HIV- and hypertension-related knowledge and medication adherence in HIV seropositive persons with hypertension.

BACKGROUND: There is increasing prevalence of diseases associated with ageing such as hypertension, among people living with HIV (PLWHV). This study sought to assess: (1) knowledge related to HIV infection and hypertension, (2) adherence to prescribed medications and (3) clinical outcomes among HIV-positive persons with hypertension at a Nigerian hospital. METHODS: The Patient's HIV Knowledge Questionnaire (PHKQ), Hypertension Knowledge-Level Scale (HK-LS) and Adherence to Refills and Medication Scale (ARMS) were administered to 220 eligible patients through the HIV clinic. Demographic and clinical data were also obtained. RESULTS: Participants were predominantly females (57.3%), with a median (IQR) age of 46 (38-58) years; majority were married (67.8%) and employed (60.8%). Participants reported a higher hypertension-related knowledge compared with HIV-related knowledge (63.6% versus 33.3%, Z = -10.263, P < 0.001), but better adherence to antiretroviral medications compared to antihypertensives (100.0% versus 89.3%, Z = -9.118, P < 0.001). Of the 98 participants with documented viral load, 55 (56.1%) had undetectable (<40 copies/ml) values; however, only four (2.0%) of the entire sample had controlled (<140/90 mmHg) blood pressure. CONCLUSIONS: Despite having a higher hypertension-related knowledge, adherence to antihypertensive medications and blood pressure control were poor. There is a need for increased attention to HIV education and comorbidities in PLWHV.

Development of a patient satisfaction questionnaire for HIV/AIDS patients in Nigeria.

OBJECTIVE: The aim of this study was to develop and validate a questionnaire for assessing HIV-infected patients' satisfaction with pharmaceutical care received in Nigerian HIV clinics. METHOD: Questionnaire's items were selected based on similar published studies and designed on a 5- point Likert response scale. Face and content validity, feasibility, factorial validity, reliability, and construct validity were evaluated. The instrument's feasibility was assessed in a secondary health care facility (St. Charles Borromeo Hospital Onitsha) and validated in a tertiary health care facility (University of Nigeria Teaching Hospital Enugu). Factor analysis used principal components and varimax rotation. Reliability was established using internal consistency with Cronbach's alpha. Convergent and discriminant validity were determined using Spearman's rho correlation. RESULTS: A self-administered 16-item questionnaire in 5-point Likert response scale format was developed. Questionnaire evaluated cumulative experience of patients with comprehensive pharmaceutical care practice in pharmacies of HIV clinics. Eighty questionnaires were collected for pilot test while four hundred questionnaires were retrieved for the validity test. Factor analysis resulted in four factors: 'Interpersonal/Professional relationship with pharmacist', 'patient counseling', 'drug information' and 'managing therapy', with a cumulative variance of 56.7%. Cronbach's alpha for the whole questionnaire was 0.85, and 0.81, 0.66, 0.67 and 0.72 for the four factors, respectively. Four items used for convergent and discriminant validity showed convergence between the related items and variance between the unrelated items. CONCLUSION: The questionnaire developed is a reliable and valid instrument for assessing patient satisfaction with pharmaceutical care in HIV clinics in Nigeria. Further research is needed to expand the instruments' robustness.

Sub-chronic Hepatotoxicity of Anacardium occidentale (Anacardiaceae) Inner Stem Bark Extract in Rats.

The extracts of Anacardium occidentale have been used in the management of different cardiovascular disorders in Nigeria. These have necessitated the assessment of the toxicity of this plant extract in sub-chronic administration. The inner stem bark of Anacardium occidentale was extracted with 80 % methanol and quantitatively analysed for antinutrients and some heavy metals. The phytochemical compositions and acute toxicity of the extract were determined also. Toxicity profiles of the extract on some liver function parameters were evaluated following a sub-chronic oral administration at doses of 1.44 and 2.87 g/kg. The phytochemical screening of extract revealed the presence of high amount of tannins, moderate saponins and trace of free reducing sugars. The antinutrient levels were 5.75 % (tannins), 2.50 % (oxalates), 2.00 % (saponins), 0.25 % (phytate) and 0.03 % (cyanide). The quantity of iron detected from dried crude was 8.92 mg/100 g, while lead and cadmium were non-detectable. The extract had LD(50)of 2.154g/kg p.o. in mice. Sub-chronic administration of the extract significantly increased the serum levels of alanine aminotransaminase and aspartate aminotransaminase, which are indicative of liver damage. The serum levels of alkaline phosphatase and total protein of the treated animals were not significantly increased. The effects of sub-chronically administered extract on hepatocytes were minimal as the serum alkaline phosphatase; total bilirubin and total protein levels in treated animals were not significant (p< 0.05). Thus, sub-chronic administrations of Anacardium occidentale inner stem bark extract did not significantly (p< 0.05) depress the function of hepatocytes in Wistar rats.

Herb-drug interaction: a case study of effect of ginger on the pharmacokinetic of metronidazole in rabbit.

The effect of ginger on the pharmacokinectic of metronidazole was studied using rabbits in a crossover study method. The relevance of this study borders on the wide use of ginger for culinary and phytotherapeutic purposes, and metronidazole that is commonly used for every gastrointestinal complain in our communities without prescription. Ginger significantly increased the absorption and plasma half-life, and significantly decreased the elimination rate constant and clearance of metronidazole (P<0.05). Thus, in clinical practice, the patients should be advised on the serious implication of using both items together.

Assessment of HIV/AIDS awareness and changes in sexual practices among secondary school students in Nsukka environment.

This study is aimed at assessing the awareness of HIV/AIDS and changes in sexual behaviour among the Nigerian teens. Two hundred and fifty secondary school students were interviewed. Only 5% of the respondents were able to state the full meaning of HIV or AIDS. A minority (28%) believed that HIV was real while the majority (72%) believed that HIV infects whites only. Forty-eight percent of them have changed their sexual practices owing to the AIDS menace. A small percentage, 12%, believed that HIV/AIDS could kill. The study revealed low awareness of HIV/AIDS as well as misconception about the infection, especially in non-urbanized cities of Nigeria.

Prediction of in vivo bioavailability of six brands of ciprofloxacin film coated tablets using the concept dissolution efficiency (DE).

A comparative in vitro dissolution efficiencies (DE) of six commercial brands of ciprofloxacin tablets were evaluated in acetic acid and phosphate buffer (pH 7.4) and results obtained were used in ranking of their probable in vivo bioavailability. The dissolution efficiencies (DE) of the six brands varied widely in the two media. This was attributed to differences in solubility of the drug in the two media. The dissolution efficiencies of five out of the six brands (Citrovenot, Ciproxin, Cipoxin, Ciproflox, and Quflox), in 0.1 N acetic acid fell within 60-75% at 30 minutes, and therefore, could be considered bioequivalent. The dissolution efficiency of a brand, Cipro, fell below 40% in the same medium and at the same sampling time and it was considered to be most likely less bioavailable in vivo. There was absence of correlation between the hardness and disintegration time of the brands with their dissolution efficiencies.