Center In Nigeria Research Articles

Lumbar hernia: An unusual abdominal hernia: A case report and review of literature (radiological perspective) in a tertiary center in south-south Nigeria

Lumbar hernias are unusual abdominal wall defects involving the posterolateral abdominal wall: the superior lumbar triangle of Grynfelt, which is the most common site, and the inferior lumbar triangle of Petit. They are located between the muscular layers of the abdominal wall and can be easily ignored because of abdominal obesity. In general, it is difficult to diagnose because of their unclear non-specific symptoms. However, radiographic studies have been valuable in confirming the diagnosis. The introduction of ultrasonography and computed tomography (CT) has greatly improved the diagnosis of lumbar hernia. Following the establishment of the diagnosis, operative management is indicated due to chance of incarceration. Our case study is an 80 years old man who presented to the Radiology department for an emergency abdominal ultrasound scan investigation on account of abdominal pain/abdominal swelling on the lateral aspect of the right flank of about 5 days as explained by his relative. The abdominal ultrasound shows a hyperechoic mass in the right flank that extends through a defect in the transversus abdominis muscle. This mass measures 5.3x4.9cm and shows no flow on Doppler interrogation. Note mild fluid collection seen surrounding the mass. Also note marked subcutaneous oedema. Another imaging modality was employed; non contrast computed tomography and shows a lateral abdominal wall defect in the right lower internal oblique with sac containing bowel loop and omental fat. Other visualized bowel loops are normal in caliber and wall thickness.

EVALUATING THE MANAGEMENT AND MAINTENANCE PRACTICES OF LINEAR ACCELERATOR AND COBALT-60 CANCER TREATMENT MACHINES IN NIGERIA: A COMPREHENSIVE ASSESSMENT

This research paper investigated the state of radiotherapy machines and their management in cancer treatment centers in Nigeria. The study aimed to identify the challenges faced by these centers and propose strategies for improvement. Through a comprehensive analysis of data collected from surveys and questionnaires, critical issues impacting the availability, reliability, and effectiveness of radiotherapy machines were highlighted. The findings revealed a significant shortage of radiotherapy machines across the nation, with Nigeria having less than 6% of the required number of linacs. This scarcity led to a high workload on the existing machines, resulting in long waiting lists and compromised treatment outcomes. Management challenges, such as the absence of preventive maintenance policies, inadequate personnel training, delayed spare parts delivery, and limited engagement of maintenance contractors, were identified. The research emphasized the need for supportive cancer treatment machines, including orthovoltage and superficial machines, to alleviate the burden on existing radiotherapy machines. However, most centers lacked these supportive machines, limiting their ability to provide comprehensive care to patients. Financial sustainability also emerged as a significant concern, as internal funds proved insufficient for maintenance and operations. The involvement of the government and the establishment of independent regulatory bodies were proposed to address these challenges. In conclusion, this study called for urgent action to address the gaps and challenges in radiotherapy machine management in Nigeria. It highlighted the importance of increasing the number of machines, implementing preventive maintenance policies, enhancing staff training, and securing adequate funding. By doing so, the quality of cancer care could be significantly improved, leading to better patient outcomes and a more robust healthcare system in Nigeria.

Intravenous Urograpphy Findings among Patients Presenting to Rivers State University Teaching Hospital-A Two Years Retrospective Study

Background: Conventional intravenous urography (IVU) is an imaging modality of choice used in evaluating urinary system especially in the third world countries despite recent advancement in imaging Aim: This study is aimed at analyzing the IVU findings in a tertiary center in South-South Nigeria. Study design and settings: A retrospective, observational study was conducted in the Radiology Department of Rivers State University Teaching Hospital (RSUTH). From 1st February 2021 to 28th February 2023. Data analysis: Data were analyzed using SPSS 21.0 version. The level of statistical significance was set at p<0.05. Results: A total of 133 data were analyzed. The age of the study group was between 7 to 72years with a mean age of 39.29 ± 13.63 years. Majority of the age group was 36-46 years (n=49, 36.8%). Females presented more for IVU in this study. The commonest indication is uterine fibroids. Normal IVU was seen in 40(30.1%) of the patients and others had one pathology or the other. Commonest renal pathology was hydronephrosis. There was a significant association between indications and gender (P=0.0001). Conclusion: This study shows that more female presented for IVU which tallies with uterine fibroids being the commonest indication. The commonest finding was hydronephrosis. There was significant association between gender and indications for the study (P=0.0001).

Penalty Point System (PePS) Adaptation for Solid Waste Assessment in Cross River State, Nigeria

Waste generation in major urban centres in Nigeria appears to be on the increase due to increased consumption occasioned by rapid urbanization. Unfortunately, appreciable efforts are only being made in few urban areas with regards to monitoring this occurrence for the purpose of control and sanitation planning. This paper adapted and applied the novel Penalty Point System (PePS) as a methodology to investigate environmental pollution consequences of solid waste in Nigeria, using Calabar municipality, Cross River State as a case study. The objectives were to demonstrate the use of Penalty Pont System (PePS) as a tool for pollution (solid waste) assessment, unravel the environmental pollution consequences of improper solid waste management in Calabar Municipality, investigate various systems of solid waste disposal and management in Calabar Municipality, determine the relationship that exists between solid waste disposal problem and environmental sanitation and render viable recommendations for the purpose of reduction in the amount of solid waste generated and the need for proper management. Data for the study included a catalogue of the number of waste dumps in drainage systems and uncollected waste sites as well as responses to 200 copies of administered questionnaire. The penalty point system was used to allocate penalties to the defaulting locations for uncollected waste sites and dump-in drainages. It was discovered that Akim and Big Qua earned the highest penalty points of 120 each, amounting to 40 percent of the study area. This attribute clearly qualifies both districts as the poorest with regard to urban environmental sanitation. Further analysis was done using the Chi-squate statistics. Findings show that solid waste management system has a great effect on the quality of the environment that is possible in urban areas. It was therefore recommended that as a long-term measure, the government should enforce, support and sustain environmental education which is needed to promote manufacturing technologies that would enhance the production of consumer goods using low waste-generating practices.. Again, the government should provide access roads that are free from surface damage.

The Status of Specialist Neurosurgical Training in Nigeria: A Survey of Practitioners, Trainers, and Trainees

Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country. An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria. Demographic information and questions relating to the content, process, strengths, and challenges of neurosurgical training were explored as part of a broader survey assessing neurosurgical capacity. Descriptive statistics were used for analysis. Respondents identified 15 neurosurgical training centers in Nigeria. All 15 are accredited by the West African College of Surgeons, and 6 by the National Postgraduate Medical College of Nigeria. The average duration of core neurosurgical training was 5years. Some identified strengths of Nigerian neurosurgical training included learning opportunities provided to residents, recent growth in the neurosurgical training capacity, and satisfaction with training. Challenges included a continued low number of training programs compared to the population density, lack of subspecialty training programs, and inadequate training infrastructure. Despite the high number of neurosurgery training centers in Nigeria, compared to other West African countries, the programs are still limited in number and capacity. Although this study shows apparent trainee satisfaction with the training process and contents, multiple challenges exist. Efforts at improving training capacity should focus on continuing the development and expansion of current programs, commencing subspecialty training, driving health insurance to improve funding, and increasing available infrastructure for training.

Pathways To Reforming Pre-Trial Detention In Nigeria: Ppdc’s Access To Justice Contributions

This paper examines the use of pretrial detention in Nigeria’s Criminal Justice Sector. An average of 65-70% of the inmates are awaiting trial. This exceeds those convicted of committing crimes. Many pretrial detainees either have no access to lawyers or may never get to court. This paper examines the legal framework for pretrial detention, analyses the efforts of previous interventions and discusses the current interventions implemented by the Public and Development Centre in Nigeria. The paper proposes recommendations including the effective use of corps lawyers, law clinics, technology and administrative improvements to cause a reformation in pretrial detention in Nigeria.

Randomized trial of shunt infection rates comparing intraoperative Vancomycin versus Gentamicin in ventriculoperitoneal shunt system preparation

BackgroundVentriculoperitoneal (VP) shunt is the mainstay of surgical management of patients with hydrocephalus. The insertion of ventriculoperitoneal shunt may be accompanied by many potentially life-threatening complications including shunt infection. Concerted efforts have been made to reduce shunt infection rates, including use of saline- antibiotic solutions containing antibiotics such as Gentamicin, mixture of Gentamicin and Vancomycin in shunt system preparation. We therefore set out to determine the infection rates following the use of intraoperative Gentamicin and Vancomycin in ventriculoperitoneal shunt system preparation and compare the infection rates. Therefore, a randomized single blind comparative study was carried out for a period of seventeen months, among 56 patients that presented to 2 tertiary health centers in Nigeria diagnosed of hydrocephalus. Patients were randomized into Vancomycin- and Gentamicin-shunt preparation groups. The outcome measure was postoperative shunt infection rates. Statistical analysis was performed using SPSS software (version) 21. Group comparisons were made using the Student's t-test for numerical variables, and chi-square test or fisher’s exact test for categorical variables. Statistical significance was inferred at p-value < 0.05.ResultFifty-six patients were included in the study. One patient was lost to follow-up in Vancomycin group. Another patient died in Gentamicin group of sudden death without the patient exhibiting symptoms of shunt infection leaving a total of 54 for analysis. All the patients included in the study were followed up for six months. Their mean ages were between 1688.5 ± 665.3 (days) for Vancomycin group and 10,222 ± 6635.8 (days) for Gentamicin group. There was male preponderance of 55.6% as against female of 44.4%. Majority of the hydrocephalus were of congenital cause accounting for 64.8%. There was one shunt infection in the Gentamicin group giving rise to an infection rate of 1.9% which was not statistically significant (P –value—0.313). The organism isolated was Pseudomonas species.ConclusionVentriculoperitoneal shunt infection rates can be reduced to the barest minimum if standard concentration of antibiotics is used to prepare the shunt hardware employing a standard surgical technique.

Using responsive feedback from routine monitoring data to guide course corrections for a family planning intervention in Nigeria.

This paper aims to promote the use of simple interrupted time series (ITS) analyses of routine data as a responsive feedback tool to improve public health programs. Although advanced ITS techniques exist, their use is often not feasible due to limitations in funding or research capacity. We propose an Excel-based analysis that requires minimal resources or statistical expertise, and illustrate it by measuring the effect of a radio campaign to promote a family planning call center in Nigeria on the demand for family planning information. We used a single group interrupted time series design (ITS) as a responsive feedback mechanism to determine whether the radio campaign influenced use of the Honey&Banana call center. ITS is ideal when there is no control group. ITS uses the pre-intervention trend to predict what would have happened if the intervention were absent. After conducting ITS analyses, the results show that the number of calls requesting family planning information increased throughout the campaign period, with a gain of about 500 additional calls per month, and then decreased after the campaign ended. However, the number of calls gained from the campaign was substantially lower than anticipated. While end-of-project impact evaluations are necessary, there should be regular feedback system to provide program implementers with information about the status of the project, such as failures, successes, and areas of improvements. This would allow implementers to make necessary adjustments as needed throughout the intervention period. The finding that the radio campaign was not living up to expectations helped Honey&Banana program implementers to end the campaign prematurely and re-allocate resources to a more promising activity. Our research shows that basic Excel-based ITS analysis of routine data can be a useful tool for receiving regular feedback to guide programming improvements for organizations that have limited resources and/or research capacity.

Characterization of Beta-Lactamase and Fluoroquinolone Resistance Determinants in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa Isolates from a Tertiary Hospital in Yola, Nigeria.

Infections due to antimicrobial resistant gram-negative bacteria cause significant morbidity and mortality in sub-Saharan Africa. To elucidate the molecular epidemiology of antimicrobial resistance in gram-negative bacteria, we characterized beta-lactam and fluoroquinolone resistance determinants in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates collected from November 2017 to February 2018 (Period 1) and October 2021 to January 2022 (Period 2) in a tertiary medical center in north-eastern Nigeria. Whole genome sequencing (WGS) was used to identify sequence types and resistance determinants in 52 non-duplicate, phenotypically resistant isolates. Antimicrobial susceptibility was determined using broth microdilution and modified Kirby-Bauer disk diffusion methods. Twenty sequence types (STs) were identified among isolates from both periods using WGS, with increased strain diversity observed in Period 2. Common ESBL genes identified included blaCTX-M, blaSHV, and blaTEM in both E. coli and K. pneumoniae. Notably, 50% of the E. coli in Period 2 harbored either blaCTX-M-15 or blaCTX-M-1 4 and phenotypically produced ESBLs. The blaNDM-7 and blaVIM-5 metallo-beta-lactamase genes were dominant in E. coli and P. aeruginosa in Period 1, but in Period 2, only K. pneumoniae contained blaNDM-7, while blaNDM-1 was predominant in P. aeruginosa. The overall rate of fluoroquinolone resistance was 77% in Period 1 but decreased to 47.8% in Period 2. Various plasmid-mediated quinolone resistance (PMQR) genes were identified in both periods, including aac(6')-Ib-cr, oqxA/oqxB, qnrA1, qnrB1, qnrB6, qnrB18, qnrVC1, as well as mutations in the chromosomal gyrA, parC and parE genes. One E. coli isolate in Period 2, which was phenotypically multidrug resistant, had ESBL blaCTX-M-15, the serine carbapenemase, blaOXA-181 and mutations in the gyrA gene. The co-existence of beta-lactam and fluoroquinolone resistance markers observed in this study is consistent with widespread use of these antimicrobial agents in Nigeria. The presence of multidrug resistant isolates is concerning and highlights the importance of continued surveillance to support antimicrobial stewardship programs and curb the spread of antimicrobial resistance.

Endemicity of Diphtheria in Some Regions of Nigeria: Chronology of a Fourteen Month Sustained Outbreak

Diphtheria in humans is caused by exotoxin produced by Corynebacterium diphtheriae which is a gram positive bacteria. The sustained endemicity of diphtheria amongst Nigerian population from May 2022 to July 2023 is significant and has not been widely reported. Secondary data was collected from the recent data base of Nigeria Centre for Disease Control, Federal Ministry of Health, and Federal Ministry of Information then analyzed applying standard procedure. The result shows in overall a total of 4,160 suspected cases of diphtheria which spanned through a period of May 2022 to July 2023. Out of these suspected cases, 1,534 were positive, yielding a total prevalence of 36.9% and mortality of 137(8.9%). In the Northern states alone, 4,061 individuals were recorded as suspected diphtheria cases; out of which 1,525(36.6%) individuals were confirmed positive with 132(8.7%) death cases. Conversely, in the southern states, a total of 40 suspected cases were recorded. Out of these, 9(22.5%) were confirmed positive with mortality of 5(55.6%). Only one state yielded a suspected case without any conclusive confirmatory evidence. The result further showed that a total of 15 states were grouped as “others”. In this group a total of 59 cases were suspected, but none yielded positive result. The prevalence was high (36.6%) in the North when compared to the south (22.5%), and mortality was high (55.6%) in the south when compared to the North where a total mortality rate of 8.7% was recorded. Amongst the Northern states affected, prevalence was highest (75.9%; 41/54) in Bauchi and least (5.0%;5/101) in Kaduna state. This present result shows that diphtheria is endemic in some parts of Nigeria leading to sporadic outbreaks overtime, predominantly in the Northern part. High spread and prevalence in the North may be that herd immunity in the North is low or inadequate. Thus, urgent attention of Government and relevant stake holders is necessitated to eliminate this negative trend.

Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria

BackgroundThe first case of COVID-19 in Nigeria was reported on February 27, 2020, and over time, spread across the country leading to many healthcare worker infections. The risk of transmission of COVID-19 within healthcare facilities makes it necessary to establish infection prevention and control measures. The World Health Organisation supported the Nigeria Centre for Disease Control to conduct a train-the-trainers workshop on infection prevention and control for key healthcare workers across Nigeria. Aim/ObjectivesThis study aims to describe the process and results of train-the-trainers as an intervention for national capacity building in infection prevention and control for COVID-19 among healthcare workers in Nigeria. MethodsEight-hour sessions were held over three days with face-to-face instruction and practical hands-on experience in April 2020. A total of 61 healthcare workers participated across the six geographic zones of Nigeria: North Central, North East, North West, South West, South East, and South South. The training included slide presentations, case-based scenarios, and practical hands-on sessions with plenary discussions. Pre- and post-test assessments were used to evaluate knowledge of COVID-19, triage, and infection prevention and control among healthcare workers. Finding/Results69 % (42) of the participants were male 31 % (19) were female, and the majority (67 %) were medical doctors. Others attending were nurses or health administrators. Of the 70 % (26) of the states with existing infection prevention and control structures within the COVID emergency response, only 40 % were functional. The average percentage of pre-test and post-test scores were 60.8 ± 13.4 and 67.8 ± 9 0.3 respectively, showing a statistically significant difference (p > 0.001) in trainee knowledge. Additionally, 70 % of participants evaluated the training workshop as “satisfactory” or higher in training format, relevance for daily clinical work, active participation, learning new concepts, and logistics. ConclusionNationwide infection prevention and control training is feasible during a national health crisis. Infection prevention and control is cardinal in the containment of epidemic-prone diseases like COVID-19 and is invaluable in the prevention of healthcare-associated infections in healthcare settings.

Pattern of diabetes and diabetic foot admissions in a tertiary centre in Nigeria: A five-year review

Pattern of diabetes and diabetic foot admissions in a tertiary centre in Nigeria: A five-year review

The impact of air pollution on urban health in Nigeria: Possible solutions

Air pollution has been a major topic of discussion due to its detrimental impact on health and the environment as a result of the urban population's explosive development and associated human activities. The main objective of the study is to give a critical review of the causes, impacts, and Nature-based Solutions (NbS) for reducing air pollution with an emphasis on urban centers in Nigeria. The study adopted natural approaches to address/improve air quality and lessen health risks related to the emission of hazardous substances. To work with nature rather than against it, however, there must be cooperation between the government and its agent, the community, non-governmental organizations, civil society, faith-based organizations, associations, union bodies, young people, women, and people with disabilities, as well as support from international organizations. The study carried out showed that human activities are the major source of air pollution in Nigeria through the release of harmful gaseous substances, carbon dioxide (CO2), nitrogen oxide (NO2) and greenhouse gas (GHG) emission, particles and heavy metal and this pollution is extremely dangerous due to the particles and substance discharged into the atmosphere. The findings contribute to the limited body of literature that already exists on the detrimental effects of ambient air pollution on respiratory health that are experienced by residents of urban cities in specific regions of Nigeria and other cities that are similar to those in Nigeria. In order to reduce air pollution in our urban centers, the study suggested adopting Nature-based Solutions (NbS).

"I can't kill myself": Local narratives and meanings that foster absenteeism in Nigerian primary health centres.

Absenteeism in the health sector is increasingly seen as a form of harmful rule-breaking, with health workers receiving a salary although they are not present to provide care. It is a barrier to achieving universal health coverage yet remains widespread in primary health centres (PHCs) in Nigeria and many other low-resource settings. Traditional approaches to combatting absenteeism have relied on anti-corruption measures such as promoting accountability and transparency. However, more needs to be understood about the social and cultural realities, including perceptions and norms enabling or constraining the application of such measures in Nigeria and in similar contexts. We conducted 34 in-depth interviews (IDIs) with frontline health workers and their managers/supervisors and two focus group discussions (FDGs) with service users (n = 22) in Enugu State, South Eastern Nigeria. We discussed their experiences and views about absenteeism, allowing the respondents' framings to emerge. We adopted a mixed approach of narrative analysis and phenomenology to examine respondents' narratives - identifying the concepts and social constructs within the narratives that manifested through the language used. Stakeholders acknowledged the problem of absenteeism but had differing perspectives on its dynamics. Health workers distinguished two forms of absenteeism: one as a mundane, everyday response to the poorly funded health system; and the other, brazen and often politically enabled absenteeism, where health workers whom powerful politicians protect are absent without facing consequences. There is a general feeling of powerlessness among both health service providers and service users confronted by politically backed absentees as the power dynamics in the health sector resonate with experiences in other spheres of life in Nigeria. Health workers rationalised mundane, technical absenteeism, adjusted to it and felt it should be accommodated in the health system. Service users are often unsure about who is absent and why, but when they notice absenteeism, they often ascribe it to wider system malpractices that characterise public services. Interventions to tackle absenteeism and other forms of health sector corruption should be sensitive to socio-cultural and political contexts that shape everyday lives in specific contexts. Challenging narratives/beliefs that normalise absenteeism should be part of reform plans.

Barriers to hepatitis B virus screening of pregnant women in primary healthcare centers in Nigeria: health workers’ perspective

BackgroundHepatitis B virus (HBV) screening is an important component of antenatal care for pregnant women in Nigeria. However, the screening rates remain low, particularly at primary healthcare centers (PHCs). The objective of this study was to identify the barriers affecting antenatal HBV screening in PHCs in Nigeria from the perspective of health workers.MethodsWe conducted a survey among 30 health workers from 30 PHCs (one per PHC) across three states (Akwa Ibom, Anambra, and Kaduna) in Nigeria. An open-ended questionnaire was used to obtain written responses on the perceived barriers limiting antenatal HBV screening in PHCs and their recommended solutions to the identified barriers. The data were analyzed using an inductive thematic approach.ResultsThe perceived barriers exist at patient, provider and health system levels. They included: lack of test kits, unaffordability of HBV test, shortage of trained personnel, poor awareness among pregnant women, knowledge of HBV among health workers, high cost of antiviral treatment, and unavailability of HBV vaccine. The recommended solutions to the identified barriers were: making test kits and vaccines available and free, creating awareness about HBV, and capacity-building interventions for health workers.ConclusionsHBV screening of pregnant women attending PHCs in Nigeria appears to be affected by multilevel barriers. As the country continues to work towards eliminating HBV, these highlighted barriers at the patient, provider and health system levels must be addressed through effective and sustainable interventions.

Seroprevalence of SARS-CoV-2 in Niger State: Pilot Cross-Sectional Study.

The COVID-19 pandemic caused by SARS-CoV-2 is causing ongoing human and socioeconomic losses. To know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the SARS-CoV-2 seroprevalence, patterns, dynamics, and risk factors in the state. A cross-sectional study design and clustered, stratified random sampling strategy were used to select 185 test participants across the state. SARS-CoV-2 IgG and IgM rapid test kits (colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to the virus in the blood of sampled participants across Niger State from June 26 to 30, 2020. The test kits were validated using the blood samples of some of the Nigeria Center for Disease Control-confirmed positive and negative COVID-19 cases in the state. SARS-CoV-2 IgG and IgM test results were entered into the Epi Info questionnaire administered simultaneously with each test. Epi Info was then used to calculate the arithmetic mean and percentage, odds ratio, χ2 statistic, and regression at a 95% CI of the data generated. The seroprevalence of SARS-CoV-2 in Niger State was found to be 25.4% (47/185) and 2.2% (4/185) for the positive IgG and IgM results, respectively. Seroprevalence among age groups, genders, and occupations varied widely. The COVID-19 asymptomatic rate in the state was found to be 46.8% (22/47). The risk analyses showed that the chances of infection are almost the same for both urban and rural dwellers in the state. However, health care workers, those who experienced flulike symptoms, and those who had contact with a person who traveled out of Nigeria in the last 6 months (February to June 2020) were at double the risk of being infected with the virus. More than half (101/185, 54.6%) of the participants in this study did not practice social distancing at any time since the pandemic started. Participants' knowledge, attitudes, and practices regarding COVID-19 are also discussed. The observed Niger State SARS-CoV-2 seroprevalence and infection patterns meansuggest that the virus has widely spread, far more SARS-CoV-2 infections have occurred than the reported cases, and there is a high asymptomatic COVID-19 rate across the state.

Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria.

Globally, one of the leading causes of preventable blindness is primary open-angle glaucoma (POAG). The study assessed the clinical presentations of POAG patients attending an eye center in Abuja, Nigeria. Records of 188 eyes, collected from 94 patients diagnosed with POAG for a period of 1 year at the eye center, were reviewed. Clinical records, including age, gender, visual acuity (VA), central cornea thickness (CCT), intraocular pressure (IOP), cup-to-disk ratios, and retinal nerve fiber layer (RNFL) thickness of the participants, were extracted and analyzed. The majority of the participants were males (56.4%) and adults (57.4%), most of whom had normal VA (>70% in each eye). Our analysis revealed normal average estimates of RNFL thickness, IOP, and CCT among the participants. Females had thicker RNFL compared to males (p = 0.02). Although CCT decreased with age (r = -0.28, p = 0.005), there was no such link between IOP and CCT (r = 0.09, p = 0.38). Central cornea thickness (CCT), RNFL thickness, and IOP in isolation should not be used as early indicators for POAG; rather, a combination of these and other indices is recommended. Early detection through active screening and treatment in the community for at-risk groups is highly advised. Ezinne NE, Kwarteng MA, Ekemiri KK, et al. Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria. J Curr Glaucoma Pract 2023;17(3):113-117.

Blood Transfusion Request and Utilization: The Trend in a Tertiary Health Care Centre in North Central Nigeria

Background: An effective blood transfusion service is anchored on an adequate supply of safe blood and its components as well as its accessibility and appropriate clinical use. There is a contrast in blood supplies and utilization between the high, middle and low-income countries necessitating the formulation of appropriate modalities to ensure judicious use of blood while minimizing wastage.&#x0D; Aims: This study was aimed at assessing the blood transfusion request trend in our institution and its utilization with the intent of curtailing the wastage of safe blood for transfusion.&#x0D; Study Design: It is a retrospective study.&#x0D; Place and Duration of Study: Jos University Teaching Hospital Blood Bank from January 2022 to December 2022.&#x0D; Methodology: Appropriately filled blood transfusion request forms of the Jos University Teaching Hospital compared with the blood bank In-house records from January 2022 to December 2022 were reviewed. Request dates, requesting Department, Unit or Specialty, indications for request, Number of units requested, and number eventually utilized were used to determine blood transfusion indices which are indicative of efficient and significant blood use.&#x0D; Results: Eight thousand, five hundred forty-eight (8,548) blood transfusion request forms from the blood bank and patients' folders were reviewed and compared with the Blood Bank's in-house records. Requests for blood transfusion for over 460 indications were received from twenty-six (26) departments and units. There was a general Crossmatch: Transfusion ratio (C: T) of 1.7 with a transfusion index (TI) of 1.2 and transfusion probability (TP) of 48.0%.&#x0D; Conclusion: Transfusion requests were characterized by low utilization across departments and units. This calls for the establishment of a transfusion protocol for the determination of blood volume required for every indication so that this limited commodity will be made available and accessible when needed.

Our bab(y)ies, your uterus—a retrospective study on surrogacy at a private fertility center in South West Nigeria

Introduction: In vitro fertilization, a form of assisted reproductive technology has evolved over the last 3–5 decades in the management of infertility and now has been expanded to include third-party reproductive solutions. There are 2 types of gestational surrogacy: (1) full surrogacy (an egg from a woman is fertilized with a sperm and the resulting embryo is implanted into another woman) or (2) partial surrogacy (sperm from a man is used to fertilize an egg from the same woman in whom the embryo will be transferred to). In Nigeria, there is a paucity of publications on the outcomes of surrogate pregnancies, even though it is being practiced. At the Medical Art Center Ikeja Lagos, we practice only full surrogacy, otherwise referred to as gestational surrogacy. Study design: This was a retrospective descriptive study of 61 cycles performed over 76 months between January 1, 2015 and April 30, 2021 at a private-run single-location fertility center in South West Nigeria. Data were extracted from the electronic medical records of the commissioning parents and the gestational carrier. Results: There were a total of 58 gestational carriers in the program. Eleven (19%) had a miscarriage and there were 63 live births, out of which were 14 twin pairs (44%), 1 set of triplets (~5%) and the rest were singletons. One (1.7%) surrogate had delivery complicated by a hysterectomy on account of postpartum hemorrhage. There was no maternal mortality. The commonest reason for choosing surrogacy was multiple failed in vitro fertilization cycles, uterine factor infertility, and advanced maternal age. Conclusion: Gestational surrogacy is a valid medically assisted reproduction option for individuals who desire to have children. This option should continue to be supported by ethical, regulatory, and legal frameworks available in Nigeria.

High risk of obstructive sleep apnea among hypertensive patients in two tertiary centers in Nigeria

Objectives: The prevalence of obstructive sleep apnea (OSA) is rising globally with its associated morbidity and mortality. Although OSA is associated with hypertension and is the leading cause of secondary and resistant hypertension, its presence is usually not actively sought during clinical evaluation of hypertensive patients resulting in a missed opportunity to treat the condition. This study assessed the prevalence of high risk of OSA and excessive daytime sleepiness (EDS) among hypertensive patients. It also assessed the pattern of symptoms of OSA among the participants. Materials and Methods: We used a structured questionnaire to collect data from hypertensive patients aged 18 years and above, who were attending the outpatient clinics of two tertiary hospitals in Enugu state. Data collected include frequency of symptoms of OSA, Epworth sleepiness scale (ESS) score, snoring, tiredness, observed apnea or choking, blood pressure, body mass index, age, neck circumference, and gender (STOPBANG) score, number of comorbidities present, and demography of participants. STOPBANG score of 5–8 classified participants as having high risk of OSA, and ESS &gt;10 as having excessive daytime sleepiness (EDS.). Results: Three hundred and twenty hypertensive patients were recruited (mean age: 56.0 ± 9.5 years; female: 58.8%). The prevalence of high-risk OSA was 13.8% and that of EDS was 6.3%. Snoring, nocturia, tiredness, and observed apnea were significantly present in 90.9%, 90.9%, 81.8%, and 22.7% of those with high risk of OSA (n = 44), respectively, compared with intermediate (60.6%, 91.5%, 53.2%, and 1.6%) and low risk (12.5%, 77.3%, 19.3%, and 1.1%) groups (P &lt; 0.001, P = 0.003, P &lt; 0.001, and P &lt; 0.001, respectively). Gasping, (χ2 [2] = 8.4, P = 0.015); memory loss, (χ2 [2] = 6, P = 0.04); and sleep fragmentation, (χ2 [2] = 9.9, P = 0.007) also showed significant difference between high-, intermediate-, and low-risk OSA groups. Conclusion: The prevalence of the high risk of OSA among hypertensive patients presenting to our tertiary hospitals are modest. Snoring and nocturia are their most common symptoms. We recommend screening hypertensive patients for OSA to identify those at high risk, as they will likely benefit from sleep study and treatment if confirmed.