- Drug
utilisation and management of Kaposi's sarcoma in urban Harare
Maphosa, S. and
Kasilo, O.
A retrospective
study was carried out to analyse drug utilization and management of Kaposi's
Sarcoma at Parirenyatwa Central Hospital. The main objectives of this study
were to find out what drugs are used for the treatment of Kaposi's Sarcoma
patients and, to find out the main methods used for the cancer therapy.
The study was also interested in finding out if these drugs were being
used rationally and to find out the stages of Kaposi's Sarcoma that are
prevalent in urban Harare. Data was collected for 270 black patients, covering
the period January 1993 to June 1994. Majority of patients were male and
the main age group was 31-40 years. The common type of Kaposi's Sarcoma
was the epidemic form. The endemic type (3,7%) only consisted of the 61
year olds and above age group. The skin was the major site of Kaposi's
Sarcoma. Radiotherapy was the most common form of cancer treatment followed
by combined chemotherapy and the single agent Etoposide was the least used.
A total of 873 drugs were utilized by the study patients, consisted of
63 different drugs and 23 pharmacological classes. Antibiotics (26,8% were
used the most, followed by non narcotic analgesics (11,1%) an anti-emetics(10,0%).
The frequently used drug was Co-trimoxazole. All the drugs encountered
in this study were part of the EDLIZ, of these drugs (87,2%) were prescribed
rationally and only (12.8%) were prescribed irrationally. There was no
difference in drug taking between the 1993 and 1994 groups (P>0,05), an
no association between the development of tuberculosis and type of Kaposi's
Sarcoma (P>0,05). It was revealed in this study, that tuberculosis (12,2%)
was the next most common diagnosis made after HIV (50,7%) and Kaposi's
Sarcoma (100%). In conclusion, Kaposi's Sarcoma patients are on polypharmacy,
and therefore adverse drug interactions should be monitored and prevented. - Quality
assurance tests on expired drug products
Matowe, L. and
Chinyanganya, F.
Expired drug products
were obtained from Government Medical Stores The drugs selected were:-
1. Propranolol Hydrochloride tablets (40mg) 2. Prazosin Hydrochloride tablets
(5mg) 3. Glibenclamide tablets (5mg) 4. Allopurinol tablets (100mg) The
physicochemical properties of these tablets such as friability, dissolution,
disintegration and hardness were studied for both the expired and non expired
drugs. The results were then compared for each set of drugs before statistical
analysis was doe to render the expired drug either usable and non usable.
Both sets of results were compared with the standard pure samples. All
but glibenclamide passed all the tests. Though the glibenclamide tablets
passed all the physical tests, the drug failed the two most crucial test
regiments, the Infrared spectroscopy analysis and the ultraviolet spectroscopic
assay. It was found out that some expired drugs even after one year of
being labelled expired might still be potent.
- Quality
control of dexamethasone tablets
Mlauzi, Y. and
Chagonda, L.
The content uniformity
of Dexamethasone tablets was studied and the batch of tablets was found
to vary from 91.00% to 104.60% of the stated amount of active ingredient,
with an average percent content of 98.69%. Extractability using two-phase
solvent systems showed the Methanol-Cyclohexane system to be better (extractability
74.45%) when compared to the ethanol-heptane system (67.88% extractability).
Two-phase solvent extraction was however found not to be suitable for extraction
of Dexamethasone prior to analysis, due to emulsion during the extraction
step. The batch of tablets passed all the other physicochemical tests.
- Accelerated
stability study of parenteral ergometrine injection (USP)
Mphoko, M. and
Chagonda, L.
An accelerated stability
study was carried out on a batch of imported Ergometrine Maleate Injection
(USP) to verify the shelf life given by the manufacturers. Three elevated
temperature conditions were employed; (a) 44oC (±2oC) (b) 66oC (±2oC)
(c) 80oC (±2oC) UV-Visible spectrophotometric analysis was carried
out on the injections to detect the amount of active ingredient at various
time intervals. The data was extrapolated to recommended storage temperature
(4oC) using the Arrhenius plot and the batch complied with the recommended
shelf-life of two years.
- Vitamin
A status in asymptomatic HIV seropositive and seronegative individuals
Mukondiwa, T.
and Nyazema, N.
Vitamin A has been
found to mediate immuno enhancement, haemopoiesis and modulation of disease
processed like cancer and a host of infections. Like most micronutrients
it has also been found that disease processes deplete Vitamin A as well
as macronutrients and nutrition therapy has been called for as possible
intervention. In the study serum concentration of Vitamin A were determined
from randomly selected serum samples which had been obtained for HIV screening.
Blood serum was obtained from healthy looking blood donors from Chiredzi
district of Zimbabwe, using an HPLC method. A food chart was used to carry
out food consumption survey with particular emphasis on Vitamin A rich
foods. HIV status data was obtained from the Blood Transfusion services
(BTS). The results obtained showed generally low Vitamin A levels in the
serum, of both HIV seronegative 4 and asymptomatic HIV seropositive individuals.
Food consumption survey showed low intake of Vitamin A rich foods in Chiredzi.
The survey also sowed that the major source of vitamin A was agricultural
products, as a result the erroneous consumption was thought to be the persistent
drought in the region which has in place for at least the past 5 years.
- Adverse
reactions to blood and blood products
Mutasa, F. and
Nyazema, N.
Transfusion of any
blood product present a significant risk to the recipient. Over 10% of
all recipient suffer from some kind of adverse reaction. Judicious and
rational use of blood and blood products reduces these risks. The present
study reports the number of patients who experienced adverse reactions,
during or after blood replacement therapy. Using a designed questionnaire,
ninety (90) patients were interviewed and followed up to observe whether
they suffer from any adverse reactions and also to observe whether any
post transfusion infection occurred. The follow up period was one to two
weeks. The results obtained showed that the majority of reactions were
due to red cells and these had the highest reaction incidence per blood
product (53%). The reaction incidence per blood product for factor IX complex
was 3%, for albumin, platelet concentrate and fresh frozen plasma was 2%
and for Anti-Haemophilic 1%. The majority of signs and symptoms reported
were mild and transient. The commonest were fever (27%), headache (21%)
and rash/urticaria (14%). The investigations carried out revealed little
that accurately defines the aetiology of a reaction, a rationalisation
of the investigation into acute transfusion reactions is suggested. A large
sample would be required. However, the results do seem to confirm that
transfusion of blood or blood product presents a significant risk to the
recipient.
- The
role of pharmacists as information disseminators regarding contraceptives
use in family planning programmes
Nyachoto, T.
and Kasilo, O.
A survey to determine,
from pharmacists and contraceptive users, whether pharmacists have a role
to play in family planning especially as information disseminators was
carried out. Two questionnaires were designed, one to be answered by pharmacists
and the other one by contraceptive users. The questionnaires of pharmacists
were randomly distributed to pharmacies (most community). A total of 31
questionnaires were filled in. Questionnaires for contraceptive users were
distributed at random to women in the 15-44 age group. Three hundred and
twelve (312) questionnaires were completed and returned. Of the total pharmacists
who responded, 93,75% said they had a role in family planning, the main
reasons being that they were the drug experts and easily accessible, being
the first link in the health chain. But time was said, by most pharmacists
in the study, to be a limiting factor making the implementation of this
role difficult. The majority said they could help, a client make an informed
choice on which contraceptive to use an dint he management of side effects
due to contraceptive use. About fifty two percent (51.6%) of the pharmacists
felt that this role was being executed, the rest felt otherwise. The majority,
(76.6%), of the of the contraceptive used in the study population said
pharmacists had a role to play in family planning, reasons being that they
were drug experts and were easily accessible. The rest, (23,4%), felt that
family planning was not the pharmacists area of work reasons being that
they did not have the time to discuss problems with patients, clinics offered
better and cheaper services and pharmacists were not knowledgeable offering
inadequate information. The lack of privacy in most pharmacies was mentioned
by many who did not entertain the idea of discussing family planning issues
over the counter.
- The
association of schistosomiasis and hepatitis B viral infection in pregnant
mothers
Patana, M. and
Nyazema, N.
Two hundred and
ninety-nine pregnant mothers from a rural population were screened for
schistosomiasis, using KATO method and membrane filtration techniques.
49.45% were found to be infected with schistosomiasis. 64.8% had suffered
schistosomiasis at one time in their life. The incidence of still-births
in mothers with history of schistosomal infection was found to be twice
the incidence in mothers that had never had schistosomiasis (16.9% versus
8.5%). One hundred and seventy four sera from the sample were examined
for HBsAg using the enzyme immunoassay technique (Abbott). Ninety-four
of these had history of schistosomiasis whilst eighty were normal, four
sera (2.3%) were positive for HB5Ag, three of these from the ninety-four
and only one from the eighty. Another nineteen sera (10.9%) were in the
indeterminate range for HBSAg. Out of the one hundred and seventy four,
ninety-five sera were further examined for anti-HBe. The four positive
for HBsAg were also positive for anti-HBe and ten others were positive
for anti-HBe. Although there was no statistically significant association
between these two pathogens, larger non-hospital based studies are needed
to resolve this question. The possibilities of conducting such screening
test were also explored, and a short literature review on the impact of
vaccinating infants born of schistosomiasis infected mothers performed.
- An
assessment on safe-keeping of medicines in Chitungwiza homes
Phezulani, S.
and Maponga, C.
A prospective survey
was carried out over a four month period to assess places where drugs are
stored in homes in Chitungwiza. The study included 120 homes of mothers
with children under the age of 12 months. Of the 17 different places where
drugs were found, wardrobes constituted 27%, kitchen-units 20%, push-trays
7.64%, bags 6.94% and headboards 5.56%. The rest were below 5%. Drug cabinets
were only 1.39% showing how unpopular they are in the population studied.
The drugs found were mainly analgesics 22%, cough remedies 145.6% and oral
contraceptives 10%. This interesting patter of drugs found, i.e. paediatric
syrups and suspensions, and oral contraceptives was attributed to the fact
that the sample consisted of mothers in the childbearing age (who use OCs)
and little children. Paracetamol syrup was the main analgesics found (90%).
Every home had at least one child under 12 months of age, and of he total
1050 people in the 120 homes, 23.05% were children below5 years. Therefore
there was a need for all the mothers to keep their medicines in lockable
places so as to prevent accidental child poisoning. Unfortunately in many
homes, drugs were kept within reach of children. Stability of drugs is
another problem encountered. Over 24% of the drugs were found in exposed
places that did not afford protection from light and heat. Some drugs had
no labels or expiry dates. So it is possible that some of the products
were no longer effective.
- Drug
utilisation in the management of pregnancy-induced hypertension (PIH)
Tagwireyi, M.
and Kasilo, O.
The major objective
of this prospective study was to investigate the epidemiology of Pregnancy
Induced Hypertension and the pattern, extent and nature of drug use in
the management of this condition. A total of 249 pregnant women were randomly
chosen and interviewed, 10 of them at Parirenyatwa Hospital and 239 of
them at Harare Hospital, the two central hospitals in Harare. It was found
that primigravida are the highest risk group where the development of PIH
is concerned. The complication occurs in the latest stages of pregnancy,
usually in the third trimester and at full term and occasionally in the
second trimester. Other findings were that a total of 544 drugs were consumed
by the 249 patients with the average number of drugs per patient being
2. The most prevalent drug class encountered were the antihypertensive
drugs and these were consumed mainly by pre-eclamptic patients. Eclamptic
patients consumed more of the antibiotics while pre-eclamptics consumed
more of the analgesics. There was no difference in drug taking between
primigravidae and multiparae. Although prescribers adhered to treatment
guidelines in the 1994 EDLIZ, it was found that they still use brand names
instead of generic names in the majority of their prescriptions and they
miss out vital drug data which is essential for evaluating cost-effectiveness.
- Synthesis
of sodium benzoate
Ushamba, D. and
Gundidza, M.
The synthesis of
sodium benzoate in order to investigate the feasibility of its manufacture
in Zimbabwe is described. Benzyl chloride was prepared by chloromethylation
of benzene (Blanc reaction). The synthesised benzyl chloride was then oxidised
to benzoic acid and subsequently converted to sodium benzoate. An average
yield of 69.5% of benzyl chloride and 70.3% of sodium benzoate were obtained.
Chemical tests, Infra-red spectra, thin layer chromatography confirmed
that the products were indeed benzyl chloride, benzoic acid (intermediates)
and sodium benzoate. A cost analysis carried out to assess the feasibility
of sodium benzoate manufacture showed that the price of raw materials required
to manufacture a kilogram of sodium benzoate is Z$ 80.44. Methods described
by Dean and Ritchie were employed to test for antimicrobial activity of
the product. Of the 10 fungal species used, Candida albicans was the most
sensitive. Of the 25 bacteria species tested Proteus vuIgaris was the most
sensitive and Yersinia enterocolitica was the most resistant organism. - The
phytochemical and antimicrobial screening of Zanthoxylum chalybeum
Maviya, C. and
Chagonda, L.
No abstract available
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