Irrational prescribing of calcium channel blockers for the elderly in health facilities: a qualitative study in four hospitals in Benin City; Nigeria

Calcium channel blockers (CCBs) can further depress a failing heart and are not recommended for elderly patients with systolic heart failure (HF).This study conducted in four hospitals in Benin City was undertaken to evaluate rational prescribing of CCBs in hypertensive elderly outpatients.Self-administered questionnaire was administered to 161 medical doctors to detect the proportion of physicians who prescribe CCBs to elderly outpatients with systolic HF with or without evaluating the heart status and/or counseling them on the possibility of recognizing the dangerous effect on heart while taking the CCBs. The association between inappropriate prescription of CCBs and sociodemographic variables was determined using logistic regression analysis.Majority (98.7) of the 150 respondents reported ever treating hypertension in 48.5 +/- 42.3 (range: 2-250) elderly outpatients per month with most evaluating the patients' heart status. CCBs (nifedipine and amlodipine) were often prescribed for systolic HF for the elderly by 34.3of participants but only 4.7of them properly counseled the patients. Area of specialization (odds ratio = 1.076); hospital where the doctors worked (OD = 1.080) and status of the doctors were good predictors of CCBs prescription in systolic HF.It is concluded that irrational prescribing of CCBs for elderly outpatients is common in the four hospitals studied. This calls for appropriate educational intervention that will improve the knowledge of physicians in Benin City in rational prescribing of drugs for the elderly

Facial Plexiform Neurofibromatosis in a 16 Year-Old Female from Eastern Nigeria: a Rare Presentation

Plexiform neurofibromatosis or von Pleckinghausen's disease is an uncommon variety of neurofibromatosis type I; usually associated with trigeminal nerve. We report a rare case of the disease on the face of a 16 year-old female patient. The patient presented with overhanging mass of skin folds on the face; completely covering one eye and partially covering the second eye; as well as occasional pain and itching. Physical examination revealed the presence of cafe au lait macules; freckling in the axillary; optic glioma and iris hamartomas. Family history was not contributory. An interventional reconstructive surgical procedure with excision of surplus skin folds on the face and lip margin was performed on the patient. Doloneurobionr (paracetamol and vitamins B1; B6 and B12 combination) as well as Vecutenr (neomycin sulphate; clortrimazole and dexamethosone combination) cream were used to successfully manage the occasional pain and itching. There was evidence of re-growth of the tumours over a one year follow-up period