Hospital In Southwestern Nigeria Research Articles

Molecular detection of OXA-48 and NDM-1 carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria

There have been increasing reports of Klebsiella pneumoniae resistant to β-lactam antibiotics. This study aimed to determine the prevalence of some selected carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria. The study was conducted over two months (February-March 2024). A total of 50 clinical isolates of Klebsiella pneumoniae from different clinical specimens were obtained from the Medical Microbiology Department, Babcock University Teaching Hospital (BUTH). The clinical isolates were then characterized using standard microbiological procedures and were tested for susceptibility to meropenem and other classes of antibiotics according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Polymerase Chain Reaction (PCR) detection for OXA-48 and NDM-1 carbapenemase genes was performed on the 50 clinical isolates. PCR analysis showed that 9 (18%) clinical isolates were positive for the OXA-48 gene, 22 (44%) were positive for the NDM-1 gene, 4 (8%) possessed both the OXA-48 and NDM-1 genes, and 23 (46%) possessed neither the OXA-48 nor NDM-1 genes. Antibiotic Susceptibility Testing (AST) revealed that all the clinical isolates were resistant to meropenem. In conclusion, this study demonstrates the presence of OXA-48 and NDM-1 genes in clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria, highlighting the role of ESBL (extended-spectrum beta-lactamase) as a major resistance mechanism alongside other mechanisms. Population-based surveillance programs should be implemented to monitor the prevalence and epidemiology of Klebsiella pneumoniae infections at the community level, facilitating early detection of outbreaks and identification of emerging antimicrobial resistance patterns.Core TipThis study highlights the significant prevalence of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae clinical isolates in a private tertiary hospital in Southwestern Nigeria, with 44% and 18% of isolates harboring these genes, respectively. Notably, 46% of isolates were resistant to carbapenems despite lacking these genes, suggesting alternative resistance mechanisms. The findings underscore the urgent need for enhanced surveillance, infection control measures, and antibiotic stewardship programs to combat the spread of multidrug-resistant Klebsiella pneumoniae in healthcare settings.

Helicobacter pylori Infection among Symptomatic Adults in a Tertiary Hospital in Southwestern Nigeria: A Retrospective Study

Aim: To determine the prevalence of Helicobacter pylori (H. pylori) infection among symptomatic adults in a tertiary hospital in a peri-urban setting in Southwestern Nigeria. Methodology: It was a retrospective, cross-sectional study conducted in the Medical Microbiology Laboratory, Department of Medical Microbiology and Parasitology, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigeria, between January 2022 and June 2024. The study involved a review of the medical microbiology laboratory records to evaluate the H. pylori stool antigen results of samples obtained from adults with gastrointestinal symptoms suggestive of H. pylori infection. Results: A total of 1061 adults were included in the study with females accounting for 56.2% of the participants. The age range of the participants was 18 – 95 years with a mean age of 34.59 + 15.51. The prevalence rate of H. pylori infection was 32.4% (344/1061). The infection was higher in females (50.6%) than in males (49.4%) and it was statistically significant (P = 0.011). However, a higher proportion (36.6%) of males had the infection than females (29.2%). The age group 21 – 30 years accounted for 23.3% of the H. pylori-positive participants while 37.6% of participants in the age group 41 -50 years were H. pylori-positive, however it was not statistically significant. Conclusion: H. pylori infection is prevalent among symptomatic adults in this locality. Hence, screening for H. pylori is recommended for detection, prompt treatment and eradication of H. pylori infection to prevent long-term complications.

Epidemiology of geriatric orthopaedic injuries in a tertiary hospital in southwestern Nigeria

Life expectancy in sub-Saharan Africa (SSA) has increased owing to economic growth and improvements in medical care. An increased representation of older people among orthopaedic trauma victims is a significant consequence of population ageing, as shown in previous studies, including few in SSA. This retrospective review in Nigeria aims to corroborate previous studies and highlight the emergence of geriatric orthopaedic trauma (GOT) as a public health concern in SSA. Among 241 orthopaedic trauma in-patients aged ≥ 60, the mortality rate was 3.7%. They made up 21.2% of adult orthopaedic trauma admissions. The incidence of GOT increased steadily over the five-year study period with a spike during COVID-19 lockdown. Males constituted 51%. Mean age was 72.5 years (range, 60–105 years). Mean distance to the hospital was 35.8 km and 50.6% lived farther than 10 km. The main causes of injury were falls (50.6%) and traffic crashes (48.1%). Fractures were the predominant (91.7%) injuries. Univariate analyses revealed significant differences along age and gender stratifications. Longer distance to the hospital significantly delayed presentation. The study supports previous studies and shows that GOT is evolving as a public health concern in SSA. The 2030 Sustainable Development agenda is apt to stem the trend.

Factors Influencing the Adoption of Technology in Pharmaceutical Service Delivery in Tertiary Hospitals in Southwestern Nigeria

The aim of this paper is to identify those factors determining the adoption of technology in pharmaceutical service delivery in selected tertiary hospitals in Southwestern Nigeria. The study was a cross-sectional survey of 132 pharmacists who were randomly selected from a pool of 186 pharmacists in eight of the sixteen tertiary hospitals in Southwestern Nigeria. Primary data were collected using a pre-tested structured questionnaire with items on a 5-point Likert scale of importance and weighting scores of 1-5. The data were analysed with the aid of SPSS statistical package version 21 using descriptive statistics including relative significance indexes (RSI) as well as ANOVA inferential statistics at p<0.05. The results show that the respondents’ knowledge (RSI = 0.96), skill in the application of technology (RSI = 0.94), quality of output of the technology (RSI = 0.91) and relative advantage over current technology (RSI = 0.91), were the key adoption influencing factors (F = 14.062, p<0.05). The chapter concludes that the main factors determining the adoption of technology in pharmaceutical service delivery in tertiary hospitals were pharmacists’ knowledge of technology and skill in the application the technology, among others.

Extent of use of digital technologies for records and information management in selected hospitals in Southwestern Nigeria

This cross-sectional survey aimed to identify the extent of the use of digital technologies in dental hospitals for records and information management. Questionnaire were administered to dental practitioners across six purposely selected dental Hospitals in Southwestern Nigeria. Amongst the 210 copies of questionnaire administered, 162 were completed, retrieved, and fit for the analysis, which resulted in a response rate of 77.1%. The extent of use of digital technologies for information management in the selected hospitals was measured by the period of purchase; number owned; frequency of use; current state of the technology; and the level of automation at the selected hospitals. Based on the period of purchase, most of the respondents (82.1%) have been using digital technologies for below 5 years. As regards the number of digital technologies owned; analysis showed that most (91.3%) of the hospitals have less than or equal to three digital technologies in use for information management. The frequency of use shows that majority (45.7% and 21.6% respectively) of the respondents never and rarely uses digital technologies for information management. However, a further investigation into the current state of the technologies owned showed that most of the respondents (65.4%) of the respondents have non-functional technologies. Furthermore, a 0% value was recorded on the question about the present level of automation of the selected hospitals. This showed that none of the hospitals have fully automated their information management processes. Finally, 80.2% of the respondents agreed that information management processes in their hospitals are totally paper-based.

Prevalence and Determinants of Sickness Absenteeism among Healthcare Workers in a Tertiary Hospital in Southwestern Nigeria

Introduction: Sickness absenteeism is a global problem that affects almost all forms of workers, especially healthcare workers. This study assessed the prevalence and determinants of sickness absenteeism among healthcare workers in a tertiary hospital in Southwest, Nigeria. Methods: An institutional-based, cross-sectional study was conducted among 360 healthcare workers in a Tertiary Hospital in Southwest, Nigeria from October to December 2022. A pre-tested interviewer-administered, semi-structured questionnaire was used to elicit information from the respondents who were selected using a stratified sampling technique. Bivariate analysis and binary logistic regression analysis were performed to identify the predictors of sickness absenteeism using SPSS version 25.0. The significance of associations was determined at p-value < 0.05. Results: The mean age ± SD of the respondents was 34 ± 7.15 years. The prevalence of sickness absenteeism among the health workers was 21.0%, while the causes of sickness absenteeism were malaria (51%), body pain (18%), and diarrhea (5%). Family obligation (AOR: 2.1, 95% CI: (1.20, 3.53), P=0.009) and the job type (AOR: 2.7, 95% CI: (1.05, 6.83), P=0.038) were the only predictors of sickness absenteeism. Conclusion: About one-fifth of the respondents had one spell of sickness keeping them away from work due to illnesses such as malaria, diarrhea, and body pain. Preventive interventions should be instituted by stakeholders based on the identified factors to reduce the prevalence of sickness absenteeism among these populations.

Hospitalization and mortality outcomes among adult persons living with HIV in a tertiary hospital in South-western Nigeria: A cross-sectional study.

HIV infection continues to be a major public health issue, with significant morbidity and mortality especially in resource poor areas. Infection with HIV results in an increased risk of opportunistic infections and other complications, which may lead to hospital admission and death. Morbidity and mortality patterns among hospitalized persons living with HIV (PLHIV) have been well documented in high income countries, but there is paucity of such data in Nigeria. We investigated the reasons for hospitalization and predictors of death among adult PLHIV at the Federal Medical Center (FMC) Abeokuta, Nigeria. This was a hospital based cross-sectional study carried out over a 15-month period between January 2018 and March 2019. All consenting hospitalized adult PLHIV who met the inclusion criteria were enrolled into the study. Causes of hospitalization and death were obtained and analyzed. Over the study period, 193 hospitalizations of PLHIV were studied. Although a number of clinical syndromes were documented, Sepsis and Tuberculosis were the commonest causes of hospitalization and mortality. Mortality rate was 37(19.2%) for outcomes on day 30, with anaemia [OR 3.00 (95% C.I: 1.04-8.67)], poor adherence with Cotrimoxazole [OR 4.07 (95% C.I: 1.79-9.28)], poor adherence with cART [OR 13.40 (95% C.I: 3.92-45.44)], and a longer duration of fever [OR 3.34 (95% C.I: 1.10-9.99)] being predictors of mortality. Part of the study's limitation was resource-constraint of some of the indigent patient which affected their ability to access some diagnostic investigations and get optimal care thereby impacting on their outcome. Despite the upscaling of cART, opportunistic infections and sepsis remain common causes of hospitalization and death in adult PLHIV. More attention should therefore be placed on early diagnosis, prevention of immunosuppression and sepsis through timely administration and adherence to cART and other prophylactic measures.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

Distribution patterns of airborne bacteria and fungi in a teaching, public and private hospital in southwestern Nigeria

Distribution patterns of airborne bacteria and fungi in a teaching, public and private hospital in southwestern Nigeria

Impacted Mandibular Third Molar Prevalence and Patterns in a Nigerian Teaching Hospital: A 5-Year Retrospective Study

Mandibular third molars are the most commonly impacted teeth. The prevalence and pattern of impacted mandibular third molars in patients presenting to the Obafemi Awolowo University Teaching Hospitals Complex, a tertiary hospital in south-western Nigeria, are largely unknown. This retrospective study examined 469 patient records, extracting socio-demographic and clinical information for analysis. It also determined the prevalence and pattern of impacted mandibular third molars from January 2015 to December 2019. The positioning of impacted teeth was assessed via periapical radiographs utilizing Winter’s classification. Data were subjected to analysis with IBM SPSS version 20, utilizing frequencies, percentages, and likelihood ratios, with statistical significance set at p < 0.05. The prevalence of impacted mandibular third molars within the study cohort was 2.51%, with a higher incidence observed in the 21–29 age group (p < 0.001). Mesioangular impaction was the most prevalent, with pericoronitis being the primary reason for extraction, and periodontal pockets being the most common associated pathology.

A correlation of 8-hour and 12-hour with 24-hour urinary protein among pregnant women with preeclampsia in a teaching hospital in South-Western Nigeria

Background and Objective: Proteinuria is one of the cardinal features of preeclampsia, which is a common and potentially severe complication of pregnancy. This study sought to determine how the quantitative measurement of urine protein from 8-hour and 12- hour samples correlate with that of a 24-hour sample in diagnosing preeclampsia.
 Materials and Methods: 52 eligible pregnant women with preeclampsia were recruited between April 2017 and April 2018. For each patient, having emptied the bladder at 0 hour, urine was collected into three different containers (containers 1, 2, 3) at 8th hour, 12th hour and 24th hour ensuring that the bladder was emptied into each container at hours 8, 12 and 24. Volumes of 8 hours urine (volume in container 1), 12 hours urine (total volume in containers 1 and 2), and 24 hours urine (total volumes in containers 1, 2 and 3) were measured and 5 ml aliquot respectively obtained from each sample for colorimetric analysis of urinary protein. Data was analyzed using the EPI Info software
 Results: A total of 52 patients completed the study. The mean gestational age was 33+ 2.82weeks. The mean 8-hour, 12-hour and 24-hour urinary protein values were 2.1+1.53, 2.3+1.52 and 3.1+1.89 respectively. There were significant correlations between the protein values of 8-and 12-hour urine samples with those of 24-hour urine samples
 Conclusion: 8-hour and 12-hour values of urine protein correlated positively with values in 24-hour samples and may be useful for initial assessment of cases of preeclampsia for prompt interventions.

Current Trend in the Epidemiology of Thermal Burn Injury at a Tertiary Hospital in South Western Nigeria.

Worldwide, thermal burn is the leading etiological type of burn injury accounting for 86% of burn injuries requiring admissions. Flame, Scald, and contact burn are the leading causes of thermal burn. Changes in the sociodemographic characteristics of societies have led to alterations in the epidemiology of burn. An understanding of such changes in the epidemiology of burn is essential in formulating and executing adequate burn prevention programs. We sought to establish the current trend in the etiology, gender distribution, age, occurrence of inhalation injury, burn surface area, burn depth, and mortality rate of thermal burns at Ibadan. This was a retrospective study carried out between January 2013 and December 2022. Thermal burns constitute 92% of burn injuries. The male-to-female ratio was 1.4:1. There were 265 (45%) patients in the pediatric age group and 323 adults (55% of the patients). The proportion of flame, scald, and contact burns were 378 (58%), 203 (32%), and 14 (2%), respectively. Flame burns resulting from liquified petroleum gas (LPG) explosion show a rising trend, with a decline in flame burns from kerosene (P < .001). One hundred and ninety (32%) patients had inhalation injury. The overall mortality was 19% (N = 114). Kerosene flame, 38% (17 of 45 patients), and LPG, 32% (41 of 130 patients), were the most lethal causes of flame injuries (P < .043). The study shows the increasing contribution of LPG to the etiology of thermal burn injuries. Burn prevention programs should target safe use of LPG stoves and cylinders.

Histopathological Outcome of Colonoscopic Biopsies in a Tertiary Hospital in Southwestern Nigeria: A 7-Year Retrospective Study.

Colonoscopy with histopathological analysis of mucosal biopsy samples remains the gold standard procedure for diagnosing lower gastrointestinal disorders. This study aimed to determine the pattern of histopathological findings of mucosal biopsies obtained at colonoscopy over a 7-year period and to correlate the histological findings with the clinical profile of the patients. This was a retrospective study conducted in a healthcare facility in southwestern Nigeria. The Histology reports from January 1, 2016, to December 31, 2022, were retrieved from the histopathology department of the institution to obtain the following information for analysis: age, gender, year of the test, presenting complaint, provisional clinical diagnosis, colonoscopy diagnosis, and histological diagnosis. The data of a total number of 81 patients were analyzed; 51 males (63.0%) and 30 females (37.0%) with a male-to-female ratio of 1.7-1. The age range of the patients was 30-86 years with a mean (±standard deviations) age of 59.87 ± 14.44. The most common indication for colonoscopy was hematochezia (23 (28.4%)) followed by change in bowel habit (16 [19.8%]), constipation (11 [13.6%]), and tenesmus (10 [12.3%]). Large bowel masses suggestive of cancers were the most common colonoscopy finding in the study subjects (36 [44.4%]). Colorectal cancer was the most common histologic abnormality in the study subjects (26 [32.1%]) followed by chronic nonspecific colitis (8 [9.9%]), polyps (7 [8.6%]), adenomas (5 [6.2%]) and acute on chronic colitis (5 [6.2%]). Twenty-two (27.2%) patients had normal histologic findings. Patients aged between 45 and 64 years had the highest prevalence of colorectal cancer (13 [50.0%]). Colorectal cancer was the most common histopathological finding in this study and the patients were mostly within the middle-age group. Early screening colonoscopy is therefore recommended and histopathological analysis of the mucosal specimens obtained is essential for early detection of premalignant lesions.

High Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Isolates Recovered in Nigerian Hospitals in 2016 to 2020.

Acinetobacter baumannii causes difficult-to-treat infections mostly among immunocompromised patients. Clinically relevant A. baumannii lineages and their carbapenem resistance mechanisms are sparsely described in Nigeria. This study aimed to characterize the diversity and genetic mechanisms of carbapenem resistance among A. baumannii strains isolated from hospitals in southwestern Nigeria. We sequenced the genomes of all A. baumannii isolates submitted to Nigeria's antimicrobial resistance surveillance reference laboratory between 2016 and 2020 on an Illumina platform and performed in silico genomic characterization. Selected strains were sequenced using the Oxford Nanopore technology to characterize the genetic context of carbapenem resistance genes. The 86 A. baumannii isolates were phylogenetically diverse and belonged to 35 distinct Oxford sequence types (oxfSTs), 16 of which were novel, and 28 Institut Pasteur STs (pasSTs). Thirty-eight (44.2%) isolates belonged to none of the known international clones (ICs). Over 50% of the isolates were phenotypically resistant to 10 of 12 tested antimicrobials. The majority (n = 54) of the isolates were carbapenem resistant, particularly the IC7 (pasST25; 100%) and IC9 (pasST85; >91.7%) strains. blaOXA-23 (34.9%) and blaNDM-1 (27.9%) were the most common carbapenem resistance genes detected. All blaOXA-23 genes were carried on Tn2006 or Tn2006-like transposons. Our findings suggest that a 10-kb Tn125 composite transposon is the primary means of blaNDM-1 dissemination. Our findings highlight an increase in blaNDM-1 prevalence and the widespread transposon-facilitated dissemination of carbapenemase genes in diverse A. baumannii lineages in southwestern Nigeria. We make the case for improving surveillance of these pathogens in Nigeria and other understudied settings. IMPORTANCE Acinetobacter baumannii bacteria are increasingly clinically relevant due to their propensity to harbor genes conferring resistance to multiple antimicrobials, as well as their ability to persist and disseminate in hospital environments and cause difficult-to-treat nosocomial infections. Little is known about the molecular epidemiology and antimicrobial resistance profiles of these organisms in Nigeria, largely due to limited capacity for their isolation, identification, and antimicrobial susceptibility testing. Our study characterized the diversity and antimicrobial resistance profiles of clinical A. baumannii in southwestern Nigeria using whole-genome sequencing. We also identified the key genetic elements facilitating the dissemination of carbapenem resistance genes within this species. This study provides key insights into the clinical burden and population dynamics of A. baumannii in hospitals in Nigeria and highlights the importance of routine whole-genome sequencing-based surveillance of this and other previously understudied pathogens in Nigeria and other similar settings.

Prevalence, Pattern, and Outcome of Gastroenterological Diseases in Primary Care Clinic of a Tertiary Hospital in Southwestern Nigeria

Purpose: Gastroenterological diseases have been documented to be common in primary care practice especially with data from western world. This study seeks to investigate its true burden and outcomes in primary care setting in this environment.&#x0D; Methodology: It was a 10-year retrospective cross-sectional study carried out at the general outpatient clinic of the family medicine department of Ekiti state university teaching hospital which is part of a larger survey and made use of secondary data.&#x0D; Findings: The study observed the prevalence of gastroenterological diseases in primary care to be 3.9% with majority of disorders being peptic ulcer disease and dyspepsia, 54.8% and 25.0% respectively. Gastroenterological diseases were poorly investigated in this study 12.2% with Abdominal Ultrasound been the most requested 63.6% and endoscopy request was 6.5%. The majority of those that presented with gastroenterological diseases were treated and discharged home, peptic ulcer diseases 100% and dyspepsia above 90%.&#x0D; Recommendations: This study showed that the prevalence of gastroenterological disorders in the primary care practice in our environment may not be as high as it’s been documented for other regions of the world. This study recommends further study into the prevalence of gastroenterological disorders using standardized definitions. Primary care doctors are encouraged to be abreast of the frequently changing diagnostic criteria in gastroenterology&#x0D;

DRUG-INDUCED DYSTONIA IN PEDIATRIC PATIENTS: PATTERNS AND OUTCOMES AT THE PAEDIATRIC EMERGENCY ROOM OF A TEACHING HOSPITAL IN SOUTHWESTERN NIGERIA

Drug-induced dystonia is a movement disorder characterized by involuntary muscle contractions and abnormal postures resulting from the use of certain medications. This study investigates the patterns and outcomes of drug-induced dystonia in pediatric patients presenting to the Pediatric Emergency Room (PER) of a teaching hospital in southwestern Nigeria. A retrospective analysis of medical records was conducted, focusing on pediatric patients diagnosed with drug-induced dystonia over a specified period. Demographic information, clinical characteristics, implicated medications, management approaches, and outcomes were analyzed. The study aims to provide insights into the epidemiology and management of drug-induced dystonia in the pediatric population in Nigeria, aiding in early recognition, appropriate treatment, and improved patient outcomes. The findings of this study contribute to the existing literature on drug-induced dystonia and inform healthcare providers about the specific challenges faced in the Nigerian context, facilitating targeted interventions and better patient care.

Intensive care unit deaths among neurosurgery patients in a tertiary hospital in South Western Nigeria

Background: Neurosurgical patients are the most critical ICU admissions. While advancements in neurosurgical ICUs (NICU) have improved outcomes of care globally, ICU mortality remains a major clinical issue in developing nations. This study evaluates ICU mortalities of neurosurgical patients in a general ICU setting at the UNIOSUN Teaching Hospital, Osogbo, Nigeria.&#x0D; Method: Case records of neurosurgery patients who died in the ICU of UNIOSUN Teaching Hospital, Osogbo, South-Western, Nigeria from June 2012 to May 2022 were reviewed. Simple descriptive statistics of data on demographics, clinical diagnoses, management and outcome were done.&#x0D; Results: Mortality rate was 38.9% (84 of 216 admissions). Males were 67(79.8%) and the mean age was 41.5years (Range: 2-85years). The average duration of ICU stay was 3.5days (Range: 30minutes-20days). Most patients had severe traumatic brain injury (TBI) (62, 73.8%). This was followed by cerebrovascular diseases (12, 14.3%) and brain tumours (6, 7.1%). Two had brain abscess. One patient each had mixed subacute/chronic subdural haematoma and severe cervical spondylotic myelopathy. Of the 69 whose case files were found, 7(10.1%) had a diagnosis of brainstem death before eventual 'final' death after an average of 13.5 additional hours on mechanical life support. The identified secondary causes of death included raised ICP, sepsis, primary surgical haemorrhage, seizures, acute kidney injury, malignant hypertension, poor glycaemic control and aggressive blood pressure lowering. Only 1 patient had autopsy.&#x0D; Conclusion: Most ICU mortalities among neurosurgical patients were from severe TBI. The establishment of NICU is necessary to improve outcome of care of neurosurgical patients.

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.