Development and in vivo evaluation of buccal tablets prepared using danazol-sulfobutylether 7 beta-cyclodextrin (SBE 7) complexes

The aim of the present work was to develop a mucoadhesive controlled-release formulation of danazol-sulfobutylether 7 beta-cyclodextrin (SBE 7) complex and to evaluate the feasibility of improving the bioavailability of danazol via the buccal route. Different types of polymers, polycarbophil (PC) and hydroxypropylmethyl cellulose (HPMC) were mixed with danazol-SBE 7 complex and compressed into tablets. These tablets were evaluated for their dissolution and mucoadhesion properties and for drug absorption in female beagle dogs. Increased mucoadhesion was observed for PC-containing tablets compared with HPMC tablets. As the concentration of polymer increased, drug release decreased, and PC-containing tablets gave slower release compared to HPMC tablets. In vivo bioavailability performed in dogs showed that the perorally administered danazol-SBE 7 complex and the danazol-SBE 7 (in PC matrix) buccal tablets had absolute bioavailabilities of 64% and 25%, respectively, that are significantly greater than 1.8% observed for the commercial formulation Danocrine. The increased bioavailability was attributed to the enhanced solubility consequent to complexation, and the possible avoidance of first-pass metabolism upon buccal administration.     

Biochemical evaluation of leachate-contaminated groundwater on the kidney of Albino rats

The effect of leachate-contaminated groundwater on the cells of the kidney was evaluated. Serum Na⁺ concentration of control rats was observed to be 120±1.0 nmol/l while that of rat placed on simulated leachate was 180±4.0 nmol/l. Serum K⁺, urea and creatinine concentrations of rats placed on simulated leachate and leachate-contaminated groundwater were significantly higher(p<0.05) than those of control rats. The activity of Alkaline phosphatase (ALP) of the kidney and serum, respectively, observed for the control rats were (237±3.70 and 0.37±0.01)nmol/min/mg protein while (116±4.20 and 3.17±0.20)nmol/min/mg protein was the ALP activity of kidney and serum, respectively, observed for the rats placed on simulated leachate. Histological examination of the kidney of the control rats showed no visible lesion while that of rats placed on simulated leachate showed extensive necrosis of muscle fibres and cellular infiltration by macrophages. It is viewed that leachate-contaminated groundwater may damage kidney cells and impair renal function.     

Perception and Practice of Emergency Contraception among Female Undergraduates of the University of Ibadan, Nigeria

Objective To assess perception and level of proper utilization of emergency contraception （EC） among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with Z-square test and logistic regressions （P 〈O. 05）. Results One hundred and five （48.2%） had been sexually exposed. Only 32 （30.5%） used regular contraception. Seventy-three （24.3%）female undergraduates were aware of EC. Only 29 （7.6%） had used EC before. Most would not use emergency contraceptive drugs in future due to lack of awareness （64.8%）, and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use （OR=9.1; 95%CI： 2.1-39.9）. Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals＇ knowledge needs improvement.     

Knowledge and behaviour of nurse/midwives in the prevention of vertical transmission of HIV in Owerri,Imo State,Nigeria: a cross-sectional study

Background  

Mother-to-Child Transmission (MTCT) of HIV remains the main mode of acquisition of HIV in children. Transmission of HIV may occur during pregnancy, delivery or breastfeeding. Studies have shown that some specific interventions help to reduce the transmission of the virus to the baby. In order to target safe, rational and effective intervention to reduce MTCT of HIV, it is necessary to ensure that the nurse/midwife has knowledge of the strategies for the prevention of vertical transmission of HIV.     

Hormonal consequences of epilepsy

Epilepsy is a common disorder in childhood. The effects of recurrent seizures and the use of antiepileptic drugs (AEDs) during childhood and adolescence on reproductive endocrine health are poorly defined. We review effects of hormones on epilepsy and vice versa along with the effects of treatment (AEDs) on hormones in children.     

Prevalence and risk factors for hypertension and association with ethnicity in Nigeria: results from a national survey

Hypertension is increasingly being recognised as an important public health problem in sub-Saharan Africa, with 26.9% of men and 28.4% of women in 2000 being estimated to have hypertension.1 Although lower than the prevalence in high-income countries (37.4% in men and 37.2% in women), in terms of numbers of people affected, the burden of hypertension in low- and middle-income countries is greater due to the large population.1Hypertension has been recognised as a strong independent risk factor for heart disease and stroke and a predictor of premature death and disability from cardiovascular complications.2 It has been reported that 13.5% of deaths and 6% of disability-adjusted life years (DALYs) were attributed to hypertension globally, and for low- and middle income people, these figures were 12.9 and 5.6%, respectively over the period 1990 to 2001.3 Although infectious diseases remain the leading cause of mortality and morbidity in sub-Saharan Africa, the prevalence of cardiovascular disease and hypertension is rising rapidly.4It has been emphasised that urbanisation is a key reason for the increasing rates of hypertension, as evidenced by the higher prevalence of hypertension in urban areas.4-6 Urban lifestyles, characterised by sedentary living, increased salt intake, obesity and stress contribute to these differences.5 With the urban population in sub-Saharan Africa projected to increase, a greater risk of hypertension is anticipated.Studies on the association between ethnicity and hypertension in high-income countries have documented a higher prevalence of hypertension in black ethnic groups compared to white ethnic groups.7-9 Reasons for this association are complex, unclear and much debated, reflecting genetic and biochemical mechanisms, and environmental and socio-economic factors.10,11 There is limited evidence regarding differences in the prevalence of hypertension between ethnic groups within the broader classification of black ethnicity.6,12,13Studies in Nigeria and sub-Saharan Africa have mainly involved specific geographical areas or have focused on sub-groups of the population.5,14 Surveys from Nigeria report prevalence estimates ranging from 20.2 to 36.6%, but all have involved participants with different age ranges.15-18 To plan services for hypertension in Nigeria, it is essential to have accurate prevalence estimates for the whole population and to identify populations at risk.Nigeria, which is the most populous country in sub-Saharan Africa, is home to over 250 different ethnic groups. Nigeria is experiencing rapid urbanisation of the population, which is likely to increase the population at risk for hypertension.19 The present study is one of the largest population-based surveys in the region and is able to provide a nationally representative estimate of hypertension for Nigeria.     

Caries-based treatment need assessment by clinical dental nurses in Anguilla, British West Indies

OBJECTIVE: To determine the ability of dental nurses in Anguilla to assess treatment need following training in WHO criteria. PARTICIPANTS: Sixty-six randomly selected schoolchildren aged 6, 9, 12, 14, 15 and 17 years. DESIGN: Point prevalence study involving three different groups of schoolchildren [n = 20 (C0), 23 (D1), 23 (D2)] and four plaster casts comprising 52 extracted teeth (T0). MAIN OUTCOME MEASURES: Tooth- and person-based inter and intra-examiner agreement. METHOD: The only three government dental nurses in Anguilla were trained and calibrated by a benchmark dentist in June 2000 using WHO criteria. Tooth-based Treatment Need and person-based Treatment Urgency were assessed during 466 evaluations involving 1,733 teeth. Examiner agreement levels were compared during two calibration exercises (T0, C0) and two duplicate examinations (D1 and D2). The treatment components were classified as preventive (diet modification, prophylaxis, OHI, sealants); restorative (restorations, pulp care and crowns); and rehabilitative (tooth removal). RESULTS: All scores presented are Kappa scores. Substantial agreement was obtained at T0 (0.614-0.764), and almost perfect agreement at C0(0.832-0.872), D1(0.917-0.954) and D2(0.966-0.977). Almost perfect reliability occurred at C0(0.963-0.991) and D1(0.971-0.992) while perfect reliability was attained by all examiners at D2(1.0). Substantial and almost perfect agreement was obtained for all treatment modalities irrespective of caries prevalence and severity. Agreement levels increased as the survey progressed. Perfect agreement was obtained for all categories of treatment urgency. CONCLUSIONS: Dental nurses in Anguilla can validly and reliably assess treatment need provided training is adequate, of realistic duration and they are involved in all aspects of the exercise.     

Trial of Trachoma Rapid Assessment in a subdistrict of northern Nigeria

PURPOSE. To assess the usefulness of Trachoma Rapid Assessment (RA) in priority ranking of trachoma areas. METHODS. RA was conducted concurrently with a cross-sectional trachoma prevalence survey in some villages selected from the communities at risk for trachoma in the Kaita Local Government Area of northern Nigeria. The RA team consisted of two ophthalmic nurses. Pen torches and loupes were used for the examination. Data were collected on the seven components of the RA ‘information pyramid’ for all the selected villages. The data were analyzed using the RA methodology guidelines to determine the priority villages for trachoma intervention. This was compared with the ranking from the cross-sectional trachoma prevalence survey. RESULTS. The results of RA were found to be in agreement with the cross-sectional survey in 53.3% of the villages in the priority ranking of trichiasis, while in the priority ranking of active trachoma the agreement between the two methods was found to be 60%. The risk factors for trachoma were shown to be of high magnitude in all the villages using both the RA method and the prevalence survey. CONCLUSION. RA may be a more useful tool when applied to a vast area where the risk of trachoma is likely to differ greatly between different parts of the area. In the determination of the trichiasis pattern of a community by RA, it may be more useful to use the actual number of trichiasis cases in the area rather than the prevalence of trichiasis. The operational definition of some risk factor indicators seems very subjective and vague. The RA method needs more validation to sharpen the indicators used.