The efficacy and toleration of celecoxib (Celebrex) in the treatment of osteoarthritis in Nigeria: a multicentre study.

BACKGROUND: Non-selective, non-steroidal anti-inflammatory drugs (NSAIDs) are effective in terms of pain relief and improving function in osteoarthritis. The advent of cyclooxygenase-2 (Cox-2) specific inhibitor, celecoxib, in the treatment of osteoarthritis has shown similar efficacy in relieving pain in osteoarthritis with low incidence of GI (Gastrointestinal) symptoms. OBJECTIVE: To determine the efficacy and toleration of celecoxib in treatment of osteoarthritis in Nigerian population. METHODS: Eighty patients were recruited from six tertiary health institutions scattered over Nigeria. A fixed dose of 200 mg celecoxib was administered daily with patient seen on the second and six weeks after commencement of study. Efficacy of the drug and safety were assessed during the study. RESULTS: The patients had a mean age of 57.8 years with a standard deviation of 13.3 year. The mean weight was 74.7 +/- 14.9kg while the female sex constituted the majority (73.8%) of the patients. Using the physician global assessment of osteoarthritis instrument, 36.3% of the patients were rated as having poor arthritis score at baseline. This value reduced to 2.6% at second visit and 0.00% at end of the study respectively. There was no significant difference between the vital signs, haematological indices, renal and hepatic function at baseline and the final visit. There was no case of serious adverse effect. CONCLUSION: The study showed statistically significant improvements in the symptoms of osteoarthristis following the administration of Celecoxib 200mg daily for six weeks.

Erectile dysfunction: prevalence and relationship to depression, alcohol abuse and panic disorder.

We studied the prevalence of erectile dysfunction in a sample of 829 Nigerian men, using the International Index of Erectile Function questionnaire. These men were also screened for depression, alcohol abuse and panic disorder using the Patient Health Questionnaire. The prevalence of erectile dysfunction (ED) was 36% in men 30 years and below, 31% in those 31 to 40, 46% in those 41 to 50, and 58% in those 51 to 60. Among those men identified as having ED, 10% were depressed, 10.3% had alcohol abuse while 0.6% had panic disorder. Using a multiple linear regression model, age and depression were found to be good predictors of erectile dysfunction but not alcohol abuse and panic disorder. We suggest that ED may be much more common than is being reported. The use of simple questionnaires by doctors, especially those working in medical and surgical clinics and those in primary health care centers, could help in detecting more cases for whom the negative life impact of ED could be minimized.

Daxazosin in the treatment of elderly patients with benign prostatic hyperplasia

Objective To evaluate the efficacy and tolerability of doxazosin tablets in elderly patients with symptomatic benign prostatic hyperplasia (BPH). Patients and Methods This study involved the use of doxazosin; a once daily alpha-1 adrenergic blocker; for the treatment of BPH in two distinct phases. Phase 1 involved a two-week dose titration; escalating from 1 mg to 8 mg depending on response and tolerability using blood pressure (BP) and pulse as a monitor to arrive at a stabilizing dose. In phase 2; the patients were maintained on the stabilized dose for 6 weeks. The International Prostate Symptom Score (IPSS) and Quality of Life Assessment (QLA) were used to evaluate the severity of the illness and the response to treatment. Twenty-six patients were enlisted while only 20 met the criteria for analysis. Mean age was 72.5 (55-90) years. Eighteen (90) were stabilized at a doxazosin dose of 4 mg; while 2 (10) stabilized on 2 mg. Results There was a significant improvement of symptoms (IPSS) in all the patients at the end of the titration period; and this was progressive and sustained over the 6-week study period. QLA was also significantly improved. BP did not vary significantly in the normotensives; while the hypertensives required other antihypertensives to maintain normal levels. One case had severe postural hypotension that warranted discon-tinuation of the test drug. Using the Physician Global Assessment; efficacy was excellent in 65; good in 30and poor in 5; while tolerability was excellent in 95and poor in 5. Drug compliance was 100. Side effects were minimal and not life threatening. Conclusion Doxazosin is effective in the treatment of BPH in elderly Nigerians. It is compatible with other drugs used in the treatment of other illnesses associated with old age. It is therefore recommended for use in elderly BPH patients

A comparative study of pyuria and asymptomatic bacteriuria in school children.

Urine samples were collected from 1,000 school children aged between 4 and 15 years. Twenty-eight children had significant bacteriuria, while 32 had significant pyuria. Seventeen pupils had both significant bacteriuria and pyuria. The study shows that although there is a positive association between pyuria and bacteriuria, the absence of pus cells in urine samples cannot be taken as evidence of absence of bacteriuria, nor can the presence of pyuria alone be considered as an indication of infection. Escherichia coli is the commonest agent in school children with significant bacteriuria.