- Epidemiology
of health and medication aspects at the University of Zimbabwe students'
health service 1987-1991
Bvochora, J.
and Nhachi, C.
Data collection
sheets were utilized to extract information from patients cards at the
University of Zimbabwe student health service. A total of 1500 cases were
studied retrospectively for the five year period, 1987-1991. The total
student population over this period was 44 030 and the cases were selected
randomly. Requisition/order books, annual budgets for drugs and medical
appliances and student population statistical data were analyzed. Analysis
of data from patients cards was done manually using the tally method. Females
accounted for 25,53% of the cases. The average age at the time of the visit
was 22,04 years. The percentage of cases involving married students was
2,53% of which 94,74% were males. The total expenditure on drugs and medical
appliances for the period 1987-1991 was $412 413.55. The government medical
stores (GMS) supplied most of the items. The most prevalent disease conditions
were respiratory tract infections (35%) and urinary treat infections (16,3%).
The patterns differed from that in district, general and provincial hospitals.
The total number of drugs dispensed for the 1500 cases was 2 600 giving
an average drugs per case of 1.7. Analgesics were the most widely used
drugs (28,5%) followed by anti-infectives (28,2%). The most popular analgesic
used was paracetamol which accounted for 66.6% of the analgesics. Antibiotics
accounted for 88,11% of the anti-infectives and 24, 88% of the total number
of drugs dispensed. The most popular type of anti-infectives were the penicillins
which accounted for 66, 06% of the penicillins and 17,76% of the anti-infectives.
Finally, recommendations were made on the need for health centres to keep
requisition/order books in order, so that these can be of use to evaluators,
on improvement of drug utilization at the student health centre and, perhaps,
other clinics too!
-
Strychnine-induced
seizures in mice: the role of the noradrenergic system
Chandomba, R.
and Amabeoku, G.
1. The influence
of some noradrenergic agents on seizures induced by strychnine (1-2mg/kg,ip)
was investigated in mice. 2. Strychnine (0.5-4mg/kg,ip) exhibited dose
dependant convulsant activity. 3. DOPS (4mg/kg,ip) and imipramine (20-40mg/kg,ip
profoundly shortened the latency of tonic convulsions induced by strychnine
(2mg/kg,ip). 4. Pargyline (100-200mg/kg,ip) weakly reduced the latency
of tonic convulsions. 5. DOPS (4mg/kg,ip) significantly increased the incidence
of strychnine (1mg/kg,ip) induced seizures. 6. Phentolamine (10-20mg/kg,ip),
propranolol (2mg/kg,ip), prazosin (1- 2mg/kg,ip) and reserpine (5-10mg/kg,ip)
markedly delayed the onset of strychnine (2mg/kg,ip) - induced seizures.
7. The data obtained from the study show a significant involvement of the
noradrenergic system in strychnine-induced seizures.
- Antianaemic
drug use in pregnancy
Chikumbo, E.
and Nyazema, N.
The rate of iron
and folic acid consumption increases in pregnancy and if not supplemented
in a poor diet, can result in anaemia. The staple diet in Zimbabwe of maize
meal is poor source of bioavailable iron and contains about 0,4ug folate
dry weight. The main objective of this research project was to determine
whether it is really necessary to give antianaemic drugs to every expectant
mother visiting an antenatal clinic. A case-control type of study was employed.
100 expectant mothers were interviewed by use of a questionnaire an each
woman had a sample of blood collected, by venipuncture, into 5ml vials
containing EDTA as an anticoagulant. The samples had their haemoglobin
and haematocrit levels measured. A sample of clay eaten by some pregnant
women was assayed for trace elements so as to find out its effect on Haemoglobin
status of the pregnant women. A mean mild anaemia (7-11 g/dL) prevalence
of 12% was found. The prevalence was classed as medium according to WHO
1989. Anaemia is women not receiving any treatment was significant with
86% of the women mildly anaemic. Clay eating parity group did not influence
frequency of anaemia. Haemoglobin status of the mother did not significantly
affect birth weight of the baby nor the apgar score. In conclusion, women
not receiving antianaemic drugs are prone to develop anaemia and so every
woman attending antenatal clinic should be given iron and folic acid supplements.
- Formulation
of cosmetics using three Zimbabwean Aloe species
Chinganga, T.
and Munjeri, O.
Extracts from three
Aloe species (chabaudii, excelsa and lutensens) were used to formulate
four types of cosmetics: that is Hand and body lotion, Cream, shampoo and
gel. Successful formulations were tested for thermal stability at 2oC,
25oC and 50oC, pH and viscosity effects for gel and shampoo, and flowability,
feel, humectant and irritant properties. It was found out that the Aloe
chabaudii was the least stable at high temperature, it also gave products
with the most undesirable properties compared to others, i.e. feel, flow,
spreadability and humectant properties were least attractive for A chabaudii.
Generally pH and viscosities obtained in final products were acceptable
(no irritancy). Shampoo formulations were also found to be of poor quality
in properties, stability test, pH and viscosity. Aloes excelsa and lutensens
gave equal (roughly) and acceptable, satisfactory results, with Aloe lutensens
the most ideal.
- The
effect of the Economic Structural Adjustment Programme (ESAP) on the drug
utilisation in the outpatients' pharmacy at Harare Hospital
Chisadza, E.
and Maponga, C.
As part of the economic
reform programme, drug user fees have been introduced in government hospitals.
The potential for profit in such ventures in often doubtful and the effects
on the patients undesirable. A carefully designed system of subsidies and
surcharges can however be used to overcome such problems. The effects of
drug user fees on drug utilization at the Harare Hospital Outpatients Pharmacy
were assessed. Data was extracted from patients using an interview schedule.
Out of the 562 patients who were interviewed, 458 provided data that could
be used in this study. 69.2% of the patients paid drug user fees. This
group managed to raise revenue that was 2.51 times greater than the cost
price of the drugs used by the whole sample. Patients who paid 50% of the
cost price had an average prescription price of $9.39 with an estimated
3.62 visits to the pharmacy per year. It was estimated that this group
spent 1.82% of its annual income on drugs. For the patients paying the
full drug prices the percentage was 0.3%. Compliance to medication was
found to be 90% amongst the non paying patients and 88.3% amongst the paying
patients. From these percentages it was not possible to make a substantive
conclusion on the effects of drug user fees on compliance. The average
number of drugs per prescription was found to be 2 with only 0.6% of the
prescriptions having more than 5 drugs on them, Polypharmacy was observed
not to be prevalent. From this study it was concluded that a phenomenal
potential for profit can be realised form drug user fees. A delicate balance
between surcharges and subsidies however needs to be attained. This is
essential in order to maximise on the revenue base whilst protecting the
poor.
- Pentobarbitone-induced
sleep in mice: the role of serotoninergic mechanisms
Dembure, R. and
Amabeoku, G.
- The influence
of some serotoninergic agents on pentobarbitone induced sleep was studied
in mice.
- Pentobarbitone (30-40mg/kg, ip) induced sleep in mice dose-dependently.
- 5-Hydrocytryptophan (5-HTP), 4-8mg/kg,ip) reduced the incidence of sleep
and significantly reduced the duration of pentobarbitone (35mg/kg,ip) sleep.
- Parachlorophenylalanine (PCPA, 200-400mg/kg,ip) profoundly shortened
the onset and prolonged the duration of pentobarbitone sleep.
- Cyproheptadine
(2-4mg/kg,ip significantly shortened the onset of sleep: but less significantly
prolonged the duration of pentobarbitone sleep.
- Mianserin (8mg/kg,ip)
significantly prolonged the duration of pentobarbitone sleep.
- Trazodone
(5-10mg/kg,ip) weakly delayed the onset and reduced the duration of sleep.
- These results suggest that enhancement of 5-hydrocytryptminergic activity
may suppress pentobarbitone sleep while attenuation of the activity may
potentiate the sleep.
- The
synthesis of clofazimine and its veterinary applications
Dewar, F. and
Morton, D.
An alternative method
of synthesis of clofazimine was attempted and the veterinary appellations
of tropical clofazimine were studied. Clofazimine cream was made and distributed
to veterinary surgeons who used it on selected cases and submitted written
reports. A would trial was conducted sing surgically made wound on eighteen
bitches to assess the effect of clofazimine cream on healing as compared
to Betadine or no treatment. Wounds treated with clofazimine cream or Betadine
ointment (povidone-iodine) were shown by histological comparison of wound
tissue to have healed more within a set time than wounds that were not
treated. The opinions of veterinary surgeons who used clofazimine cream
support these finding.
- Prophylactic
antibiotic use in Caesarean section
Fundira, S. and
Nyazema, N.
Many studies have
been carried out on the use of antibiotics as prophylaxis against infection
Caesarean section and most of these studies have revealed a significant
reduction in post-operative morbidity. Not much has been done, however,
to assess the attitudes of clinicians toward antibiotic prophylaxis, and
also little has been done to assess the cost-benefit value of the practice.
About twenty-seven randomly selected practitioners took part in answering
an anonymous questionnaire and then all characteristics of Caesarean sections
performed at Harare Hospital during the greater part of May 1992 were recorded.
Blood samples were taken to analyse levels and in a way to check presence
of chloramphenicol. Chloramphenicol appear to be the most commonly prescribed
antibiotic, appearing in 8 of the 9 regimens used. The general attitude
observed was that prophylactic antibiotic were used routinely on all cases
undergoing Caesarean delivery and the general trend was to give antibiotics
before and after operation. The commonest regimen used was that of benzylpenicillin
5MU iv pre-operatively followed by benzylpenicillin 2.5 MU qid iv and chloramphenicol
500 mg qid i.v or orally after the operation. Other antibiotics used besides
chloramphenicol and benzylpenicillin were ampicillin and metronidazole.
The antibiotics were used for about 5 days post operatively.
- Potency
testing and adverse effects of measles vaccine
Goremusandu,
R. and Nyazema, N.
In community wide
immunization programmes against childhood infections, there is a conflict
between the interest of the individual (vaccine safety and efficacy) and
the interest of the community (vaccine uptake and level of herd immunity).
The testing of potency of the vaccines being used in the immunization programmes
is necessary, considering the comparison in the expense of testing compared
to the benefit that would accrue in terms of the reduction of the likelihood
of generating a false sense of security in the population from the use
of subpotent vaccines and the risk of epidemics associated with that. The
present study was carried out within the framework of Zimbabwe expanded
programme of immunisation (ZEPI) at Mbare Clinic. After obtaining permission
from the Harare City Health Department, Consent from mothers who had vaccinated
children was obtained and the children enrolled in the study. They were
to be brought back after 2 weeks. If they failed to a appear they were
seen after 4 weeks on returning. A questionnaire was administered to the
mothers to obtain information about knowledge on the vaccine and related
adverse reactions. The potency of the vaccine used was tested using vero
and chick embryo cells. Of the 82 children enrolled in the study, 23% did
not develop any adverse effects, 30% were pyrexial, 23% vomited 14% were
irritable, 4% had cough and 6% sneezed. No local or immediate reactions
were reported by the mothers interviewed. It was unusual for vaccinated
children to show more than 3 of symptoms usually seen with natural measles,
e.g. an adverse reaction observed did not represent a minor case of measles
but instead consisted of fever and cough. No serious complications due
to the vaccine were reported. The potency of the vaccine used was found
to be acceptable according to WHO specification. It would appear from the
results that mothers who were interviewed were aware of reactions due to
vaccination but did not consider these to be important to report back to
the clinic. The question, however still remains whether it is important
to monitor adverse reactions due to vaccines especially when most mothers
do not appear to be concerned.
- Potentiation
of paracetamol-induced hepatotoxicity by theophylline in male rats
Hadebe, D. and
Munjeri, O.
Co-administration
of theophylline and a hepatotoxic dose of paracetamol to male rats potentate
the paracetamol induced hepatotoxicity. In this experimental study one
group of rats was dosed with 100mg/kg theophylline orally and a hepatotoxic
dose of paracetamol (600 mg/kg) intraperitoneally, (group PT). The next
group was given paracetamol 600 mg/kg i.p and the vehicle for theophylline
orally (group P)> The third group received a subtoxic dose of paracetamol
(200 mg/kg) i.p plus the vehicle for theophylline orally (group S). The
last group received vehicles for both drugs (group c). The results showed
significantly elevated SGOT and SGPT levels for group PT over the other
groups. Histopathological examination revealed marked hepatocellular damage
for group PT in comparison with group P. No noticeable hepatocellular damage
was seen for group S and C. Group S and C did not show any difference in
serum enzyme levels. Possible biochemical mechanisms of the potentiation
were suggested. The need for greater care on co-administration of paracetamol
and theophylline was emphasised.
[ii]
|
.jpg)
