Hospital In Southwestern Nigeria Research Articles

Health-Seeking Behaviour and Health Outcome among Uninsured Patients Attending a Primary Care Clinic of a Teaching Hospital in Southwestern Nigeria

Health-Seeking Behaviour and Health Outcome among Uninsured Patients Attending a Primary Care Clinic of a Teaching Hospital in Southwestern Nigeria

Profile of Paediatric Refractive Errors in a Tertiary Care Hospital of South Western Nigeria

Refractive errors are part of the priority areas for Vision 2020, a global initiative for the elimination of avoidable blindness introduced by W.H.O. (World Health organization). The presence of refractive errors in children is a cause for concern for the overall development and not only the vision of the child. It may also constitute a form of disability if left unattended to. This study therefore aims to determine the pattern of refractive errors and its associations with selected variables among children presenting to a tertiary hospital. This is a cross-sectional retrospective study conducted in the Ophthalmology Department of Ekiti State University teaching hospital which is a tertiary hospital in South-western Nigeria. Children of ages 5years - 16years with diagnosis of refractive error were recruited for the study. The medical records between Jan 2018- December 2020 were reviewed and patients’ data including age, gender and type of refractive error were extracted. Data obtained was analysed with SPSS version 20(inc.) and results are shown by frequency, tables and figures. Measure of association of the variables was done using chi square and P value =0.005. A total of 193 children with various refractive errors were seen during the period of study. There was a slight male preponderance. M: F (1.2:1) and highest frequency of refractive error was seen in children of ages between 5-7years. The most common refractive error seen was astigmatism in 140(36.2%) patients, most of the patients (46.4%) presented with moderate refractive error.

Chronic Subdural Hematoma: Predicting Postoperative Recurrence Using a Correlation of Computerized Tomographic Volume with Intraoperative Volume.

Chronic subdural hematoma (CSDH) recurrence is the most common complication following surgery. To predict postoperative recurrence of CSDH using a correlation of the calculated preoperative brain computerized tomographic (CT) volume with the intraoperative volume. A prospective study was conducted over 14 months in a tertiary hospital in southwestern Nigeria. History with focused examination findings and patient grading using Markwalder classification were documented preoperatively. Preoperative CSDH CT volume was documented and compared with the intraoperative volume. Patients were followed up clinically for features of recurrence at 1, 3, and 6 months postoperatively, and repeat brain CT was done when recurrence was suspected clinically. Forty-seven out of 51 patients recruited completed the study, and four were lost to follow-up. Thirty-three (70.2%) were males, and the average age was 51.4 years. Most of the patients were in the 5th and 7th decades of life. Three patients had recurrence (6.5%), and one patient died (2.1%). Trauma was the most common cause of CSDH (35 out of 47 [74.5%]), spontaneous in 11 (23.4%), and anticoagulant related in 1 (2.1%) patient. Most patients (37/47; 78.7%) presented with headache. The mean brain CT volume and intraoperative volume of CSDH were 102.58 ± 54.13 and 87.74 ± 46.6 mL, respectively, with no significant difference between them (P = 0.104). The receiver operating characteristics curve of intraoperative volume predicted the recurrence of CSDH at a volume >130 mL, with a sensitivity of 66.7%. The calculated preoperative CT volume had a positive linear correlation with intraoperative volume. Intraoperative CSDH volume >130 mL was associated with an increased risk of recurrence.

Perceived Family Support and Medication Adherence among Diabetic Patients with Good and Poor Glycaemic Control Attending a Teaching Hospital in South-Western Nigeria

Aim: To compare perceived family support (PFS) and medication adherence among adult T2DM patients with good and poor glycaemic control.
 Methods: This was a hospital-based cross-sectional comparative study among patients with T2DM. The participants were systematically recruited and divided into two groups after glycated haemoglobin testing. Additional data was collected using a structured interviewer – administered questionnaire adapted from Perceived Social Support – Family Scale and 8-item Modified Morisky Adherence Scale.
 Results: The mean PFS scores among participants with good and poor glycaemic control were 16.37 and 13.97 points respectively. The difference between their mean scores was significant (P 0.000). The mean score of medication adherence among participants with good glycaemic control was 7.13 points while participants with poor glycaemic control had a mean score of 6.42 points. The difference between their mean scores was significant (P 0.012). A statistically significant association was found between medication adherence and glycaemic control (P 0.025).
 Conclusions: This study found that T2DM participants with stronger PFS and better medication adherence had better glycaemic control than participants with weaker PFS and poor medication adherence. It is therefore important to emphasise family support and measures that improve medication adherence in the holistic management of T2DM.

Pattern of indications for tracheostomy in a tertiary hospital in South Western Nigeria.

Tracheostomy is a life-saving procedure; the benefits and frequency of procedures being performed have led to frequent reviews of indication in many regions of the world. The aim is to establish the indications, diagnosis and complications of tracheostomy performed in the past 10 years in a tertiary hospital in Lagos. This is a 10-year retrospective study of all patients who had tracheostomies for various indications from 2010 to 2019. Patient medical records were analysed for demographic profile, diagnosis, indication, elective or emergency tracheostomy, surgeon's rank, technique of decannulation and type of complications. All the variables in the data were imputed and analyzed using the IBM Statistical Package for the Social Sciences version 27. Continuous variables were presented as mean and standard deviation, whereas categorical variables were presented as frequency and percentage. Four hundred and eighty-six tracheostomies were carried out during the period under review, and 440 patients had complete data retrieved. The age group of 0-9 years constituted the most common age for tracheostomy (18%). The most common indication for tracheostomy was for relief of upper airway obstruction in 53.4%. Neoplasms (40%) and trauma (30.7%) constituted primary diagnosis requiring tracheostomies. Amongst the paediatric age group with upper airway obstruction, infections (31.8%) and foreign body inhalation (24.3%) constituted the most common primary diagnosis. Stoma infection and peristomal granulation tissue were the most common early complication (21.8%) and late complication (43.4%), respectively. Relief of upper airway obstruction from neoplasm remains the most common indication for tracheostomy, and peristomal granulation infection was the most common complication.

Metastatic Breast Cancer in a Tertiary Hospital in South-Western Nigeria

Metastatic Breast Cancer in a Tertiary Hospital in South-Western Nigeria

Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria

Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria

Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria.

Maternal health is the mother's state of well-being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State. This study is a cross-sectional survey. One hundred and eighty-eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self-designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product-moment correlation at 0.05 level of significance. From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women. Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.

Family-integrated diabetes education for individuals with diabetes in South-west Nigeria.

This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). The design was a two-group Pretest Posttest quasi-experimental. The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS). A1C and diabetes knowledge. Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better. African Doctoral Dissertation Research Fellowship (ADDRF) award offered by the Africa Population and Health Research Center (APHRC) in partnership with the International Development Research Centre.

Trend of Antenatal Bookings in a Teaching Hospital in South Western Nigeria

Introduction: The age-long practice of late booking is gradually changing towards early pregnancy booking because of the benefits. Implementation of new medical guidelines is however often delayed in developing countries. Aim: The study proposes to observe the trend in antenatal booking in respect of booking gestational age, and the relationship with maternal socio-demographic and obstetric characteristics. Methodology: A retrospective study of antenatal bookings between 2016 and 2020 in Olabisi Onabanjo University Teaching Hospital, Sagamu Ogun State, Nigeria was carried out. Data were collected from pregnant women that had a minimum of 4 clinic attendances and delivered in the hospital. Data analysis was by descriptive statistics and presented in simple frequency tables. Results: Six thousand, eight hundred and ninety-nine pregnancies were booked, with early bookings (&lt; 13 weeks) in 23.9% and late bookings in 64.6% (14-26 weeks) and 11.5% (27-36 weeks). The proportion of early bookings (23.9%) was higher compared with 18.8% reported in 2014 in same centre. Every year, the number of early bookings was initially stable at 20.4%, but rose to 26.7 - 30.8 in the last 2 years of study. Maternal age &lt; 30 years, secondary or tertiary educational level and previous caesarean delivery were the predominant variables among women that booked in early pregnancy. Previous or on-going medical disorders and/or delivery complications were not strongly associated with early booking. Conclusions: The practice of late pregnancy booking is still a major issue, though the proportion of early bookings has continued to increase compared with previous study. Improvement in education, economic empowerment and health education that emphasizes preventive rather than curative role of ANC is advised.

Intervention Study on Pharmacists’ Knowledge and Counselling on Ophthalmic Preparations in a Tertiary Hospital in South-Western Nigeria

The study aimed to assess hospital pharmacists’ knowledge and counselling on ophthalmic preparations before and after an educational intervention was carried out. A cross-sectional study was carried out among 83 pharmacists working at the University College Hospital, Ibadan, Nigeria. A 30-item semi-structured questionnaire was administered to participants to assess their background knowledge and counselling points on use of ophthalmic preparations. An educational intervention was carried out among the pharmacists to address the gaps discovered. Post-intervention assessment of the pharmacists’ knowledge and counselling on ophthalmic preparations was done a month after the educational intervention to evaluate the impact of the intervention. Data obtained was summarised using descriptive statistics and inferential statistics. Level of significance was set at p &lt; 0.05. Response rate was 79% (83/105). Fifty-six (67.5%) participants were female and 38 (45.7%) had other educational qualification(s) aside from the basic Bachelor of Pharmacy qualification. The average knowledge scores of the pharmacists on ophthalmic preparations increased from 2.55 ± 1.602 at baseline to 7.93 ± 2.879 post-intervention (p &lt; 0.001). Also, the average counselling scores of the pharmacists on ophthalmic preparations increased from 8.12 ± 1.603 at baseline to 11.46 ± 1.0277 post-intervention (p &lt; 0.001). Years of working experience and postgraduate education were predictors of participants’ knowledge and counselling on ophthalmic preparations. The study addressed the knowledge and counselling gaps identified and there was significant improvement in the knowledge and counselling of the study participants, vis-à-vis ophthalmic preparations.

836 Value of Clinical and Ultrasonic Parameters as Preoperative Predictors of Risk of Developing Hydrocephalus Post Myelomeningocele Repair: A Cohort Study

INTRODUCTION: The risk of developing hydrocephalus after myelomeningocele repair may be determined by using preoperative clinical and transcranial ultrasound parameters. METHODS: A prospective longitudinal cohort study from November 2016 to October 2018, that involved 28 patients with myelomeningocele who presented to a tertiary hospital in southwestern Nigeria. Transcranial ultrasound was done before myelomeningocele repair and patients followed up for six months to detect hydrocephalus. Analysis of the state of the anterior fontanelle, the occipitofrontal circumference (OFC), ventricular index, bicaudate diameter, lateral ventricular ratio, thalamo-occipital distance and maximum transverse lateral ventricular diameter were done to determine their predictive values for the development of hydrocephalus after myelomeningocele repair. RESULTS: Age range was 1 -120 days with a mean of 20 days and the average age at the time of myelomeningocele repair was 23 days. There were 16 (57.1%) females and 12(42.9%) males in the study. OFC range at presentation was 31- 42cm with a mean of 34.7cm ±2.6 SD. The probability that a patient will develop hydrocephalus after myelomeningocele repair increased by 1.74 times for every1cm increase in the OFC above 34.5cm before myelomeningocele repair, p= 0.03. However, the state of the anterior fontanelle as well as the trans cranial ultrasound parameters were not found to be predictors of hydrocephalus post myelomeningocele repair. CONCLUSIONS: The OFC of the patients before myelomeningocele repair was predictive of development of hydrocephalus post repair, but the state of the anterior fontanelle and pre-operative trans fontanelle ultrasound parameters were not.

Foot care practices among patients with diabetes mellitus in South-Western Nigeria

Introduction: Diabetes foot care is an evidence-based means of preventing diabetes foot ulcer. The components of diabetic foot care include yearly comprehensive foot examination, prompt identification of risk factors to diabetic foot ulcer, diabetes foot education, and standard footwear practices. This study is aimed at evaluating the foot care practices of patients with diabetes in a tertiary hospital in South-Western Nigeria. Methods: It is a cross-sectional study that employed standardized pretested structured questionnaire to obtain data from 100 participants. The study was conducted at the diabetes clinic of a tertiary hospital in South-Western Nigeria. Ethical approval was obtained from the Institutional Review Board of the hospital. Data were presented in tables and charts. Descriptive and analytical statistics was done with Statistical Package for the Social Sciences (SPSS) version 22. Results: The mean age of the participants was 58.8 ± 11.8 years. There were 66 females and 34 males. The study showed that 77% of the participants were not having yearly comprehensive examination although 94% of the respondents did daily foot inspection at home. Only 16% had continuous foot education. Moreover, only 11% of the respondents wear recommended shoes, but 88% inspected their shoes before wearing them. Sadly, 11% of the respondents walked barefooted at home. The health-seeking behavior of respondents in an event of foot ulceration was significantly associated with their educational status. Conclusion: Foot care practices of the respondents were sub-standard. So, there is an urgent need to reinforce foot care education so as to improve these subpar practices.

Misconception on oxygen administration among patients and their caregivers in Ado Ekiti, Nigeria.

Appropriate oxygen administration is a life-saving therapy; however, patients and their caregivers could decline such therapy for several reasons. Poor perceptions may delay consent to oxygen therapy. There is a lack of data on the perception of oxygen use among patients and caregivers in our setting. Hence, this study was aimed at evaluating the perception of patients and their caregivers toward emergency oxygen use in a tertiary hospital in Nigeria. This survey was a descriptive cross-sectional study conducted between December 2017 and May 2018 at a tertiary hospital in southwestern Nigeria. We administered a structured questionnaire to 334 eligible patients and their 539 caregivers while on admission. A significant proportion of the patients compared to their caregivers have had oxygen therapy in the past 40.6% versus. 6.9% P < 0.0001. The majority of the participants (patients vs. caregivers 84.7% vs. 81.1% P = 0.511) believed oxygen therapy to be beneficial and safe for use (patients vs. caregivers 79.4% vs. 78.6%; P = 0.8949). However, 21.1% of patients and 19.5% of caregivers believed it is solely for terminally ill patients. More than 50% of patients and caregivers thought oxygen can cause adverse effects and fire outbreaks. Most of the respondents considered oxygen therapy as expensive (patients vs. caregivers; 78.2% vs. 87.2%; P = 0.0176) which was regarded as a possible barrier to treatment (patients vs. caregivers 81.9% vs. 85.0% P = 0.3893). <1% of both patients and their caregivers have had any form of training in basic life support. The misconceptions about oxygen use require urgent attention by raising community awareness and knowledge toward improving the acceptability of this life-saving intervention.

Predictors and causes of in-hospital maternal deaths within 120 h of admission at a tertiary hospital in South-Western, Nigeria: A retrospective cohort study.

An efficient, comprehensive emergency obstetrics care (CEMOC) can considerably reduce the burden of maternal mortality (MM) in Nigeria. Information about the risk of maternal death within 120 h of admission can reflect the quality of CEMOC offered. This study aims to determine the predictors and causes of maternal death within 120 h of admission at the Lagos University Teaching Hospital, LUTH, Lagos South-Western, Nigeria. We conducted a retrospective cohort study amongst consecutive maternal deaths at a hospital in South-Western Nigeria, from 1 January 2007 to 31 December 2017, using data from patients' medical records. We compared participants that died within 120 h to participants that survived beyond 120 h. Survival life table analysis, Kaplan-Meier plots and multivariable Cox proportional hazard regression were conducted to evaluate the factors affecting survival within 120 h of admission. Stata version 16 statistical software (StatCorp USA) was used for analysis. Of the 430 maternal deaths, 326 had complete records. The mean age of the deceased was 30.7± (5.9) years and median time to death was 24 (5-96) h. Two hundred and sixty-eight (82.2%) women out of 326 died within 120 h of admission. Almost all maternal deaths from uterine rupture (95.2%) and most deaths from obstetric haemorrhage (87.3%), induced miscarriage (88.9%), sepsis (82.9%) and hypertensive disorders of pregnancy (77.9%) occurred within 120 h of admission. Admission to the intensive care unit (P = 0.007), cadre of admitting doctor (P < 0.001), cause of death (P = 0.036) and mode of delivery (P = 0.012) were independent predictors of hazard of death within 120 h. The majority (82.2%) of maternal deaths occurred within 120 h of admission. Investment in the prevention and acute management of uterine rupture, obstetric haemorrhage, sepsis and hypertensive disorders of pregnancy can help to reduce MM within 120 h in our environment.

Review of the demographic pattern and outcomes of acute chemical poisoning in patients in a tertiary hospital in South-western Nigeria

Introduction: Acute chemical poisoning is a public health problem especially in developing countries where there is unrestricted access to chemical products, underreporting and absence of poisoning registers. Despite its importance, there is limited information on acute poisoning among adult population in Nigeria. The study was aimed at determining the demographic pattern and short term outcomes of acute chemical poisoning in patients in a tertiary health institution in South-western Nigeria over a 2 year period.Methodology: Records of cases of acute chemical poisoning over a 2-year period were retrieved and the following information extracted: socio-demographic data of patient, type of substance ingested, type of poisoning, reason for poisoning, intervention, and outcome of treatment. Results:There were 58 patients with a M:F ratio of 1:1.1. The mean age was 28.53±13.47 years. The most commonly ingested chemical was organophosphate seen in 31(53.4%). Poisoning was deliberate in 43 (74.1%); 36 patients (62.1%) had atropine; 16 patients (27.6%) had gastric lavage; one patient (1.7%) was dialyzed and 2 patients (3.4%) were admitted into ICU. Mortality rate was 8.6%. Conclusion: Deliberate acute chemical poisoning was common in young adults. Organophosphate is the most commonly ingested chemical. Government should enforce laws that that would restrict access to potentially harmful chemicals.&#x0D; French title: Schéma et résultats à court terme d'une intoxication chimique aiguë dans un hôpital tertiaire du sud-ouest du Nigéria&#x0D; Introduction : Les intoxications chimiques aiguës sont un problème de santé publique en particulier dans les pays en développement où il existe un accès illimité aux produits chimiques, une sous-déclaration et l'absence de registres des intoxications. Malgré son importance, il existe peu d'informations sur les intoxications aiguës parmi la population adulte au Nigéria.Objectif de l'étude: Déterminer le schéma démographique et les résultats à court terme des intoxications chimiques aiguës chez les patients d'un établissement de santé tertiaire du sud-ouest du Nigéria sur une période de 2 ans.Méthode de l'étude : Des dossiers de cas d'intoxication chimique aiguë sur une période de 2 ans ont été récupérés et les informations suivantes extraites : données sociodémographiques du patient, type de substance ingérée, type d'intoxication, raison de l'intoxication, intervention et résultat du traitement.Résultat de l'étude : Il y avait 58 patients avec un rapport M : F de 1:1,1. L'âge moyen était de 28,53 ± 13,47 ans. Le produit chimique le plus couramment ingéré était l'organophosphate vuswzsw3 dans 31 (53,4 %). L'empoisonnement était délibéré dans 43 (74,1 %); 36 patients (62,1%) avaient de l'atropine ; 16 patients (27,6 %) ont eu un lavage gastrique ; un patient (1,7%) a été dialysé et 2 patients (3,4%) ont été admis en réanimation. Le taux de mortalité était de 8,6%. Conclusion : Les intoxications chimiques aiguës délibérées étaient fréquentes chez les jeunes adultes. L'organophosphate est le produit chimique le plus couramment ingéré. Le gouvernement devrait appliquer des lois qui restreindraient l'accès aux produits chimiques potentiellement nocifs.

Clones and Clusters of Antimicrobial-Resistant Klebsiella From Southwestern Nigeria.

Background Klebsiella pneumoniae is a World Health Organization high-priority antibiotic-resistant pathogen. However, little is known about Klebsiella lineages circulating in Nigeria.MethodsWe performed whole-genome sequencing (WGS) of 141 Klebsiella isolated between 2016 and 2018 from clinical specimens at 3 antimicrobial-resistance (AMR) sentinel surveillance tertiary hospitals in southwestern Nigeria. We conducted in silico multilocus sequence typing; AMR gene, virulence gene, plasmid, and K and O loci profiling; as well as phylogenetic analyses, using publicly available tools and Nextflow pipelines.ResultsPhylogenetic analysis revealed that the majority of the 134 K. pneumoniae and 5 K. quasipneumoniae isolates from Nigeria characterized are closely related to globally disseminated multidrug-resistant clones. Of the 39 K. pneumoniae sequence types (STs) identified, the most common were ST307 (15%), ST5241 (12%), ST15 (~9%), and ST25 (~6%). ST5241, 1 of 10 novel STs detected, is a single locus variant of ST636 carrying dfrA14, tetD, qnrS, and oqxAB resistance genes. The extended-spectrum β-lactamase (ESBL) gene blaCTX_M-15 was seen in 72% of K. pneumoniae genomes, while 8% encoded a carbapenemase. No isolate carried a combination of carbapenemase-producing genes. Four likely outbreak clusters from 1 facility, within STs 17, 25, 307, and 5241, were ESBL but not carbapenemase-bearing clones.ConclusionsThis study uncovered known and novel K. pneumoniae lineages circulating in 3 hospitals in Southwest Nigeria that include multidrug-resistant ESBL producers. Carbapenemase-producing isolates remain uncommon. WGS retrospectively identified outbreak clusters, pointing to the value of genomic approaches in AMR surveillance for improving infection prevention and control in Nigerian hospitals.

Early Outcome of Endoscopic Third Ventriculostomy With Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunt as Primary Treatment of Hydrocephalus in Children With Myelomeningocele: A Prospective Cohort Study.

Myelomeningocele is associated with hydrocephalus in 35% to 90% of cases. Hydrocephalus is usually treated with insertion of ventriculoperitoneal shunt; however, there is growing evidence that endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is an alternative. To compare the success rate and morbidity of ETV with CPC and ventriculoperitoneal shunt (VPS) as the primary treatment of hydrocephalus in patients with myelomeningocele. A prospective study from January 2016 to February 2019, involving 46 patients with myelomeningocele who developed hydrocephalus after repair in a tertiary hospital in southwestern Nigeria. Biodata and preoperative features of hydrocephalus were documented. ETV+CPC or VPS was done using standard operative techniques. Patients were followed up monthly for 6 mo. There were 23 patients in the ETV+CPC arm and 22 patients in the VPS arm. Morbidities were cerebrospinal fluid leak, 8.3% in the ETV+CPC arm and 4.5% in the VPS arm, wound dehiscence, 13.6% in the VPS arm, none in the ETV+CPC arm. At 6-mo follow-up, success rate for ETV+CPC was 60.9% and 59.1% for VPS, P=.9. ETV+CPC had similar success rate with VPS at 6 mo with lower morbidity. ETV+CPC should be considered a viable alternative when treating patients with myelomeningocele and hydrocephalus.

Correlation of Plasma Magnesium with Insulin Resistance in Type 2 Diabetes

Introduction: Insulin resistance (IR) is a core component of the pathophysiology of type 2 diabetes mellitus (DM). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is the most commonly used marker of IR. Plasma magnesium is a relatively cheap analyte and has been linked with the pathophysiology of IR. This study primarily was aimed at evaluating the possible use of plasma magnesium as a surrogate marker of IR in type 2 diabetes. Materials and Methods: The study was a hospital-based cross-sectional study carried out at a tertiary hospital in South-western Nigeria between March and September 2018. The study was conducted on 70 persons with diabetes, and age- and sex-matched 70 controls who met the eligibility criteria were recruited into the study. Ethical approval was obtained and informed consent was obtained from the participants. Fasting plasma glucose, fasting plasma insulin, and plasma magnesium were measured using standard protocols. HOMA-IR was determined using the appropriate formula. Data analysis was carried out using the Statistical Package for Social Sciences software, (SPSS) version 22. Results: The mean age of the participants was 53.34 ± 9.57 years and that of the gender-matched controls was similar. Frequency of hypomagnesemia was significantly higher in the participants compared with controls (25.7% vs. 5.7%; P &lt; 0.001). Similarly, a significantly greater proportion of the study participants (62.9%) had IR as expected compared with just 8.7% of the controls. The mean plasma magnesium (mg/dL) among the participants was significantly lower than that of the controls (1.73 ± 0.16 vs. 1.87 ± 0.14; P &lt; 0.001). As expected, the mean HOMA-IR in the participants was significantly higher than that of the controls (2.64 ± 0.91 vs. 1.71 ± 0.32; P&lt;0.001). There was a statistically significant negative correlation between plasma magnesium and IR among the participants (r=−0.443; P&lt;0.001). However, among the controls, there was no statistically significant correlation between plasma magnesium and HOMA-IR (r=−0.034; P = 0.778). Conclusion: Plasma magnesium was found to correlate significantly with IR and may be used as a surrogate marker of IR in persons with type 2 DM but not in the general population.

Knowledge of Risk Factors for Foot Ulceration among Patients with Diabetes Mellitus Attending a Tertiary Health Facility in Nigeria

Objective: Diabetic foot ulcer (DFU) is a relatively common complication of diabetes mellitus and constitutes a major cause of mortality. This study aimed to assess the knowledge of risk factors for foot ulceration among patients with diabetes in a tertiary health facility in South Western Nigeria. Materials and Methods: This cross-sectional study was initiated with participation of 100 diabetic patients. Diabetic patients were attending the medical outpatient clinic of the University College Hospital, Ibadan. A structured and validated questionnaire was administered and data was analyzed using SPSS 22. Association between sociodemographic characteristics and knowledge of risk factors for foot ulceration was evaluated by chi-square test. Results: Most of respondents were female (66%). The mean age of the patients was 58.77 (±11.8) years and 51% of patients did not know that it is possible to develop foot ulcer without feeling pain and 30% did not know that features suggestive of neuropathy could be associated with development of foot ulcer. 75% did not know that surgical vascular repair could play any role in the healing of a diabetic foot ulcer. 11% of patients were walking barefooted at home and as much as 63% of respondents did not know that poor longterm glycemic control could be a risk factor for the development of diabetic foot ulcers. Conclusion: The knowledge of the patients attending the diabetes clinic of a tertiary hospital in south-western Nigeria on foot care is generally poor. Education in this direction is very paramount to correct this defect.