Nigerian Tertiary Health Institution Research Articles

Clinical Profile and middle cerebral artery velocity of children with sickle cell anaemia seen in UUTH, Uyo, Akwa Ibom state, Nigeria.

The risk of stroke in individuals with Sickle Cell Anaemia (SCA) can be assessed by routine non-invasive measurement of their cerebral blood flow using a Transcranial Doppler (TCD) ultrasound scan. This study aimed to determine the difference in blood flow velocity parameters in the middle cerebral artery (MCA) of children with sickle cell anaemia compared to a normal age-matched population. This was a hospital-based comparative cross-sectional study among 40 SCA patients aged 3-16 years, in steady state and 40 age and sex-matched HbAA healthy subjects. This study lasted from June to October 2019. Medical history was retrieved using a structured questionnaire. The time-averaged mean of maximum velocity (TAMMV) of the right and left MCA was measured using non-imaging TCD. The mean age ± SD of the SCA patients was 9.1 ± 4.4 years. The SCA patients and sex and age-matched HbAA group consisted of 23 (57.5%) males and 17 (42.5%) females respectively. SCA patients had a significantly lower mean ± SD haemoglobin (Hb) than the controls (7.1 ± 1.1g/dl vs 11.1 ± 1.4g/dl; p<0.001). The right MCA of the patients with SCA had a significantly higher mean flow velocity compared to the controls (94.1 ± 23.1 vs 55.0 ± 8.8cm/sec, p<0.001). The mean TAMMV recorded in the SCA subjects were significantly higher than that of the non-SCA subjects. There is a need to ensure that TCD ultrasound is employed as a routine screening tool for stroke risk among SCA patients in Nigerian tertiary health institutions.

Gestational diabetes mellitus: Awareness, risk factors, perceived effects, and lifestyle intervention among pregnant women in a Nigerian tertiary health institution

Objectives: To assess the awareness, risk factors, perceived effects, and level of awareness of lifestyle interventions for the prevention of gestational diabetes mellitus (GDM) as well as the association between educational background and the level of awareness of GDM. Materials and Methods: A cross-sectional survey of 244 antenatal women was carried out using a validated self-administered questionnaire containing five sections with sections A to E bordering on demographics, awareness of GDM, risk factors, perceived effects on pregnancy, and lifestyle interventions towards prevention from May through August 2021. Data were analyzed using descriptive statistics of frequencies, percentages, means, and standard deviation. The chi-square test was used to assess the association between educational background and level of GDM awareness. Results: Out of 244 respondents who showed awareness of GDM, 212 (86.9%) had an understanding of what GDM is, 212 (86.9%) knew the risk factors, 227 (93.0%) agreed that they knew the effects, 191 (78.3%) knew about lifestyle interventions. Despite the positive responses, disparities exist in their levels of awareness of each alleged variable. There was an association between educational background and level of awareness of GDM with a P-value of 0.0001 (&lt;0.05). Conclusion: The majority of antenatal women were aware of GDM, risk factors, effects, and lifestyle interventions with diverse degree levels. Less than half were fully aware of the risk factors, and the effects on pregnancy. Regular health/medical professional visits were the most acceptable lifestyle intervention for the prevention of GDM. There was a significant association between education and the level of awareness of GDM. Thus, the government is to enact strong policies that will favor female education as education is a strong determinant of awareness of disease conditions.

Burn Out and Psychological Distress among Care Givers of Dementia Patients Attending the Out Patient Geriatric Clinics of Two Nigerian Tertiary Health Institutions

Aim: This study investigated burnout and psychological distress among 460 caregivers of dementia patients attending the outpatient geriatric clinics of two Nigerian tertiary health institutions. Study Design: The study used the descriptive cross sectional study design. Place and Duration of the Study: The study was conducted at the outpatient geriatric clinics of two tertiary health institutions in Enugu, South East Nigeria between the months of July and August 2023. Methodology: A total of 460 care givers of dementia patients, aged 18- 65 years, attending the outpatient geriatric clinics of two tertiary health institutions in Enugu, who consented to participate in the study, were assessed for burnout and psychological distress using the Maslach Burnout Inventory (MBI), and the General Health Questionnaire (GHQ-12). Results: Result showed that 23.9% had emotional exhaustion, 14.6% had depersonalization and 18.5% had reduced personal accomplishment, while psychological distress was present in 39.6% of the respondents. Significant relationships were noticed between age and psychological distress, \(\chi\)2=57.36; p= 0.03; marital status and burnout \(\chi\)2=10.95; P= 0.01 as well as education and psychological distress \(\chi\)2=10.95; p= 0.05. Conclusion: High levels of burnout and psychological distress were present among the caregivers who participated in the study, in view of this there is need for government to ensure proper institutional care for dementia patients and provide some incentives for those who care for them. Policy formulation should also aim at establishing community caregiving centers were dementia patients can receive adequate attention from government agencies.

Self Esteem, Depression and Life Satisfaction among HIV out Patients Receiving Highly Active Anti Retroviral Therapy in a Nigerian Teaching Hospital

Aim: The aim of this study is to investigate self esteem, depression and life satisfaction in a sample of HIV patients receiving highly active anti retroviral therapy (HAART) attending a Nigerian tertiary health institution.&#x0D; Study Design: The descriptive cross sectional study design was used for the study.&#x0D; Place and Duration of the Study: The study was carried out at the HIV/AIDS clinic of the university of Nigeria teaching hospital Enugu in south east Nigeria between the months of January and February 2023.&#x0D; Methodology: A total of 480 HIV/AIDS positive patients on HAART aged between 23 to 61 years attending the HIV/AIDS clinic of the University of Nigeria Teaching hospital Enugu who consented to participate in the study were assessed for self esteem, life satisfaction and depression with the Rosenberg self esteem scale, the life satisfaction scale by Diener and the Beck’s depression inventory version two.&#x0D; Results: Results revealed that 53.7% of the HIV patients on HAART manifested no signs of depression; 63.8% had high self esteem and 73.1% were satisfied with their lives; however 25.2%; 15.8% and 5.5% showed signs of mild, moderate and severe depression respectively; 36.2% had low self esteem, whereas 26.9% indicated not being satisfied with their lives.&#x0D; Conclusion: Following the benefits of HAARTS on the management of HIV/AIDS patients as noticed in the study, there is need for health workers to ensure strict adherence on HAART regimen for optimum suppression of HIV as recommended by The World Health Organization; furthermore, there is need to ensure continuous provision of psychological support to all HIV/AIDS patients as a way of reducing the psychosocial sequelae associated with HIV/AIDS.

Outcomes of Evacuating Subacute Extradural Hematoma Through a Minicraniectomy: A 5-Year Study

Abstract Background Extradural hematoma (EDH) is a hematoma between the dura and the inner surface of the skull, found in 1 to 3% of all head-injured patients, rising to 9% among the unconscious ones. It is said to be subacute when about 2 to 4 days old. Further enlargement of the burr hole to about 3 to 5 cm wide (minicraniectomy) may allow its total evacuation. Objective To recommend it as a treatment option, this study aims to evaluate the surgical outcomes of evacuating a subacute EDH through a minicraniectomy. Method This was a 5-year prospective study in a Nigerian tertiary health institution. Results In total, 108 patients, consisting of 96 males and 12 females with a male to female ratio of 8:1 were included. Their ages ranged from 10 to 69 years. Etiologies were road traffic accident (RTA, 73.2%), assault (18.5%), and falls (8.3%). Hematoma ages were 2 days (61.1%), 3 days (25%), 4 days (13.9%). GCS were mild (11%), moderate (56%), and severe (33%). Locations were right-sided (59.3%), left-sided (40.7%) with 73.1% in parietotemporal area. Active bleeding was encountered in 15% only. Postoperative complications were seizure (13.9%), death (12%), and surgical site infection (4.6%) among others. Outcomes at 2 weeks were good (83, 76.9%), moderate disability (12, 11.1%), severe disability (10, 9.3%), vegetative (1, 0.9%), and death (2, 1.9%). Conclusion Considering the significant morbidity and mortality and the need for urgent interventions in EDH, most patients presenting in the subacute acute (2–4 days) stage can be evacuated via a minicraniectomy with good outcomes.

Economic burden and catastrophic cost among people living with sickle cell disease, attending a tertiary health institution in south-east zone, Nigeria.

Out-of-pocket spending and lack of adequate health policy support for people living with sickle cell disease in Nigeria may predispose to high economic burden and catastrophic cost. The objective of the study was to evaluate the economic burden and catastrophic cost of sickle cell disease patients in a Nigerian tertiary health institution. In this study, a cross-sectional descriptive survey design was used to study a sample of 149 sickle cell disease patients managed at University of Nigeria Teaching hospital Enugu, South east Nigeria. A structured pre-tested interviewer-administered questionnaire was used to collect primary data from adult participants and caregivers of paediatric patients. Data collection lasted for three months. The major findings were median monthly economic burden of approximately N76, 711 (US$385) per person. Of this, outpatient cost constituted approximately 88%. Admission, drugs and blood transfusion constitute the major contributors to the economic burden experienced by the sickle cell disease patients in the study. All socio-economic status groups suffered catastrophic expenditure but the poorest quartile had the highest incidence: 61% at 40% threshold, 71% at 30% threshold and at 88% at 10% threshold. Conclusion: economic burden was high for sickle cell disease patients who also suffered high catastrophic costs due to the impact of out-of-pocket expenditure. People living with sickle cell disease need financial protection especially for the poorest since they buy from the same market and incur same costs. Policy decision making to assist the sickle cell disease patients cope with cost of care is needful in Nigeria.

Awareness, perceived efficacy, and utilization of assisted reproductive technologies among women attending fertility clinic in a Nigerian tertiary health institution: a cross-sectional study.

Introductioninfertility is a source of distress for couples considering the high accolade placed on having children in family settings in Nigeria. Assisted reproductive technologies (ARTs) offer a chance for parenthood to couples. However, studies on knowledge of ARTs abound in Nigeria but no previous studies exist on the extent of utilization of assisted reproductive technologies. This study thus explored the level of awareness, perceived efficacy, and utilization of ARTs among women attending fertility clinics in a Nigerian Tertiary Health Institution.Methodsthis cross-sectional study which utilized a self-administered questionnaire was adopted for this study. The questionnaire contains five sections with sections A to E bordering on demographics, awareness, perceived efficacy, utilization, and factors influencing utilization respectively.Resultsone hundred and seven women with infertility problems, aged between 26 and 35 years with a mean age of 31.46 ±5.72 participated in the study. Sixty-two patients (57.9%) were aware of ARTs while 97 (90.7%) believed that ART cannot address male infertility. Only 27 (25.2%) admitted to having used ART procedures before while 82 patients (76.6%) stated that the cost of the procedure was the major hindrance to use.Conclusionawareness of ARTs is average while there is low utilization and perceived efficacy of ART. The high cost of the procedure remains the major setback to its utilization.

Knowledge, Attitude and Perception of Disability among Healthcare Workers in a Nigerian Tertiary Health Institution

In Nigeria, people living with disabilities often face unintentional poor treatment and neglect. This cross-sectional study was aimed at exploring the level of knowledge, attitude, and perception of healthcare professionals towards PLWD in Nnamdi Azikiwe Teaching Hospital, Nnewi Anambra State.

Relationship between Subjective Quality of Life and Major Depression among Outpatients with Rheumatoid Arthritis Attending a Nigerian Tertiary Health Institution

Background: Rheumatoid arthritis is a chronic and debilitating immunological disorder that majorly affects joints with swollen and painful characteristics. These patient-reported symptoms worsen their quality of life, which may consequently, predispose them to having major depression. Method: Using a simple random sampling, one hundred and eleven adult patients in the age range of 18 to 64 years with rheumatoid arthritis were cross-sectionally evaluated at the rheumatology Out-Patient Clinic of the Lagos State University Teaching Hospital. The socio-demographic questionnaire, WHO Composite International Diagnostic Interview (CIDI), World Health Organization Quality of Life Scale Short Form (WHOQOL- BREF) were administered to participants to obtain their demographic/clinical variables, make diagnosis of depressive disorder and assess their subjective quality of life respectively. Results: About one-third (n=33; 29.7%) of the participants reported having current depressive disorder. None of the tested variables after controlling for the cofounders was found to be an independent risk factor for current depression among the participants. Conclusion: The prevalence of major depressive disorder is high among individuals with rheumatoid arthritis, and specialists managing this population should routinely screen for depression in patients with rheumatoid arthritis.

Age-Related Pattern of Dental Trauma in a Nigerian Tertiary Health Institution

Age-Related Pattern of Dental Trauma in a Nigerian Tertiary Health Institution

A Survey on Patients' Opinions of Alternative Drug Delivery Systems for the Treatment of Glaucoma in South-South Nigeria.

Despite the human ocular surface being easily accessible, ocular drug delivery can be challenging. When applied improperly, topical medications, the most popular first-line treatment used to treat glaucoma, can have a very brief contact time with the ocular surface and may not have the desired therapeutic impact. Drug delivery devices are gadgets that can address some of these problems. This study aims to determine patients' opinions on ocular drug delivery devices used in the treatment of primary open-angle glaucoma (POAG). A pretested interviewer-administered questionnaire was used in a cross-sectional study of 115 POAG patients recruited from outpatient clinics in two Nigerian tertiary health institutions. Participants were asked about their understanding and acceptance of five Ocular drug delivery systems (ODD), namely drug-emitting contact lenses (CL), punctual plugs, subconjunctival injections, intracameral implants, and trabecular meshwork micro-stents, for the treatment of POAG. Sixty (52.2%) participants, whose average age was 50 ± 9.8 years, were men. Self-pay was used for eye health treatments by 65% of participants. Of the participants, 68.7% admitted to using eye drops on their own. 57% of people were said to take their glaucoma medications consistently. CL and subconjunctival implants were seen to be most acceptable according to 39% and 30% of participants, respectively. Major factors determining the acceptability of ODD for POAG treatment were observed to be cost and effectiveness. Patients in our cohort who are being treated for POAG have a fairly positive attitude towards ODD. The prospective use of these devices for POAG treatment in Nigeria will depend on their efficacy and cost, as well as how ophthalmologists will weigh ODD options.

Prevalence and outcome of care among patients with spinal cord injury in a Nigerian Tertiary Health Institution

ObjectiveThis study assessed the prevalence, causes, pattern of management and outcome of care among patients SCI in University College Hospital, Ibadan, Nigeria. MethodsThe study adopted a retrospective research design and case files of all patients with spinal cord injury that received treatment at the hospital from 2015 to 2018 were used for the study. A self-developed checklist was used for data collection. Collected data were analysed using the statistical package for the social sciences (SPSS) version 25. The data were presented with descriptive and inferential statistics at a significance level of p = 0.05. ResultsFindings showed that 132 admitted patients out of a total of 850 admissions over four years had SCI with a prevalence rate of 15.5% with highest percentage in 2018 and 65.2% of the SCI resulted from trauma and 34.8% were non-traumatic. Majority of the patients (99.2%) were given analgesics, 97.7% were placed on bed resting, 90.2% received psychotherapy, 89.4% were placed on adequate nutrition, 71.2% were placed on anticoagulants 68.2% placed on catheterization and 57.6% benefited from surgery. Findings also showed that outcomes of care for spinal cord injury ranges from Paraplegia (29.5%), salvaging of bladder or bowel continence (25.0%) and Quadriplegia (15.2%). ConclusionThe study concluded that there is high prevalence of SCI and trauma, road traffic accident and occupational hazard were the major causes of spinal cord injury.

Oral pyogenic granuloma: Analysis of 137 cases that presented in a Nigerian tertiary health institution

&#x0D; &#x0D; &#x0D; &#x0D; Background: Oral pyogenic granuloma is a common oral lesion among African population. It often presents as a painless, pedunculated, or sessile mass within the oral cavity. However, etiopathogenesis of oral pyogenic granuloma is still debatable. This article reviewed and identified the possible predisposing factors to the development of oral pyogenic granuloma amongst patients presenting at a sub urban tertiary health care facility.&#x0D; Methods: Information about 137 patients that presented with pyogenic granuloma from January 2009 to December 2019 were retrieved from the records department of Federal Medical Centre, Nguru. The data that were reviewed and analyzed included ages of patients, gender, anatomical site of lesions, treatment instituted as well as clinical and histopathologic features.&#x0D; Results: Patients ages ranged from 10 to 70 years (mean=41.02± 2.1 years), with the greatest degree of occurrence (29.19%) in the third decade of life. The male-to-female ratio was 1:1.7. The most frequently involved site was the gingiva. Other sites where pyogenic granuloma was located were the tongue, check mucosa, and palate. Oral pyogenic granulomas were more prevalent in the maxilla than in the mandible, with the labiobuccal gingiva of both jaws more commonly affected. The main complaint of the patients was painless swelling associated with occasional bleeding. More than half of the lesions had a pedunculated base, with surface ulceration in some cases. All lesions were surgically excised, although 8.03% of the cases existed as recurrent lesions.&#x0D; Conclusion: Although the clinicopathologic features of oral pyogenic granuloma in the study population were similar to those previously reported and their aetiology multifactorial, this study revealed that poor oral hygiene status of patients played a major role in their development.&#x0D; &#x0D; &#x0D; &#x0D;

Knowledge of Exclusive Breastfeeding among Nursing Mothers Attending under 5 Welfare Clinic in a Nigerian Tertiary Health Institution

Background: Exclusive Breastfeeding (EBF) offers important protective effects on child survival. Knowledge on EBF is a prerequisite to enhance its practice among nursing mothers.&#x0D; Objective: To determine the knowledge of exclusive breastfeeding practice among nursing mothers attending Under-5 Welfare Clinic in a tertiary health facility in Nigeria.&#x0D; Materials and Methods: This was a cross-sectional descriptive study involving 333 nursing mothers. Pre-tested self/interviewer administered questionnaires were used to obtain information from consenting eligible women. Knowledge was assessed using a 12-point score and classified as good or poor. Data obtained was analyzed using IBM SPSS version 25.&#x0D; Results: Our respondents had a mean age of 31±4.9years while 84.7% were 27 years and above. Majority were married (93.1%) with 57% of them having at least two (2) living children. Well over half of the respondents had attained a tertiary education. Antenatal care (ANC) was attended by 94.9% of the women where 96.8% said they had received advice on EBF. A total of 86% of the women had good knowledge score of EBF. Educational status and occupation showed statistically significant association with knowledge of EBF among the mothers (p=&lt;0.001 and p=0.018) respectively while marital status (p=0.046), number of living children (p=0.001), educational status (p=&lt;0.001) and occupation (p=0.050) all showed significant association with ANC attendance.&#x0D; Conclusion: The effect of female education on knowledge of health issues is brought to the fore by the findings of this study. More emphasis on delivering at health facilities where information to women on the practice of optimal breastfeeding is readily available will go a long way to reduce the infant and maternal mortality rates in Nigeria.

Obstetric and gynaecologic admissions in an intensive care unit in a Nigerian tertiary health institution

Rationale: Obstetric and gynaecological patients with critical medical or surgical complications represents unique challenge to the Obstetrician and Gynaecologist and often require multi-disciplinary management in a hospital intensive care unit. Objectives: To determine the common indications for ICU (intensive care unit) admission, management and outcome. Methods: This was a retrospective study carried out over a period of 4 years from January, 2015 to December, 2018. All the case notes of obstetrics and gynaecological patients admitted in to the intensive care unit of the Usmanu Danfodiyo University Teaching Hospital, Sokoto were retrieved. from the medical records department and intensive care unit. Relevant information was extracted and the data obtained was analysed using the SPSS software version 20. A p-value of &lt;0.05 was considered statistically significant and the results are expressed in tables and charts. Findings: Out of 716 ICU admissions, 131 Obstetrics and gynaecological patients accounted for 18.16%. Among them, 83.1% comprised of obstetrics while 18.2% are gynaecoloical cases. The main indication for ICU admission is for observation in very high risk patients post-operatively (66.3%). Blood transfusion is the most common intervention offered (54.5%). The most common complication noticed is AKI (11.1%) with mortality rate of 24.7% The mean duration of CU stay is 2.8 &plusmn; 3.5 days There is statistically significant association between duration of hospital stay and maternal death at P= 0.01. Conclusion: Obstetric cases remain the most common indication for ICU admission. Hypertensive disorders of pregnancy being the leading cause and acute renal impairment as the most common complication.

Histopathologic Characteristics of Childhood Malignant Tumours in a Referral Medical Centre in Nigeria

Background: Diseases of children in most developing countries revolve commonly around infectious disorders and malnutrition. However, other conditions including neoplastic diseases may be unassuming challenges to the attending physician. The objective of this study was to determine the epidemiological and histopathological pattern of malignant tumours among children in a northern Nigerian tertiary health institution. Materials and Methods: This is a retrospective study of malignant tumours in children aged fifteen years and below diagnosed over a ten year period (1st January 2011- 31st December 2020). Histopathology laboratory records at the Department of Pathology, Federal Medical Centre, Birnin Kebbi, Kebbi state, were reviewed and all diagnoses of malignant tumours were extracted. The findings were compared with similar studies elsewhere. Results: There were 36 children with confirmed cases of malignant tumours; 22 males and 14 females. The male to female ratio was 1.7:1. The peak age of incidence was 11-15years. The most common childhood malignant tumours were rhabdomyosarcoma, retinoblastoma, osteosarcoma, non-Hodgkin's lymphoma and squamous cell carcinoma. Head and neck region was the commonest area of affectation. Conclusion: The most common malignant tumours in children in our setting are sarcomas and small round blue cell tumours of childhood affecting predominantly older male children with head and neck regional predilections. Malignant tumours in children though not very common, are an important aspect of paediatric disorders to the attending physician due to their high morbidity and mortality. The diagnosis of such can be challenging to the pathologist, especially in resource constrain environments. High index of suspicion is therefore advocated to detect the tumour in its early stage that is associated with low morbidity and mortality.

Radiographic assessment of endodontic accidents at a Nigerian tertiary health institution: A one-year retrospective study

Introduction: Dental treatment can produce iatrogenic injury to the tooth with endodontic procedural errors occurring during the various stages of endodontic treatment. This study determined the prevalence and pattern of endodontic accidents in clinical practice at a tertiary health center in Nigeria.&#x0D; Methodology: This was a retrospective study of teeth treated with conventional hand-held file systems. Digital peri-apical working length, pre-obturation and post obturation radiographic images of teeth which received root canal treatment, were assessed for the presence or absence of errors. All errors present were recorded and data analysis was done using IBM SPSS version 22.0.&#x0D; Results: The prevalence of procedural errors was 31.3% with ledges being the most prevalent error followed by transportation while gouging was the least encountered error. Majority (83.8%) of the errors occurred during root canal instrumentation. A higher proportion of molars had errors compared to the other types of teeth with the prevalence of errors increasing from incisors to premolars and then to molar teeth. The mandibular molars were found to be most frequently involved in procedural errors.&#x0D; Conclusion: The prevalence of procedural errors seems high. Practitioners should show greater care during the canal preparation stage and to maintain the accuracy of the working length throughout the procedure, as errors which occur during canal preparation accounted for the vast majority of errors seen in this study. Special care should be taken when working on molars, which had a significantly higher error rate when compared to anterior teeth or premolars.

Gender, Age, Marital Status and Quality of Life in a Sample of HIV Clinic Attendees in a Nigerian Tertiary Health Institution

Quality of life has to do with the extent to which a person sees himself or herself as being healthy, comfortable and has the ability to enjoy or take part in life events. Human immunodeficiency virus (HIV) is a virus that attacks immune cells called CD4 cells. When HIV targets and infiltrates these cells, it reduces the body’s ability to combat other diseases. As HIV disease progresses the quality of life of the individual worsens. This study looked at the relationship between age, sex, marital status and Quality of life among 480 HIV/AIDS clinic attendees in a Nigerian tertiary health institution using the WHO-QOL BREF. 31.9%; 34.8% and 33.3% respectively had high, moderate and low quality of life respectively. The relationship between quality of life and gender was significant. Discussion of the result was based on literature reviewed and recommendations to guide policy formulation were proffered.

Evaluating The Effectiveness Of Donor Recruitment Strategies Towards Improving Availability Of Blood Product In Nigerian Tertiary Health Institution

Abstract Introduction/Objective Over the years, many strategies has been put in place to improve blood donations and overcome socio-cultural myths and fear that has held groups of people from voluntary blood donation in Nigeria and other subsahara africa countries. Among these are adequate education, approaches through religious group leaders, non-monetary incentives like giving them special awards during world blood donor day. The aim of this study is to evaluate the effectiveness and adequacy of our blood donor recruitment and retention strategies in improving availability of blood product in our institution Methods For this cross sectional retrospective study, Data including blood donation and break down of pattern of donations, request for blood products, monthly units of blood issued gotten from our 5 year Transfusion services records were searched, same entered into Microsoft Excel and the were analysed Results Our voluntary non-renumerated blood donation steadily increased from 4.55 in 2015 to 33.3% in 2019, this represent a five fold increase in our voluntary donor recruitment within the period under review. However overall blood donation rate remained steady at approximately 12000 units per annum over this period of time. There is an increase in request rate, on the average the rate of blood request was 1214 units per month in 2015, but in 2018 this has increased to an average of 1738 units per month and by 2019 average rate of request was 2300 units per month. Out of this huge request only 67.9% of them was met, implying a huge deficit in our blood availability despite increasing pool of voluntary blood donor. Conclusion Findings in this study revealed a steady increase in the pool of voluntary blood donor which did not reflect in our overall blood availability. This might be due to concurrent decrease in our family replacement donor. This finding also suggests that even though our current strategy used in donor recruitment and retention might seems effective, they are still not adequat, as there is no commensurate rise in blood donation to match the progressive increase in blood demand. In the face of this inadequacy it might be expedient to also audit the blood ordering pattern in our centre in order to reduce wastage while we continue to work towards increasing the voluntary blood donor base.

The diagnostic utility of cell block in fine needle aspiration cytology of palpable breast lesions in a Nigerian tertiary health institution.

Although fine needle aspiration cytology (FNAC) is highly accurate for detecting breast malignancies, concerns remain among cytopathologists about false-positive and false-negative diagnoses. Cell block (CB) preparations have been advocated by some cytopathologists as one of the methods to improve and consolidate the diagnostic accuracy of FNAC. The aim of this study was to determine the diagnostic utility of CB in FNAC of palpable breast lesions among female patients. Following FNA, CBs were prepared using 10% neutral-buffered formalin from the residual breast aspirates of 100 consecutive female patients attending the FNAC clinic. The slides of the conventional smears, CB and excisional biopsies were examined, and results were analysed using the SPSS. Of the 100 patients that had FNAC, 44 (44%) had excisional biopsy performed. An additional 13% diagnostic yield for malignancy was obtained with the use of CB preparations. CB reduced equivocal diagnoses by 25%, corresponding with 90.9% improvement on definitive diagnoses. In our setting, the addition of CB to smear remarkably improved the diagnostic utility of breast FNAC by minimising atypical and suspicious for malignancy diagnostic categories.