Awolowo University Teaching Hospitals Complex Research Articles

Conversion and complications of elective laparoscopic cholecystectomy in a West African population

Background Laparoscopic cholecystectomy (LC) is increasingly adopted in Nigeria, but the procedure is limited due to the low incidence of gallstone diseases. This study aims to determine the incidence of conversion and complications following elective LC. Patients and methods Consecutive patients undergoing elective LC at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, were the participants. Patients’ preoperative characteristics including ultrasonographic findings, instances of conversions, and intraoperative and postoperative complications were documented. The influence of gallbladder wall thickness on the outcome was analyzed. Results There were 150 patients, including 124 (82.7%) women and 26 (17.3%) men aged 18–82 years (mean=45.4, SD=13.38). Indications for LC were chronic calculous cholecystitis in 101 (67.3%), 45 (30%) acute calculous cholecystitis, whereas four (2.7%) had acalculous cholecystitis. Gallbladder wall thickness was normal (≤3 mm) in 98 (65.3%), thick (4–9 mm) in 35 (23.6%), and very thick (≥10 mm) in 17 (11.3%) patients, whereas 11 patients had pericholecystic fluid collection. Gallbladder mucocele was encountered in nine (6%), empyema in six (4%), and gangrenous gallbladder in two (1.3%) cases. Ten (6.7%) procedures were converted to laparotomy including two patients with hemoglobinopathies. Postoperatively, bile leaks occurred in two patients, bleeding requiring reeploration in one, and bile duct dilatation after 4 months in one patient. Acute cholecystitis, hemoglobinopathy, and thickened gallbladder wall significantly influenced conversions and occurrence of complications in this series. Conclusion We observed a low rate of conversion and complication following LC. Acute cholecystitis and thickened gallbladder wall significantly influence the conversion of LC to open procedure in our setting.

Review of instrumental vaginal delivery at the Obafemi Awolowo University teaching hospitals complex

Background: Instrumental vaginal delivery (IVD) is one of the signal functions of the basic emergency obstetric and newborn care. Some recent reviews point towards a sustained fall in the performance of this lifesaving procedure. With increasing caesarean section rates, institutional reviews of the practice of IVD are important to improve and sustain this art which is on the path of extinction.Objectives: To determine the IVD rate at the OAUTHC over a 5-year period from January 2013 to December 2017 and to review the maternal and newborn outcomes.Methods: This was a retrospective review. Case records of parturients who had either forceps or vacuum delivery during the study period were retrieved and relevant information were extracted. Data analysis was done with IBM-SPSS version 20.Results: There were 10,286 deliveries and 101 IVDs over the 5-year period giving an IVD rate of 0.98%, with 0.41% for forceps and 0.57% for vacuum delivery. Seventy-one case records were available for review. Mean maternal age was 27.21 ± 5.8 years and 31 (43.7%) of the parturients were primigravidae. Thirty-nine (54.9%) were booked and 66 (93%) of the procedures were performed as emergencies. Senior residents conducted most (94.4%) of the procedures and poor maternal efforts in the second stage of labor was the most common indication (43.8%). All resulted in vaginal delivery with the most common maternal complication being genital tract laceration, most notably first and second-degree perineal tears. Of the 66 livebirths, neonatal ward admission rate was 45.5%. There was an early neonatal death which followed a traumatic vacuum delivery.Conclusion and Recommendations: The IVD rate at OAUTHC is low, with higher preference for vacuum delivery. Appropriate case selection is evident, and poor maternal effort in second stage of labor remained the leading indication. The neonatal admission rate is high. Training and retraining of resident doctors is necessary towards increasing the conduct and ensuring better outcome.

Sonographic evaluation of lens thickness in diabetes mellitus in a Nigerian tertiary hospital

Objectives: To noninvasively evaluate the lens thickness in type 2 diabetic patients using ultrasound, and to correlate age, disease duration, fasting blood sugar (FBS), and proteinuria with lens thickness. Materials and Methods: The study was performed in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, a secondary and tertiary referral center. The study population consisted of 100 type 2 diabetic patients with age and sex-matched controls. Antero-posterior lens thickness, age, duration of diabetes, FBS, and proteinuria were assessed. Results: The lens was thicker in the diabetic group than in the controls (3.76 ± 0.45 versus 3.56 ± 0.34 mm; P = 0.001). There was a positive correlation between patient’s age and lens thickness (r = 0.533, P = 0.001 for the controls; and r = 0.335, P = 0.001 for diabetics). There were no significant correlations between lens thickness with duration of diabetes, proteinuria, or FBS. Conclusion: The lenses of type 2 diabetes were thicker than those of the control patients.

The distribution and pattern of neurological disease in a neurology clinic in Ile-Ife, Nigeria.

Neurological disorders are common and contribute significantly to disease burden, disability-adjusted life years and death. To assess the distribution of neurological disease in patients presenting to our hospital. The records of the Adult Neurology Clinic in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria were reviewed retrospectively for the years 2003-2005 and 2010-2014, and diagnoses as made by the Consultant were obtained and analyzed. The total number of complaints was 1,524 and 86.4% of these were neurological in nature. Episodic and paroxysmal disorders (ICD-10) accounted for 54.1% of the diagnoses, and epilepsy and stroke were the most common of these. Of the 1,226 patients seen during the period, 91.4% had neurological disorders. The peak occurrence of these disorders was within the first three decades of life. Epilepsy and stroke are the commonest neurological disorders in the outpatient setting and there should be more studies in the community on their prevalence and impact.

Pathologies associated with impacted mandibular third molars in sub-saharan africans

Background: The prevalence of third molar pathology and problems associated with surgical extraction of impacted third molars has been extensively discussed in the literature; however, few have discussed the pathologies that can be associated with impacted third molar tooth. Aim: The aim of the current study, therefore, is to evaluate the types of associated pathologies with impacted third molars in Sub-Saharan Africans. Materials and Methods: This is a prospective study that was conducted in the Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria, between January and March 2012. Consented patients between ages 18 and 35 years were recruited into the study. Data were analyzed using IBM SPSS Statistics for Windows Version 20 (IBM Corp., Armonk, NY, USA). Statistical significance was set at P < 0.05. Results: A total of 135 mandibular third molar extractions was carried out during the study period from 72 (53.3%) females and 63 (46.7%) males (F:M = 1.1:1). Mesioangular impaction was the most frequent spatial relation of the impacted mandibular third molar to the lower second molar tooth (70 [51.9%]), followed by distoangular impaction (29 [21.5%]). Mesioangular impaction was mostly associated with pathology (70 [51.9%]), with a statistical significant difference of P = 0.000. Pathological pocket and caries on both impacted lower third molar and lower second molar tooth accounted for the highest number of associated pathologies (37 [27.4%]). Conclusion: Caries and pathological pockets were the most common associated pathology with impacted third molar.

Contributions of uterine fibroids to infertility at Ile-Ife, South-Western Nigeria

Background: Uterine fibroid is the most common tumor of the female genital tract. The benign tumors often grow into large sizes and assume unsightly shapes with concomitant symptoms and signs. Being a predominantly reproductive age disease, concurrent infertility and symptomatic uterine fibroids pose management challenges. Individualization of the patient is thus essential to the success of the reproductive outcome. Objectives: This study determined the prevalence, trend, management modalities, pregnancy outcome, and exposition of factors affecting pregnancy outcome among patients presenting with uterine fibroids and infertility at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). Materials and Methods: This is a retrospective study of case records of 106 women managed for uterine fibroids and infertility over a 5-year period (January 1, 2012, to December 31, 2016) at the OAUTHC. The outcome measure is the pregnancy rate among those who had a myomectomy. Results: About a quarter of women with infertility had symptomatic uterine fibroids and this represents about 35%–40% of the overall number of women presenting as uterine fibroid within the study. About 84.9% had uterine size >12 weeks at presentation. Two-third of the patients had open myomectomy alone with 43.9% achieving conception thereafter. Conception rate for myomectomy with tuboplasty was 31.3% whereas myomectomy with subsequent in vitro fertilization (IVF) was 50%. Pregnancy rate decreased with increasing size of the uterus before myomectomy. Conclusion: Symptomatic fibroid was significantly prevalent among women with infertility. Myomectomy improves fertility potential and success rate of IVF. Uterine fibroid has both direct and indirect effect on infertility and pregnancy rate in this group of the patient can be improved through routine screening for uterine fibroids and early removal of the fibroids before they grow into giants size.

Maternal mortality in the last triennium of the Millennium Development Goal Era at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

The maternal mortality ratio (MMR) of Nigeria remains high. This retrospective study aims to suggest evidence-based strategies towards achieving the sustainable development goal target 3.1 at the Obafemi Awolowo University Teaching Hospital (OAUTHC), Nigeria by providing contemporary data on MMR between October 2012 and September 2015. There were 86 maternal deaths and 5243 live births over the triennium, with annual MMRs of 1744, 1622 and 1512/100,000 live births, respectively. Fifty-six (65.2%) were postpartum deaths, while 44 (51.2%) occurred within 12 hours of admission. Using the WHO ICD-10 system, the causes of mortality were pregnancy-related infections; 26 (30.2%), haemorrhage; 20 (23.3%), hypertension; 13 (15.2%) and pregnancies with abortive outcomes; 11 (12.7%). Financial constraints, misdiagnosis and delayed referrals constituted the predominant contributors. The MMR at OAUTHC, Nigeria in the last triennium of the MDG was ‘Extremely High’. Improved aseptic techniques, blood transfusion services, antimicrobial sensitivity evaluation, Universal Health Coverage, training-retraining of skilled birth-attendants and effective referral systems are advocated. IMPACT STATEMENT What is already known on the subject of the paper: Nigeria now contributes the largest proportion (19%) of the burden of maternal mortality worldwide, despite constituting just 2% of the global population. Reversing this adverse trend during the sustainable development goal (SDG) period demands effective strategies, which can only be predicated on reliable data at the hospital, regional and national levels. What this study adds: This article provides the contemporary maternal mortality data of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, during the last triennium of the Millennium Development Goal era. The findings from the study revealed that the average maternal mortality ratio (MMR) of the Hospital over the three years was 1640/100,000 live births, and that pregnancy-related infection is now the leading cause of maternal death, followed by obstetric haemorrhage. What the implications are for clinical practice: Improvement in aseptic techniques, evaluation of antimicrobial sensitivity patterns and efficient blood transfusion services, as well as Universal Health Insurance coverage and Skilled Birth Attendants will improve the maternal health indices of the hospital, and ultimately the country during the SDG execution period.

Cryptosporidiosis: Prevalence, risk factors and diagnosis in adult HIV-infected patients at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria

Cryptosporidiosis: Prevalence, risk factors and diagnosis in adult HIV-infected patients at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria

Patterns of Patient Flow to Obafemi Awolowo University Teaching Hospital Complex’s Cancer Treatment Centre, Ile-Ife, Osun State, Nigeria

Abstract This study analyses the spatial dimensions of patronage of Obafemi Awolowo University Teaching Hospital Complex’s Cancer Treatment Centre, Ile-Ife, Osun State, Nigeria, with a view to provide information on the sphere of influence of the centre and to inform future locational decisions. The geographic coordinates of relevant phenomena were obtained using a GPS receiver. Also, the medical records of cancer patients were assessed for relevant information. The collected data were analysed using descriptive and inferential statistics, and geo-spatial techniques. The data showed that a total of 1809 patients from 15 states in Nigeria were enrolled for the treatment of cancer at the hospital. The volume of patronage at the centre was seen to be inversely related to the distance travelled by patients (r = −.657, p&gt;0.05). For instance, 85% of the patients came from the three (3) states nearest to the health facility, with Osun, the host State, accounting for about half (50.6%) of the total number. Additionally, the study revealed some demographic and socio-economic peculiarities among the cancer patients.

Pharmacokinetic Characterization of Piperaquine in Nigerian Healthy Volunteers after Co-administration with a Commercial Brand of Moringa Tea

This 2-phase cross-over drug–herb interaction study investigated the effect of co-administration of tea prepared from the commercial product of Moringa oleifera on the pharmacokinetic parameters of piperaquine. Fourteen healthy subjects were recruited for this study, but ten subjects (age range, 22–30 years) completed the study. Blood samples were collected from the subjects at the Obafemi Awolowo University (Ile Ife, Nigeria) and the bio-analysis took place in the Therapeutic Drug Monitoring Laboratory (TDM) of Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria, between January 2016 and October 2016. In the first phase of the study, each of the subjects received three tablets of Dihydroartemisin- Piperaquine (DHA/PQ) combination (artelad® containing DHA/PQP, 40/320 mg). After a washout period of three months, each of the subjects received 25g freshly prepared Moringa tea twice daily for 5 days and on the sixth day, received Moringa tea concurrently with three tablets of DHA/PQ combination. The plasma concentrations of PQ were determined using a validated HPLC method. The results showed a 23.8% significant decrease (P=0. 01) in the Cmax of PQ and a 5.8% decrease in the AUC after co-administration with Moringa Tea. The Tmax also increased by 61%, while the half-life increased by 12.2%. There was no difference in the clearance and C28. The geometric mean ratio showed that there is no significant difference in the disposition of PQ with Moringa Tea. The study showed wide variability in PQ pharmacokinetics following a single oral dose. The effects of concurrent administration of Moringa oleifera tea did not significantly influence the PQ plasma exposure but delayed its absorption.

Determinants of hospital solid waste composition of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile-Ife, Nigeria

AbstractHospital solid waste dumped indiscriminately into the municipal bins often increases the chances of survival and mutation of pathogenic microbial population in the waste. Therefore, this study examined the determinants of hospital solid waste composition in Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Data were obtained from both primary (Actual measurement of waste in kg) and secondary sources. Waste produced in the wards and clinics were measured for seven days in each week over the period of three months. The study showed that sharps and general waste produced in wards represented 27.3 and 72.7%, respectively. The study also showed that the highest quantity of wastes was generated on Monday representing 15.17%, while the least quantity was on Sunday (11.54%). The daily and weekly per capita waste quantities generated in the wards of OAUTHC were 0.799 and 5.689 kg, respectively. The study concluded that the methods and materials of waste storage in OAUTHC were not in ...

Surface Colonization of Health Care Facilities in Hematology by Methicillin Resistance Staphylococcus aureus (MRSA) at Obafemi Awolowo University Teaching Hospital Complex, Nigeria

Gram positive bacteria is not unique to intensive care units but has been increasingly reported in health care facilities, especially among Hematology patients worldwide. We evaluate microbiological disease etiology of Staphylococcus aureus in Hematology and frequency of harboring of pathogens by the facilities, medical equipment, surfaces and the possibility of cross contamination between health care workers including the antibiotic sensitivity pattern of the isolates recovered. Hundred sourced swabbed samples were taking from the facilities/equipment, rails, door knobs, personnel cell phone and other surfaces at hematology wards of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile-Ife. Swabs collected were inserted aseptically into test tubes that contain freshly prepared nutrient broth and then incubated at room temperature (37°C). After 24 h, the broth culture was inoculated into mannitol salt agar (MSA) plates using the inoculating loop. The streaking was done and the plates were incubated at 37°C for 24 h. Coagulase and DNAse biochemical test later conducted to establish the Staphylococcus aureus isolates. Out of the 54 Staphylococci sp. obtained from hundred samples taken from different sources of various facilities and equipment in the wards, 25(46.3%) Staphylococcus aureus isolates showed total Staphylococcus aureus contaminant of facilities/environment/equipment where door knobs 7(28.0%) showed higher contamination rate followed by 5(20.0%) bed rails, which is higher than the % constitution of Personnel Stethoscope and cell phones which constituted 4(16.0%) and 3 (12.0%) respectively. All isolates were 98%, 64% and 28% susceptible to vancomycin, chloramphenicol and streptomycin respectively and 100% resistant to penicillin and oxacillin used. It is imperative for optimal patient care in the Hematology that effective aseptic techniques and use of sterile gloves, hand hygiene practices in handling surfaces with constant evaluation of antibiotic sensitivity pattern of pathogens for commonly used antimicrobial agents in a particular environment should be greatly maintained.

Trend Over Time for Cholecystectomy following the Introduction of Laparoscopy in a Nigerian Tertiary Hospital.

Background:There still exist some concerns about the desirability of laparoscopic surgery in lower-middle income countries. We recently adopted laparoscopy for common general surgical procedures and observed many benefits. This study aims to describe the changing rate of cholecystectomy before and after the introduction of laparoscopy in our hospital.Methods:We reviewed the records of cholecystectomies performed before and after the introduction of laparoscopic cholecystectomy (LC) in 2009 in a single general surgery unit of the Ife Hospital Unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Cholecystectomy was reviewed as a percentage of general procedures performed, and postoperative length of stay was calculated.Results:A total of 173 cholecystectomies were performed in the hospital between January 2005 and December 2015. The yearly number rose from 7 in 2005 to 31 in 2015 corresponding to 2.7% of total elective major general surgery procedures in 2005 and 9.1% in 2015. A marked progressive increase was observed in the number and rate of cholecystectomies from 2009 following introduction of LC. From 0% in 2005, LC rose to 90% of all cholecystectomies in 2015. The mean postoperative length of stay of patients undergoing cholecystectomy declined from 5.2 days in 2005 to 3 days in 2009 and 1.8 days in 2015.Conclusion:This study demonstrates an increased rate of cholecystectomy following the introduction of LC in our setting. We recommend increased adoption of laparoscopy and other forms of minimally invasive surgery across the country.

Quality of life of adult patients with vitiligo at a tertiary health care centre in Nigeria

Background/Objectives: Vitiligo is a depigmentary skin disorder which occurs worldwide due to the loss of melanocytes in the skin of affected persons. People living with vitiligo can have psychological disturbances and impaired Quality of Life (QOL) as a result of the cutaneous disorder. The aim of the study is to determine the effect of vitiligo on the Quality of Life (QOL) of affected patients using the Dermatology Life Quality Index (DLQI) and to ascertain the exact domains affected. Methods: The QOL assessment was done using the Dermatology Life Quality Index (DLQI) questionnaire which was administered to patients and controls. All consecutive adult patients with vitiligo attending the Dermatology clinics of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife (OAUTHC Ile-Ife) who gave consent were recruited. A control group, matched for age and sex, was recruited from consenting individuals attending the General Out Patients’ Clinic of the same hospital who did not have vitiligo or any other cutaneous disorder. Results: The total DLQI scores were significantly higher for patients (range: 2- 13) than for controls (range: 0 - 1) and the total mean score for the patients (6.12 ± 2.90) was also higher than the total mean score for the controls (0.32 ± 0.47). The patients with vitiligo had a significant impairment in their self-esteem, daily activities and leisure when compared with the controls. The study also showed that vitiligo patients with extensive disease had impairment in their daily activities when compared with those who had limited disease. Conclusion: This study highlights the fact that patients living with vitiligo have impaired QOL. It is thus pertinent to identify the psychological challenges that vitiligo patients are faced with and offer psychotherapy in addition to treatment of the primary disorder.

Intestinal parasites among HIV-infected patients at obafemi awolowo university teaching hospitals complex, Ile-Ife

Background: Intestinal parasites are a cause of morbidity and mortality throughout the world particularly in HIV-infected patients. This study determined the prevalence of intestinal parasites among HIV-infected patients, assessed risk factors predisposing to infection and also assessed association of intestinal parasites with the CD4 counts of the patients. Materials and Methods: It was a cross sectional study and 226 HIV-infected patients attending the Virology Research Clinic of OAUTHC were recruited. Questionnaires were administered to obtain relevant demographic information. Stool samples were collected and examined. Data processing was done using SPSS Inc USA version 17. Statistical analysis was done using frequency, proportion, percentages, tables and Pearson's chi-square was used to determine the association between intestinal parasites and risk factors. Results: The overall prevalence of intestinal parasites in this study is 15.4%. Cryptosporidium sp. and Ascaris lumbricoides had the highest prevalence, both had rates of 4.4% followed by Entamoeba histolytica with a rate of 3.1%. Cyclospora sp. had a rate of 1.8%, Strongyloides stercoralis had a rate of 0.9% while Entamoeba coli and hookworm both had rates of 0.4%. Co-existence of Cryptosporidium with Strongyloides stercoralis occurred in one of the HIV-infected patients. Exposure to goats and dogs was found to be significantly associated with intestinal parasites. The CD4 count was not significantly associated with presence of intestinal parasites. Conclusion: Intestinal parasites are still prevalent among HIV-infected patients and exposure to dogs and goats was a risk factor. There was no association between intestinal parasites and CD4 counts of the patients.

Učestalost vezico-vaginalnih fistula u ILE-IFE-u, u jugo-zapadnoj Nigeriji

Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality , which can result in marital disruption, rejection, and eventual destitution. Methodology: A retrospective study of all cases of vesicovaginal fistula managed over a 30 year period between 1 st January 1984 and 31 st December 2013 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria. Relevant data were obtained from the case notes and analyzed for the demographics, clinical features, management and outcome using SPSS version 20. Result: There were 213 patients with vesicovaginal fistula over the period of the study with a prevalence of 3.9 per 1000 deliveries. The age range was 15-45 years with a mean age of 24.8 years. Most of them were primiparous, (52.1%) and of the low social class (84.5%). Obstetric fistula accounted for 93.9%. The majority of them (64.8%) did not have antenatal care during the antecedent pregnancy. Labor was attended by unskilled attendants in about 90% of them while 92% labored for at least 24hours. The juxta-cervical fistula was the most common anatomical type (47.0%). The overall success rate at repair was 76.4%. Stillbirth rate in the antecedent pregnancy was 67.5%. Other associated morbidities included chronic vulva excoriation, obstetric palsy, and secondary amenorrhea. Conclusion: Vesicovaginal fistula (VVF) is a major public health problem in developing countries with too many calamities as shown in this study. Improving the educational and economic status of women in Nigeria will go a long way in empowering them to access quality antenatal care. This will also enhance hospital delivery thereby preventing prolonged obstructed labor which is a strong etiological factor for VVF. Decentralization of treatment centers and training of specialists in fistula surgery is very important to improving treatment outcomes.

A Case study of Group B Streptococcus Associated with Women in Antepartum Period and their Neonates, Ile Ife South-western Nigeria

Streptococcus agalactiae colonizes the genital and gastrointestinal tract. In pregnancy, vertical transmission of GBS to the new-born can cause neonatal sepsis, pneumonia and meningitis. The aim of this study was to determine the prevalence of GBS in pregnant women in their third trimester, frequency of neonatal colonization and Antibiotics Susceptibility of the isolates recovered at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile- Ife, Osun State, Nigeria. Rectum and vaginal swabs were collected from a total number of 24 third trimester pregnant women between 35 - 37 weeks of gestation and their neonate delivered at OAUTHC both at labour ward and labour ward theatre. The samples were cultured in Todd Hewitt Broth and sub cultured on sheep blood agar and Chromogenic Strepto BID agar and incubated at 37oC for 24 hours. Identification was based on the Gram staining, presence of β-haemolysis and absence of catalase production. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk-diffusion methods. GBS colonization on average was confirmed in 27.8% of pregnant women and their neonate and proportion of GBS isolated from the vagina 6 (30%) as compared to rectum 7(35%), neonates 4 (20%), vaginal and neonate 1(5%), rectum and neonate 1(5%), and both vagina, rectum and neonate1 (5%). All isolates were found susceptible to 40% clindamycin 35% vancomycin, 90% ciprofloxacin 40% erythromycin and 100% resistance to penicillin used. There is need for proper handling of neonates by the health care practitioner and screening of pregnant women attending antenatal care, including known antibiotic Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation susceptibility for an appropriate antepartum antimicrobial prophylaxis can be offered.

B-mode ocular ultrasound findings in adults with refractive errors at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

Objective: To ascertain the relationship between B-mode ocular ultrasound findings and standard autorefraction results of participants with refractive errors, with the aim of using B-mode ultrasound as a complementary technique to determine the refractive state of the eye. Materials and Methods: The study population consisted of 255 adult patients with refractive errors, aged 18–40 years. The ocular dimensions were measured using MINDRAY DC-7.0 real-time ultrasound machine with frequency probe of 5 and 7–12 MHz. The ocular shapes and other biometric measurements were then correlated with the results of the standard autorefraction. Results: The sensitivity for prolate ocular shape corresponding with myopia/astigmatism was 88.6%, whereas that of oblate ocular shape corresponding with hyperopia/astigmatism was 87.4%. The Pearson’s correlation coefficient between right axial length and right spherical equivalent was negatively strong at −0.79 (P Conclusion: Real-time B-mode ocular ultrasound has a high sensitivity in determining ocular shape, which corresponded well with the refractive state of the participants’ eyes. Axial length (AL) was found to correlate strongly with spherical equivalent, and, thus, a regression equation can be used to predict the spherical equivalent from the AL measurements.

Staphylococcus aureus Surface Colonization of Medical Equipment and Environment, Implication in Hospital- Community Epidemiology

Staphylococcus aureus has been known to be a predominant nosocomial infection occurring majorly among immune-compromised patients in hospital environments and other health care facilities. This study was carried out to identify the prevalence of Staphylococcus aureus on fomites in both male and female orthopedic wards, Radiology Department and the hospital environment at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Standard conventional methods of microbial analysis in isolation of S. aureus including catalase, coagulase and DNase tests as well as the antibiograms of the isolates from fomites were determined. Out of 34 (thirty-four) samples collected, 11 samples were confirmed positive for S. aureus isolates with the female ward constituting of 45.5%. Pure cultures of S. aureus isolated were 100% susceptible to both ciprofloxacin and pefloxacin, 69% resistant to amoxicillin and ampiclox, 80% to septrin, 54% erythromycin, 31% streptomycin, 38% rocephin and 15% to gentamycin used. Periodic routine disinfection of hospital environment should be implemented in order to reduce the risk of infection among patients and staff. Protocols to reduce the transmission may need to be extended to hospital beds, trolleys, nurse desk, tables and taps. Frequent need for strict compliance to effective Infection Control Program must be maintained.

Antimicrobial Susceptibility Pattern of Escherichia Coli Isolates from Clinical Sources at Tertiary Health Care Setting, Ile Ife, South Western Nigeria

Antimicrobial resistance is majorly an issue of public health concern. The aim of this study is to isolate and identify Escherichia coli from samples of stool and urine obtained from the clinical settings at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, and to determine their antibiotics susceptibility patterns. Nineteen (19) of stools and 22 of urine samples were analysed using standard microbiological and biochemical techniques and 11 pure isolates were obtained comprised of 5 (12,2%) isolates from urine and 6 (14,6%) isolates from stool. Antibiotics susceptibility studies were conducted using Kirby and Bauer disc diffusion method, and the results were determined using the Clinical and Laboratory Standards Institute (CLSI) guides. The studies showed that all the E. coli isolated were 100% resistant to augmentin, gentamycin, streptomycin, tetracyclin and chloramphenicol, and 90.90% resistant to oflaxin, sparfloxacin, and amoxycillin while the isolates were susceptible tociprofloxacin (26.33%), and pefloxacin (45.46%). Effective hygiene must be encouraged and indiscriminate usage of antibiotic must be avoided in the study area.