Hospitals In Southeast Nigeria Research Articles

Awareness and Frequency of Encounter With Subjects With Antiphospholipid Syndrome by Medical Practitioners in Tertiary and Some Other Health Institutions in Southeast Nigeria

Abstract Background: Antiphospholipid syndrome (APS) is an autoimmune multisystem disorder. There has been a limited number of reported cases from Nigeria. Objectives: To determine the awareness and frequency of encounters with APS cases by medical practitioners in health institutions in South East Nigeria. Materials and Methods: It was a descriptive cross-sectional study. All medical doctors met in the clinics who were willing to participate in the study were recruited during the period of the study. Statistical Package for Social Sciences was used for data entry, validation, and analysis. Results: A total of 581 study questionnaires were distributed to medical doctors met at the clinics and clinical meetings of five hospitals in Southeast Nigeria however, 581 were approximately filled and retrieved, giving an response rate of 94.84%. Males were 383 (69.5%) and females were 168 (30.5%). A total of 445 (80.8%) were unaware of the autoimmune multisystemic nature of APS. Of the 551 respondents, 348 (63.2%) were aware that Rheumatologist is the primary care physician for APS, 290 (52.6%) reported rarity of APS, and 366 (66.4%) had up to 50% overall knowledge of APS. Respondents’ encounters with unexplained thrombotic events and unexplained stroke in the young were limited. A total of 62 (11.3%) were aware of the international classification criteria for APS. Conclusion: The authors conclude that APS awareness among medical practitioners in South East Nigeria is suboptimal.

Health-Related Quality of Life of People Living with HIV: Contributions of Emotion Regulation and Self-Compassion

Living with chronic health conditions such as HIV has implications for health-related quality of life (HRQoL) and improving the HRQoL of people living with HIV (PLWH) is becoming increasingly important for researchers, policymakers, and health practitioners. However, there is limited research on factors that help to explain HRQoL among persons with HIV in sub-Saharan Africa. We examined the contributions of emotion regulation and self-compassion in the HRQoL of 187 PLWH (56.1% female) drawn from the HIV clinic in a specialist hospital in southeast Nigeria. They completed the Brief Version of the Difficulties in Emotion Regulation Scale (DERS-18), Self-compassion Scale, and Patient-Reported Outcome Quality of Life-HIV (PROQOL-HIV). While controlling for participants’ demographic variables, the regression results showed that self-compassion was positively associated with HRQoL. Higher difficulties in emotion regulation were not associated with HRQoL in the presence of self-compassion. The findings extend the outcomes of previous research in other parts of the world and support the notion that enhancing self-compassion interventions may shore up the HRQoL of people living with chronic health conditions. HRQoL interventions that embody culturally informed self-compassion strategies and developmental level approach are needed for the health system in sub-Saharan Africa.

Morphological Pattern of Benign Skin Tumors in a Teaching Hospital in Southeast Nigeria

Morphological Pattern of Benign Skin Tumors in a Teaching Hospital in Southeast Nigeria

Epidemiological trends and treatment abandonment of paediatric solid tumours in a nigerian tertiary hospital: a seven-year review (2016–2022)

BackgroundPaediatric solid tumours, both benign and malignant, present significant health challenges, particularly in Sub-Saharan Africa where comprehensive data is limited. This study aims to elucidate the prevalence, distribution, and treatment outcomes of paediatric solid neoplasms in a tertiary hospital in South-East Nigeria over a seven-year period.MethodsA retrospective cohort study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Clinical details and histological slides of confirmed cases from January 2016 to December 2022 were reviewed. Data extraction focused on socio-demographic variables and treatment outcomes, analysed using statistical methods.ResultsThe study included 293 children diagnosed with solid tumours (58.1% malignant, 41.9% benign), with a female predominance (61.8%). The median age at diagnosis was 12 years. Fibroadenoma was the most common benign tumour (61.8% of benign cases), while non-Hodgkin lymphoma was the predominant malignant tumour (18.2% of malignant cases). Treatment abandonment rates differed significantly between benign (13.8%) and malignant (51.2%) tumours. Significant associations were found between treatment outcomes and factors such as gender (p = 0.0001 for benign tumours), age category (p = 0.0001 for benign tumours), and specific diagnoses (p = 0.0001 for both benign and malignant tumours).ConclusionThis study underscores the substantial burden of paediatric solid tumours in South-East Nigeria and highlights the critical need for improved treatment adherence strategies, particularly for malignant cases. The findings emphasize the importance of tailored interventions based on tumour type, age, and gender. These insights can inform future research, policy formulation, and healthcare strategies aimed at enhancing the management and outcomes of paediatric solid neoplasms in resource-limited settings.

Influence of Combined Intramuscular Hyoscine and Vaginal Misoprostol for Cervical Ripening on the Need for Labour Augmentation and Pregnancy Outcome in a Tertiary Hospital in South-East Nigeria

Influence of Combined Intramuscular Hyoscine and Vaginal Misoprostol for Cervical Ripening on the Need for Labour Augmentation and Pregnancy Outcome in a Tertiary Hospital in South-East Nigeria

Palliative Social Work Services for Cancer Patients in Southeast Nigeria: An Exploration

Palliative social work services are essential for addressing the complex psychosocial needs of cancer patients, particularly in resource-constrained areas like Southeast Nigeria. Despite the recognition of social work in palliative care for cancer patients, effective delivery faces significant challenges impacting both social service delivery and patient outcomes. This study investigates the provision of palliative social work services for cancer patients using in-depth interviews with 18 participants (six social workers and twelve cancer patients) from two hospitals in Southeast Nigeria. Participants were purposefully sampled based on their roles in providing or receiving palliative care support. Thematic analysis of the data revealed that social work palliative services encompass psychosocial support, spiritual guidance, and educational resources. However, social workers encounter barriers such as emotional stress, burnout, communication gaps, financial constraints, and socio-cultural factors. The study suggests that regular debriefing sessions and educational programs could improve palliative care delivery. Policy advocacy is recommended to recognize and support the pivotal role of palliative social workers in cancer care. Future research should explore innovative strategies using quantitative methods to overcome barriers and enhance palliative social work effectiveness across diverse cultural and healthcare contexts, ultimately improving social service delivery to cancer patients and advancing social service research.

Ocular disorders in a tertiary Hospital in South East Nigeria

The object of this study was to determine the pattern of ocular disease patients that presented to the Enugu State University of Science and Technology Teaching Hospital, Park Lane, Enugu, Nigeria. A retrospective study was conducted, where the medical case notes of patients who had ocular examinations, other clinical examinations, and investigations from April 2022 through December 2022 were retrieved. There were a total of 1145 patients, with a male population of 476 (41.6%), while females were 669 (58.4%). The mean age of the study population was 40.8 years, with a Standard Deviation (SD) of 22.4. A total of 924 (80.7%) participants were adults while children (aged 16 years and below) were 221 in number and constituted 19.3% of the study population. The most common eye disease was refractive error, which occurred in 266 (23.2%) of the participants; it was followed by allergic eye diseases, 201 (17.6%), cataract, 170 (14.9%), glaucoma, 111 (9.7%), and trauma to the eye, 94 (8.2%). Among the children, the most common eye disease seen were allergic eye diseases, 78 (35.3%), followed by refractive error, 70 (31.7%), trauma, 21 (9.5%), cataract, 11 (5.0%), while infections of the eye were 10 (4.5%). The most common eye disease among the adult participants was refractive error, 196 (21.1%), and then cataract, 159 (17.2%), allergic eye diseases, 123 (13.3%), glaucoma, 105 (11.4%), and retinal pathologies, 82 (8.9%). The most common causes of eye diseases in this study were refractive error, allergic eye diseases, cataracts, glaucoma, and trauma. Health education at community and primary health care level could help to reduce the number of people with avoidable causes of visual impairment.

Effect of dolutegravir-based regimen on the body mass index of adolescents living with HIV in an African population: a pre-post design

ABSTRACT Dolutegravir, an integrase strand inhibitor, has been linked to an increase in body mass index among adults. However, little is known about its effect on adolescents. The study assessed the effect of a dolutegravir-based regimen on adolescents’ body weight and emphasized the gender-specific differences in weight gain, if any. This prospective cohort study was conducted among 182 treatment-experienced adolescents living with HIV at a tertiary hospital in Southeast Nigeria. The body mass index measurements were calculated before transitioning to dolutegravir and after six months of being on the dolutegravir regimen. A comparison of the difference in mean body mass index before and after dolutegravir-based therapy was determined using a paired t-test. At the end of the six-month follow-up, there was a significant increase in the respondents’ overall body mass index z-score (t = −10.00, p < 0.001). There was a significant increase in the body mass index z-score of both genders (male; t = −7.49, p < 0.001, female; t = −6.91, p < 0.001). The dolutegravir-based therapy (β-coefficient = −0.17, t = − 2.09, p < 0.001) and baseline body mass index z-score (β-coefficient = 0.76, t = 15.86, p < 0.001) were significant predictors of body mass index z-score at six months. In adolescents living with HIV, the transition to dolutegravir is associated with increased body weight. Female adolescents tend to gain more weight compared to males. Therefore, there is a need for regular monitoring of body weight for early detection of obesity and prompt intervention.

Knowledge and Attitude of Eye Care Workers towards Electronic Medical Records in a Tertiary Eye Facility in South-East Nigeria

Electronic Medical Records (EMR) has been an integral part of patient management in the developed world but still gradually gaining popularity in the developing world. It was met with resistance by health workers in Nigeria though this is changing in the post COVID era. However, there still appears to be some resistance to its acceptance for different and sometimes justifiable reasons. The aim is to determine the knowledge and attitude towards EMR among eye health workers in a teaching hospital in South East Nigeria. This cross-sectional quantitative study was conducted among consenting consecutive eye care workers at Guinness Eye Centre, Onitsha aged≥ 18years from July to September, 2023. A pretested semi structured self-administered questionnaire was used. Information of interest were biodata, knowledge and attitude towards EMR. They were summarized into simple frequencies and percentages. Knowledge scores were grouped into good and poor using the blooms cut off for knowledge attitude and practice. Univariate and bivariate analysis were done and results represented in tables and charts with levels of significance placed at p&lt;0.05. There was a total of 135 respondents; the mean age was 32.6 years ± 10 SD, male to female ratio of 1:1.1. The result showed good knowledge and positive attitude towards EMR (85.2% and 73.2% respectively) with younger age group, professional cadre and computer literacy found to be associated with good knowledge and positive attitude towards EMR in the population. The hospital/ clinic were the most common sources of EMR information. This study showed good knowledge and positive attitude toward EMR in the study population. It also suggested an association with younger age group, professional cadre and computer literacy.

Investigation into quality of life of patient receiving chemotherapeutic regimen in selected hospital in South East Nigeria: A pilot study

In 2008 approximately 12.7million cancers were diagnosed and 7.6million people died due to cancer worldwide. People living with cancer experience a variety of reactions as such quality of life and chemotherapy for cancer patients and its associated side effects are topical issues in oncology practice. A survey was conducted among 264 breast cancer patients selected by Purposive sampling technique, the instrument for the study was (EORTC QLQ - C30 &amp; BR 23). This instrument was used to determine the quality of life of cancer patients and breast cancer in particular. It has a total of 53 items. The first 30 items (i.e. EORTC QLQ - C30), bothers on patients perception of health, the last 23 items which are numbered 31 – 53 (i.e. BR 23). QOL of breast cancer patients using EORTC QLQE30-BR23, revealed that they have trouble taking a long walk, they have you had pains, they need to rest with a mean of 1.9, 2.7 and 2.8 respectively. Also, 15.9% of the respondents had an excellent quality of life in the past week, 78.0% have good quality of life in the past week, it also further revealed that 14.8% had an overall excellent quality of life during the past week. Also, findings revealed that most of the respondents 57.95% had a very bad/poor QOL. Furthermore, findings further revealed that the patients’ perception of overall health past weeks was good, 206(78.03%). Cancer patients experienced many adverse reactions that affected their QOL. There is a need to develop strategies for managing their adverse event resulting from interventions for cancer, thus improving the patient quality of life.

Predictors of Intern Pharmacists Job Satisfaction in Federal Teaching Hospitals in Southeast Nigeria

Background: Job satisfaction is a quality assessment standard measure used in evaluation of employers output and outcomes. Increase in job satisfaction correlates positively with employees output. This study assessed the predictors of intern pharmacists job satisfaction ina tertiary hospital in southeast Nigeria. Methods: The study was a questionnaire web and paper-based prospective cross-sectional survey among eligible intern pharmacists who gave their informed consent to participate in the study. Data was summarized with descriptive statistics. Linear regression analysis were used to predict factors affecting intern pharmacist’s job satisfaction while correlation coefficient was used to determine the strength of association. Reliability estimation was done using the Cronbach alpha. All tests for differences between subgroup distributions were regarded as significant if p-values equal to or less than (0.05) (two-tailed test) was reported. Results: Overall, (168) intern pharmacists participated in the study out of which (87) (51.8%) were females. Majority of the respondents were resident outside the hospital premises (136) (86%) while (21) (12.5%) were also locum practitioners. Most of the interns have spent (5-9) months out of the mandatory (12) months (139) (82.7%). Accomodation within the hospital and choice of hospital educational funding had a p-value of (0.864) in the linear regression analysis while the choice of hospital was 0.003. Conclusion: Interns accommodation within the hospital and choice of hospital for inernship training were the major predictors of job satisfaction among the respondents. Job satisfaction is an essential determinant of work output and outcomes.

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Medical ethics and compliance amongst physician groups: a self-assessed survey in a hospital in Southeast Nigeria.

Being a doctor remains a moral enterprise as he is expected to make some medical decisions based on ethical principles during encounter with patients. The objective of this study was to investigate the knowledge and application of medical ethical principles amongst physician groups in a Hospital in Enugu, Nigeria. This was a cross-sectional self-assessed study conducted amongst medical doctors in five specialty groups in a teaching hospital in Enugu, Nigeria.Descriptive and inferential statistics were used to summarize the items and determine whether significant differences on knowledge and application of medical ethics existed amongst the physician groups in the treatment of patients. Observance and compliance with medical ethical conduct was highest among doctors that were aged 55 years and above. In sex, male doctors had higher ethical conduct compliance than female doctors. Comparing the doctors by rank, medical officers, consultants and senior registrars respectively had the highest ethical conduct. Knowledge and practice of medical ethics were mostly deficient among younger Nigerian and female doctors. Remedying the situation will require better curricula both at the undergraduate and post-graduate medical school programmes for doctor trainees. Requiring certification in bioethics for license renewal will also help in resolving and improving the knowledge gap.

Risk perception and hesitancy towards malaria vaccines among hospital pharmacists in southeast Nigeria: a cross-sectional study

ABSTRACT This study evaluated the willingness and perceived concerns of hospital pharmacists in allowing and recommending malaria vaccines. This was a cross-sectional-based study. Participants were recruited from two teaching hospitals in southeast Nigeria – the University of Nigeria Nsukka (UNTH) and the Enugu State University Teaching Hospital (ESUTH). Outcomes were acceptability of the malaria vaccine and concerns about the use of malaria vaccine measured using a validated 21-item questionnaire adapted from a similar study. Descriptive statistics were used to characterise and compare data, with chi-test to test the association between variables. A sub-group analysis within the acceptability was done to determine the predictors of ‘probably’ by also dichotomizing the responses. Data were analysed using STATA v17. Out of 250 participants recruited for this study, 187 completed and returned the questionnaire, with UNTH having the highest response rate (n = 137, 73.3%). Ninety-two (54.1%) out of 170 participants agreed that they would allow their children to take the malaria vaccine. Sixty-six (50.4%) out of 131 and 30 (62.5%) out of 48 participants from UNTH and ESUTH, respectively, will likely recommend the vaccine to family members, while 64 (49.6%) out of 129 and 31 (64.6%) out of 48 participants from UNTH and ESUTH, respectively, were likely to recommend the vaccine to their patients. Eighty-three (61.9%) out of 134 and 33 (67.3%) out of 49 participants from UNTH and ESUTH, respectively, had concerns about the adverse effects of taking this vaccine. Education level (p = 0.017) and age (p = 0.014) were significantly associated with the likelihood of recommending this vaccine to patients. Our findings showed that pharmacists are not likely to accept and recommend malaria vaccines to their children and patients. Hospital pharmacists’ demographic characteristics did not predict their acceptability or probability of allowing the malaria vaccine to be administered to their children. Similar findings were also observed for hesitancy towards malaria vaccines. There were concerns about the failure of the vaccine and its adverse effects.

Comparative Assessment Of Job Satisfaction Among Frontline Health Care Workers In A Tertiary Hospital In South East Nigeria

Background: Job satisfaction cuts across facets of mental perception and responses individuals make towards their jobs. They include cognitive, affective, and behavioral components. In light of reducing workforce in the Nigerian healthcare, this study was aimed at comparing the outlook of job satisfaction among healthcare workers in Nnamdi Azikiwe University teaching Hospital, Nnewi, Nigeria. Methods: It was a cross-sectional study design with a sample size of 281 healthcare personnel consisting of doctors, nurses, medical laboratory scientists, pharmacists, physiotherapists, and radiographers using a structured, self-administered questionnaire. The data was analyzed using SPSS version 20. Statistical significance was set at p≤0.05. Results: The study showed that Radiographers and Physiotherapists averagely had the best job satisfaction scores in comparison to other healthcare personnel. Doctors and Nurses were noted to have the worst average scores in relation to other personnel. Conclusion: The disparity in job satisfaction among different professional cadres may be a reflection of disproportionate work expectations, outlooks, and rewards experienced by different professionals in the course of their duties. Favorable and unfavorable work environments and policies may be weighted differently in the work experience of different professionals.

Perception, precausions and acceptance of vaccination against SARS COV-2 viral infection among health workers in two tertiary hospitals in southeast Nigeria, four years after the onset of the pandemic

Background: The study was conducted in two tertiary hospitals located in ababkaliki the capital city of Ebonyi State.&#x0D; Aim: To ascertain the perception, awareness and vaccination of COVID-19 among the health workers.&#x0D; Methods: A questionnaire/data sheet was developed for the study. Information on sociodemographic characteristics, perception and awareness and COVID 19 vaccination were obtained. The data were fed into the computer using SPSS version 25, Illinoi USA and analysis done.&#x0D; Results: We had 420 respondents with the mean age of 39.1±9.8 and ranged from 20 to 70years made up of doctors, nurses/midwives, laboratory scientists, pharmacists and others. There was high awareness of COVID 19 in the group but with poor knowledge of spread 47.4% and preventive measures 43.1%. awareness of vaccine was high 96.9% but the uptake was low 33.8% with major reason being fear of side effect and some also believe vaccine is a scam. Some of the respondents were survivors of COVID 19.&#x0D; Conclusion: There is high awareness of COVID 19 disease in the hospitals but poor knowledge of mode of spread and preventive measures including very low uptake of anti-COVID 19 vaccines and inadequate provision of PPEs 4 years after the onset of the pandemic.

Strangles in a stallion in southeast Nigeria: clinical and pathological report

ABSTRACT. Streptococcus equi subspecies equi is the causative agent of strangles, a highly contagious mucopurulent upper respiratory tract infection of horses. This report describes the clinicopathologic findings of a fatal case of pulmonary form of strangles in a two-and-half-year-old stallion presented at a Veterinary Teaching Hospital in Southeast Nigeria. Treatment was attempted in quarantine using high doses of procaine penicillin; but it was unsuccessful. The clinical signs observed in the affected horse include a left unilateral supra-orbital swelling containing purulent matter, which progressed to a chronic intractable exudative pus. Anaemia with leukocytosis (due to neutrophilia) were observed in the haematologic parameters. Gross and histologic lesions were multifocally extensive abscessing necrotic lymphadenitis and bronchopneumonia with inflammatory oedema and infiltrate of polymorphonuclear leukocytes.

The Spectrum of Intradialysis Complications in Renal Patients Accessing Care in A Tertiary Hospital in South East Nigeria

Background: Haemodialysis (HD) is currently the most common mode of renal replacement therapy (RRT) in the Sub-Saharan Africa. It is however, fraught with many complications which sometimes cause morbidity and mortality outside the primary kidney problems. Hence, there must be concerted effort to identify them early. This would enable the clinician institute preventive measures or treat them efficiently when these adverse effects occur. Materials and Method: A prospective study was carried out among chronic kidney disease (CKD) and acute kidney injury (AKI) patients in failure assessing HD care at the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi dialysis center. Subjects were one hundred and twenty six in number: 84 CKD and 42 AKI. Sixty five (65) were males while sixty one (61) were females. A total of three hundred and sixty nine (369) HD sessions were done. Sociodemographic data and medical history were obtained from each subject and relevant physical examinations and laboratory investigations were carried out prior to and intra dialysis for each subject. Results were analyzed using Statistical Package for Social Sciences (SPSS) software version 17. Results: Intradialytic complications occurred in 86 out of 126 subjects. The commonest intradialytic complication was hypotension (20.6% for patient-based analysis and 21.1% for session-based analysis). This was followed by hypertension (19.8% for patient-based analysis and 16.5% for session-based analysis). Other complications noted were fever (9.95%), chest pain (9.95%), cramps (1.0%) and seizure (1.0%). Conclusion: In this study population, intradialysis hypotension was the most common complication followed by intradialysis hypertension. Patients on HD should be assessed and monitored actively to identify and possibly prevent or treat these complications when they occur.

Effect of Open Book Management and Teamwork on Productivity among Staff of Teaching Hospitals in Southeast Nigeria

Background: Open book management (OBM) is a style of management in which employees learn about an organizational operation, contribute to it, and get rewarded for meeting financial targets. A method of running an organization in which the information received by employees should not only help them operate effectively but also assist them to understand how the company is run. Objectives: The aim of this article is to determine the effect of OBM and teamwork on productivity among staff in public tertiary hospital in Southeast Nigeria. Materials and Methods: A cross-sectional analytic study was done among 500 staff of 5 public tertiary hospitals in Southeast Nigeria. The respondents were selected using a multistage sampling technique. Information obtained includes sociodemographic profile, staff disposition, knowledge of hospital policy and management, level of cooperation among staff, level of teamwork, productivity, and employees’ job satisfaction, and these were assessed using 5-point Likert scale. Data were analyzed using SPSS version 20.0; chi-square and Pearson's correlations were used to test the level of relationship. Results: Five hundred respondents participated in the study. All respondents had tertiary education; 38.8% had work experience ranging from 1 to 5 years, whereas 61.2% had more than 5 years of experience. About 53% of the respondents at least agreed that there is transparency in information flow in the hospital with a response score of more than 3.0. The practice of teamwork had a response rate of less than 3.0. More than 60% of the respondents attested to a lack of teamwork. The response score of organizational productivity was 3.78, with 74.8% of the respondents at least agreeing that the institutions are productive in their activities. Conclusion: Teamwork is lacking in our health institutions and affects organizational productivity of teaching hospitals. Hence, workplace harmony should be encouraged in order to improve productivity.

Trends in Emergency Room Visits of Oral and Maxillofacial Surgery Patients in a Tertiary Hospital in South-East Nigeria

Background: The accident and emergency unit is usually the first port of call for patients involved in road traffic and domestic accidents, emergency dental conditions, and advanced-stage malignancies during call hours and weekends. Objective: This study aimed to evaluate the pattern of emergency maxillofacial injuries in the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. Materials and Methods: This is a 3-year retrospective study of patients that presented to the accident and emergency unit of the University of Nigeria Teaching Hospital Enugu on account of pathologies involving the oral and maxillofacial region. Results: One hundred and eighty-three cases were recruited into the study. There were 131 males and 52 females. The mean age of the patients was 38.0 ± 18.6 years. The majority 121 (66.1%) occurred due to road traffic accidents followed by 18 (9.8%) due to complications of untreated carious teeth, then 12 (6.6%) from complications of advanced-stage tumors. Facial bone fractures 76 (41.5%) followed by lacerations 42 (23.0%) were the commonest conditions seen. Eighty-four (45.9%) had reduction and immobilization of their fractures, whereas 51 (27.8%) had suturing of various lacerations. Conclusions: Pathologies resulting from road traffic accidents, orofacial space infections, and late-stage malignancies were the commonest indications for accident and emergency unit visits by oral and maxillofacial surgery patients in the study center. The need for regular training of first-line staff in the emergency units of hospitals in this part of the world is necessary.