Introduction
One of man’s best inventions is drugs, especially disease-specific ones. Drugs are substances other than food, which can prevent, relieve the symptoms, or cure an abnormality or disease. Globally, the cost of drugs has soared over the years, resulting in a situation whereby low-income earners are unable to buy branded medications. In underdeveloped and developing countries where food and drug agencies have poor capacity to perform their regulatory functions optimally, we tend to see the proliferation of substandard or fake drugs. So many times, this ugly trend is energized by not just greed but by the market demands for affordable medications.
Why Medication exceeds expiry date
To mitigate the challenge of not being able to buy drugs, when necessary, people from resource-limited settings stack up some essential medications in their homes, which eventually exceed the best before or expiry dates on them. Sometimes, doctors could change a patient’s prescription because of reactions, allergies, or inability to purchase the drug, which could result in leftover drugs that eventually exceed the expiration date. Also, big pharmacies and patent-drug stores cannot sell all their stock, leading to the expiration of some drugs. This situation has raised many questions about the safety of these drugs after their expiration or beyond the “best before” date. Because of the importance of drugs and the health risks involved when taken wrongly, people have always consciously discarded unused drugs when it’s past the expiration date, even one day.
How Safe is a drug after the expiry date?
The debate about drugs being safe after their expiration date has persisted over the years, as many people still hold the opinion that pharmaceutical companies deliberately label their drugs with short shelf lives to guarantee steady patronage. Eventually, most of these unused drugs are discarded. The context that drugs can still be safe for a long time after expiration has gained several affirmations. In a recent study by Benjamin Davido and others titled ‘Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages’ published in MDPI Journal “Antibiotics”, it was reported that when appropriately stored in line with the expected conditions, no expired antibiotics tested failed to be potent after one year of expiration. In another study by Sushil Sharma and others, titled ‘A study to investigate the chemical potency, physical stability, and efficacy of analgesic agents over a period of two years post their expiry date’ published in the “Medical Journal Armed Forces India”, it was seen that drugs such as Diclofenac, Piroxicam, and Ibuprofen retained their stability, analgesic efficacy, chemical active ingredients and by implication their potency up to a duration of two years after expiration.
Important factors to consider
However, the issues of proper storage and handling can play a big role, especially in the tropical climate of West Africa and other geographical regions. Hence, people in the tropics may have to rely on their capacity to store their drugs in the required condition in deciding whether to use a drug past the expiration date or not.
Conclusion
This article doesn’t advocate for the use of expired medication but to reduce anxiety about accidental use. It is essential to understand factors that impact drug stability.
(Written by Ebenezer Dic-Ijiewere PhD.)
NB: Always consult your healthcare professionals regarding expired medications to ensure medication safety and effectiveness.
Coronary Heart Disease Risk Factors: Measures for ReductionCoronary Heart Disease (CHD) is a chronic and intricate ailment associated with substantial morbidity and mortality, primarily attributed to atherosclerotic lesions in coronary vessels, ultimately leading to myocardial infarction (MI) and stroke. Unhealthy eating habits, often influenced by chronic inflammation, are closely linked to CHD. Various health conditions, lifestyle choices, as well as your age and family history, can elevate the risk of developing heart disease; approximately 47% of Americans have at least one of the three primary risk factors for heart disease: high blood pressure, elevated cholesterol levels, and smoking. Certain risk factors for heart disease, such as age or family history, are beyond your control. However, you can proactively reduce your risk by changing the factors you can control.
Behaviors that heighten the risk for heart disease are
- Smoking: The Food & Drug Administration (FDA) estimates that cardiovascular disease causes 800,000 deaths and 400,000 premature deaths per year. About one-fifth and one-third of these result from smoking, respectively. Additionally, research reported that smoking resulted in a 51% increased risk of coronary heart disease in patients with diabetes. Cigarette smoking has the potential to harm the heart and blood vessels, amplifying the risk for heart conditions like atherosclerosis and heart attacks. Even nonsmokers face an increased risk of heart disease when exposed to secondhand smoke.
- Excessive alcohol consumption can elevate blood pressure and elevate the risk of heart disease. It also leads to increased triglyceride levels, a fatty substance in the blood associated with an elevated risk of heart disease.
- Sedentary lifestyle: Insufficient physical activity is a precursor to heart disease and can strengthen the likelihood of other medical conditions that serve as risk factors, including obesity, high blood pressure, high cholesterol, and diabetes. Engaging in regular physical activity can effectively decrease the risk of heart disease.
- Unhealthy Eating Habits: A diet rich in saturated fats, trans fats, and cholesterol has been associated with heart disease and related conditions like atherosclerosis. Recent research has provided more explicit evidence that trans-fat significantly raises the risk of cardiovascular disease by adversely affecting lipids, endothelial function, insulin resistance, and inflammation. For each 2% increase in calories consumed from trans-fat, there is a 23% higher risk of coronary artery disease. Recent studies and systematic reviews have focused on red and processed meat consumption. The research consistently demonstrates an increased risk of coronary heart disease and cardiovascular events. The risk ranges from 15% to 29% higher with red meat consumption and 23% to 42% higher with processed meat consumption
Measures for Reducing the Risk of Coronary Heart Disease
- Educating children and adolescents about the dangers of smoking to deter the initiation of tobacco use. The Food & Drug Administration (FDA) reported that the risk of coronary artery disease decreases to the level of lifetime nonsmokers within four years of quitting and within ten years.
- The DASH, Mediterranean, and vegetarian diets have the most evidence for cardiovascular disease prevention. The DASH diet has been shown to lower systolic blood pressure by up to 11.5 mmHg in adults with hypertension. Additionally, reported findings indicate a 21% reduction in coronary artery disease risk with adopting the DASH diet.
- The American Heart Association suggests substituting saturated fat with polyunsaturated and monounsaturated fats. A 5% shift from saturated fat to polyunsaturated fat consumption is linked to a 10% lower risk of coronary artery disease.
- Engaging in about 150 minutes per week of moderate-intensity aerobic activity significantly lowers the risk of cardiovascular disease. Moderate-intensity aerobic exercise is characterized by activity that maintains a heart rate between 50 to 70 percent of the individual’s maximum heart rate, calculated as 220 beats per minute minus the person’s age.
How to Decrease High Cholesterol LevelsHigh cholesterol (hypercholesterolemia) refers to elevated levels of cholesterol in the blood, especially low-density lipoprotein cholesterol (LDL-C)—which is widely regarded as a key modifiable risk factor for atherosclerosis and cardiovascular disease (CVD). LDL-C can deposit in arterial walls, forming plaques that narrow arteries and increase the risk of heart attack and stroke. Meanwhile, high-density lipoprotein (HDL-C) is considered “good” cholesterol because it helps transport cholesterol away from the arteries to the liver for excretion. Several factors can increase the level of cholesterol in the blood, as indicated below
Factors That Contribute to Elevated Cholesterol
- Poor diet
- Lack of Physical Exercise
- Excess body weight
- Smoking increases cholesterol profile, and excessive alcohol increases triglycerides
- Genetic traits
- Chronic stress and poor sleep
- Diet low fiber
To decrease high cholesterol in the blood, it is important to make positive changes to health behaviors by following the strategies below:
Strategies to Decrease High Cholesterol Levels
- Reduce intake of saturated and trans fats, and substitute with MUFA and PUFA-rich foods such as fatty fish(Salmon and Mackerel), olive oil/canola oil, Avocado/nuts
A study by Okobi et al. (2023) found that an avocado-rich diet can lower total cholesterol (TC) and low-density lipoprotein (LDL) levels.
- Increase consumption of food high in soluble fiber, such as oats, fruits, apples, and legumes.
- Regular aerobic exercise for 150 minutes/week lowers LDL and triglycerides and improves HDL.
- Losing excessive weight will improve LDL profiles.
- Quitting smoking will improve cardiovascular health and HDL levels
Our connections with family, friends, and colleagues are crucial. Individuals who have strong social connections and supportive relationships are more likely to adopt healthy lifestyles and effectively cope with stress, anxiety, and depression, especially during difficult times. A supportive network of family members, close friends, and colleagues provides a sense of belonging and emotional support.
Ways to create meaningful impacts are;
1.Showing kindness: Providing a listening ear, checking in on them, offering assistance, or simply sharing a smile can profoundly influence the overall well-being of others.
2. Promoting physical activity: Encouraging others to participate in physical activities such as organizing sports events, walking or running together, or engaging in group activities can enhance physical and social well-being.
3. Spreading awareness and education: Educating others about healthy lifestyle choices, including proper nutrition, exercise, and stress management, can empower them to make positive life changes.
4. Promoting a healthy diet: Sharing recipes, discussing healthy eating habits, organizing cooking classes, and advocating for nutritious foods can encourage healthier dietary choices.
5. Supporting access to healthcare: Being present for others during difficult times is crucial and can significantly improve their lives. Providing transportation to healthcare facilities encourages them to seek professional help when needed, and assisting with paperwork can make access easier.
6. Advocating for policy changes: Supporting policies and initiatives that promote public health, such as mental health services, water regulation, and access to healthcare, can have a broad impact on the well-being of entire communities.
7. Assisting those with chronic illnesses: Offering understanding and support to individuals with chronic health conditions can help them manage their conditions and enhance their quality of life.
Strategies for Improving Sleep QualitySleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.
Recommended Sleep Duration
The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.
Prevalence of Sleep Disorders and Mental Health Impacts
About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.
Improving sleep Quality
Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.
Strategies for Improving Sleep Quality
- Creating a relaxing sleep environment
- Limiting daytime naps
- Managing stress and worries
- Being mindful of food and drink choices
- Sticking to a consistent sleep schedule
- Incorporating physical activity into daily routines.
The Struggle to Survive: Living Through the Rising CostThe rising cost of living has become a significant public health concern, particularly for low-income individuals who are struggling daily to survive. Addressing the social determinants of health among this population remains an urgent issue, as many face ongoing challenges accessing essential needs such as food, housing, transportation, and healthcare. During my assessment of some of the low-income individuals, I found that several individuals eat only once a day to save money for rent. Many reported choosing to go hungry rather than risk homelessness. Some have been living in their cars for nearly a year, while others rely on the homes of friends to shower and change clothes. It is heartbreaking to witness the difficult situations people endure every day to stay alive.
The rising cost of living has multiple impacts on health and well-being. According to Grewal et al. (2024), increasing housing costs—one of the key components of living expenses—can have both direct and indirect health consequences. Their study indicates that:
- Financial strain from high housing and living expenses contributes to increased stress, anxiety, and depression, particularly among renters and low-income individuals.
- Food insecurity often results when households must prioritize rent or transportation over nutrition, leading to poor dietary intake and higher risks of chronic diseases.
- Limited access to healthcare arises when individuals cannot afford medical visits, medications, or preventive care due to competing financial demands.
- Housing instability or homelessness can expose individuals to unsafe environments, lack of sanitation, and interrupted social support networks, which worsen both physical and mental health outcomes.
Overall, Grewal et al. (2024) emphasize that the effects of rising housing and living costs are unequally distributed, disproportionately affecting low-income individuals who already face multiple barriers to health. This highlights the need for comprehensive policy approaches that integrate housing affordability, income support, and healthcare access as essential strategies to promote health equity.
Source: https://doi.org/10.1186/s12889-024-18360-w
Prevalent Barriers to obesity within the African American population.As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.
Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).
Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.
Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.
References
Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383
Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640
