Category Archives: Research

Drug Revolving Fund (DRF) BY PHARM BUKOLA FABIYI

I was engaging my followers on the need for constructive methods of essential medicine financing when Pharmacist Bukola Fabiyi mentioned “Drug Revolving Funds” as a potent and strategic means of ensuring people do not die due to live saving medications like insulin.

So i pleaded with her to submit an article about this which she did and i hope our readers can begin to task the government at local, state and federal level into making sure the right things are done towards ensuring essential medicines are made available, affordable and accessible to everyone irrespective of the social status.

Drug Revolving Fund (DRF)

The Bamako Initiative (BI) was introduced by WHO/UNICEF in the late 1980’s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes (Chukwuani et al., 2006).

Essential medicines, as defined by the World Health Organization (WHO), are the medicines that “satisfy the priority health care needs of the population”. These are the medications to which people should have access at all times in sufficient amounts.

Essential medicines selected for diabetes are “Insulins and analogues” and “Oral blood glucose lowering medicines”

The DRF is a method of financing medicine in which, after an initial capital investment, drug supplies are replenished with monies collected from the sales of drugs according to the world health organization. It is an effective strategy for ensuring regular drug supply in the healthcare delivery system.

This scheme according to the research conducted by ogbonna however has not been successful due to the following reasons:

  • Poor management
  • Mis-application of the Fund
  • Purchasing of drugs at exorbitant prices
  • Lumping of the proceeds of the fund into a general account
  • Non-reimbursement of the cost of drugs for exempted patients.

According to Gazelle News, May 14, 2013, it stated that 17 states went to understudy and adopt Ekiti’s unified DRF.

A case study was also carried out and evaluated on the efficiency in the drug supply system in Kano state in 2013. Kano state was able to increase their procurement significantly from N133 million in 2008 to N1 billion in 2013 without additional financial support. This was managed and supported by key institutions.

To ensure the success of DRF, quality medicines must be identified, the medicine must be affordable and the monitoring and evaluation of the DRF facility must be achieved in accordance to the set performance targets (Ogbonna and Nwako, 2016).

The Central medical stores in Lagos was renovated in 2013 through funding from Non-Governmental Organisation and Federal Ministry of Health (NGO/FMOH). The Lagos state ministry of health has gone into collaboration with PATHS (Partnership for Transforming Health Systems) and private suppliers of medicines to enhance the operation of sustainable DRF system.

References:

Ogbonna, B. O., and Nwako, C. N. (2016) Essential Drug Revolving Fund Scheme in Nigeria, from the Edge of a Precipice towards Sustainability. Journal of Advances in medical and Pharmaceutical Sciences. Vol 8(2), Pp1-8.

WHO (2009) How to establish a successful revolving drug fund: the experience of Khartoum state in the Sudan. Available [online] from here

3 hours of Daily TV time May Increase A Child’s Risk of Type 2 Diabetes

Previous research already showed that increased time spent watching TV or with the computer increases risk of obesity and insulin resistance in adults.

Children especially males have shown far more increased time watching television or playing video games, or with smart phones and electronic tablets in recent times, a study from by researchers from St. George’s, University of London says.

How the study was conducted

The recent study involved 4495 children aged between 9-10.

Their activity levels, body proportions and time spent watching TV was recorded daily.  Pubertal status was also taken note of in girls.

 

Findings from the study

It was reported that children who spent 3 hours or more had higher levels of leptin and insulin than those that had less than one hour screen time. This can cause insulin resistance causing a risk for diabetes. Impaired leptin levels noticed can also result in difficulty controlling appetite.

Of the children who took part in the study between 2004 and 2007 and for whom complete data were held, 18 per cent – around one in five – said they spent more than three hours on screens every day. It was reported that boys 22 percent of boys spent 3 or more hours watching TV or using electronic devices compared to 14 percent of girls.

Screen related activities are mostly sedentary in nature and pose a risk to metabolic health.

Recommendations

Study author Dr Claire Nightingale from St George’s, University of London, said:

“Our findings suggest that reducing screen time may be beneficial in reducing type 2 diabetes risk factors, in both boys and girls, from an early age.”

He  also said:

“This is particularly relevant, given rising levels of type 2 diabetes, the early emergence of type 2 diabetes risk, and recent trends suggesting screen-related activities are increasing in childhood.”

The American Academy of Pediatrics has previously suggested that children should limit daily screen time to less than 2 hours per day, more recent guidance fro, AAP did not propose a time limit but suggested that parents should place consistent limit on the hours per day of media use.

There is currently an alarming rate of type 2 diabetes starting earlier than would have been expected and if this trend continues, it might pattern screen related behaviour in later life.

The findings were published in the journal the  Archives of Disease in Childhood

Woman Living With Diabetes No Longer Needs Insulin After Bioengineered Pancreas Transplant

The major problem with type 1 diabetes is that the body produces antibodies that attack the body’s healthy islet cells in the pancreas which produces insulin. This limits insulin production making the body the body unable to make use of glucose gotten from diet leading to high blood sugar. The patient then has to makes rely on insulin injections or pumps to survive.

Before now, several research works have being aimed at transplanting islet cells from deceased donors into the liver but this has not been ideal The liver can only take few islet cells and with risk of bleeding.
Recently, researchers at the University of Miami Diabetes Research Institute have tried another location – the omentum, a fatty membrane in the belly.

A 43 year old single mother with a 25 year history of type 1 diabetes has been off insulin for over a year following islet cell transplant in the omentum. Before the transplant, she was said to have been on about 33 units of insulin per day. No surgical complications were observed during the procedure.

The researchers said

“The cells began producing insulin faster than expected, and after one year she is doing well and doesn’t need insulin injections”.

“We’re exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach,”

Dr. David Baidal, assistant professor in the University of Miami Research Institute who led the study said. The research is the first step towards developing a mini organ called BioHub.

The BioHub would be like a home to the islet cells providing it with blood supply and nutrition, making it easier to remove in cases of complications. The researchers plan to test the use of omentum as a site in 5 new patients.

IMPROVED LIFESTYLE
Baidal explained that

“Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father”.

This is indeed good news.
This is a step in the positive direction for about 422 million people worldwide living diabetes. It would also markedly save cost for insulin in the long term.
More information of this ground breaking research headed by Dr David A. Baidal can be seen in the New England Journal of Medicine.

Meanwhile, you can win an all expense paid trip to a Diabetes youth camp in Ghana. Click here for details

Merck Diabetes and Hypertension Awards

Merck Diabetes Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Diabetes Award 2017
Theme: Every Day is a Diabetes Day

Please submit a concept paper about:

  • How to improve the awareness about Diabetes Early Detection and Prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to Think and Act on Diabetes Every Day.
  • Your ideas of developing new policies, strategies, social media campaigns and more.

 

Merck Diabetes Award 2017

is:

“Postgraduate Diabetes Diploma with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October, 2017 in Cairo, Egypt to receive the award”.

Merck Diabetes Award is being rolled out in many of the African and Asian universities as part of our commitment to building diabetes capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Diabetes Award is to create a Diabetes Experts Platform across the globe.

Please submit your one page concept paper to:
submit@merckdiabetesaward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

Merck Hypertension Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Hypertension Award 2017

Theme: What the Healthy Heart needs

Merck Hypertension Award is being rolled out in many of the African and Asian universities as part of our commitment to building healthcare capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Hypertension Award is to create a Hypertension Experts Platform across the globe.

To raise the required awareness to control and prevent hypertension, countries need systems, policies and services in place to promote universal health coverage and support healthy lifestyles: eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and stopping the use of tobacco.

Please submit a concept paper about:

  • How to improve the awareness about hypertension control and prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to think and act on Hypertension Every Day
  • Your ideas of developing new policies, strategies, social media campaigns and more.

Merck Hypertension Award 2017
is:

“Postgraduate Diploma in Preventive Cardiovascular Medicine with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October 2017 in Cairo, Egypt to receive the award”.

Please submit your one page concept paper to:
submit@MerckHypertensionAward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

For more information visit Merk’s Official website

The 3rd Africa Diabetes Congress (YAOUNDE 2017)

3rd AFRICA DIABETES CONGRESS CALL!

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PRE CONGRESS WORKSHOPS 17-19 APRIL 2017

CONGRESS DATES: 19-22 APRIL 2017

CONGRESS STREAMS:

1.       Education and patients

2.       Clinical

3.       Basic sciences and physiology

4.       Epidemiology public health

5.       Endocrinology (including paediatrics and reproductive)

CORPORATE SYMPOSIA

Wednesday 19th April 2017: 3 from 14:00 – 15:30

Thursday 20th April 2017: 3 from 12.30 – 14:00 and 2 from 18:00 – 20:00

Friday 21st April 2017: 2 from 12.30 – 14:00

 

SOCIAL PROGRAMME

Opening Ceremony: Wednesday 19th April 2017 from 17:30 – 18:30

Welcome reception: Wednesday 19th April 2017 from 18:30 – 19:30

Congress dinner: Friday 21st April 2017 from 19:00 – 22:00

 

IMPORTANT DATES

First Announcement: 30th April 2016

Second Announcement and Call for Abstracts: 1stJune 2016

Abstract Dateline: 30th October 2016

Breaking Abstract Dateline: 15th January 2017

Early Registration Dateline: 1st February 2017

 

PUBLICATION OF ABSTRACTS

 

Accepted abstracts for oral presentation, poster discussion and poster display will be published in a Supplement of Diabetes Research and Clinical Practice

Congress Secretariat.

Yaounde – Cameroon.

NGDOC partners with Ogun State Government

 

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The 21st of May was a memorable day for the students of Ogun State as the ministry of health launched its School Health Cadet program.

The School Health Cadets involves cross section of secondary school students from across Ogun State.
Their responsibility is to create a health conscious Community through their various activities in their schools and respective communities.

The Nigeria Diabetes Community partnered with the ministry of health to train the students on Diabetes education and Advocacy with the aim of creating adequate diabetes awareness at community level.

Special guests with The Honorable Commissioner for Health
Special guests with The Honorable Commissioner for Health

The Honorable Commissioner for Health Dr. Olaokun Soyinka charged the children to be health ambassadors in their communities creating passionate change that will make the communities a safer environment and healthier.

Among distinguished guests present at the launch are the representatives from Ogun State ministry of education, Dangote Groups, Talabi Diabetes Center, Unity Bank, Eli Lilly Pharmaceuticals and The Nigeria Diabetes Community .

Diabeducation manual for secondary school students
Diabeducation manual for secondary school students

A team of 10 participants to include students, a school teacher and school health worker from 10 schools across the 3 geographical zones in the states were trained.

Cross Section of Participants at the Program
Cross Section of Participants at the Program

 

It is expected that the team will  translate the knowledge acquired during the training to their colleagues at school and their respective communities.

Followup on their activities will be done through the school health unit of the department of public health.

PHOTOSPEAKS

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Facilitators
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Cross section of secondary school students
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Cross section of participants
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Cross section of secondary school students
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Cross section of secondary school students
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NGdoc Co-Founder speaking on ‘You too can save a life;role of youths in diabetes advocacy’
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A training unit with their facilitator
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A training unit with their facilitator
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A training unit with their facilitator
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Facilitators Meeting prior to the event at The Commissioner for health conference room.

 

Our Profound Gratitude goes to everyone who has supported this program and made it a reality most especially the sponsors of the diabeducation project:
Eli Lilly Pharmaceuticals
Mr Olumuyiwa Talabi – Talabi Diabetes Center
Dr Gbadebo Saba – Owokoniran Memorial Hospital
Dr Dunni Osofisan
Dr Okubenna Oladunni
Dr Tosin Ojo
Alhaja R.O Balogun

Diabetes and Sickle Cell Anaemia

The burden of Diabetes in resource poor settings are enormous and coupling it with other co-morbidities might not be a very pleasant experience.

A couple of days ago I met a young lady in her early 30s who was recently diagnosed with diabetes. Looking at her facie I requested for her genotype done and was surprised when the result came and she is SS- Sickle Cell Anaemia.

In my 3 years of Advocacy it has never occurred to me a possibility of both conditions coexisting and this lady got me thinking so I decided to conduct a mini research into it.

Sickle-cell disease (SCD ), also known as sickle-cell anaemia (SCA ) , is an inherited blood disorder , characterized by an abnormality in the oxygen carrying haemoglobin molecule in red blood cells .

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This leads to a propensity for the cells to assume an abnormal, rigid, sickle -like shape under certain circumstances. Sickle-cell disease is associated with a
number of acute and chronic health problems, such as severe infections, attacks of severe pain (“sickle-cell crisis”), and stroke , and there is an increased risk of death.

According to an article on Medscape, clinical experience in tropical countries with a high incidence of SCD indicates that the concurrence of SCD with either type 1 or type 2 diabetes is a rare finding.

Although there are no population-based data to determine the relative prevalence of diabetes among patients with SCD in the tropics, it seems that the SCD population enjoys relative ‘protection’ from diabetes.
Theoretical mechanisms for such protection would include the low BMI, hypermetabolism, and possibly other genetic factors.

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The situation in the tropics might be quite different from that in affluent countries, where blood transfusions are more widely used to palliate the anemia of SCD.

According to this article iron overload due to multiple transfusions can result in β-cell damage and decreased insulin production. The result can range from glucose intolerance to frank diabetes that requires insulin for control.

The analysis revealed that, for every 10 years of transfusion use, transfused subjects with SCD had 2.5-times greater odds of diabetes. The analysis showed, moreover, that transfused patients with thalassemia had 5.2-fold greater odds of diabetes compared with transfused patients with SCD.

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But beyond this scientific expose there is need for specialized adequate medical care for people living with diabetes and those who might have other co-existing morbidities such that the burden won’t lead to state of hopelessness, depression and mortality.

Food for thought:

After interacting with her I discovered she is from a middle class family hence she might be able to get her medical supplies but what if she were from a family living below the UN $1 a day poverty benchmark?
What will be her fate?

NGOs and advocates should brace up to stand for equity in medical access across board and a health system that can cater for people in dire need for support and care.

Adejumo Olamide H.

Contact us on thengdoc@gmail.com

Join the Nigeria Diabetes Online Community on twitter @theNGdoc and visit our website and blog www.ngdoc.com and www.ngdocblog.com respectively for more information.

Just One Less Sugary Drink A Day Makes A Difference

Just One Less Sugary Drink A Day Makes A Difference

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A new study on Diabetologia says that every 5% of a person’s daily energy intake that comes from sugary drinks correlates to an 18% higher risk of developing Type 2 Diabetes – that’s almost a 20% greater risk of developing Type 2 Diabetes for ever glass of sugary soda!

“The good news is that our study provides evidence that replacing a daily serving of a sugary soft drink or sugary milk drink with water or unsweetened tea or coffee can help cut the risk of diabetes,” said researcher Dr. Forouhi, adding that this allows them to “(offer) practical suggestions for healthy alternative drinks for the prevention of diabetes.”

The researchers’ analysis of the data, which accounted for a range of factors such as total energy intake, found that soft drinks and other sweetened beverages posed a particularly insidious risk, as opposed to the consumption of natural fruit juice, coffee, or tea.

News and Image Credit: Daily Health Post

DIABEDUCATION

INTRODUCTION

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Currently in Nigeria, the emphasis of most policies and interventions is on screening and early treatment.

Though diabetes education forms a part of most strategies, screening of people at risk is the main focus.
The current strategies that exist in Nigeria are mainly health-care facility based and as such do not provide adequate information to the teeming population.

According to the IDF Diabetes Atlas (2013), about 3.9million out of the 78 million adult population in Nigeria (20-79years) is diabetic.
This puts the National prevalence of type 2 diabetes at approximately 5%. According to the same report, about 105,000 diabetes related deaths occurred in 2013.

There is thus a need for improved diabetes education and awareness

WHY DIABEDUCATION?

DIABEDUCATION is aimed at imbibing healthy living lifestyle, good physical activities among young individuals as well as make them diabetes advocates in their schools and communities through adequate diabetes education in a “catch them young approach”.

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The training manual was developed to teach basic symptomalogy of the disease in easy to understand plain language for children and adults as well as utilizing community focused advocacy methods and via the use of social media- the latest social trend as a veritable tool for diabetes advocacy.

With Nigeria’s mobile subscriber base estimated to grow by a significant 14 percent this year to 120 million, utilization of social media in youth health advocacy will help educate, motivate, encourage, and act as a viable propagation medium for adequate diabetes information and education among Nigerians.

With this project we will be directly training over a hundred secondary school students across Ogun State who will then create awareness and educate their peers and community hence indirectly affecting over a hundred thousand individuals across the state.

Our profound gratitude goes to The Ogun State Government, The Ogun State Ministry of Health and the Department of Public health and School health board for the tremendous support.

We also say a big thank you to the Honorable Commissioner for Health for Ogun State, Dr Olaokun Soyinka, Mr Talabi Olumuyiwa – Patron of The Talabi Diabetes Center, the Directors, Facilitators, Volunteers, Sponsors and finally our contributing authors.

This program is scheduled to hold on the 16th of April, 2015. Follow the hashtag #diabeducation on Twitter and on Facebook.

Interested in being a part of the program either as a sponsor or volunteer? Please send us an email on thengdoc@gmail.com

Pan-African Diabetic Foot Study Group Bi-annual Scientific Meeting.

 Pan-African Diabetic Foot Study Group Biannual Scientific Meeting.
Pan-African Diabetic Foot Study Group Biannual Scientific Meeting.

The 2nd Pan-African Diabetic Foot Study Group Bi-annual Scientific Meeting.

This Bi-annual meeting being the first of its kind in Africa, took place at the conference room of the Blue Pearl Hotel Morogoro Road, Ubungo Plaza, Dar-es-Salaam Tanzania between 24th to 26th August 2014.

It was aimed at providing updated information regarding the prevention and management of diabetic foot complications in Africa, by bringing together a group of international specialist who are well known for their work in the field of diabetic limb complication.

Delegates from 29 countries around the world, 19 African countries out of which 4 Nigerians were in attendance.The scientific conference was fully packaged with twenty-two lectures on diabetic foot by specialists, eight live workshops which focused on various aspect of clinical practice and management of diabetic foot complications, oral and poster presentations by selected delegates.

The PADFSG was created to promote an advancement of knowledge on all aspect of diabetic foot care through active cooperation and collaboration between diabetologist, podiatrist, specialist nurses, orthopaedics and vascular surgeons and all other specialist with an interest in caring for people living with diabetic foot problems.

This collaborative effort will be to bring together, researchers working in this fields to exchange experiences in research and clinical practice during regular meetings. In addition, the PADFSG may also work actively for the promotion of African collaborative studies and also act as a reference group for other groups in matters relating to foot problems, amputation etc.

Diabetes is a serious chronic disease that needs urgent attention. It affects rich and poor,young and old, and industrialized in equal measure. In 2013, the global prevalence of diabetes was estimated at 382 million (20-70yrs) of which 80% live in low and middle income countries. This figure is predicted globally to reach 592 million ( 55% increase) by 2035. In Africa, total number of diabetes was 19.8 million in 2013 and will increase to 41.4 million by 2035. At present, it is estimated that still 190 million people (55%) with diabetes are undiagnosed. At the same time, diabetic foot complication will increase.

Every 20 seconds a limb is lost due to diabetes somewhere in the world. Approximately 15% of all people with diabetes will be affected by a foot ulcer during their lifetime and up to 85% of amputations in relation to people with diabetes are preceded by a foot ulcer. 1 in 4 of diabetes patient with DM foot require immediate amputation and five years recurrence rates of ulcer is 70%.

Research studies have shown that people with one lower limb amputation as a result of uncontrolled diabetes have a 50% risk of developing a serious lesion in the second limb within 2 years. People with diabetes have a 50% mortality rate in the 5 years following the initial amputation. Across the globe, 40-60% of all lower extremity non-traumatic amputations is due to diabetic foot.

The prevalence of diabetic foot among people with diabetes in Nigeria is 55% and mortality is 12%. Globally, up to 70% of all leg amputations happens to people living with diabetes, lower extremely amputations in diabetes count over 1 million per year. Foot complications, especially serious ones like the septic limb can be serious and costly.
85% of all diabetic foot related problems are preventable.

In other to improve diabetic foot care, education and prevention of amputation in Africa, Dr. Z.G. Abass who doubled as the chairman PADFSG and also chairman organising committee of the conference, initiated the “Step by Step Foot Project” in Tanzania in 2004, which was the first in Africa and has due to the successful establishment of its model of diabetic foot care in Tanzania encouraged other countries to do likewise. To date, the model has been exported to various other countries in Africa, Pakistan, Saudi Arabia and the Caribbean.

As part of the step by step foot project, a book “Pocket guidelines of diabetic foot for health care worker” by Dr. Z.G. Abbas was launched on the first day of the conference to provide a broad sweep of current knowledge in the field of diabetic foot complications.

Thus, educating patients and health care workers which is the integral part of any prevention program. The pocket guideline is a useful tool for clinical practice aimed at managing the diabetic foot; it focuses on the key aspect of prevention and education through initiatives based on sharing of knowledge and guidelines for managing diabetic foot.

We want to profoundly appreciate the immense contribution of the PADFSG, particularly Dr Z.G. Abass for the sponsorship of the NGDOC representative to the conference.

Dr Foluke Ajose is a diabetes advocate, NGdoc DiabLink Cordinator interested in Diabetes Limb Salvage, she is currently in talks with Dr Abass towards inviting him to Nigeria and replicating the “Step by Step Foot Project” model in Nigeria.

Next PADFSG Conference holds Oct 14-15th 2016,in Cairo Egypt. Don’t Miss it!

PHOTO SPEAKS

Traditional Display at the Gala dinner

Traditional Display at the Gala dinner

BLUE PEARL HOTEL MAIN ENTRANCE

BLUE PEARL HOTEL MAIN ENTRANCE

DELEGATE REGISTRATION

DELEGATE REGISTRATION

Delegates at Lunch

Delegates at Lunch

Delegates from Nigeria

Delegates from Nigeria

Dr. Ajose Foluke with Dr. Z.G. Abbass(chairman PADFSG)

Dr. Ajose Foluke with Dr. Z.G. Abbass(chairman PADFSG)

Dr. Arun Bal,Founder President Diabetic Foot Sosiety of India

Dr. Arun Bal,Founder President Diabetic Foot Society of India

Launching of Book and Opening of the Meeting

Launching of Book and Opening of the Meeting

Overview of Delegates at the Conference

Overview of Delegates at the Conference

Prof Andrew Bolton, Founding Chair Diabetic Foot Study Group Of EASD 1998

Prof Andrew Bolton, Founding Chair Diabetic Foot Study Group Of EASD 1998

TANZANIAN MINISTER FOR HEALTH

TANZANIAN MINISTER FOR HEALTH – Dr Seif S. Rashid

The Blue Pearl Hotel

The Blue Pearl Hotel