The novel human coronavirus (CoV) 2019, similar to previous severe acute respiratory syndrome cor... more The novel human coronavirus (CoV) 2019, similar to previous severe acute respiratory syndrome corona virus-1 outbreaks, has posed the unprecedented challenges that have shaped global action on preventive and easy to employ measures and policies, including regular disinfection. There is an indiscriminate use of antimicrobial agents, which may pose toxicity to humans, environmental hazards, and, in some cases, development antiviral drug resistance. This review comprehensively highlights the physical and chemical countermeasures applied to prevent various CoV infections and their potential toxicity on humans and the environment, as well as the danger of developing drug resistance. Literature information was sourced from PubMed, ScienceDirect, Embase, MEDLINE, and China National Knowledge Infrastructure databases using Google Scholars and Free Full PDF as search engines. Articles written in the English language were retrieved and included in the study. Researches covering the literature on physical and chemical severe acute respiratory syndrome corona virus-2 preventive measures, their toxicity, and possible ways of developing drug resistance were also discussed. The literature review reveals that physical inactivation under the influence of temperature, humidity, and light, especially ultraviolet-C radiation, has proven effective in reducing the spread of CoV infections. Similarly, chemical countermeasures such as the use of alcohol-and iodine-based disinfecting agents have demonstrated inhibitory potentials of the viruses on surfaces depending on nature, dose, and exposure time. The inactivation occurs through the interference of these agents with the lipid envelope, thereby disrupting the viral activity. A vast majority of the antimicrobial agents are reported to contain corrosive chemicals that are toxic to humans, especially children, and the environment. The toxicity is due to the unhealthy accumulation and pollution caused by the inappropriate disposal of biomedical waste. This study showed that chemicals might have long-term effects on public health, such as reproductive disorders, chronic obstructive pulmonary disease, cancers, skin damage, and central nervous system impairment. Therefore, further research on long-term preventive alternatives such as the formulation of these agents with natural products as active ingredients is necessary to mitigate the effects of alcohol-and iodine-based chemicals on humans and the environment.
The number of patients with diabetes and associated complications is rising across countries incl... more The number of patients with diabetes and associated complications is rising across countries including patients requiring insulin to control their diabetes. Hypoglycemia combined generally with poor control adds to the burden of diabetes. Long-acting insulin analogs were developed to reduce hypoglycemia, including nocturnal hypoglycemia, and enhance adherence, which can be a problem. These benefits have resulted in their increased use among high and highmiddle income countries, which is continuing. However, concerns in middle and lower-income countries as insulin analogs are considerably more expensive than standard insulins. Biosimilars can reduce their costs. Consequently, it is important to ascertain current usage and prices of analogs across middle-income countries with high patient co-payment levels to provide future direction. Overall, limited use of insulin glargine in Kenya, up to 3.6% of total insulins in one leading hospital with prices up to 3.4 fold higher than standard insulins. Overall, limited use of insulin glargine among hospitals in Northern Nigeria and in pharmacies again due to high prices. Appreciably higher use of long-acting insulin analogs in Bangladesh enhanced by low cost biosimilars with increasing competition. Increased competition enhanced by local production can lower biosimilar costs enhancing future use of insulin glargine to the benefit of all diabetes patients requiring insulin.
Background: Hydroxychloroquine(HCQ), one of the repurposed drugs in COVID-19, has several known c... more Background: Hydroxychloroquine(HCQ), one of the repurposed drugs in COVID-19, has several known cardiovascular(CVS) toxicities. Methods: VigiBase data were used to analyze the reported ADEs linked to HCQ. The data were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification level and the individual Preferred Term level. Results: The majority were above 18 years(91.6%) and from Europe(41.6%). A total of 5,315 ADEs were associated with HCQ use in COVID-19. Of these, 918 ADEs were attributed to CVS and reported from 773 patients. Grossly, CVS ADEs were associated with concomitant use of HCQ and azithromycin(AZM), and only 40 ADEs were solely due to HCQ. The majority were serious (69.3%) and resolved afterward (51%). In CVS ADEs, there were 366 cardiac disorders, 38 vascular disorders, and 514 ADEs under investigation. Among the cardiac disorders, palpitation was the most typical (N=65), followed by bradycardia(N=44) and tachycardia(N=33). Among arrhyth...
Spontaneous reporting and intensive monitoring are the conventional systems used for detecting, r... more Spontaneous reporting and intensive monitoring are the conventional systems used for detecting, recording and reporting adverse drug reactions. Using spontaneous reporting a lot of successes was made as existing adverse drug reactions were identified and new ones were prevented. In general, regulatory authorities consider only the information and outcome of the premarketing clinical trial in controlled settings to approve and register a drug for human use. As such, not much is known about the drug beyond the data obtained from clinical trials in controlled settings. The outcome of pre-marketing studies for safety, efficacy, and quality of new medicines will not represent the whole population of patients that will use the drugs when they are approved. Henceforth, suitable and constant post-marketing surveillance (PMS) is indispensable. The two types of post-marketing studies are descriptive and analytical. Descriptive study is carried out to generate adverse drug reaction signals (hypotheses) while the analytical study is done to test hypotheses and determine associations or causal relations between observed effects and particular drugs. Examples of descriptive studies are spontaneous reporting and intensive monitoring while analytical studies include case-control studies, cohort studies, and post-marketing clinical trials. The aim of this review is to highlight the menace of adverse drug reactions, challenges of the spontaneous reporting system and, more importantly, the information available from Malaysia and Nigeria.
ABSTRACT Introduction Dementia is a progressive neurodegenerative disorder impairing memory and c... more ABSTRACT Introduction Dementia is a progressive neurodegenerative disorder impairing memory and cognition. Alzheimer’s Disease, followed by vascular dementia – the most typical form. Risk factors for vascular dementia include diabetes, cardiovascular disease, hyperlipidemia. Lipids’ levels are significantly associated with vascular changes in the brain. Areas Covered The present article reviews the cholesterol metabolism in the brain, which includes: the synthesis, transport, storage, and elimination process. Additionally, it reviews the role of cholesterol in the pathogenesis of dementia and statin as a therapeutic intervention in dementia. In addition to the above, it further reviews evidence in support of as well as against statin therapy in dementia, recent updates of statin pharmacology, and demerits of use of statin pharmacotherapy. Expert Opinion Amyloid-β peptides and intraneuronal neurofibrillary tangles are markers of Alzheimer’s disease. Evidence shows cholesterol modulates the functioning of enzymes associated with Amyloid-β peptide processing and synthesis. Lowering cholesterol using statin may help prevent or delay the progression of dementia. This paper reviews the role of statin in dementia and recommends extensive future studies, including genetic research, to obtain a precise medication approach for patients with dementia.
The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2),... more The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later named COVID-19 by the World Health Organization (WHO), was initiated at Wuhan, Hubei, China, and there was a rapid spread of novel SARS-CoV-2 and the disease COVID-19 in late 2019. The entire world is now experiencing the challenge of COVID-19 infection. However, still very few evidence-based treatment options are available for the prevention and treatment of COVID-19 disease. The present review aims to summarize the publicly available information to give a comprehensive yet balanced scientific overview of all the fat-soluble vitamins concerning their role in SARS-CoV-2 virus infection. The roles of different fat-soluble vitamins and micronutrients in combating SARS-CoV-2 infection have been recently explored in several studies. There are various hypotheses to suggest their use to minimize the severity of COVID-19 infection. These vitamins are pivotal in the maintenance and modulation of innate and cell-mediated, and antibody-mediated immune responses. The data reported in recent literature demonstrate that deficiency in one or more of these vitamins compromises the patients' immune response and makes them more vulnerable to viral infections and perhaps worse disease prognosis. Vitamins A, D, E, and K boost the body's defense mechanism against COVID-19 infection and specifically prevent its complications such as cytokine storm and other inflammatory processes, leading to increased morbidity and mortality overemphasis. However, more detailed randomized double-blind clinical pieces of evidence are required to define the use of these supplements in preventing or reducing the severity of the COVID-19 infection.
Background: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lun... more Background: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lungs leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. Research design and methods: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients' demographic and clinical variables, and severity of involvement of organ system. Results: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18-64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. 'Injury, Poisoning, and Procedural Complications' remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. Conclusion: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting.
Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly chal... more Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.
The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number o... more The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number of fatalities calls for the speedy pursuit of a remedy. This review emphasizes the changing aspects of the COVID-19 disease, featuring the cytokine storm's pathological processes. Furthermore, we briefly reviewed potential therapeutic agents that may modulate and alleviate cytokine storms. The literature exploration was made using PubMed, Embase, MEDLINE, Google scholar, and China National Knowledge Infrastructure databases to retrieve the most recent literature on the etiology, diagnostic markers, and the possible prophylactic and therapeutic options for the management of cytokine storm in patients hospitalized with COVID-19 disease. The causative agent, severe acute respiratory coronavirus-2 (SARS-CoV-2), continually threatens the efficiency of the immune system of the infected individuals. As the first responder, the innate immune system provides primary protection against COVID-19, affecting the disease's progression, clinical outcome, and prognosis. Evidence suggests that the fatalities associated with COVID-19 are primarily due to hyper-inflammation and an aberrant immune function. Accordingly, the magnitude of the release of pro-inflammatory cytokines such as interleukin (IL)-1, (IL-6), and tumor necrosis alpha (TNF-α) significantly differentiate between mild and severe cases of COVID-19. The early prediction of a cytokine storm is made possible by several serum chemistry and hematological markers. The prompt use of these markers for diagnosis and the aggressive prevention and management of a cytokine release syndrome is critical in determining the level of morbidity and fatality associated with COVID-19. The prophylaxis and the rapid treatment of cytokine storm by clinicians will significantly enhance the fight against the dreaded COVID-19 disease.
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globa... more A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and invivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
The global pandemic from COVID-19 infection has generated significant public health concerns, bot... more The global pandemic from COVID-19 infection has generated significant public health concerns, both health-wise and economically. There is no specific pharmacological antiviral therapeutic option to date available for COVID-19 management. Also, there is an urgent need to discover effective medicines, prevention, and control methods because of the harsh death toll from this novel coronavirus infection. Acute respiratory tract infections, significantly lower respiratory tract infections, and pneumonia are the primary cause of millions of deaths worldwide. The role of micronutrients, including trace elements, boosted the human immune system and was well established. Several vitamins such as vitamin A, B6, B12, C, D, E, and folate; microelement including zinc, iron, selenium, magnesium, and copper; omega-3 fatty acids as eicosapentaenoic acid and docosahexaenoic acid plays essential physiological roles in promoting the immune system. Furthermore, zinc is an indispensable microelement essential for a thorough enzymatic physiological process. It also helps regulate gene-transcription such as DNA replication, RNA transcription, cell division, and cell activation in the human biological system. Subsequently, zinc, together with natural scavenger cells and neutrophils, are also involved in developing cells responsible for regulating nonspecific immunity. The modern food habit often promotes zinc deficiency; as such, quite a few COVID-19 patients presented to hospitals were frequently diagnosed as zinc deficient. Earlier studies documented that zinc deficiency predisposes patients to a viral infection such as herpes simplex, common cold, hepatitis C, severe acute respiratory syndrome coronavirus (SARS-CoV-1), the human immunodeficiency virus (HIV) because of reducing antiviral immunity. This manuscript aimed to discuss the various roles played by zinc in the management of COVID-19 infection.
Objective: Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and... more Objective: Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding treatments such as hydroxychloroquine with misinformation fuelling prices hikes and suicides. Shortages have also appreciably increased costs of PPE, potentially catastrophic among lower- and middle-income countries such as Nigeria with high copayment levels. Consequently, a need to investigate changes in availability, utilization, and prices of relevant medicines and PPE during the pandemic in Nigeria. Methods: Exploratory study among community pharmacists with a survey tool comprising four sections including questions on changes in consumption, prices, and shortages of medicines and PPE from the beginning of March 2020 to the end of June 2020. In addition, suggestions from community pharmacists and co-authors on ways to reduce misinformation. Findings: 30 out of 34 pharmacists participated giving a response rate of 88.2%. Significant increases were seen (3-fold or more increase) in the consumption of hydroxychloroquine (100%), vitamins/immune boosters (96.7%) and antibiotics (46.7%) as well as PPE (100%). Considerable price increases (50% increase or greater) also seen for antimalarials (96.7%), antibiotics (93.3%), vitamins/immune boosters (66.7%), and PPE (100%). Shortages are also seen for hydroxychloroquine and vitamins/immune boosters but most severe for PPE (80% of pharmacies). Conclusion: Encouraging to see increases in the utilization of vitamins/immune boosters and PPE. However, a considerable increase in the utilization and prices of antimicrobials is a concern that needs addressing including misinformation. Community pharmacists have a key role in providing evidence-based advice and helping moderate prices.
Background:Diabetes mellitus rates continue to rise, which coupled with increasing costs of assoc... more Background:Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers.Objective:To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin a...
Background: Countries across Africa and Asia have introduced a variety of measures to prevent and... more Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic.Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: One hundred and thirty one pharmacists took pa...
Background: Adverse drug reactions (ADRs) have been making headlines because of life threatening ... more Background: Adverse drug reactions (ADRs) have been making headlines because of life threatening issues. ADRs are always underreported and still the major public health problem. Spontaneous reporting system has remained the most significant method for safeguarding patients' lives. Objectives: Is to examine and analyse the various pharmacovigilance (PV) studies conducted among doctors and to make recommendations for future research. Study Selection: 32 studies covered from 2004 to 2014 were selected. Data Sources: Four electronic databases including Science-Direct, Springer-Link, PubMed and MEDLINE were used to obtain 129 relevant publications using HotBot, FreeFullPDF, and Google Scholar as search engines. Data Extraction: Studies conducted on doctors were selected covering research from ten countries. Inclusion Criteria: Only studies done from 2004 to 2014 were included, KAP studies done on ADRs and pharmacovigilance among doctors were selected. Exclusion criteria: All studies done before 2004 and studies done on general public KAP were excluded; similarly, studies conducted on healthcare professionals in general were excluded; also studies done on adverse drug event (ADE) reporting were excluded. The study was conducted from April to August, 2014. Data Synthesis: Knowledge, attitude and practice (KAP) regarding ADRs reporting by doctors were poor. Longitudinal study involving educational intervention and training through workshops and seminars were found to be effective in improving doctors' knowledge and attitude. Conclusion: There is urgent need to improve knowledge, awareness and practice of doctors on pharmacovigilance. It is imperative for WHO and national pharmacovigilance centres to take proactive measures to curve the menace of ADRs in order to safeguard the patients' lives. The curriculum of all health and health related schools should be restructured with respect to pharmacovigilance without any delay and hesitation.
Depression is a serious disorder that affects people in all communities across the world, a major... more Depression is a serious disorder that affects people in all communities across the world, a major cause of disability and morbidity worldwide. The drugs used in its management are associated with adverse effects and delayed response, hence it’s important to look for antidepressant plants with proven advantages and favourable benefits. Leptadenia hastata (Pers.) Decne belongs to the family Asclepidiaceae and is widely used in Tropical Africa as a vegetable due to its low toxicity and therapeutic benefits, it is used in the treatment of evil spirit, psychiatric disorders and hallucination. The aim of this study was to evaluate the antidepressant-like effect of the methanol leaves extract of Leptadenia hastata (LHME) and its fractions. Phytochemical screening and acute toxicity (LD50) study were done using standard procedures. Antidepressant-like effects of the LHME and its fractions was evaluated using the tail suspension test (TST) and forced swim test (FST). The intraperitoneal (i....
Journal of Pharmacy Practice and Community Medicine, 2020
Background: Recent evolution in terms of technology and availability of the internet has brought ... more Background: Recent evolution in terms of technology and availability of the internet has brought several innovations that made work and access to information straightforward. Nonetheless, the danger of pathological internet addiction and its adverse consequences are frightening. Objectives: The primary goal of this research is to determine the level of internet addiction among undergraduate medical students at National Defence University, Malaysia. Methods: A structured questionnaire comprising of section A consisting of student demographic information and section B made up of Dr. Kimberly Young's 20 items internet addiction test (IAT) in 5-point Likert's scale. Internet addiction scores were classified based on Young's scale. Results: The response rate obtained from this study was 89.6%. Out of the 224 respondents, only 4 (1.8%) were found to be regular internet users, 98 (43.8%) were established to be mild addicts, 110 (49.1%) were moderate addicts and finally, 12 (5.4%) were severe internet addicts. There was a statistically significant difference in the mean internet addiction score between males and females, with males having higher ratings. Conclusion: The prevalence of internet addiction among undergraduate medical students is high and needs to be controlled. As such, the use of the internet at colleges and universities may need to be regulated.
Herbal medicine has played a vital role in the phytotheraphy of various ailments including centra... more Herbal medicine has played a vital role in the phytotheraphy of various ailments including central nervous system disorders. Various part of the plants such as leaves, stems, roots, fruits, seeds, flowers etc. were used by both traditional and orthodox medicine practitioners as their source of medicaments (
Psychopharmacology, especially behavioral studies is attracting increasing interest of researcher... more Psychopharmacology, especially behavioral studies is attracting increasing interest of researchers because of lower quality of life, and higher prevalence of mental disorders such as anxiety in Nigeria. Various experimental animal models have been used successfully to demonstrate the anxiolytic property of medicinal plants. Techniques such as open field test, elevated plus maze, staircase test method, light, and dark box test, hole-board test, and beam walking assay are available and functioning effectively in various pharmaceutical research centers and higher education institutions in Nigeria. Consequently, this has led to the advancement in the field of behavioral studies. Furthermore, these experimental models are easy to operate, and in many instances, yielded promising and reproducible results. However, the accuracy and the validity of the outcome depend on the experience of the researcher, familiarization with laboratory animals and indepth knowledge of animal psychology. It is recommended that experimental models of anxiolytic testing can be improved by making an automated apparatus connected to digital watches, video cameras and computers available in Nigeria. The primary goal of this paper is to discuss the most commonly available experimental models in the evaluation of the anxiolytic activity of medicinal plants in Nigeria and to give a recommendation for further improvement and drug development.
The novel human coronavirus (CoV) 2019, similar to previous severe acute respiratory syndrome cor... more The novel human coronavirus (CoV) 2019, similar to previous severe acute respiratory syndrome corona virus-1 outbreaks, has posed the unprecedented challenges that have shaped global action on preventive and easy to employ measures and policies, including regular disinfection. There is an indiscriminate use of antimicrobial agents, which may pose toxicity to humans, environmental hazards, and, in some cases, development antiviral drug resistance. This review comprehensively highlights the physical and chemical countermeasures applied to prevent various CoV infections and their potential toxicity on humans and the environment, as well as the danger of developing drug resistance. Literature information was sourced from PubMed, ScienceDirect, Embase, MEDLINE, and China National Knowledge Infrastructure databases using Google Scholars and Free Full PDF as search engines. Articles written in the English language were retrieved and included in the study. Researches covering the literature on physical and chemical severe acute respiratory syndrome corona virus-2 preventive measures, their toxicity, and possible ways of developing drug resistance were also discussed. The literature review reveals that physical inactivation under the influence of temperature, humidity, and light, especially ultraviolet-C radiation, has proven effective in reducing the spread of CoV infections. Similarly, chemical countermeasures such as the use of alcohol-and iodine-based disinfecting agents have demonstrated inhibitory potentials of the viruses on surfaces depending on nature, dose, and exposure time. The inactivation occurs through the interference of these agents with the lipid envelope, thereby disrupting the viral activity. A vast majority of the antimicrobial agents are reported to contain corrosive chemicals that are toxic to humans, especially children, and the environment. The toxicity is due to the unhealthy accumulation and pollution caused by the inappropriate disposal of biomedical waste. This study showed that chemicals might have long-term effects on public health, such as reproductive disorders, chronic obstructive pulmonary disease, cancers, skin damage, and central nervous system impairment. Therefore, further research on long-term preventive alternatives such as the formulation of these agents with natural products as active ingredients is necessary to mitigate the effects of alcohol-and iodine-based chemicals on humans and the environment.
The number of patients with diabetes and associated complications is rising across countries incl... more The number of patients with diabetes and associated complications is rising across countries including patients requiring insulin to control their diabetes. Hypoglycemia combined generally with poor control adds to the burden of diabetes. Long-acting insulin analogs were developed to reduce hypoglycemia, including nocturnal hypoglycemia, and enhance adherence, which can be a problem. These benefits have resulted in their increased use among high and highmiddle income countries, which is continuing. However, concerns in middle and lower-income countries as insulin analogs are considerably more expensive than standard insulins. Biosimilars can reduce their costs. Consequently, it is important to ascertain current usage and prices of analogs across middle-income countries with high patient co-payment levels to provide future direction. Overall, limited use of insulin glargine in Kenya, up to 3.6% of total insulins in one leading hospital with prices up to 3.4 fold higher than standard insulins. Overall, limited use of insulin glargine among hospitals in Northern Nigeria and in pharmacies again due to high prices. Appreciably higher use of long-acting insulin analogs in Bangladesh enhanced by low cost biosimilars with increasing competition. Increased competition enhanced by local production can lower biosimilar costs enhancing future use of insulin glargine to the benefit of all diabetes patients requiring insulin.
Background: Hydroxychloroquine(HCQ), one of the repurposed drugs in COVID-19, has several known c... more Background: Hydroxychloroquine(HCQ), one of the repurposed drugs in COVID-19, has several known cardiovascular(CVS) toxicities. Methods: VigiBase data were used to analyze the reported ADEs linked to HCQ. The data were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification level and the individual Preferred Term level. Results: The majority were above 18 years(91.6%) and from Europe(41.6%). A total of 5,315 ADEs were associated with HCQ use in COVID-19. Of these, 918 ADEs were attributed to CVS and reported from 773 patients. Grossly, CVS ADEs were associated with concomitant use of HCQ and azithromycin(AZM), and only 40 ADEs were solely due to HCQ. The majority were serious (69.3%) and resolved afterward (51%). In CVS ADEs, there were 366 cardiac disorders, 38 vascular disorders, and 514 ADEs under investigation. Among the cardiac disorders, palpitation was the most typical (N=65), followed by bradycardia(N=44) and tachycardia(N=33). Among arrhyth...
Spontaneous reporting and intensive monitoring are the conventional systems used for detecting, r... more Spontaneous reporting and intensive monitoring are the conventional systems used for detecting, recording and reporting adverse drug reactions. Using spontaneous reporting a lot of successes was made as existing adverse drug reactions were identified and new ones were prevented. In general, regulatory authorities consider only the information and outcome of the premarketing clinical trial in controlled settings to approve and register a drug for human use. As such, not much is known about the drug beyond the data obtained from clinical trials in controlled settings. The outcome of pre-marketing studies for safety, efficacy, and quality of new medicines will not represent the whole population of patients that will use the drugs when they are approved. Henceforth, suitable and constant post-marketing surveillance (PMS) is indispensable. The two types of post-marketing studies are descriptive and analytical. Descriptive study is carried out to generate adverse drug reaction signals (hypotheses) while the analytical study is done to test hypotheses and determine associations or causal relations between observed effects and particular drugs. Examples of descriptive studies are spontaneous reporting and intensive monitoring while analytical studies include case-control studies, cohort studies, and post-marketing clinical trials. The aim of this review is to highlight the menace of adverse drug reactions, challenges of the spontaneous reporting system and, more importantly, the information available from Malaysia and Nigeria.
ABSTRACT Introduction Dementia is a progressive neurodegenerative disorder impairing memory and c... more ABSTRACT Introduction Dementia is a progressive neurodegenerative disorder impairing memory and cognition. Alzheimer’s Disease, followed by vascular dementia – the most typical form. Risk factors for vascular dementia include diabetes, cardiovascular disease, hyperlipidemia. Lipids’ levels are significantly associated with vascular changes in the brain. Areas Covered The present article reviews the cholesterol metabolism in the brain, which includes: the synthesis, transport, storage, and elimination process. Additionally, it reviews the role of cholesterol in the pathogenesis of dementia and statin as a therapeutic intervention in dementia. In addition to the above, it further reviews evidence in support of as well as against statin therapy in dementia, recent updates of statin pharmacology, and demerits of use of statin pharmacotherapy. Expert Opinion Amyloid-β peptides and intraneuronal neurofibrillary tangles are markers of Alzheimer’s disease. Evidence shows cholesterol modulates the functioning of enzymes associated with Amyloid-β peptide processing and synthesis. Lowering cholesterol using statin may help prevent or delay the progression of dementia. This paper reviews the role of statin in dementia and recommends extensive future studies, including genetic research, to obtain a precise medication approach for patients with dementia.
The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2),... more The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later named COVID-19 by the World Health Organization (WHO), was initiated at Wuhan, Hubei, China, and there was a rapid spread of novel SARS-CoV-2 and the disease COVID-19 in late 2019. The entire world is now experiencing the challenge of COVID-19 infection. However, still very few evidence-based treatment options are available for the prevention and treatment of COVID-19 disease. The present review aims to summarize the publicly available information to give a comprehensive yet balanced scientific overview of all the fat-soluble vitamins concerning their role in SARS-CoV-2 virus infection. The roles of different fat-soluble vitamins and micronutrients in combating SARS-CoV-2 infection have been recently explored in several studies. There are various hypotheses to suggest their use to minimize the severity of COVID-19 infection. These vitamins are pivotal in the maintenance and modulation of innate and cell-mediated, and antibody-mediated immune responses. The data reported in recent literature demonstrate that deficiency in one or more of these vitamins compromises the patients' immune response and makes them more vulnerable to viral infections and perhaps worse disease prognosis. Vitamins A, D, E, and K boost the body's defense mechanism against COVID-19 infection and specifically prevent its complications such as cytokine storm and other inflammatory processes, leading to increased morbidity and mortality overemphasis. However, more detailed randomized double-blind clinical pieces of evidence are required to define the use of these supplements in preventing or reducing the severity of the COVID-19 infection.
Background: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lun... more Background: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lungs leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. Research design and methods: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients' demographic and clinical variables, and severity of involvement of organ system. Results: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18-64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. 'Injury, Poisoning, and Procedural Complications' remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. Conclusion: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting.
Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly chal... more Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.
The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number o... more The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number of fatalities calls for the speedy pursuit of a remedy. This review emphasizes the changing aspects of the COVID-19 disease, featuring the cytokine storm's pathological processes. Furthermore, we briefly reviewed potential therapeutic agents that may modulate and alleviate cytokine storms. The literature exploration was made using PubMed, Embase, MEDLINE, Google scholar, and China National Knowledge Infrastructure databases to retrieve the most recent literature on the etiology, diagnostic markers, and the possible prophylactic and therapeutic options for the management of cytokine storm in patients hospitalized with COVID-19 disease. The causative agent, severe acute respiratory coronavirus-2 (SARS-CoV-2), continually threatens the efficiency of the immune system of the infected individuals. As the first responder, the innate immune system provides primary protection against COVID-19, affecting the disease's progression, clinical outcome, and prognosis. Evidence suggests that the fatalities associated with COVID-19 are primarily due to hyper-inflammation and an aberrant immune function. Accordingly, the magnitude of the release of pro-inflammatory cytokines such as interleukin (IL)-1, (IL-6), and tumor necrosis alpha (TNF-α) significantly differentiate between mild and severe cases of COVID-19. The early prediction of a cytokine storm is made possible by several serum chemistry and hematological markers. The prompt use of these markers for diagnosis and the aggressive prevention and management of a cytokine release syndrome is critical in determining the level of morbidity and fatality associated with COVID-19. The prophylaxis and the rapid treatment of cytokine storm by clinicians will significantly enhance the fight against the dreaded COVID-19 disease.
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globa... more A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and invivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
The global pandemic from COVID-19 infection has generated significant public health concerns, bot... more The global pandemic from COVID-19 infection has generated significant public health concerns, both health-wise and economically. There is no specific pharmacological antiviral therapeutic option to date available for COVID-19 management. Also, there is an urgent need to discover effective medicines, prevention, and control methods because of the harsh death toll from this novel coronavirus infection. Acute respiratory tract infections, significantly lower respiratory tract infections, and pneumonia are the primary cause of millions of deaths worldwide. The role of micronutrients, including trace elements, boosted the human immune system and was well established. Several vitamins such as vitamin A, B6, B12, C, D, E, and folate; microelement including zinc, iron, selenium, magnesium, and copper; omega-3 fatty acids as eicosapentaenoic acid and docosahexaenoic acid plays essential physiological roles in promoting the immune system. Furthermore, zinc is an indispensable microelement essential for a thorough enzymatic physiological process. It also helps regulate gene-transcription such as DNA replication, RNA transcription, cell division, and cell activation in the human biological system. Subsequently, zinc, together with natural scavenger cells and neutrophils, are also involved in developing cells responsible for regulating nonspecific immunity. The modern food habit often promotes zinc deficiency; as such, quite a few COVID-19 patients presented to hospitals were frequently diagnosed as zinc deficient. Earlier studies documented that zinc deficiency predisposes patients to a viral infection such as herpes simplex, common cold, hepatitis C, severe acute respiratory syndrome coronavirus (SARS-CoV-1), the human immunodeficiency virus (HIV) because of reducing antiviral immunity. This manuscript aimed to discuss the various roles played by zinc in the management of COVID-19 infection.
Objective: Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and... more Objective: Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding treatments such as hydroxychloroquine with misinformation fuelling prices hikes and suicides. Shortages have also appreciably increased costs of PPE, potentially catastrophic among lower- and middle-income countries such as Nigeria with high copayment levels. Consequently, a need to investigate changes in availability, utilization, and prices of relevant medicines and PPE during the pandemic in Nigeria. Methods: Exploratory study among community pharmacists with a survey tool comprising four sections including questions on changes in consumption, prices, and shortages of medicines and PPE from the beginning of March 2020 to the end of June 2020. In addition, suggestions from community pharmacists and co-authors on ways to reduce misinformation. Findings: 30 out of 34 pharmacists participated giving a response rate of 88.2%. Significant increases were seen (3-fold or more increase) in the consumption of hydroxychloroquine (100%), vitamins/immune boosters (96.7%) and antibiotics (46.7%) as well as PPE (100%). Considerable price increases (50% increase or greater) also seen for antimalarials (96.7%), antibiotics (93.3%), vitamins/immune boosters (66.7%), and PPE (100%). Shortages are also seen for hydroxychloroquine and vitamins/immune boosters but most severe for PPE (80% of pharmacies). Conclusion: Encouraging to see increases in the utilization of vitamins/immune boosters and PPE. However, a considerable increase in the utilization and prices of antimicrobials is a concern that needs addressing including misinformation. Community pharmacists have a key role in providing evidence-based advice and helping moderate prices.
Background:Diabetes mellitus rates continue to rise, which coupled with increasing costs of assoc... more Background:Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers.Objective:To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin a...
Background: Countries across Africa and Asia have introduced a variety of measures to prevent and... more Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic.Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: One hundred and thirty one pharmacists took pa...
Background: Adverse drug reactions (ADRs) have been making headlines because of life threatening ... more Background: Adverse drug reactions (ADRs) have been making headlines because of life threatening issues. ADRs are always underreported and still the major public health problem. Spontaneous reporting system has remained the most significant method for safeguarding patients' lives. Objectives: Is to examine and analyse the various pharmacovigilance (PV) studies conducted among doctors and to make recommendations for future research. Study Selection: 32 studies covered from 2004 to 2014 were selected. Data Sources: Four electronic databases including Science-Direct, Springer-Link, PubMed and MEDLINE were used to obtain 129 relevant publications using HotBot, FreeFullPDF, and Google Scholar as search engines. Data Extraction: Studies conducted on doctors were selected covering research from ten countries. Inclusion Criteria: Only studies done from 2004 to 2014 were included, KAP studies done on ADRs and pharmacovigilance among doctors were selected. Exclusion criteria: All studies done before 2004 and studies done on general public KAP were excluded; similarly, studies conducted on healthcare professionals in general were excluded; also studies done on adverse drug event (ADE) reporting were excluded. The study was conducted from April to August, 2014. Data Synthesis: Knowledge, attitude and practice (KAP) regarding ADRs reporting by doctors were poor. Longitudinal study involving educational intervention and training through workshops and seminars were found to be effective in improving doctors' knowledge and attitude. Conclusion: There is urgent need to improve knowledge, awareness and practice of doctors on pharmacovigilance. It is imperative for WHO and national pharmacovigilance centres to take proactive measures to curve the menace of ADRs in order to safeguard the patients' lives. The curriculum of all health and health related schools should be restructured with respect to pharmacovigilance without any delay and hesitation.
Depression is a serious disorder that affects people in all communities across the world, a major... more Depression is a serious disorder that affects people in all communities across the world, a major cause of disability and morbidity worldwide. The drugs used in its management are associated with adverse effects and delayed response, hence it’s important to look for antidepressant plants with proven advantages and favourable benefits. Leptadenia hastata (Pers.) Decne belongs to the family Asclepidiaceae and is widely used in Tropical Africa as a vegetable due to its low toxicity and therapeutic benefits, it is used in the treatment of evil spirit, psychiatric disorders and hallucination. The aim of this study was to evaluate the antidepressant-like effect of the methanol leaves extract of Leptadenia hastata (LHME) and its fractions. Phytochemical screening and acute toxicity (LD50) study were done using standard procedures. Antidepressant-like effects of the LHME and its fractions was evaluated using the tail suspension test (TST) and forced swim test (FST). The intraperitoneal (i....
Journal of Pharmacy Practice and Community Medicine, 2020
Background: Recent evolution in terms of technology and availability of the internet has brought ... more Background: Recent evolution in terms of technology and availability of the internet has brought several innovations that made work and access to information straightforward. Nonetheless, the danger of pathological internet addiction and its adverse consequences are frightening. Objectives: The primary goal of this research is to determine the level of internet addiction among undergraduate medical students at National Defence University, Malaysia. Methods: A structured questionnaire comprising of section A consisting of student demographic information and section B made up of Dr. Kimberly Young's 20 items internet addiction test (IAT) in 5-point Likert's scale. Internet addiction scores were classified based on Young's scale. Results: The response rate obtained from this study was 89.6%. Out of the 224 respondents, only 4 (1.8%) were found to be regular internet users, 98 (43.8%) were established to be mild addicts, 110 (49.1%) were moderate addicts and finally, 12 (5.4%) were severe internet addicts. There was a statistically significant difference in the mean internet addiction score between males and females, with males having higher ratings. Conclusion: The prevalence of internet addiction among undergraduate medical students is high and needs to be controlled. As such, the use of the internet at colleges and universities may need to be regulated.
Herbal medicine has played a vital role in the phytotheraphy of various ailments including centra... more Herbal medicine has played a vital role in the phytotheraphy of various ailments including central nervous system disorders. Various part of the plants such as leaves, stems, roots, fruits, seeds, flowers etc. were used by both traditional and orthodox medicine practitioners as their source of medicaments (
Psychopharmacology, especially behavioral studies is attracting increasing interest of researcher... more Psychopharmacology, especially behavioral studies is attracting increasing interest of researchers because of lower quality of life, and higher prevalence of mental disorders such as anxiety in Nigeria. Various experimental animal models have been used successfully to demonstrate the anxiolytic property of medicinal plants. Techniques such as open field test, elevated plus maze, staircase test method, light, and dark box test, hole-board test, and beam walking assay are available and functioning effectively in various pharmaceutical research centers and higher education institutions in Nigeria. Consequently, this has led to the advancement in the field of behavioral studies. Furthermore, these experimental models are easy to operate, and in many instances, yielded promising and reproducible results. However, the accuracy and the validity of the outcome depend on the experience of the researcher, familiarization with laboratory animals and indepth knowledge of animal psychology. It is recommended that experimental models of anxiolytic testing can be improved by making an automated apparatus connected to digital watches, video cameras and computers available in Nigeria. The primary goal of this paper is to discuss the most commonly available experimental models in the evaluation of the anxiolytic activity of medicinal plants in Nigeria and to give a recommendation for further improvement and drug development.
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Papers by Rabiu Abubakar