ministry of Health.
  3.       iii.            From the PSN (national and state branches) and all the technical groups.
  4.       iv.            From the websites of any or all of the organisations mentioned above.

Dr. Lolu Ojo FPSN

Chairman, Drug Distribution Committee

Curbing cancer through early detection

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From all indications, the ravage of cancer has been on the increase in recent years. Hardly a day goes by without someone dying of a type of cancer. In Nigeria alone, it is reported that no fewer than 80,000 people die from various forms of cancer annually, with an estimated 10 people dying from it every hour.

Yet, judging by reports from other developed countries, the rate of cancer deaths doesn’t have to be so high – provided that strategies and facilities are put in place for early detection and management. These strategies will be considered here, but first, let’s have an understanding of the scourge.

Cancer is a class of diseases characterised by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumours (except in the case of leukaemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumours can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function.

Tumours that stay in one spot and demonstrate limited growth are generally considered to be benign. More dangerous or malignant tumours form when two things occur:

  • A cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
  • That cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasised. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.

Why cancer spreads

Scientists reported in Nature Communications (October 2012 issue) that they have discovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumour site, they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumours, those that grow from cells that have travelled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumours.

The scientists, from the Massachusetts Institute of Technology, say that finding a way to stop cancer cells from sticking to new sites could interfere with metastatic disease, and halt the growth of secondary tumours.

 

Malignant cells are more agile than non-malignant ones

Scientists from the Physical Sciences-Oncology Centres, USA, reported in the Scientific Reports (April 2013 issue) that malignant cells are much “nimbler” than non-malignant ones. Malignant cells can pass more easily through smaller gaps, as well as applying a much greater force on their environment compared to other cells.

Professor Robert Austin and team created a new catalogue of the physical and chemical features of cancerous cells with over 100 scientists from 20 different centres across the United States. The authors believe their catalogue will help oncologists detect cancerous cells in patients early on, thus preventing the spread of the disease to other parts of the body.

Prof. Austin said “By bringing together different types of experimental expertise to systematically compare metastatic and non-metastatic cells, we have advanced our knowledge of how metastasis occurs.”

What causes cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.

Genes – the family type

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.

Other medical factors 

As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) – and anything else that suppresses or weakens the immune system – inhibits the body’s ability to fight infections and increases the chance of developing cancer.

What are the symptoms of cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumour is. Some cancers can be felt or seen through the skin – a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.

Other cancers have symptoms that are less physically apparent. Some brain tumours tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumour grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhoea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.

As cancer cells use the body’s energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anaemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.

When cancer spreads, or metastasises, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

 

 

 

Classification of cancer

Cancers are categorised into five broad groups.

Carcinomas are characterised by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.

Sarcomas are characterised by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.

Lymphomas are cancers that begin in the lymph nodes and immune system tissues.

Leukaemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.

Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

Another classification is according to the affected organ as listed below:

Types of cancer

  • Bladder Cancer
  • Brain Cancer
  • Breast Cancer
  • Cervical Cancer
  • Colorectal Cancer
  • Lung Cancer
  • Melanoma
  • Non-Hodgkin’s Lymphoma
  • Ovarian Cancer
  • Pancreatic Cancer
  • Prostate Cancer

 

Diagnosis of cancer

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumour is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Cancer testing

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyse your body’s sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumour, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumour that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumours are curable, most Stage 4 tumours are inoperable or untreatable.

Cancer treatment

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

 

 

Surgery

Surgery is the oldest known treatment for cancer. If a cancer has not metastasised, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.

Innovations continue to be developed to aid the surgical process, such as the iKnife that “sniffs” out cancer. Currently, when a tumour is removed surgeons also take out a “margin” of healthy tissue to make sure no malignant cells are left behind. This usually means keeping the patients under general anaesthetic for an extra 30 minutes while tissue samples are tested in the lab for “clear margins”. If there are no clear margins, the surgeon has to go back in and remove more tissue (if possible). Scientists from Imperial College London say the Knife may remove the need for sending samples to the lab.

Radiation/radiotherapy treatment

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilises high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumour or destroy cancer cells (including those associated with leukaemia and lymphoma), and it is also used in combination with other cancer treatments.

Chemotherapy

Chemotherapy utilises chemicals that interfere with the cell division process – damaging proteins or DNA – so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasised because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukaemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

Immunotherapy

Immunotherapy aims to get the body’s immune system to fight the tumour. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumour to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumours. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoietic stem cell transplantation) can also be considered immunotherapy because the donor’s immune cells will often attack the tumour or cancer cells that are present in the host.

Hormone therapy

Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing oestrogen levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukaemia and lymphoma cases can be treated with the hormone cortisone.

Gene therapy

The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.

Using cancer-specific immune system cells to treat cancer

Scientists from the RIKEN Research Centre for Allergy and Immunology in Yokohama, Japan, explained in the journal Cell Stem Cell (January 2013 issue) how they managed to make cancer-specific immune system cells from iPSCs (induced pluripotent stem cells) to destroy cancer cells.

The authors added that their study has shown that it is possible to clone versions of the patients’ own cells to enhance their immune system so that cancer cells could be destroyed naturally.

Hiroshi Kawamoto and team created cancer-specific killer T-lymphocytes from iPSCs. They started off with mature T-lymphocytes which were specific for a type of skin cancer and reprogrammed them into iPSCs with the help of “Yamanaka factors”. The iPSCs eventually turned into fully active, cancer-specific T-lymphocytes – in other words, cells that target and destroy cancer cells

Prevention of cancers

Cancers that are closely linked to certain behaviours are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer – most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.

Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus’s relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumours as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

Targeting cancers for new drug therapies

Researchers at The Institute of Cancer Research reported in Nature Reviews Drug Discovery (January 2013) that they have found a new way of rapidly prioritising the best druggable targets online. They managed to identify 46 previously overlooked targets.

The researchers used the canSAR database together with a tool and were able to compare up to 500 drug targets in a matter of minutes. With this method, it is possible to analyse huge volumes of data to discover new drug targets, which can lead to the development of effective cancer medications.

The scientists analysed 479 cancer genes to determine which ones were potential targets for medications. Their approach was effective – they found 46 new potentially “druggable” cancer proteins.

Not only will this approach lead to much more targeted cancer drugs, but also considerably cheaper ones, the authors added.

Having examined cancers generally, we shall zero in on breast cancer, because of its common occurrence among women, the world over. The essence of this is for proper enlightenment, as well as keeping women abreast of early detection techniques.

Breast Cancer

More than 261,000 women are diagnosed with breast cancer each year, according to the American Cancer Society, making it the second most common malignancy in women after skin cancer. While all cancers arise from an uncontrolled growth of abnormal cells, each patient’s treatment and prognosis can differ radically depending on her type of breast cancer, how advanced it is and a variety of other factors.

Symptoms and Types

All breast cancers are not created equal, either in symptoms or category. Though some cases emerge without any noticeable symptoms, breast changes that warrant a doctor’s attention include a lump, swelling or thickening; dimpling or skin irritation; breast pain; nipple pain or an inverted nipple; red or flaky nipple or surrounding skin; or a discharge other than breast milk, according to the National Breast Cancer Foundation.

It is important to note that even these symptoms don’t necessarily mean a malignancy is present and often signal a benign condition, such as a cyst or infection.

Just as breast cancer has many symptoms, the disease is comprised of many specific types. Defined by whether it begins in the lobules or ducts, the parts of the breast responsible for milk production, these types include:

  • DCIS, or Ductal Carcinoma in Situ. This non-invasive malignancy is the earliest and most curable form of the disease because is confined to the duct and rarely spreads. DCIS comprises about 20 per cent of all breast cancers, invasive and non-invasive, diagnosed annually.
  • IDC, or Infiltrating Ductal Carcinoma, is an invasive malignancy because it has spread beyond the ducts. It accounts for almost 80 per cent of all invasive breast cancers. IDC appears as rounded or star-shaped areas on mammograms, with the star-like lesions signalling a poorer prognosis.

The remaining five types of invasive breast cancer comprise about 20 per cent of all total cases. According to the National Breast Cancer Foundation, they include the rare and aggressive Inflammatory Breast Cancer, or IBC, which unlike other forms is often visible on the outside of the breast. IBC causes the breast to look red or inflamed due to blocked lymph vessels in the skin and mimics certain breast infections such as mastitis.

Diagnosis and Tests

Breast cancer screening tests, which are done on symptom-free women, can help to diagnose early cases. Early detection methods include clinical exams by medical professionals, self-breast exams and screening mammograms, which are recommended for women age 40 and over, according to the American Cancer Society. Women with a family history of the disease can also undergo genetic testing to determine if they are at increased risk of developing it.

If a screening method reveals possible breast cancer, several tests can help confirm or disprove the diagnosis. These include:

  • Imaging tests such as mammograms, MRI scans or breast ultrasound. Each of these methods produces internal pictures of the breast that help doctors see a potential mass.
  • Biopsies, which entails taking cells from suspicious lumps to study in a pathology lab to determine if they are malignant. Cells are extracted through special needles or during surgery.

If cancer is confirmed, doctors will assess the cells to determine key information such as the type of cancer and its grade, which signals how fast it is growing. They will also learn if the tumour is caused by a genetic mutation passed through families or is hormone receptive. According to the American Cancer Society, the presence of hormone receptors on breast cancer cells usually indicates a better prognosis because certain drugs can prevent oestrogen or progesterone from promoting cancer growth.

Typically, women with a positive breast cancer diagnosis will also undergo a battery of tests to determine if the cancer has spread to surrounding tissues, organs or bone. Common sites for breast cancer metastases are the bones, the lungs and the liver.

 

 

Treatments & Medications

With more than 2.5 million breast cancer survivors in the United States, it’s clear that researchers have developed effective treatments and drugs that can either cure the disease or prevent it from quickly recurring. Treatments either target the cancer locally or systemically, depending on the location of the breast tumour, its size and the extent of the disease.

Local treatments include surgery and radiation, which attempt to remove or destroy the cancer in the breast without affecting the rest of the body. Surgery can include a breast-sparing lumpectomy or the more aggressive mastectomy, which removes the entire breast and is usually done in more advanced cases, according to the National Breast Cancer Foundation.

Systemic treatments are given by mouth or through the bloodstream and target cancer cells throughout the body. These include chemotherapy, which uses toxic drugs such as cyclophoshamide (sometimes referred to by its brand name, Cytoxan) or methotrexate. Cancer fueled by the hormones oestrogen or progesterone can be treated with hormone suppressors such as tamoxifen or raloxifene (Evista).

More recent systemic treatments include biological therapy, which uses the immune system to fight the cancer and targets breast cancer cells containing high levels of a certain protein. Commonly used biologics are bevacizumab (Avastin) or trastuzumab (Herceptin).

Depending on a variety of factors, including type and stage of cancer, her care regimen might include only one of these treatments or a combination of several.

Prevention

Some breast cancer risks, such as age and heredity, can’t be controlled. But as with so many other diseases, eating right and exercising can help lower the chances of developing breast cancer. According to the Mayo Clinic, other risk-reducing tips include:

  • Limiting alcohol intake to less than one drink per day
  • Limiting dietary fat
  • Maintaining a healthy weight
  • Foregoing hormone therapy at menopause
  • Limiting exposure to pesticides and antibiotics

Collated by TemitopeObayendo with additional information from Webmd.com and livescience.com

 

Pharmacy Plus rewards outstanding staff

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Rep awarded N1m for overall best performance

By Adebayo Folorunsho-Francis

As a befitting honour for a sterling performance, Emmanuel Ubah, PharmacyPlus medical representative (Rivers/Bayelsa) has been rewarded with cheques totalling N1 million for coming first in two categories of the company’s awards.

The award ceremony which took place during PharmacyPlus 2014 Annual National Sales Meeting at Solab Hotel & Suites, Ikeja, on 24 January, had all the regional managers, medical representatives and staff as well as stakeholders in attendance.

Ubah, who won in both the Reload Multivitamin Best Performance and the Overall Distribution categories got a cheque of N500,000 for each award.

Other winners in the Reload Multivitamin Best Performance category were Olumide Olutade (won N300,000 for emerging second) and Pharm. Ijeoma Uchem (N100,000 for coming third); while the Overall Distribution category also saw Don Michael (with N300,000 reward) and Esther Ibeanuka (N100,000) come second and third respectively.

Giving his award acceptance speech, Ubah expressed appreciation to the management for encouraging him since joining the company.He also challenged his colleagues to continue striving towards excellence.

“I have always believed that everything happens for a reason” he gushed.“Many of you know the challenges before I was officially engaged by PharmacyPlus. Secondly, between last year and 2014 alone, I was robbed and involved in accident in the course of my work. But look at me now! Today, I am going home as a ‘millionaire!’”

Earlier in his remark, Pharm. Chukwuemeka Obi, PharmacyPlus’ chief operating officer, charged his staff to continue to work hard because it is always a rewarding commitment.

“I urgeyou to take your work seriously,” he counselled.“I am happy in particular with the progress we made in 2013 and we can surpass that, God helping in 2014. There is always a reward waiting for every hardworking person in PharmacyPlus Ltd,” he stressed.

The three-day meeting was also used as a forum to spell out the way forward for the company in2014, with all the senior managers presenting their plans for the year.

Pharmanews gathered that the interactive meeting was developed in-house by the sales and marketing team, and it confirms the company’s commitment in developing its most valuable asset – people.

PharmacyPlus Limited was incorporated in 2003 as a subsidiary of the parent company – J3 Group – with the mission to engage in franchising, importation and distribution of OTCs and healthcare products.

Being a WACN Fellow has many benefits – Okelola

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(By Temitope Obayendo)

 In this exclusive chat with Pharmanews, Mrs Mojisola Okelola, chairperson of West African College of Nursing (WACN), Nigeria chapter, reveals all there is to know about WACN. She also highlighted the advantages Fellows of the institute have over other nurses.

Below is the full text of the interview:

 Tell us about yourself, especially your early years

 My name is Mrs Mojisola Titilayo Okelola. I am the current chairman of the West African College of Nursing (WACN), Nigeria chapter. I am a psychiatric nurse. I retired as an Assistant Director of Nursing Services at the Federal Neuro-Psychiatric Hospital, Yaba, Lagos.

I did my psychiatric nursing training at the Federal Neuro-Psychiatric hospital Abeokuta. I
had my general nursing training at the Lagos University Teaching Hospital, Idi Araba.
I did my nursing administration and management at the University of Benin, Benin City. I also attended the Administrative Staff College of Nigeria (ASCON) where I did my Advanced Management Course. I am a member of the Nigerian Institute of Management.

I am someone who is consistently growing and takes time to continue learning even though it’s not a direct requirement for the job. I had my BNSc. from the Open University of Nigeria.
I find that many times my professional growth is based on what I studied directly and indirectly in relation to my work.

Why did you choose nursing as a career?

My motivation to choose nursing as a profession was from my mum, who observed that I was a kind, caring and happy child. She encouraged me so much to the extent that she personally went to collect the School of Nursing form for me. Being a nurse has offered me the opportunity to help others and make a difference in their lives on a daily basis. I like working often one-on-one with patients and assist them to recovery and rehabilitation.

When you help others, empathise with them, as well as exercise patience and dedication towards them, it makes you emotionally stable, fulfilled and happy in life.

As the WACN chairperson in Nigeria, what are the objectives of the institution?

The objectives of WACN are: to promote excellence in nursing education (basic and post basic level) and maintain the standard of nursing within the sub-region; formulate and support nursing educational programmes; contribute to the improvement of health care within the West African sub-region; plan and implement continuing educational programmes for nursing personnel; and promote and encourage research in the field of nursing.
In fulfilment of these objectives, WACN plans and implements workshops and seminars throughout the sub-region. Its major activities are carried out through its five constituent faculties, namely:

1. Medical surgical nursing, with three sub-areas: critical nursing (accident and emergency, intensive care, peri-operative nursing, special care babies nursing); palliative nursing (terminally ill (HIV/AIDS, Cancers etc.) rehabilitation); and adult nursing (non-communicable diseases).
2. Reproductive health nursing (MCH)
3. Mental health/psychiatric nursing
4. Community health nursing
5. Faculty of administration, management.

What are the benefits of being a Fellow of WACN and what qualities make a Fellow differ from a non-Fellow?

At WACN, efforts are put in place to ensure that our Fellows gain certain qualities that set them apart from non-Fellows. Chief among these are leadership and management skills. The goal of the WACN is to strengthen the public health sector of the West African sub-region. One way of doing this is to provide a platform for members to meet and share ideas about how to improve the health care sector. Members do collaborate on issues that affect the health care sector.

Fellows envision the future and lead the way in nurturing productive personnel. We don’t stop seeking additional professional growth and opportunities to make a difference in our profession. Fellows are encouraged to be politically conscious. Fellows are also encouraged to read professional journals and to attend continuing education courses in the nursing field.

We also run workshops – faculty by faculty, zone by zone, as well as branch by branch. Constant continuing education enhances the knowledge of nurses and this in turn improves the quality of care that patients receive. These workshops and seminars provide the platform for advancements in the field of medicine and caregiving to be discussed.  Therefore it is important to stay abreast of current research to make sure patients are given the most up-to-date treatment.

As a Fellow of WACN, you are able to demonstrate confidence at all times. Self-confidence is essential in leadership. As a Fellow, the courage is always there for you. You are willing to take calculated risks as a good leader. As a Fellow, you are able to communicate clearly and consistently and remember to listen.

Recently, nurses and other health care workers planned an industrial action which was suspended eventually. Do WACN Fellows believe in strike as a tool for pressing their demands?

It is important to listen to the voices of heath care providers, including physicians, nurses and pharmacists, before policies that affect the health sector are formulated. For us to have a healthy nation, we must reform the health care sector. Workers in the sector ought to be treated better. The recurrent issues of understaffing, overworking and underpaying employees should be addressed. These are not only detrimental to the workers but also to the patients who depend on the attentive care of their medical providers.

When government promises to do things to improve the health sector, it should fulfil its promise and should not wait until the workers go on strike or until it notices there is an impending strike. And those at the helm of affairs in the Ministry of Health should not give preferential treatment and engage in discriminative practices amongst various professionals. We all have our professional roles to play in the health sector.

What are some of the challenges of WACN and how can they be resolved?

We have our challenges in the institution, chief among which is finance. Our small subvention is not regular and even when it comes, it is late. Our offices at the headquarters (6, Taylor Drive Yaba, Lagos) are not well-equipped.

Also some institutions refuse to sponsor nurses for courses and workshops thereby denying them the opportunity to gain much-needed knowledge.

What’s your advice to nurses across the nation?

My advice to nurses across the nation is to remember that our profession is a calling and, so, when there is a misunderstanding between the nurses and the government, we, as advocates of our clients, should embrace dialogue.

 

 

 

 

 

 

 

How regular visits to hospital save lives – Dr. Oladipupo

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(By Yusuff Moshood)

In this recent interview with Pharmanews, Dr. Gentry Albert Oladipupo, a general practitioner medical officer at All Souls Hospital, Agege, Lagos, spoke on the common health conditions bringing patients to the hospital. He also explains what can be done to reduce hospital visits for these conditions, while urging Nigerians not to wait until they are ill or bedridden before visiting hospitals.

                Below is the full text of the interview:

 What are the common health conditions bringing patients to hospital in this area?

The most common condition bringing patients to hospital is malaria.  Not only in this part of the country, but in the country as a whole. Malaria is endemic.  This is basically because of the huge presence of mosquitoes in the environment.  As such, people come down with malaria quite often.  The worst hit is the young age group.  They are the most affected and it is sometimes very serious when they are affected.

Another regular condition I have observed is hypertension.  This is becoming very common among people of middle age and the elderly.

Other common health conditions, depending on the age group, are diarrhoea, typhoid and gastroenteritis. The reason we have more cases of typhoid is because of the poor sanitation habits of our people. People eat contaminated food and ingest dirty water.  This is why typhoid and gastroenteritis are common.

How can the incidence of these health conditions be reduced?

For malaria, government is already doing quite a lot to fight the disease through the Roll Back Malaria Campaign. An example is the campaign urging people to sleep under insecticide-treated bed nets.  The use of insecticides to kill mosquitoes is also good. For me, all you need to avoid malaria is to kill the mosquitoes.  As long as you rid the environment of mosquitoes then you avoid malaria.

The government also needs to ensure that there is improvement in the drainage system. We must have flowing gutters, not stagnant water in the gutters, which enables the mosquitoes to breed.

For typhoid and gastroenteritis, our people must avoid contaminated foods and ensure good hygiene when cooking or preparing foods.

 How correct is the assertion that Nigerians don’t go to hospital until their health condition worsens?

This is true to a certain extent.  It is basically because of poor economic conditions and low level of understanding on health issues. People in this country don’t like going to the hospital routinely.  Even when people are sick, if it is not so serious as to keep them in bed, they still don’t go to the hospital.  Besides, the level of poverty is high in the country and people are always concerned about how they will raise money for consultation and treatment. What they resort to is self-medication which doesn’t help and it is only when they are down completely that they are brought to the hospital.  Sometimes, it is already too late to help them because of serious complications.

  Tell us some of the challenges you experience as a general practitioner medical officer?

I have explained one of the challenges earlier, which is the attitude of our people to coming to access health care on time. Another challenge I have observed is availability of genuine drugs.  The incidence of fake drugs is becoming an issue in this country. Sometimes, when you prescribe drugs to patients and you are expecting a good outcome, the patient still comes back without feeling better; then you discover that it is because the medicine is not effective.

Some drugs in the market which are said to contain, for example, 100mg of the active ingredients only have 50mg. So if you prescribe such and expect the patient to get better, you will find that the symptoms will still persist. It is a serious problem, and even though NAFDAC is trying, more still needs to be done.  We need to improve on our drug monitoring system.

Some people are even bypassing NAFDAC to bring fake drugs through the borders. We need to improve our surveillance on drug importation and ensure only genuine drugs are in the system.

 What is your advice to people on seeking medical intervention when they are unwell?

My advice is that people should develop the habit of visiting hospitals routinely. People should not wait until they are down completely before coming to the hospital. Once you observe any symptom of ill health, you should come to the hospital because you stand a better chance of resolving that health challenge if tackled early.

 

Experts advocate safe medicine use at INSUM forum

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(By Adebayo Folorunsho-Francis)

Eminent pharmacists, health officials and stakeholders in the health care sector recently converged to discuss ways to curb arbitrary use of medicines in the country.

The inaugural consultative forum under the auspices of a non-governmental organisation, Initiative for Safe Use of Medicine (INSUM), was held at Nigerian Institute of Medical Research (NIMR) on January 29, 2014.

In attendance were Pharm. Akintunde Obembe, chairman, Lagos branch of the Pharmaceutical Society of Nigeria (PSN); Pharm. (Sir) Ifeanyi Atueyi, managing director of Pharmanews Ltd; Dr. S. O. Tanimowo, a community physician; Pharm. Bisi Bright, chief executive officer of Livewell Initiative; Dr. Tony Anyanwu, physician and endocrinologist at the Lagos University Teaching Hospital (LUTH), Idi Araba, and a host of other dignitaries.

Describing medicines as substances, including vaccines, used in the diagnosis, treatment or prevention of a disease, Pharm. (Sir) Ifeanyi Atueyi, the keynote address speaker, lamented that the use of medicines in the country had largely degenerated into a state of abuse.

He was however quick to add that, in modern times, medicines have greatly changed the way in which diseases are managed and controlled.

“Many years ago, there were no remedies for diseases like polio, diphtheria, whooping cough, tuberculosis, schizophrenia, and other related illnesses. Today, therapies for these are relatively commonplace interventions which have yielded immeasurable benefit,” he said.

He further disclosed that despite these benefits, all medicines are known to have side effects.  “In the words of Paracelsus, all things are poison and nothing is without poison; only the dose makes a thing not to be a poison,” he noted.

Using Nigeria as a focal point, the Pharmanews publisher noted that a typical case in such medicine abuse was the date rape and subsequent murder of Cynthia Osokogu involving the use of Flunitrazepam (Rophynol®), a potent short-term prescription–only Benzodiazepine hypnotic that causes strong amnesia.

“Sad as it was, this would not have happened if there was sufficient control to the access to such a potent drug,” he pointed out. ““There are other reported cases of adverse drug reactions such as abortion or miscarriage resulting from misuse of Misoprostol, and common ones like liver damage from arbitrary use of paracetamol.”

The eminent pharmacist however said that with the proposed implementation of the drug distribution guideline in July 2014, there is renewed hope that the menace would be curtailed.

Atueyi also took a swipe at unethical use of advertisement and bogus claims by pharmaceutical companies which he said encouraged use of medicines without prescription.

Also sharing the same view, Pharm. Ibrahim Oreagba, a senior research fellow at the College of Medicine, University of Lagos, declared that fostering safe use of medicine begins with patient-oriented practices.

One of such practices, according to him, was pharmacovigilance which came into being afterthe thalidomide tragedyof the 1960s. He also urged pharmacists to spend some time counselling patients on the use of drugs.

“I am happy INSUM has taken up this challenge. This is why I think we need more NGOs that will focus more on sensitive health issues like this,” he stated.

In appreciation of the speakers, Pharm Dotun Amosun, INSUM Board of Trustees chairman, remarked that he was happy with the turnout of participants as the consultative forum was meant to foster partnership of individuals, organisations and stakeholders in the health care sector.

“The main objective of INSUM is to promote and support the safe and appropriate use of medicines in Nigeria through advocacy, research and public education,” he said.

In the same vein, Dr. (Mrs) Nkiru Asoegwu, INSUM Board of Trustees vice chairman,also drummed up support for the initiative, saying, aside targeting nurses, doctors and several other health care players, there was need to take the programme to the broadcast media and also make it dominant on the social media.

“I believe there are lots of people out there whom I am sure will benefit from this Initiative,” she stressed.

On how she came up with such a laudable initiative, Pharm. Nneka Egbuchulam, founder and project director of INSUM reminisced that she simply observed that people had too many questions about how to use their medicines and that they often ended up making wrong choices. That, according to her, made her decide to start an initiative that would address the disturbing trend.

 

 

The power of goal-setting

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Imagine playing football or hockey in an unmarked field or rink with no goal posts. It would be a hopeless endeavour, with nothing to be gained, with no goal to strive for and not a score to be attained. We must have purpose in our lives and goals to strive towards; for a strong passionate purpose is the flame that sets the soul on fire.

Everyone must have a goal. Ralph Waldo Emerson is often quoted as saying, “The world makes way for the man who knows where he is going.”

The dramatic significance of setting goals is illustrated by a study that was conducted in 1953 at Harvard University. The University gave a questionnaire to the class of 52 asking them about their goals or if they had any. The result was 3 per cent had written goals, another 10 per cent had goals but they weren’t in writing and 87 per cent had no goals at all. Twenty years later, in 1972, they gave out another questionnaire to the same grads and the results were as follows:

The 3 per cent who had written goals had a combined net worth in excess of the other 97 per cent combined.

The main reason for great success in any endeavour is clear, specific, and measurable goals written down and backed by a written plan and a burning desire to accomplish them. The primary reason for failure and underachievement is vagueness, confusion and the inability to decide exactly what it is that you desire. As sales trainer, Tom Hopkins, says, “You must be specific to be terrific.” ZigZiglar says, “Most people are wandering in generalities rather than meaningful specifics.”

Goal Setting

The fact is you can’t hit a target you can’t see and, worse still, how can you hit a target you don’t even have? Denis Waitley writes, “Most people spend their time in tension-relieving activities rather than goal-achieving activities, getting no closer to the goals they haven’t even set for themselves.”

If you don’t know where you’re going, any road will take you there. A person without clear, specific goals is like a ship without a rudder blown about in a constant sea of indecision and confusion. A person with clear, specific goals, written down with time lines, on the other hand, is like a ship with a rudder, sailing straight and true to its destination port.

It’s incredible how fast your life will improve and be enhanced by becoming intensely goal-oriented. When choosing your goals, let passion and excitement be your guide. They are the physical translation of the vibrational resonance that is your true, core natural being. Whatever your goal is, you must plan to win, prepare to win, and then you can legitimately expect to win.

The reason writers make so much money writing stories and the movie industry is so enormous is because most people never realise their dreams. They’ve given up and become disheartened. Regarding their dreams, most people wish to avoid confrontation. When you ponder and think about what sets most men apart, you’ll discover it is goals.

There are two great tragedies in life, however. The first is never to have had great goals, and the second is to have fully reached them without setting more goals, so that tomorrow holds no eager anticipation of challenge. Napoleon Hill said, “Cherish your visions and your dreams as they are the children of your soul, the blueprints of your ultimate achievement.” In the Book of Proverbs, it states, “Where there is no vision the people perish”; and of course the flipside of that is, where they have a vision and goals, the people prosper.

Listen to what the late great Malcolm Forbes had to say about this, “When you cease to dream, you cease to live.” Cease to live? That’s strong! Do you know anyone who has ceased to live? Abraham Maslow said, “The history of the human race is the story of men and women selling themselves short.” The reason people settle for far less than what is possible for them is that they have become consciously or unconsciously convinced that there is nothing or very little they can do to change things. In reality, the only limitations on what you can accomplish are your imagination, desire and your ability to set and achieve goals. Remember Napoleon Hill’s famous words, “Whatever the mind of man can conceive and believe, it can achieve.” And I would add that you must be heart-aligned as well.

Mark Victor Hanson says, “The secret to goal-setting is how much and when.” A goal in writing makes every day exciting. Regarding goals and the achievement therein, ZigZiglar says, “It’s your moral responsibility to set and achieve high goals since others who see us will either draw inspiration from us and decide to do likewise, or they draw discouragement from us because they see us not doing the most with our abilities.”

All depressed people share the following three negative thought patterns: 1. They have a negative view of themselves; they have low self-esteem. 2. They have a pessimistic outlook of their experience. 3. They have a negative outlook regarding their future; they have no goals.

If you are successfully setting and realising your worthy goals, it’s impossible to be depressed.

 

Culled from SUCCESS TO SIGNIFICANCE by Richard Carswell

Health wonders of wheat germ oil

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(By Pharm. Ben Chukwudile)

You may already be familiar with wheat as it is the major ingredient in wheat flour, wheat bread and other wheat-based foods. But there is certainly more to the wheat grain than you already know.

The wheat grain consists of three parts: the husk, the germ and the endosperm. Wheat germ oil is extracted from the germ of the wheat kernel, which makes up only 2.5 per cent of the weight of the kernel. Wheat germ oil is particularly high in octacosanol – a 28-carbon long-chain saturated primary alcohol found in a number of different vegetable waxes.

Octacosanol has been studied as an exerciseand physical performance-enhancing agent. Very long chain fatty alcohols obtained from plant waxes and beeswax have been reported to lower plasma cholesterol in humans.

Wheat germ oil is also very high in vitamin E (255mg/100g), and has the highest content of Vitamin E of any food that has not undergone prior preparation or vitamin fortification.

Although the germ of the wheat forms only 3 per cent of the weight of the grain, the benefits of wheat germ stem from the fact that it contains almost 25 per cent of the total proteins, vitamins and minerals of the wheat grain. It is a very sensitive kind of oil that tends to degrade if not stored with care. It should be kept away from high temperatures because if exposed to extreme temperatures, it may turn rancid. However, if kept properly, the shelf life of wheat germ oil can be extended up to a few months.

Wheat germ oil has a high content of vitamins A and D. It is also rich in protein and lecithin. As cooking oil, wheat germ oil is strongly flavoured, expensive and easily perishable.

Good Source of Vitamin E

Vitamin Eprotects the body against free radicals and is an important weapon in the fight against premature aging, cancer and heart disease. The vitamin E in wheat germ oil works with the minerals selenium and zinc for powerful antioxidant protection.

The vitamin E in wheat germ oil is effective as a topical agent as well. The high antioxidant content can facilitate regeneration and healing in the skin, while protecting against future damage. Many people have noticed remarkable improvement by applying wheat germ oil to treat dry skin, sun spots, wrinkles, scars, stretch marks, psoriasis and eczema.

Although its vitamin E content may be its most outstanding benefit, wheat germ oil also contains other valuable nutrients.

Component g/100g
Linoleic acid (Omega-6) 55
Palmitic acid 16
Oleic acid 14
Linolenic acid (Omega-3) 7

 

Essential Fatty Acids

The essential fatty acid, alpha-linolenic acid, in wheat germ oil fights inflammation, while protecting the cardiovascular and immune systems. Wheat germ oil contains other highly beneficial essential fatty acids, such as stearic acid, which has been shown to produce positive effects on lipid profiles;and oleic acid, which protects the heart.

Lecithin

This phospholipid is vital for heart health, brain function and liver health.

Benefits of Wheat Germ Oil

There are many benefits of wheat germ oil. It is very useful for the skin.It fights ageing of the skin and promotes skin health by improving blood circulation. It is very popular for external application due to its beneficial effects on the skin. Hence, it is increasingly finding place in the manufacture of skin care products. The various nutrients present in it improve the immune and nervous systems.

Additional Health Benefits

If you are still wondering what wheat germ oil is good for, consider the following:

  • Wheat has been called the staff of life, and the oil from the germ of the wheat has long been used by people with a variety of health concerns.
  • The Doctor’s Research TM states, “Wheat germ oil protects and nurtures the skin;it is a laxative and reduces lipids. It is a valuable dietetic because of the high level of polyunsaturated acids and vitamin E. Chinese medicine uses it for night sweats, whereas “flatulence, constipation, itching, and menorrhagia are indications for use in Indian medicine.”
  • Recent research confirms that wheat germ oil can help reduce oxidative stress. Wheat germ oil is one of the most concentrated sources of vitamin E.

  How to Use

There are many ways to use wheat germ oil externally. For skin care, you can apply this oil to remedy dry skin. Wheat germ oil, being excellent for dry skin, can be applied twice, daily. It can be applied after bath in the morning and once more in the night before sleeping. What‘s more, it can also be taken orally as a supplement. Wheat germ oil can also be taken in capsules especially if you find swallowing the oil disagreeable.

Caution

  • Keep in mind that wheat germ oil is not meant to replace other healthy fats in your diet. Rather,it should be thought of as a beneficial supplement.
  • It is susceptible to rancidity; but if kept refrigerated in an opaque, airtight container, it will last several months. Using wheat germ oil for cooking is not recommended.

In summary, wheat germ oil has antioxidant abilities as well as a variety of substances shown to be beneficial to health. Therefore wheat germ oil or the supplement is the product to consider when looking for the health benefits these substances provide.


RESEARCH/REFERENCES

  1. Lee R Wheat Germ Oil Perles. Lee Foundation for Nutritional Research, Milwaukee, circa 1950
  2. Irmiak S, Dunford NT. Policosanol contents and compositions of wheat varieties. J Agric Food Chem. 2005;53(14):5583-6
  3. Oil, wheat germ. USDA National Nutrient Database for Standard Reference, Release 19, 2006
  4. Traber MG. Vitamin E. In Modern Nutrition in Health and Disease, 10th ed. Lippincott Williams & Wilkins, Balt. 2006:396-411
  5. Traber MG. Vitamin E. In Modern Nutrition in Health and Disease, 9th ed. Williams & Wilkins, 1999:347-362
  6. Wheat Germ Oil (Octac osanol)” (http ://www . nutrasanus.com/wheat-germ. html).
  7. Ola. A. Megahad and Omayma S. El Kinawy (2002). “Studies on the extraction of wheat germ oil by commercial hexane” (http://grasasyaceites.revistas.csic.es/index.php/grasasyaceites/article/download/339/342). Grasas y Aceites 53 (4): 414—418. Retrieved 2010-05-18.
  8. Wheat Germ Oil” (http://www.nutros.com/nutrients/wheat-germ-oil/). Nutros. Retrieved 2010-05-18. . 8. A “Is Wheat Germ Oil Good for Scar Diminishing?” (http://oilyoily.com/is-wheat-germ-oil-good-for-scarsdirninishing/). OilyOily. Retrieved 22 August 2013.

Manage diabetes, heart diseases with African cherry

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 (By Temitope Obayendo)

At a glance, the African cherry appears rather small and insignificant in comparison with many other fruits. Yet experts on nutrition have repeatedly affirmed its uncommon nutritional benefits, as well as its efficacy in the prevention and management of diabetes and heart diseases.

Botanically called Chrysophyllum albidum, the African cherry (also known as African star apple) belongs to the Sapotaceae family. It is popularly called agbalumo among the Yourbas, while the Igbos called it udara.

C. Albidum is sub-spherical in shape, about 3cm in diameter, usually 5-celled and contains an edible, sweet fruit-pulp. The skin or peel is orange to golden yellow when ripe and the pulp within the peel may be orange, pinkish, or light yellow. Within the pulp are at least five seeds, which are not usually eaten.

The fleshy pulp is usually eaten as snack and it has been found to have high contents of ascorbic acid. It is also acclaimed to be an excellent source of vitamins, irons and flavours to diets.

In Benin, where researchers recently focused on the used pattern of the fruit, the African cherry occurs on ferallitic soils. It is a lowland rain forest tree species, which can reach 25 to 37m in height at maturity with a girth varying from 1.5 to 2m. Its nature occurrence has been reported in diverse ecozones in Nigeria, Uganda, Niger Republic, Cameroon and Cote d’ Ivorie.

In a chat with Professor Ignatius A. Onimawo of the Department of Biochemistry, Ambrose Alli University, Ekpoma, Edo State, on the nutritional contents of C. Albidum for human consumption, he said the fruit serves as a good source of calcium, with each serving providing an individual with 10 per cent of the daily requirement.

Onimawo, who is professor of nutritional biochemistry, asserted that the calcium lends strength to human’s bones and teeth, and may also lessen symptoms of premenstrual syndrome, such as cramping and abdominal bloating.

“This fruit also contains 5 per cent of the daily recommended value per serving of vitamin C and vitamin A. Additionally, one serving of cherry serves up to  2 per cent of iron, a mineral vital for oxygenating your body, that you need every day”, he explained.

Speaking on other health benefits of the African cherry, the expert noted that cherries may have particular benefits for diabetics. Citing a research published in the September 2009 edition of the African Journal of Pharmacy and Pharmacology, he said the result indicated that the leaves of the fruit reduced glucose levels in diabetic rabbits, the same function that insulin in the human body performs.

However, he said more research is needed to determine the effectiveness of cherry leaves to control diabetes in humans.

Onimawo further referred to a study by researchers at the Department of Biological Sciences, College of Science and Technology, Covenant University, Ogun State, Nigeria. The study showed that the local cherry fruit lowered blood sugar and cholesterol, and could be useful in preventing and treating heart diseases.

“Methanolic extracts of the cotyledons from the seeds of chrysophyllum albidum led to the isolation of eleagnine, tetrahydro-2-methylharman and skatole,” he said. “Eleagnine was found to be the main compound responsible for its antimicrobial activity. Eleagnine was further shown to exhibit anti-nociceptive, anti-inflammatory and antioxidant activities. The seed cotyledon has been reported to possess anti-hyperglycemic (lowers high blood sugar) and hypolipidemic (lower blood cholesterol) effects.”

The researchers, who investigated the effects of oral administration of the leaf extract of the African cherry on biochemical and haematological parameters in albino rats for 16 days, wrote: “In conclusion, the study has demonstrated that the leaf extract of Chrysophyllum albidum may not cause any adverse effect on the biochemical and haematological indices of toxicity. Moreover, the extract was found to possess anti-platelet and hypoglycemic (lowers blood sugar) properties and might be employed in the management of myocardial infarction (heart attack) and diabetes mellitus, respectively. Further investigation is needed to establish the anti-platelet property of the extract.”

Onimawo, a public health nutritionist, also quoted from another study conducted by researchers at the Forest Research Institute, Ibadan, Oyo State, which showed that the African cherry leaves exhibited strong antibacterial activity against common bacteria isolates.

Titled, “Antibacterial Activity and Phytochemical Screening of Chrysophyllum Albidum Leaves”, the study was published in the Asian Journal of Food and Agro-Industry.

Since the fruit is seasonal, and always available in the summer, Onimawo advised that the fruit pulp could be extracted and packaged in bottles and stored in refrigerator for proper preservation. And now that fruit is in abundance, he urged people to consume it liberally as a great source of phytochemical.

Nutritional Contents

According to Onimawo, the proximate composition analysis of C. Albidum is as follows:

Moisture 66.67 per cent; carbohydrate 78.34 per cent; protein 5.66 per cent; fibre 4.50 per cent; fat 9.83 per cent; ash 2.12 per cent and total energy value 420.42 kcal. The ascorbic acid content is 19.68 per cemt.

The anti-nutrients composition are: oxalate 4.95mg, saponins 3.66 per cent, cyanogenic glycoside 0.17 per cent, phytate 0.02 per cent and tannins 0.03 per cent.

Additionally, a research on “Evaluation of proximate compositions and mineral elements in the star apple peel, pulp and seed” by Ukana D. Akpabio, Aniekan E. Akpakpan, and Godwin N. Enin of the Department of Chemistry, University of Uyo, Akwa Ibom State, suggests that the African star apple fruit is an edible fruit of uncommon nutritional benefit.

In the study, recently published in the Journal of Basic and Applied Scientific Research, the peel, pulp and seed were analysed to determine the proximate composition and mineral elements. The findings showed that the pulp contains greater amounts of crude fibre, fat, ash and caloric value, while greater amount of moisture was found in the peels.

Carbohydrate content and crude protein was higher in the seed. Mineral elements composition revealed that the pulp has greater amounts of sodium and iron, while the peel contains greater amounts of potassium and zinc. Calcium and magnesium were higher in the seed.

Moisture contents of the star apple peel, pulp and seed were 47.95 per cent, 32.65 per cent and 26.55 per cent respectively with an average of 35.76 per cent. This clearly shows that the peel contains much moisture.

Moisture content is one of the most important and most widely used parameter in food processing; hence, the star apple’s seed can easily be processed and preserved, since it contains less moisture.

Crude protein contents of the star apple peel, pulp and seed were 6.68 per cent, 4.73 per cent and 8.75 per cent respectively with an average of 6.73 per cent. The Food and Nutrition Board of Nigeria (1972) recommends 56kg of protein per day in the diet of adult men weighing 70kg and 40kg for women weighing 56kg of body weight.

The Fat contents of the star apple peel, pulp and seed were 8.94 per cent, 10.00 per cent and 3.45 per cent respectively with an average of 7.46 per cent.  Fat is an excellent source of energy, enhances transport of fat soluble vitamins, insulates and protects internal tissues and contributes to vital cell processes.

Folklore Uses

The star apple is a folk remedy in several countries, although no research exists to confirm this. The seeds of the fruit may be useful in reducing fevers and treating diarrhoea. Some people also eat the fruit to reduce the inflammation associated with laryngitis and pneumonia. Other uses, including treatment for hypertension, tooth abscesses, heart problems, intestinal issues and cancer exist; but it is strongly advised not to eat star apple for any medical condition without first consulting a qualified physician.

Fibre

Eating a serving of star apple contributes 3g of fibre to the recommended daily intake of 25 to 38g. Fibre provides bulk to your diet, a factor that can make your stomach feel fuller for longer. This can keep you from eating too much, and it may help you lose weight. This nutrient can also help protect you from diabetes and some forms of cancer.

Daily Nutrition

1-cup serving of fresh star apple contains 67 calories. Eating star apple as a snack is a good choice as it provides no fat and the calories are low; however, these may not be enough calories to ease hunger pains or boost energy levels, as between-meal snacks are meant to do. The Diet Channel notes that 100 to 200 calories per snack is best. Consider eating an oz. of cheese or a tsp. of peanut butter to boost the number of calories into this range.

One serving of star apple also has 15g of carbohydrates, or 11.5 per cent of the 130g suggested for daily consumption by the Institute of Medicine.

References:

Journal of Basic and Applied Scientific Research, 2012

Journal of Ethnobiol Ethnomed. Oct. 2012

 

Making it big in the Nigerian economy

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 Not too long ago, I watched a speech presented by Elon Musk at Oxford University, England. Elon Musk is the CEO of Tesla motors (electric car company) and SpaceX, co-founder of PayPal and current chairman of Solar City.

In the presentation, he spoke of the achievements of Tesla, how despite vested interests in the energy business, the company was able to develop an electric car that outperforms most standard SUVs. Their ground-breaking work with Model S and now Model X (to be out later this year) has earned Elon Musk numerous awards, including Fortune Magazine’s Man of the Yearand MarketWatch’sCEO of the Year. Mr Elon has also found more than a six billion dollar fortune taking on seemingly impossible business projects.

No doubt, the energy business is changing and Elon Musk is among those leading this change. But the major point to note from his exploits and those of others like him (Jeff Bezos of Amazon, Steve Jobs of Apple, Mark Zuckerberg of Facebook and Bill Gates of Microsoft) is that the global business arena is now knowledge-based and that the great CEO of the future will be donning an academic gown. He may not have a university degree or a PhD but chances are that he will be technically savvy in at least one field.

In Musk’s presentation, he emphasised starting from the first principles, breaking down the variables and asking if “success is a possible outcome?”

Today, I wish to ask that question of the innovation-driven business landscape in Nigeria.

The Nigerian scenario

Nigeria’s Global Competitiveness Index as ranked in the 2012-2013 Global Competitiveness Report is 115th of the 144 countries studied. The Global Competitiveness Report presented by the World Economic Forum measures 12 pillars of competitiveness as shown in the spider web summary below:

 12 pillars of competitiveness

From the above, it is easy to see where the country is wobbling. The report (that is, the Global Competitiveness Report) categorises the countries of the world into three broad categories:

  1. Factor-driven;
  2. Efficiency-driven; and
  3. Innovation-driven

Nigeria was categorised as a factor-driven economy along with 37 other economies. These economies compete on their factor endowments—primarily low-skilled labour and natural resources. In other words, our biggest assets are our raw materials.

From the report, some examples of other factor-driven economies include India, Ghana and Kenya.

Significance of being a factor-driven economy

 The significance of our present scenario is that our GDP is a reflection of our raw productivity – in other words, our inefficient, minimal innovation productivity.

The challenge

The challenge therefore is in achieving efficiency and innovationin our productivities.In the pharmaceutical industry, this is a real and present challenge. If we can achieve this, Nigeria can multiply her GDP by five.

According to the competitiveness report, the barriers we must overcome include:

  1. Access to financing
  2. Corruption
  3. Tax rates
  4. Poor work ethic in national labour force
  5. Inadequate supply of infrastructure
  6. Inflation
  7. Policy instability
  8. Inefficient government bureaucracy
  9. Tax regulation
  10. Foreign currency regulations
  11. Inadequately educated workforce
  12. Crime and theft
  13. Insufficient capacity to innovate
  14. Government instability
  15. Poor public health

The global market

Before considering the possibility of initiating projects that will deliver this efficiency and innovation, it will be good to evaluate the Influence of the global market.

Despite the data presented in theabove report, Africa(and Nigeria in particular) is still the beautiful bride at the moment for international businesses and the reason is quite simple – a growing middle class with a huge disposable income (as a result of our fairly large crude oil-induced GDP). The only problem is that companies coming to Africa need not sell Africa’s products and services. The point is, without a deliberate effort, this current attractiveness may not make much difference other than that we can live like our friends in the West and eventually get caught up in debt.

Foreign firms

If you operate a foreign firm, a good business strategy will be to find ways to meet the needs of the market at present and to strategically position your firm within the productive chain of the nation. In other words, provide efficiency and innovation to Nigeria’s crude materials.For example, startbusinesses that deal in consumables, plastics, pharmaceuticals, toiletries, stainless steel, telecommunication, hospitals, diagnostics, shopping marts, cars, etc. Then continue to innovate around products and processes.

We are seeing a whole lot of this already and at the rate things are changing, the future will be remarkably different.

Nigeria: Does ownership matter?

For a Nigerian, the question will be “does ownership matter?” Does it matter who provides the innovative products and services? Well, it depends on the way you look at it, though I have decided to leave the nationalistic side of the discourse for another day.

Is success a possible outcome?

I believe it is, with the right management capacity, technology and finance–hence, my earlier reference to Elon Musk.

The ability to find finance for technological processes that offer innovation and efficiency to product or service delivery in Nigeria is key to achieving success within our context. Firms coming to Nigeria would have to do exactly this same thing – find the right management to deploy relevant technology in Nigeria and bankroll them.

No doubt, there are challenges to finding skilled people in Nigeria but I believe the real question is “who is doing the finding?” Who is building the team? This question is important because at the end, the character and dispositions of these individuals, much like that of Elon Musk, would influence all of us tremendously.

The team builders

Finding success in our horizon will be done by great teams; in other words, we all need to find a good team or create a good one.

Ideal team components

  1. Innovation – Processes and products
  2. Management – Proven ability/potential to lead the team and deliver
  3. Finance – Ability to raise money

Thesummary

There are lots of challenges and opportunities in Nigeria at the moment, and this calls for able leadership. In the pharmaceutical industry, it is even much more. The onus however is on finding management teams that have the integrity and character to raise finance and lead the technical team members to achieve outstanding success. I believe these leaders are really the scarce resources; their task is an earnest one and their cause is indeed noble.
 

Secrets of staying young and fit

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I visited a friend some time ago, and was impressed with his collection of souvenirs from different countries.  He travels regularly to Kenya, South Africa, Ethiopia, Paris, London and other parts of the world for business and acquires mementoes during the trips. A portion of his living room looks like a museum.

I thought of my own interest during travels. I don’t very much appreciate paintings and carvings and therefore do not spend money on them. Instead, I buy books as souvenirs. I like to remember places with books purchased there. And, usually, I indicate the location and date on the books.

In my library, I have some books that I bought during my recent travels. These include:  “I Declare” by Joel Osteen, North Carolina, 6/10/12; “The 15 Invaluable Laws of Growth” by Brian Tracy, Chicago, 20/09/12; and “Standing Tall” written by a colleague, Dr N. K. Ebube in Philadelphia, 20/09/13. My Holy Bible was dated 1/10/13, Orlando, Florida. This was another gift from my wife on my 73rd birthday.

Returning from Washington to Lagos via London on Sunday, 6th October, 2013, I bought “20 Years Younger” by Bob Greene at the Heathrow Airport. It proved to be a very engaging in- flight reading material.

Usually, when I invest in a book, my primary objective is to improve my knowledge on that subject. Secondly, I try to apply the lessons I have learnt to myself. Thirdly, I share that knowledge with others.

“20 Years Younger” is an appealing title for a book. Everyone wants to look younger than their age. Incidentally, there are two ways to describe age. There is the chronological (calendar) age, which is determined by the date of birth.  The other is the biological age, which reflects the rate at which we are getting older. Everyone’s desire is to reduce the biological age and live healthy long life.

Bob Greene, an exercise physiologist, believes strongly that exercise is the ultimate anti-ageing weapon.  He made it clear that you can halt or even reverse the ageing process of your body through exercise.

Much of what we think of as ageing – wrinkles, weight gain, memory loss, lack of energy, certain types of illnesses – is not primarily attributable to the passage of time. Rather, it’s a direct result of sedentary living, poor diet, lack of sleep, insufficient (or nonexistent) skin care, too much stress, and even a defeatist attitude to life. Therefore, it stands to reason that if you reverse those habits – if you sufficiently exercise your body, eat longevity-promoting foods, sleep soundly and adequately, protect and nourish your skin, and improve your outlook on the world – the signs of ageing will reverse themselves, too.

Living longer is important, but the ultimate goal is to live longer and live well into your later years. Through the science of ageing it has become clearer that by making certain lifestyle choices you can slow down the effects of ageing.

However, the big question has been, “Why do we age and eventually die?” Several evolutionary theories have been propounded on the issue. But one major theory not based on evolution has to do with the cumulative effects of damage to the body. This is the free radical (oxidative stress) theory of ageing. Over the years, injury from simple wear and tear, sun damage, a poor diet, smoking, pollution, and even the body’s own metabolic processes, add up to promote ageing and eventual death.

Oxidative stress refers to the injury done to DNA, cells, and tissues in the body by free radicals. The free radicals are molecules with unpaired electrons that are produced when the body metabolises oxygen. They are also produced in our personal environment, e.g., through sunlight, smog, high altitude, exposure to X-ray, toxins in food and water, pollen, ozone, moulds, dust, and so on.

In their incomplete state, free radicals become thieves, trying to steal electrons from nearby molecules and wreaking havoc along the way. The body has the ability to absorb free radicals and repair the damage they do, but its defence system tends to weaken over time, leaving it vulnerable to disease.

We need free radicals to live, but they are also the bane of our existence. Free radicals damage can impair the immune system and result in various types of cellular damage. Such cellular damage is associated with many of our degenerative diseases like arthritis, some types of cancer, heart attacks, hardening of arteries, Parkinson’s disease, cataracts etc.

  Based on this theory, what do we do to fight the damaging effects of the free radicals?

Free radicals are rendered harmless by antioxidants. An antioxidant is a substance that can donate an electron to a free radical without becoming dangerous itself. An antioxidant puts an end to the rampage of cellular and bodily destruction. Antioxidants can saturate our cells and tissues and protect against free radicals, if taken in sufficient amounts.

The body makes special antioxidant enzymes, but you can also get many antioxidants in foods (especially fruits and vegetables) and nutritional supplements.

NAFDAC tips Strides Vital for WHO pre-qualification

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By Adebayo Folorunsho-Francis –

It was a pleasant surprise when a team of National Agency for Food Drug Administration and Control (NAFDAC) inspection officials, led by its Director General, Dr. Paul Orhii, recently visited the premises of Strides Vital in Adeniyi Jones, Lagos.

Among the visiting NAFDAC team were Mrs Stella Denloye, NAFDAC director of laboratory services and MrsEdosaOgbeide, NAFDAC deputy director, Port Inspection Directorate, Drug Port Division.

The team was taken round on facility inspection to sections like quality control laboratory, microbiology laboratory, granulation and mixing, compression, blending, coating, blister packing room and packing hall.

Commending the company for sustaining its good manufacturing practice (GMP) and improving generally since the last visit (during Prof. Dora Akunyili’s era), MrsOgbeide disclosed that she was pleased that a lot of positive things had taken place over the years.

“I know Strides Vital is one of few companies with good GMP in this country. It even gladdens my heart to hear that your company is putting up a new structure aside from the old warehouse, to commence on production of your proposed ARVs,” she said.

Mrs. Denloye, on her part, also counselled the company to put necessary documents on scale safety, system suitability and other needs in place, to prevent inspectors from erroneously thinking the company had certain skeletons to hide.

In appreciation of the observations, Mr. Matthew Philips, Stride’s operations manager, said the suggestions of the NAFDAC team were much esteemed, as the management clearly understood that the opinions of inspectors were vital for improvement.

Making his own contribution, Dr. Orhii said that he was impressed with the inspection, as no major flaw was noticed.

“If two of my most critical inspectors can see little or no flaw, what more can I say?” he asked rhetorically. “I am even more surprised that, given the whole lot of progress we saw here today, Strides Vital was not included in the earlier WHO pre-qualification list we submitted. But God willing, I am hoping we could have you on the next one. Your management has done well! I also thank you for accepting us, given the short notice we gave. Please be free to ask our inspectors questions or invite us whenever you have issues to clarify,” he said.

Thanking the NAFDAC boss, MrAnoop Kumar, regional head of the company, noted that quality had always been Strides’ watchword.

“Even when we started out, Nigeria was our first market, before establishing our presence in other 55 countries across the globe. The country is like a second home to the management, as well as to many Indian investors,” he emphasised.

Leading change in a knowledge economy

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(By Pharm. Nelson Okwonna)

“Money motivates neither the best people, nor the best in
people. It can move the body and influence the mind, but it
cannot touch the heart or move the spirit; that is reserved
for belief, principle, and morality. As Napoleon observed,
‘No amount of money will induce someone to lay down their
life, but they will gladly do so for a bit of yellow
ribbon.'” – Dee Hock (founder of VISA)

 

Leadership

Leadership at the centre is all about causes. They reveal who the leader is, and the things that matter to him. Basically then, the best of leaders are those with the best causes.

This illustration reveals how effective team leaders function:

Pharmaceutical Business

These leaders lead from the centre. They tell the team “why” they have to do the things they are doing. The outer part, “what”, shows their products and services; while the inner part, “how”, shows their operative strategy. The core is where leadership begins.

A great leader is one with a great cause and who goes about it in the best possible way. The process of leadership is about influence and there are three ways to influence individuals: compulsion, manipulation and persuasion.

The first two are against the free spirit of man and the inherent laws of nature. Brute force has always worked with lower animals but never with man. Manipulation, on the other hand, can be very effective but is always devoid of charity which is the vitality of life; hence it is not in line with the basic nature of reality and cannot produce lasting results.

Compulsion says “do this or…”. It thrives on the strength of the leader. If the leader is strong enough then he is compelling enough. Actions are taken not because of the desire to act, but for fear of the penalty for inaction. The strength could be derived from position, financial clout or from emotional dependence.

 

Persuasion appeals to the good judgement of an individual; it presents facts and figures and aims to convince the other party to tow a given line. Persuasion seeks to inspire the follower to follow simply because in so doing he will also find good for himself. No doubt, a persuasive leader at times will need to compel obedience but he knows he must not dwell on that and if he must then that particular team member would need to be changed.

LEADERSHIP IN A KNOWLEDGE ECONOMY

In the agrarian and industrial era, the landowners and the employer of labour had the balance of power in their favour and could manipulate or compel labour to act in their interests. Despite the development of labour unions, the employer of labour still had a greater bargaining chip and could exploit the labour greatly.

This was possible because of the abundance and ease of mobility of labour; it was relatively easy to find a replacement for a factory worker at a very short notice as the contribution was either semi-skilled or unskilled labour.

As the industrial era led to the computer era, the degree of skill possessed by labour increased dramatically. Consequently, employers of labour started paying closer attention to human resource management as the individual roles of these employees became much more of a determinant to the outcome of the enterprise. The ease of replacement became considerably reduced.

In this era, the employee earned much more and could afford to stay off work for a considerable duration of time while looking for a more satisfactory employment. The relationship between employer and employee became more of a partnership and the salary was no longer the greatest bargaining chip. Other factors like insurance, availability of crèche facility, maternity leave, holidays, management disposition and location of the enterprise became important considerations for the choice of where to offer services.

In this knowledge era, the individual, and not land or money, is king, as the contribution of knowledge workers has become the determinant of the success of any enterprise. The leader of nearly every successful business is essentially a knowledge worker and a great business is one with many of such leaders on its team.

Here, the enterprise is “the team”, and the preoccupation of the chief executive officer is more of providing leadership for this team, to persuade team members to not only stay with the team but to contribute their knowledge. Many times, this leader would have to identify individuals needed for building a particular kind of team and to go about persuading them to join the team.

Leaders who are willing to contribute consistently to the society in this era must realise that the game has changed very much. The words of Jesus Christ has become much more relevant in the market place: “He that wants to be the greatest, let him be the servant of all”.

Leadership is serving the need of the team; it is keeping them happy and focused on the vision. A lot of employers and managers are yet to grasp this understanding and have inevitably shot themselves in the foot. They have succeeded in employing unwilling hands. In such organisations, the staffs are there simply because they have nowhere else to go. These leaders have missed the privileges that come from operating in a knowledge economy, and they have deprived their firms of the magic that pooled intellectual capital can create.

In a business particularly, the challenge of leadership is to discover that strategic reward system that rewards impressive efforts effectively. When this reward system is not in place the leader will oftentimes find that his employees leave to build companies that will compete with his. The result is that both firms produce at suboptimal levels. A new shift in leadership in our era comes with the realisation that a firm may never be able to own the intellectual capacity of an individual completely and this intellectual capital matter greatly. The responsibility therefore is to create structures that allow certain key individuals to own or have a certain degree of ownership on the results of their intellectual capacities; this will lead to decreased human resource turnover rates.

To achieve this, the organisational structure of the organisation may need to change.

PERSUADING THE STAFF

Much more than ever, great staffs are hard to find. Individuals with the rare combination of integrity, passion, competence and commitment are rare to find and they do not migrate to manipulative or compulsive systems. If you find them in such manipulative teams, it wouldn’t be for long.

Persuasion, therefore, is the act of convincing relevant individuals to join the cause of your organisation. It is retaining their respect by giving them due respect for their potentialities and capacities. It is refusing to belittle anyone.

This can be achieved using some time-tested approaches:

  • By effectively communicating the vision of the enterprise.
  • Communicating the personality, values and passion of the leader.
  • Standardising the compensation plan: salaries, equity, capacity development, etc.
  • Regulating the structure of the enterprise.

 

INFORMATION FLOW

In this information age, intellectual capital is becoming an investable entity that can be quantified in monetary terms. The level of knowledge or the corporate IQ of your firm is a reflection of the corporate information flow and processing in your organisation.

Everybody knows that the boss doesn’t know it all. Even if he does, everybody also knows that he cannot be there all the time. Every day there is new information in your area of business and chances are that the staff know many things the boss needs to hear. The key is building an atmosphere that makes such contributions possible.

A staff’s ability to contribute positively to the firm would depend on the level of information available to him or her. It is the job of the leader to paint the big picture for the team and dare them to make the necessary contributions.

Bill Gates in his book “Business at the Speed of Thought”, introduced the concept of the Digital Nervous System (DNS). The DNS occurs when thinking and collaboration are significantly assisted by computer technology. The “nervous system” of an organisation should be horizontal enough to share information with employees. When the employees can get the most information from the organisation and the organisation can get the most information from the employees, the corporate IQ becomes the collective IQ of its employees/associates.

This information flow system assumes that employees want to do a good job, which is the absolute truth. Most times employees do want to do a good job.

OF INTEGRITY, AUTHENTICITY AND CANDOUR

Without integrity, a leader cannot be authentic (real) and phony leaders cannot sustain a character of information flow in any system as they cannot stand discovery. Integrity, authenticity and candour are therefore cardinal attributes for the viability of the points earlier made.

Leadership, as explained from the outset, is about causes. “It is all about love” says Tom Peters, and I agree.

Love is defined as passion, enthusiasm, appetite for life, engagement, commitment, great causes and determination to make a difference, shared adventures, growth, and an unshakable appetite for change.

To communicate this passion, the leader must be real (authenticity) and talk real (candour). He must be able to see eye to eye with his team members and to motivate them to the next level.

Sound like an impossible job?

Welcome to the club! Attempt is the first virtue; go out there and do it!

Pharmacist organises HIV/AIDS campaign for students

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 By Adebayo Oladejo –

Zonal coordinator of the Association of Community Pharmacists of Nigeria (ACPN), Oriade Zone, Amuwo Odofin Local Government Area of Lagos State, Pharm. ObyIkwu, has advised stakeholders in the country’s health care sector to rise up to the challenge of reducing the scourge of HIV/AIDS, which she said had affected over 3.1 million people, so far, in the country.

Speaking with Pharmanews during the HIV/AIDS Awareness Campaign programme for primary and secondary schools in AmuwoOdofin Local Government, Lagos, held last December, Pharm. Ikwu, who is also the organiser of the programme, lamented that Nigeria had the second highest number of people living with HIV/AIDS in the world, adding that the greater percentage of infections were among the young people.

Speaking further, Ikwu, who is also the managing director of Lopez Pharmacy and Stores Limited, explained that the programme was organised in commemoration of the 2013 World AIDS Day with the theme “Share Responsibility: Strengthening Results for an AIDS-Free Generation”. She explained that she chose to focus on secondary and primary school students because the World Health Organization (WHO) had decided to focus on the adolescents, so as to enlighten them on the current challenges regarding the scourge of HIV/AIDS.

In her lecture, Pharm. Oby explained the nature and transmission patterns of the human immuno-deficiency virus (HIV), while also advising the students to abstain from ungodly relationship and affairs that could lead to pre-marital sex. “This will not only save you from contracting HIV/AIDS,” she counselled, “it would also prevent you from contracting other sexually transmitted diseases (STDs). Also, you should avoid sharing needles, syringes and any other sharp object, while you should also ensure blood is duly certified HIV-free before transfusion.”

On the suitability of the programme to the students, the organiser noted that it was important to catch the students young, so that as they grow, they get more information about the infection and also tell the coming generations about it.

While citing funding as the major challenge of her project, Ikwu quickly added that the joy she derives from her relationship with the students has been her motivating factor. “As community pharmacists, we are the first port of call in any community, and we should make it a duty to affect the community where we practise and this is exactly what I enjoy doing most,” she said.

Another speaker at the programme, MrsAnurikaAdetunji, a biochemist, remarked that the programme was very important and timely, considering the disturbing rates of decadence among youths. “If you are privileged to see what these little children are doing in secret, you will be baffled; so this is the best time to catch them.

This kind of awareness programme should not only come once in a year but as many times as possible. There should be more awareness programmes about HIV/AIDS in all primary and secondary schools across the nation. They should tell them about the growing trends, the implications and how they can protect themselves,” she stated.

She further emphasised that “the reason HIV/AIDS is growing at an alarming rate is ignorance. Many people do not know that AIDS truly exists. They think it is an agenda of the western people to reduce our population and scare us, but it does exist. HIV/AIDS awareness is needed most in schools, mosques, churches, market places and everywhere because the disease burden is increasing every day and people really need to be aware of its existence.”

Recounting the lessons learnt at the programme, one of the participating students, YahayaIsah said, “I have really learnt a lot today, especially the issue of stigmatisation against those who have it [HIV] and how to ensure it does not spread.”

Another student, Ruth Christopher, from De Ultimate School, said one important thing she learnt at the programme was the ABC strategy of preventing HIV/AIDS, which comprise: Abstinence, Being faithful and Condom usage.  “We learnt that we could abstain from sex, be faithful or always protect ourselves with condom; but based on the fact that we are still young, we have been told that abstinence is the most important method to adopt.  We are told to avoid being lured into having sex. Today’s programme has helped to remind us of what we have heard before that AIDS is real,” she said.

Stakeholders say best pharmacy practice not realistic in Nigeria

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By Adebayo Oladejo –

Stakeholders at the recently concluded Association of Community Pharmacists of Nigeria (ACPN), Lagos State chapter’s Continuing Education Conference have expressed concerns that the dreams of achieving excellent pharmacy practice and best possible medicine in Nigeria may not be achievable in a while.

The conference which held last December at NECA House, Agidingbi, Ikeja, Lagos, was graced by notable personalities in the Nigerian pharmaceutical industry.

Speaking on the theme of the conference “Good Medicine, Excellent Practice: Myth or Reality?”, chairman of the conference, Pharm. Ebenezer Adeleke, said for the country to have excellent pharmacy practice and safe medicine, there must be a conducive environment for the practitioners to operate. “Some people believe that good medicine and excellent pharmacy practice are not possible in this country, while others believe it is possible, but in reality, we need to examine and re-examine the way we practise,” he noted. “Are we doing the right thing in the right way? Is there an enabling environment to achieve this purpose? And we must also note that we cannot achieve the desired result without the cooperation of the people.”

Continuing, he said, “We are happy now that the Pharmacists Council of Nigeria (PCN) has been reconstituted and we believe that there will be a conducive environment for us to operate henceforth; but I want to implore the National Agency for Food and Drug Administration and Control (NAFDAC) not to rest on its oars, as there are still issues of fake drugs in the country, while some people still produce drugs from their toilets.”

While delivering the keynote address titled “Good Medicine, Good Practice: Myth or Reality?, Pharm. AzubikeOkwor said it was not easy to assure good medicine and good pharmacy practice in the country because there were still challenges of widespread counterfeiting, poor storage facility, poor quality assurance during manufacturing and problem of electricity, coupled with the problem of excessive decomposition of active ingredients, as a result of exposure to high temperature and high humidity, among others.

The respected pharmacist and immediate past president, Pharmaceutical Society of Nigeria (PSN), also revealed that, while he personally believed in excellent practice and safe drugs, such expectations might not be achievable yet, due to various challenges facing the pharmaceutical industry.

“How do we have good practice when most private medicine outlets still prefer to engage the services of untrained staff in the provision of pharmaceutical service to the populace? When most of them still sell prescription medicines to patients without prescriptions, or when medicines are not appropriately labelled or not labelled at all? He asked rhetorically.

Okwor however noted that, with a focused approach, as exhibited by many other communities of pharmacists across the globe, it was still possible to attain the goal. He added that the country desperately needed a comprehensive strategy that would unify the efforts of all the stakeholders, including the government, drug companies, health care professionals, regulatory agencies, civil societies, judicial system and the citizens, to combat poor quality medicines and create the enabling environment for pharmacists to serve the society optimally.

He also commended the ACPN, Lagos State chapter, which he described as the most vibrant and active technical group of the Pharmaceutical Society of Nigeria. “Lagos State is a pacesetter state and so also is the ACPN Chapter of the state,” he said. “Also, the leadership of the chapter is usually God-given from year to year, and I am always impressed with what they are doing to move the practice of pharmacy forward in this country.”

Speaking earlier with journalists, Pharm. AminuYinkaAbdusalam, chairman, ACPN, Lagos, said the essence of the seminar was to reactivate the members’ knowledge base and to update them on the new trends in the practice of pharmacy. He explained that the seminar was an annual programme, adding that in Nigeria, the level of expertise of pharmacists had yet reached the level of other specialists like oncologists, opticians and so on. This, he said, necessitated the need for training and retraining, so as to be relevant and as well follow the dynamics in the development of pharmacy practice in Nigeria. He added that the training strategy was not only happening at the state level, but also at the zonal areas of the state.

Speaking on the choice of the theme of the conference, Aminu disclosed that having excellent practice and good medicine is possible, depending on the conduciveness of the environment but also argued that there were so many factors militating against it. “It is really a complex situation,” he said, “but we pray that, in due course, we will have a well-developed infrastructure and constant power supply that will make our environment conducive in Nigeria. If you travel to some African countries, you will find out that the level of practice there is somehow encouraging than what we have here, because apart from the fact that the society is so free, almost everybody is selling medicine in Nigeria. ”

“Also, in terms of enforcement,” he emphasised, “we are not observing up to 30 per cent of the enforcement in this country and therefore exposing members of the public to the danger of inappropriate medicine and that is why you see that today, there are lots of chronic ailment coming up. So, it is high time those in the position do something about these challenges and rise up to the situation before it gets out of hand.”

Other dignitaries at the event include: Pharm. Olufemi Ismail Adebayo, national chairman, ACPN; Pharm. Bisi Bright, one of the guest speakers; Pharm. DejiOshinoiki, chairman, Board of Trustees, Lagos State PSN; Pharm. AkintundeObembe, chairman, PSN, Lagos State; Pharm. Regina Ezenwa; Pharm. GbengaOlubowale; Pharm. Anieh Felix Anieh, among others

Olpharm bags Lagos Merit Award -promises to do more on maternal health in 2014

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By Yusuff Moshood –

In recognition of its outstanding performance and contribution to health care delivery in Lagos State, Olpharm Nigeria Limited was recently awarded the 2013 Lagos State Health Merit Award.

The award was presented by the State Governor, BabatundeFashola, during an event held at City Hall, Lagos, last December.

According to the state government, the award was conferred on Olpharm for providing exemplary support in health care services and for loyalty and dedication to duty.

Speaking with Pharmanews in an exclusive interview on the award, Pharm. Johnson Olusetire, managing director/CEO, Olpharm Nigeria Limited, said the company was grateful to God for the privilege of being singled out among all the pharmaceutical companies in Nigeria and given the award.

He added that the company was glad and proud to be recognised for contributing to health care services, not only in Lagos State but in the whole country, stressing that the company, along with its principal partner, Ajanta-India, had been at the forefront of the national malaria control programme of the Federal Government of Nigeria and had also participated actively in the malaria programme of WHO, UNICEF and the Global Fund for more  than two years.

The Olpharm boss disclosed further that the company, with its product, Olpharm Baby Zinc, had also been at the forefront of the WHO and UNICEF diarrhoeaprogramme.

He stated further that with the Olpharm Baby Zinc, the only product certified by the United States Pharmacopoeia (USP) for diarrhoea in Nigeria, the company had consistently demonstrated its commitment to WHO and UNICEF programmes of helping to provide quality health care to the under-five. This, Pharm. Olusetire said, would help the government and other partners in meeting the Millennium Development Goal 4.

The Olpharm helmsman also assured that aside consolidating on its programmes and success in helping to achieve the MDG Goal 4 through the provision of quality medicine and care for the under-five, the company would equally focus more on maternal health care in 2014.

He revealed that the company would introduce products for maternal health care in the New Year to help complement efforts of the federal and state governments to reduce maternal mortality in the country.

He also stated that Olpharm, in partnership with Ajanta, would also expand its scope in anticancer products because the incidence of the ailment had been on the increase in the country, adding that the country was already involved in fighting the condition through partnership with teaching hospitals and some private and specialist hospitals.

Novartis Pharma introduces Coartem 80/480

81

By Adebayo Folorunsho-Francis –

In a bid to encourage patients complete the full course of treatment for malarial infection, Novartis Pharma has launched one of its biggest anti-malarial brands, Coartem® 80/480.

In a colourful event held at the Muson Centre recently, Mrs Vera Nwanze, head of Novartis Pharma (Nigeria & Ghana), explained that the new-look Coartem 80/480 has been specially designed to reduce the number of tablets to be taken from the old regime of 24 doses to six.

Among the dignitaries who attended the ceremony were Mrs Maureen Edigbeyi, representative of NAFDAC; Pharm. Bola Oyawole, representative of the Pharmaceutical Society of Nigeria (PSN); Pharm. Olufemi Adebayo, chairman of the Association for Community Pharmacists of Nigeria (ACPN); and Pharm. IfeanyiAtueyi, chairman of the occasion.

According to Nwanze, people often dislike swallowing a large number of tablets and therefore miss a dose or stop treatment altogether, leaving them vulnerable to re-infection by the malaria parasite.

This view was further affirmed by Dr Linus Igwemezie, executive vice president and head of the Novartis Malaria Initiative, who hinted that Nigeria has one of the highest incidences of malaria globally and, together with the Democratic Republic of Congo, it accounts for over 40 per cent of deaths from malaria worldwide.

“The launch of Coartem® 80/480 in Nigeria marks a new chapter in this battle, and promises to benefit many people with a convenient and quality treatment for malaria,” he said. “For over a decade, Novartis has been a pioneer in the fight against malaria. Besides, the rapid review and approval of the new formulation by the Nigerian health authorities has enabled it to be the first country to launch Coartem® 80/480.”

Commenting on how the new product can be distinguished from counterfeits, Igwemezie added that the Coartem® 80/480 packs feature an additional level of security popularly known as Mobile Authentication Service (MAS) label, which allows people to verify that the product is genuine.

“All the buyer simply needs to do is to scratch off the label to reveal a unique 12-digit number, which can then be texted, without cost, to 38353. Within seconds, a response is received, which informs them whether the code is valid,” he stressed.

In his presentation, Pharm. Atueyi declared that although reports on HIV/AIDS are said to be frightening, that of malaria is quite devastating.

“It is sad to note that the North Central and North Western parts of this country are worse hit. Only the South East can be truly said to be relatively free of the scourge.

“Chloroquin has fallen out of favour. Artemether-Lumefantrine is now regarded as the first line of treatment. I commend the effort of Novartis and challenge them to do more in the area of R&D because there is no guarantee that ACT will last forever,” he urged.

Atueyi also lauded Igwemeziefor  his active role in the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) which brings together Nigerian pharmacists in the USA every year.

Community pharmacy beyond drug selling – Agbude

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 (By Adebayo Oladejo)

In this exclusive interview with Pharmanews, Pharm. George Agbude, managing director, Teglo Pharmacy Nigeria Limited, Iju Agege, and zonal coordinator, Association of Community Pharmacists of Nigeria (ACPN), Iju/Agege Zone, shared some of his experiences from the early days as a fledgling pharmacist to the present day as an established community pharmacist.

He also spoke about some of the major challenges facing the practice, especially in his zone and the state in general.

Read the interview below:

How long have you been in the community practice and how was it when you started?

I have been in this practice since 1991; but at that time, I was still working with people, but in 1996, my own pharmacy, Teglo Pharmacy was born. However, it was not easy when I started because finance is always a major challenge to most community pharmacists. Still, I was a bit lucky when I started because I had worked with some senior colleagues and that had made me to know so much about community practice; and by the time I was ready to take off with Teglo Pharmacy, I had gained enough experience and made so many friends in the industry. In fact, my advice to our young ones who are aspiring to go into community practice is that they should strive to serve under the tutelage of an established community pharmacist for a period of, at least, five years before they establish their own pharmacy. By the time I started, how to raise capital, knowing where to buy quality drugs and so many other useful considerations were no longer problems for me and that was because I had gained enough experience from 1991 to 1996.

How lucrative is community pharmacy practice business in this part of the state?

Community pharmacy practice, as a matter of fact, is very lucrative but very challenging. It’s very challenging in the sense that you have to give up a lot of things for the practice to succeed. For instance, you open your pharmacy in the morning and close in the evening.You stay there almost throughout the day and, all your life, you nurture and grow it, and that is a very big challenge.But, then, it is very lucrative, provided you do it according to how you are supposed to do it and with God on your side, you can be a very successful person in it. In fact we have a lot of successful people in the practice and they are all doing well.

 How would you assess community pharmacy practice in this part of the country?

Community pharmacy practice in this part of the country is highly challenging.Challenging in the sense that we have to contend with lots of charlatans and patent medicine dealers. It is normal in this part of the country that, once somebody retires from work, the next thing they think of is to start community pharmacy and this has been a major challenge. These people are not professionals and they are not formally trained in the aspect drug-selling.They see it as merebuying and selling, which community pharmacy is not, as it involves professionalism. The patients need to be counselled.We need to see the patient, evaluate pharmaceutical care in terms of the drug the person is using and how best we can help the person. So, those quacks infiltrating the profession are causing a lot of havoc to the profession and they are not giving us access to really assist the masses in terms of their health care challenge.

Finance is another area that is hampering the growth of community pharmacy in the country. Community pharmacists are meant to cater for the needs of the people of our community; but in a situation where we are financially handicapped…and the banks are not really helping our situation because the condition they give most times could be more than what most practitioners can cope with. So, it has been a great challenge on our part.

Meanwhile, the practice is very interesting as it affords us opportunity to meet with lots of people, both rich and the poor and it makes us popular among the people of our community. I have had opportunities to meet with several people – couples, families – and I have interacted with them, counselled them, advised them and they have become like family to me.

Talking from the perspective of our zone, finance has been a great challenge to us. Also, when you go to our markets at night in this area, you see so many women with different kinds of baskets full of all assorted capsules for treating any ailment. This is a big challenge because people take all these drugs and before they know it they break down with different kinds of health challenges and when they come to us for remedy, we may not even know where to start from because they have taken lots of drugs and you are confused as a professional. So, to me, it’s a big challenge because I feel that this area needs to be looked into.

Recently,too, I have discovered that many young people are going down with kidney problems and I believe that all the drug abuse and misuse are some of the factors responsible for it.

Do you think ACPN, Lagos, is actually living up to expectations as an umbrella body for community pharmacists in the state?

They are really trying, especially when compared with other state branches across the federation.They are a pacesetter branch and I give them kudos for what they are doing. Recently they helped community pharmacists in the state to access Fidelity Bank loan so as to overcome the problem of finance. They have discovered that most of our colleagues want to practise but are limited by finance; so they helped them to access this soft loan and I give them kudos for that.

Do you have the statistics of all the registered community pharmacy outlets in this zone?

We are about to carry out the zonal mapping.Although we did it sometime ago, we want to update it this time around.But let me be sincere with you: there are more unregistered shops than the registered ones. I wouldn’t want to give a statistics until we are done with the new mapping of genuine pharmacies. Meanwhile, during the daytime, there are more registered pharmacies than the unregistered ones; but at night, there are more unregistered shops than the registered ones – these are the people who sell provisions during the day but suddenly turn to pharmacists at night.At night, they display more drugs in their shops than even most pharmacists.

What are the most common health conditions patients in this area come to the pharmacy for and why is this so?

Malaria has been a big challenge to everybody – not only the people of this area because, from the statistics available to us, malaria is a big challenge everywhere. However, environmental factors and other factors could be responsible for the rise in malaria cases in this area.The area is densely populated and the gutters are not flowing; there are stagnant gutters everywhere.Also the drainage system is bad and, generally, thelow level of environmental hygiene is not helping matters at all.

Malaria can be prevented if the drainage system is working well, if the bushes around are cleared and if there is availability of treated mosquito nets for people to use. So, to be sincere, we sell more of malaria drugs than any drug here.In fact, it is second to paracetamol.

If you were not a community pharmacist, which other areaofPharmacy would you have gone into and why?

If I was not in community practice, I would have loved to be in the industry because I believe in challenges; and that is the area I would have loved to work so as to explore and task my brain on so many things.

Who is your role model in pharmacy practice?

I don’t have a specific one but I have role models in this practice,including Prince Julius Adelusi-Adeluyi of Juli Pharmacy, Pharm. Ike Onyechi of Alpha Pharmacy, and Boluke Pharmacy. In fact, I mentioned Boluke pharmacy because of the way she came up – she started from the rough bottom and, today, she is making it big and we all look up to her.

How do you see the war on fake drugs and what other strategies can be adopted to effectively tackle this menace?

Fake drugs in Nigeria is a big issue and if the war must be won, the federal government must develop the nerve to really stand and fight it. I see fake drug as a cartel business in Nigeria and, from top to bottom, many people are involved because the mega drug business is not a business any person can go into.So,the federal and state governments and all other parastatals should have the nerve to stand and fight it; and if we must succeed in the war, it has to start from the federal government and there has to be punishment for those who trade in fake drugs. If we start doing that, even though we may not be able to wipe it out, we can curb it to an extent because so many people have suffered from it.

If the government can be bold enough to take some steps like impounding the drugs and sending culprits to about 20 years imprisonment, I am sure others would be scared to go into it because of the punishment.

Also on the part of the National Agency for Food and Drug Administration and Control (NAFDAC), the proliferation of fake drugs had started reducing at one time but, recently, it seems the problemhas resurfaced. Also this their new Mobile Authentication Service (MAS) doesn’t seem to be working as there are times you send it and the result you get is that the product is not genuine and you get confused because the drug came directly from the company and this has happened with Lonart and Ampiclox. In fact, ACPN has complained about it so many times.So I think the only way out is that drug fakers should be severely punished and the government should not spare anyone.

Pharm. George Agbude