Scientists said taking antidepressants during pregnancy could harm the emotional development of the unborn child.
This is the findings of a new study published in JAMA Pediatrics. The researchers from The Columbia University found that those babies who were exposed in the womb to drugs such as Prozac and Seroxat had differences in both the gray and white matter of their brains.
Prozac and Seroxat are antidepressants. This included an increase in neurons – and the connections between them – in areas of the brain linked to feelings that could predispose them to anxiety and depression. While the gray matter is the emotional hub of the brain, the white matter controls feelings of anger, fear, disgust, happiness and sadness.
Antidepressants are drugs used for the treatment of major depressive disorder and other conditions, including dysthymia, anxiety disorders, obsessive–compulsive disorder, eating disorders, chronic pain, neuropathic pain and, in some cases, dysmenorrhoea, snoring, migraine, attention-deficit hyperactivity disorder (ADHD).
Some medications including antidepressants are known to be harmful when taken during pregnancy. Based on this, the safety of most medications taken by pregnant women has been difficult to determine.
Prescriptions of antidepressants have soared in the US by 65 percent in the last 15 years. Hence, the general advice given to pregnant women is that medications in pregnancy should be prescribed by the medical doctor.
Known as SSRIs (selective serotonin reuptake inhibitors), they are used to treat depression, anxiety disorders, obsessive-compulsive disorder as well as post-traumatic stress disorder.
Prescriptions for them in pregnancy have risen in recent years, despite the fact that the drugs’ effects on developing fetuses are poorly understood and evidence that they could be harmful is mounting. Lead author Dr. Claudia Lugo-Candelas, a psychiatrist at Columbia University, said the drugs boost production of serotonin in unborn babies’ brains – leading to abnormal development of the circuit between the amygdala and insular cortex.
Lack of definite roles for govts, limiting Universal Coverage
Universal Health Coverage is a critical component of sustainable development and poverty reduction, and a key element to reducing social inequities. APPOLONIA ADEYEMI highlights some of the factors that hinder its actualisation
As the global drive to ensure that majority of countries key into Universal Health Coverage (UHC) as a strategy to provide accessible and affordable care for people all over the world continues to spread, Nigeria is one of the countries lagging behind in taking advantage of its numerous benefits.
In spite of this yearning, too many people are still missing out on health coverage. According to the World Health Organisation (WHO), at least, half of the world’s people are currently unable to obtain essential health services. Presently in Nigeria, only about five per cent of Nigerians have prepaid health care through social and voluntary private insurance.
This has resulted in majority of Nigerians paying out-ofpocket to access care. However, based on national and state commitment to reverse the trend, medical doctors under the auspices of the Association of Association of Public Health Physicians of Nigeria (APHPN), Lagos Chapter, at their 2019 Biennial Conference, focused on how to make a difference in achieving the much needed UHC in the country with a view to ensure that majority of Nigerians access needed care when it matters.
The conference organised by APHPN, has the theme ‘Universal Health Coverage: Defining The Bottom Line’. In his submission at the conference, the Commissioner for Health in Lagos State, Professor Akin Abayomi warned that Nigeria may not achieve Universal Health Coverage (UHC) if grey areas in health sector were not urgently addressed. According to Abayomi, lack of clear definition of roles and responsibility of the federal, states and local governments in delivering quality healthcare to Nigerians through primary healthcare (PHCs) may hinder efforts towards achieving the UHC in the country. Universal Health Coverage also called universal coverage, or universal care) is a health care system that provides health care and financial protection to all residents of a particular country or region.
The WHO defines UHC as a situation where citizens can access health services without incurring financial hardship. According to the Director General of WHO, UHC is the “Single most powerful concept that public health has to offer” since it unifies “services and delivers them in a comprehensive and integrated way”. One of the goals with universal healthcare is to create a system of protection, which provides equality of opportunity for people to enjoy the highest possible level of health.
“Some people will say local governments have the mandate of delivering quality primary healthcare platform as embedded in the law. While I won’t disagree with that, we cannot disengage the role and responsibilities of states and the federal government.” Abayomi said that the situation was worse than that in some other states of the country, “This situation doesn’t speak well of the platform that want to deliver UHC, considering the formula of one PHC per ward.” According to him, if we really want to achieve UHC, the three tiers of governments must come together and clearly outline what their responsibilities will be towards the PHCs.
He said, “There are grey areas in terms of responsibility when we talk of building, equipping, running and sustaining Primary Healthcare Structure. In Lagos State we have over 300 PHCs of which only 57 are considered flagships in which they have complimentary staff of doctors, nurses and other healthcare workers that deliver services.
“The remaining consisting over 200 PHCs are controlled by nurses while significant number of the Centres are abandoned and dilapidated.” Corroborating his view, wife of the Lagos State Governor, Dr. Ibijoke Sanwo- Olu who spoke on the topic, “Universal Health Coverage: In Defining The Bottom Line,” said good health was essential to sustain economic and social development as well as poverty reduction. Access to needed health service is also crucial for maintaining and improving health.”
At the same time, she said people need to be protected from being pushed into poverty because of the high cost of health care.Sanwo-Olu who was the Special Guest of Honour at the event, said tge Lagos State Government has done a lot in concerning UHC and “I think it is appropriate at this point to urge Lagosians to fully embrace the Lagos State Health Insurance Scheme, which is a strategic policy designed to achieve affordable, comprehensive and unhindered quality health care service for all residents in the state. She said, “The health insurance scheme is designed for basic, primary and selected health care services for beneficiaries such as treatments and management of malaria, hypertension, common childhood illnesses, antenatal care services including caesarean section, amongst others. “
It is indeed a right move towards attaining UHC, the second pillar of the developmental agenda for the greater Lagos promised by the current administration in the state.” Dr. Olufunmilayo Tolu, chairman, APHPN, Lagos Chapter, said the conference was to start conversation around UHC by identifing the gaps and how to proffer solutions.
Tolu who is also a public health physician and honourary consultant at the Lagos University Teaching Hospital (LUTH), said the conference focused on the theme so as to engender discussion on this very difficult subject of UHC. “We are looking at a situation where every citizen in the state and by extension in the country, has access to an essential package of health care, where there will be no inequalities and everybody accessing what he/she needs. “That is why we are not limiting ourselves to speeches; we are having panel discussions so that people can interact with various stakeholders.”
Moving forward, she disclosed that the APHPN will engage those in authority more than it had done previously in ensuring the attainment of UHC. According to her, the association currently have greater interaction with medical officers of health (MOH) who were being trained in view of the Basic Health Care Provision Fund (BHCPF), which was recently released to some states in the country. She stressed that “Certain things have to happen in the communities before these fund could be fully accessed; there need to be more community mobilisation.
“In the next few months there is definitely going to be a change in the health space at the community level and we want to be vitally involved in that.” The chairman of APHPN in Lagos said the conference was about engagement, proferring solutions, taking the problems head-on so as to have results to show for it.
Beyond championing for the meaningful impact of UHC in both Lagos and Nigeria at large, Tolu said the APHPN has also been involved in other public health issues including nutrition, HIV, Ebola Virus Disease (EVD) outbreak in 2014, among others. Although, the slow progress of UHC in the country is discouraging, the Political Declaration on UHC, adopted recently at the United Nations General Assembly, could set the stage for a better world in which health is viewed as a human right and not as a commodity. On paper, we have a compact that enshrines the idea of universality.
At the local, state, and country levels it will mean healthier populations and greater global health equity. It may not be easy to fully actualise UHC on ground, demonstration of strong political will by the governments, contributions of stakeholders and the willingness of individuals to key into the plan could ultimately pave the way for its attainment
Reducing exposure to radiation could curb Leukemia
Dr. Excellence-Oluye Olukayode is a public health advocate and general practitioner. In this interview, he discusses preventive measures that could put Leukemia, a blood cancer type at bay, persistent blood shortage in Leukemia patients, key role of blood transfusion sustaining lives, among others. APPOLONIA ADEYEMI reports
How common is leukemia and how dangerous is it?
Leukemia like every other cancer, is dangerous. There is no cancer that is a joke. Like every other cancer, leukemia being a cancer of the blood is very dangerous. It is an illness that can affect both adult and children.
There are different categories of leukemia, but something that is common to all of them is the fact that they emanate from blood cells and they lead to destruction and disfunction of blood cells.
Blood cells have different functions. There are different types of blood cells. There are red blood cells and they have their own functions. When leukemia happens it disturbs the function of the red blood cells. Similarly, when leukemia happens it disturbs the function of white blood cells and so the people are prone to different infections. When leukemia happens, it will distrupts the function of cells that we call platelets, which are responsible for blood clotting.
So, for people that have leukemia, they are susceptible to bleeding or uncontrolled bleeding. So, leukemia is a very dangerous problem; it is something that needs to be detected as early as possible.
Is it treatable?
Yes, it is treatable, especially when it is detected early. There are treatment options for it. There are drugs for the treatment of Leukemia including radiotherapy, stem cell transplant, among others.
Why are more Nigerian’s coming down with Leukemia, most of which also lead to premature deaths?
Like every other cancer, if is detected early there is chance of survival is increased. The key thing is early detection and for those that are detected, treatment can be expensive.
Even when it is detected early and the person cannot finance the treatment it becomes another problem. One other thing about the treatment is the place of blood transmission because while the person is undergoing the treatment providers have to be replacing blood to sustain the life of the fellow. This is mainly so because to access treatment, the person has to be alive; it is someone that is alive that can undergo treatment. For the person to be alive the fellow must have enough blood and that is when blood transfusion comes into the picture. Consequently, ensuring that enough blood is available in the blood bank becomes necessary. That is also where getting people to donate blood in the blood bank comes in.
What can the government do to assist and do you think the government is creating enough awareness about the disease?
No awareness can be too much. Even if the government is doing some things now, we can only encourage the government and expect that such should be increased. There is no awareness that can be too much because there are people that still don’t know about it and even for people who know about it due for different challenges of life, they forget. So, there is no awareness that is too much.
On what government can do, the principal is creating awareness because when there is awareness people can take more proactive steps. Government has so many burdens to address; the Nigerian government is facing a lot of challenges.
In the area of finance, funds are infinite; resources are limited. Hence, the government has to manage the little that it has.
When there is awareness private individuals will be more willing to offer assistant to foundations like the Timilehin Leukemia Foundation that is working to speak for and advocate for Leukemia patients.
When people are aware of the disease, they will not mind to part with portion of their resources to help Leukemia patients so that the financial burden of treating or managing Leukemia is not entirely on the patients and their families alone. Consequently, awareness about the medical condition is key. Once there is awareness, Nigerians will help. Some people have good hearts; Nigerians are their brothers keepers. They know that this is a worthy cause to donate to and they will be willing to assist the government. The government alone cannot do it.
What are the simple symptoms to look out for?
Simple symptoms to look out for are the malaria symptoms. Adults in Nigeria know what malaria symptoms are, especially when such symptoms become very frequent.
You could just go to the laboratory and do something as simple thing like the blood count, pax cell volumn (PCV), that is to determine the volumn of blood in the body because by the time you go to the lab and hey take blood sample to do the PCV test so as to check the blood level. Normally, for adults blood level should be at a particular level and they now discover that the blood level is lower. The doctor will then start thinking that malaria alone may not be responsible for these; hence, there could be other reasons and based on that, the doctor may start looking for other things that cool cause this low level of blood in the patient.
The world is going into preventive care. What are the preventive things that Nigeria should know about Leukemia and generally in preventing cancers?
Generally, there are some risk factors that has been associated with the development of cancers. For instance, cigarette smoking is linked to almost all cancers. Therefore, for people who indulge in that particular habit, cutting down on cigarette smoking or avoiding it totally will help in reducing the risk of cancer.
Exposure to chemicals including radiation should be avoided; if it is not necessary, you should not get yourself exposed to such things. In addition, we should consume more home grown food. Let us de-emphasise the eating of processed foods.
Let us endeavor to eat healthy; when we eat healthy, our body will be empowered to fight cancer and nip them in the bud.
Grant: Expert makes case for Nigerian researchers
The Director of Research at the Nigerian Institute of Medical (NIMR), Dr. Stella Smith said building the capacity of Nigerian researchers through the provision of grants could strengthen the nations’ health sector as well as fact-track development.
Speaking at the first Humboldt College International Conference, tagged: “From Basic Science to Translational Research: The Journey so far in Nigeria”, Smith said the advocacy for research, seeking funding for the study, networking and collaboration were part of the steps to tackle the challenges affecting translational research in the country.
The Humboldt College International Conference sponsored by the Alexander Von Humboldt Foundation, Germany, held recently at the Nigerian Institute of Medical (NIMR).
Smith who is also the convener of the event, further said: “People just publish research for promotion, but how many go beyond doing that for promotion to inform policy, affect the common man in Nigeria, in terms of their health, everyday life and social life -what are those researches that people are doing that would affect the lives of the generality of the population of Nigerians.”
Highlighting problems of conducting research in the country, she said: “There are lot of challenges, which include inadequate funding, unfriendly environmental conditions including scientific and cultural conditions,” most of which hinder scientists from conducting research especially in an area that people think it is a taboo for you to do; those are some of the challenges.
“The government had a role to play in terms of funding, but we only get funds from international agencies.These kinds of funding improve a quality of research in our laboratories and government has a role to play in funding research in Nigeria because without research there is no development in any nation and any society.
Harping on the central message of the conference, Dr. Smith, explained that there was need to do research beyond the laboratory, not research from bench to bedside, meaning that research where we can translate to informe policy in the country.
In his remarks, the Director-General at NIMR, Prof. Babatunde Salako, said that translation research means research that could lead to bedside practices or useful government policies or diagnostics in two laboratories; so, it has a wide range of value.
He further said: “Research goes beyond collecting data just for information. It has to be something that will change a certain situation within the medical health system. The issues of translation research from basic science, the basic sciences are the ones that look at issues of research using molecular methods, carrying out laboratory experiment such that when they design research it will snowball into something that can be used in the clinical science”.
Consul General, Federal Republic of Germany, Dr. Stefan Traumann, said that the Government of Germany will continue to support scientific development in Nigeria through grants given to Nigerian scientists.
Traumann noted that Germany-Nigeria Development Corporation in the area of science and health sector, were great partners for around 160 years already, adding that there have been a lot of success recorded in the area of academics and research. This, according to him include about 2000 Nigerian students serving in Germany.
Commissioner for Health, Lagos State, Akin Abayomi, said: “We have a reasonable amount of basic scientists in Nigeria, but when they have their discoveries, that’s just the beginning of the process. That discovery really needs to go through innovation pipeline that translates into a tangible product, either a drug or device, or some kind of policy that transforms and translates the impact to the community.
“So, in many part of Africa, translation research is very rudimentary and behind the curve because it requires a lot of funding to take an idea through a series of tests to determine whether it is going to have an impact, whether it is going to change the way we manage certain conditions and whether it is going to make life easier. It requires a lot of economic investment and our government generally do not recognise this as the bedrock of knowledge economy in the sciences and the health fraternity.
NMA tasks FG on policy for emergency care patients
In order to effectively tackle the health care needs of unknown patients under emergency care, top executives of the Nigerian Medical Association, Lagos Chapter, have called for the establishment of a national policy on how to address the treatment so as to reduce mortality.
Among those who made the call are the Chairman Medical Advisory Committee (CMAC), Lagos State University Teaching Hospital (LASUTH), Dr. Ibrahim Mustapha, President of the NMA, Dr. Francis Faduyile and the Chairman of the NMA in Lagos State, Dr. Saliu Oseni.
The trio made the call at the Physicians’ Week 2019 organised by the NMA, Lagos Chapter. The theme of the Physicians’ Week 2019 is ‘Care Of The Unknown Patient: Policy Overview’.
While the first sub-theme is “Curbing The Increasing Trend of Suicide In Nigeria: Role of NMA,” the second sub-team, which is “Doctors As Entrepreneur’’ was aimed to improve the medical state of medical doctors.
Mustapha,urged the three tiers of government to commission a study to identify the burden that unknown patients pose to health and formulate policies based on the issues at stake.
Considering the risk of mortality posed to the unknown patient, most of whom don’t get needed care, Mustapha said it has become necessary to formulate the policy to address their treatment. He said, in just one second someone who was known could become an unknown patient and whatever have not provided for such patients, will not get to them at the point of their need.
“So the important thing was to put down a policy to take care of the unknown patients,” adding that everybody caught in emergencies would be the beneficiary at the end of the day.”
In his speech, Faduyile said “Care Of The Unknown Patient: Policy Overview,” was chosen to bring to the fore the issues affecting Nigerians who suddenly found themselves in an unconscious state arising from traumatic cause majorly road traffic accident or medical conditions that impaired his or her consciousness with attendant difficulty in proper identification.
He reiterated the need for an enduring and unambiguous policy statement on the care of emergencies and most importantly this group of people.
In his speech, the Chairman of NMA, Lagos Chapter, Dr. Saliu Oseni called for a national policy, which stipulated type of services to be rendered for the care of unknown patients and the possible ways providers would access refund or payment of their bills.
He said, “The medical profession has suffered financial inadequacy due to the humanitarian nature of the service we render, making it important for physicians to seek alternative source of income from medical practice.
Breast milk’s antimicrobial property boosts health
Breast milk contains many antimicrobial and immunomodulatory molecules such as immunoglobulins, antimicrobial peptides, and fatty acids that cow milk lacks.
According to the findings of a new study published in the journal ‘Scientific Reports’ human milk contains 3,000 µg/ml of glycerol monolaurate (GML) compared to 150 µg/ml in cow milk and none in infant formula.
According to researchers, breast milk contains more glycerol monolaurate (GML) and has more antimicrobial compounds (for eg. Staphylococcus aureus, Bacillus subtilis, Clostridium perfringens, Escherichia coli) than cows’ milk and infant formula.
The findings revealed that GML inhibited inflammation in epithelial cells lining the gut and other mucosal surfaces. Inflammation damages epithelial cells and contributes to susceptibility to both bacterial and viral infections.
“Positive effects of human milk appear to be due to the presence of GML combined with other known and unknown factors, and further researches can determine whether or not supplementation of cows’ milk and commercial infant formula with GML will be beneficial,” the researcher said.
National Jewish Health’s Professor and lead author Donald Leung said high levels of GML were unique to human milk and inhibited the growth of pathogenic bacteria.
“While antibiotics can fight bacterial infections in infants, they kill the beneficial bacteria along with the pathogenic ones. However, GML is much more selective and fights only the pathogenic bacteria while allowing beneficial species to thrive,” the University of Iowa Professor and co-author Patrick Schlievert explained.
The researcher continued to say that GML held great promise as a potential additive to cows’ milk and infant formula to promote babies’ health across the world.———–END
Nutritional benefits of garden eggs
The garden egg, also known as eggplant ‘aubergine, ’ guinea squash, ‘melongene,’ and ‘brinjal,’ usually has an egg-like shape and a vibrant purple colour.
While there are many varieties of the African eggplant, with a range of shapes, sizes and colours, the eggplant most commonly found across Africa is ‘Solanum aethiopicum’. This variety has a brilliant red exterior and is about the size and shape of an egg, giving it the name, garden egg. It is also known as mock tomato or ‘fake tomato.’
Though technically a fruit, it is usually picked when it is green and is eaten as a vegetable; cooked into stews and sauces or even consumed raw. Many people don’t even associate the garden egg with the red colour because most times it is harvested and eaten when it is still green. If picked after it is ripe, it can be enjoyed as a fruit—though some varieties are sourer than others.
Most garden eggs sold in markets in Nigeria come from locally grown, small plots of land—in fact, 80 per cent of total production comes from small-scale growers. Women, especially use them as an additional source of income.
Garden egg is a very good source of dietary fibre, potassium, manganese, copper and thiamin (vitamin B1).
It is also a good source of vitamin B6, folate, magnesium and niacin.
Eggplant also contains phytonutrients such as nasunin and
chlorogenic acid. Garden egg also contains nutrients that include beta carotene, vitamins B6 E and foliate, calcium, iron, magnesium fibre and many essential vitamins and minerals. They come in two shades, the cream and green colour.
There are so many health benefits of garden eggs that make them exceptional for our body. For those battling with excessive body weight, garden egg is a perfect food option. This is because of its high fibre, among other things. It fills up the tummy quickly, and this subsequently reduces consumption of other high calories options.
The fibre content in the eggplant also helps to lower cholesterol levels in the human body, protecting the heart in the process.
It also helps to lower blood sugar. In fact, garden egg is a tremendous dietary option for diabetic patients because of its ability to reduce glucose absorption in the body, thereby lowering blood sugar levels. It also possesses low soluble carbohydrates, which assist in this regard.
Garden egg improves the digestive system, and so is beneficial for constipation and eradicates bloating totally. The mildly bitter taste of the garden egg is due to the presence of small amounts of nicotinoid alkaloids, which helps to protect from poor vision due to glaucoma.
Garden egg provides the body with both soluble vitamin and water-soluble vitamins such as thiamin (vitamin B1), which promotes healthy growth and proper functioning of the heart and nervous system, and niacin (Vitamin B6), which supports cellular respiration.
Garden egg is good protection against cardiovascular diseases, such as stroke and heart diseases. Garden egg is diuretic in nature, and because of this reason, pregnant women are advised not to consume it on a regular basis as it can stimulate menstruation in them.
In addition to this, it is a good source of phytohormones that aids the treatment of premenstrual syndrome and amenorrhea. For this reason, pregnant women should not take more than two garden eggs in a day.
Despite the many health benefits of the garden egg, I still prefer to prescribe the leaves to my clients, as I find the leaves safer and more effective. Garden egg leaves are known as natural blood cleansing herbs especially when eaten raw.
The leaves serve as detoxifiers to the kidney, and it’s more effective when eaten raw or converted into juice by boiling for few seconds and then filtering the juice in a container; this juice can be taken three times daily. This helps in cleansing the kidney by filtering the blood and unwanted materials from entering the organ, thereby preventing any form of kidney related issues, especially the ones that will disrupt the blood filtration and purification like in kidney failure.
The mineral potassium, which can be found in garden egg leaves also help the kidney to improves its function of filtering blood.
Garden egg leaves contain an anti-inflammatory property, which makes it one of the suitable vegetables that can be used to reduce swelling and prevent cancer-causing inflammations. These vegetables help in the prevention of cancer formation due to the presence of phytochemicals that fight free radicals that are prone to cause inflammations that might lead to cancerous diseases in the body system. Studies have shown that polyphenols in eggplant have anti-cancer effects. The anthocyanins and chlorogenic acid that are contained in garden egg help protect cells from damage caused by free radicals, thus preventing tumour growth and the spread of cancer cells. It was also shown that the anticancer action of anthocyanins appears to include preventing new blood vessels from forming in a tumour, reducing inflammation, and blocking the enzymes that help cancer cells to spread.
Studies have shown that the importance of garden egg to the liver cannot be overemphasised because the antioxidants in garden egg help protect the liver from certain toxins; thereby making it a remedy for liver issues. Just like garden egg itself, many African cultures believed that garden egg and its leaves represent fertility, and have been used locally in the treatment of infertility and low libido. Though, there is no scientific proof to back this up for now, in many locals where it is used for this purpose, they believe it works, and it helps to boost their sexual health as well for both men and women.
PSN retools pharmacy practice for sustainability
Pharmacists under the umbrella of Pharmaceutical Society of Nigeria (PSN) said it has become necessary to retool professional pharmacy practice to meet international standards and survive the volatile Nigerian economy.
President of the PSN, Mazi Sam Ohuabunwa who made this known recently while addressing journalists ahead of the association annual conference, said there was need to close up gaps in practice between Nigeria and other developed countries with better health indices, stating that resources and means of production were dwindling and consequently pressing on every facet of Nigerians’ life, not sparing healthcare.
According to Ohuabunwa, the conference, which is schedule to take place in Kaduna from November 4 to 9, 2019, has the theme: “Navigating The Winds of Change in Professional Practice In A Volatile Economy.”
He said it has become difficult to sustain professional practices with poor patronage due to technology closing down on the developing countries.
He lamented that finished products were dumped in Nigeria from other countries at the expense of developing local brands, noting that the issue of regulation of pharmacy practice facing the country has made charlatans falsify the real cost of pharmaceutical care and products.
He said pharmacists occupied a very strategic position in the primary healthcare delivery pattern of Nigeria, being the most accessible, qualified healthcare professionals located within the reach of patients in all towns and cities, adding that unfortunately healthcare is financed by out of pocket expenditure, which is “inequitable and exposes the people to high cost burden.”
He added that primary healthcare is essential to strengthening Nigeria’s healthcare system and a “low hanging fruit” towards achieving the sustainable development goals.
The Chairman of the Conference Planning Committee, Bankole Ezebuilo said to address the conference, which has been framed on pharmacoeconomics, Pat Utomi, a professor of economy and management would give the key not address.
He said the conference would also showcase research findings, new technologies, pharmaceutical products and consumables among other areas that would be addressed to ensure navigation to cushion and leverage on the disrupted practice environment.
Study: Men more likely to die of breast cancer than women
Men who are diagnosed with breast cancer are more likely to die of the disease than their female counterparts across all stages, according to a study conducted by Vanderbilt University.
The study, published in JAMA Oncology last month, found that men had higher rates of death resulting from breast cancer even when clinical characteristics, such as the type of cancer, the manner of treatment and access to care were taken into account, reports Newsweek.com.
The disparity was derived from an analysis of 10 years’ worth of data from the National Cancer Database, according to a Vanderbilt University news report. The data was compiled from January 1, 2004 to December 31, 2014, and included 1.8 million female patients but only 16,025 male patients.
Across five years, the male patients were 19 percent more likely to die from breast cancer than the female patients.
The fact that slightly more (85 percent) cases of male breast cancer in men are ER-positive—meaning its cells grow in response to estrogen, according to the American Cancer Society—than in women (75 percent), should have actually given men better chances of surviving the cancer.
“[ER-positive breast cancer] is a cancer type where patients usually fare better because we have a hormonal treatment,” according to Xiao-Ou Shu, senior author of the study. “We have a lot of treatment options for that type of breast cancer. In theory, men should have better outcomes and have lower mortality as women do if the treatment is equally effective.”
More research needs to be conducted to determine the precise cause of this trend, Shu said. Prior studies indicated that men tend to be less compliant with hormonal treatments than women. Further, factors such as smoking, drinking and a sedentary lifestyle may also be what makes men more susceptible to death from breast cancer.
Niger lays off 50 health workers
Niger State government has disclosed that it has taken steps to put an end to the continuous complaints of people about the attitudes of staff of the hospitals, saying “we have disciplined over 50 health workers in the various health centres across the state”.
Permanent Secretary in the Ministry of Health, Dr. Muhammad Maikunsidi, on Tuesday while addressing journalists said the Ministry had to take these steps to cut down indiscipline among its staff.
According to him: “The services of about six consultant doctors have been discontinued, five doctors have been disciplined while over 40 nurses and health attendants have been disciplined in various ways.
“We have sacked several doctors while others are undergoing series of disciplinary measures. For most of them, we withheld their salaries and took way their off-days while for others, we suspended them. You know it is sometimes difficult to fire civil servants but we have devised various ways to discipline them.
“For those who are not found on duty during their duty time, we send them to the rural areas and for those who are sent to rural areas and do not report there, we terminate their services.”
He further disclosed that the state government could no longer take the complaints coming from the people about the attitude of the health workers especially while they are in duty.
How bad roads, ambulance shortage cause more deaths
Despite the volumes of money dedicated to their repair by successive governments annually, the deplorable state of roads have become death traps for millions of road users. REGINA OTOKPA reviews the absence of ambulances on the highways and government’s present position
With the rate of accidents occurring everyday, one would expect that emergency medical services, ambulances and referral centres, should be made available by the federal and state governments in strategic locations for rescue operations on every highway across the country as witnessed in other parts of the world. Alas!, the opposite seems to be the case.
Meaning, it is rare to find an operational ambulance on Nigerian highways, their services have been relegated for undertakers’ services, which usually come with at a fee.
Even though we find stationed ambulances within some cities where there is a National Emergency Management Agency (NEMA) post or at Federal Road Safety Corps outposts found in very few places, majority of the time you find accident victims dead or alive being rushed to hospitals in private vehicles or in a police open van.
Under normal circumstances, an ambulance is part of the medical service infrastructure of a society.
In the developed world, no wonder about two years ago, Dr. Osagie Ehanire, who was Minister of State for Health at the time, lamented that Nigeria had less than 1,000 functional ambulances, which attended to medical emergencies, further revealed that many of the vehicles were not functional, adding that it was part of the reason the country had been recording poor response to medical emergencies in the face of an increased level of road crashes due to negligence and carelessness both on the part of government and drivers as the case may be.
Federal Government had at the time while launching an operational guidelines for national ambulance services and national policy on emergency to structure and harmonise Emergency Medical and Rescue (EMS), said the country needed at least 5,000 ambulances to meet its emergencies.
Ehanire had said, “Nigeria currently has about 1,000 registered ambulances in both government and private operations. The number is clearly insufficient to achieve the desired average response time for our population and road network. However, most of them are connected to an emergency service network, but sit idle in hospital premises or by the roadside and may be used for purpose other than emergency.”
To help in reducing the rate of preventable deaths on the nation’s highway, the Senate had one time called for the establishment of ambulance service on major highways in the country even though many have continued to argue that establishing ambulance service on the highways is the duty of states through their ministries of health. But establishment of ambulance on the highways is something that ordinarily should not be taken for granted had Nigeria’s federal system worked in truth and the states had not become mere appendages of an overbearing central government.
Only recently, the Community Health and Research Initiative (CHR), both raised concerns over the non-implementation of ambulance services on the highways four months after disbursing N327 million to the Federal Ministry of Health (FMOH) for the programme.
The programme, which is domiciled with the Department of Hospital Services of the FMOH is captured in the operation manual of the Basic Health Care Provision Fund (BHCPF), which indicates that Emergency Medical Treatment (EMT) carries 2.5 per cent of the total funding for BHCPF annually.
According to Dr Aminu Magashi, the coordinator CHR, based on the BHCPF provided by the National Health Act (NHA) 2014, ambulance, referral and trauma services were part of EMT.
He explained that the EMT got N327 million from the May disbursement of the BHCPF, to be used as start up for the services but about five months after the disbursement, Nigerians were yet to see ambulances, referral or trauma services on the highways.
“The money is available, the operational manual is available since the discussion on the matter has commenced we need to see ambulances on the six identified highways.
“We also need to see the ambulances responding to patients and referring them to the nearby identified facilities.”
However, according to the Permanent Secretary in the FMOH, Mr Abdulaziz Mashi, there were a lot of administrative bureaucratic frameworks that have been set up by the ministry to ensure an effective take off of the EMT programme.
While giving assurances that the programme would soon kick off to safe guard lives involved in automobile accidents on the highways, he explained that the emergency fund was a five per cent of the BHCPF, which was further subdivided into 2.5 per cent to the Department of Hospital Services of the ministry and the remaining 2.5 per cent went to the Nigeria Centre for Disease Control (NCDC).
“We are still coming up with emergency management committee team to ensure that we block all the leakages and get it right before we take-off. Just a little more patience, I know we will be there.”
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