Obafemi Awolowo University Teaching Hospitals Research Articles

Perception of Health Information Management Professionals on the Importance of Computer System in Health Information Management in Obafemi Awolowo Teaching Hospital, Ile- Ife, Osun State, Nigeria

Healthcare system in this contemporary time is moving towards digitalization with respect to management of patients’ health information, this is however pertinent to achieve improved healthcare quality, Information and Communication Technology (ICT) in hospital settings. The process therefore requires migrating from paper records to Electronic Health Records (EHRs) particularly in Africa where it has been a lingering challenge. However, adopting technology in the management of patient records will provide more accurate and details patient’s profile. This study therefore investigated perceptions of health Information Management Professionals on the importance of computer system in health information management in Obafemi Awolowo University Teaching Hospital ,Ile-Ife, Osun- State, Nigeria. A descriptive survey design was adopted and thirty (30) Health Information Management Professionals were randomly selected from Obafemi Awolowo Teaching Hospital.

Perception of Health Information Management Professionals on the Importance of Computer System in Health Information Management in Obafemi Awolowo Teaching Hospital, ILE- IFE, Osun State, Nigeria

Healthcare system in this contemporary time is moving towards digitalization with respect to management of patients’ health information, this is however pertinent to achieve improved healthcare quality, Information and Communication Technology (ICT) in hospital settings. The process therefore requires migrating from paper records to Electronic Health Records (EHRs) particularly in Africa where it has been a lingering challenge. However, adopting technology in the management of patient records will provide more accurate and details patient’s profile. This study therefore investigated perceptions of health Information Management Professionals on the importance of computer system in health information management in Obafemi Awolowo University Teaching Hospital ,Ile-Ife, Osun- State, Nigeria. A descriptive survey design was adopted and thirty (30) Health Information Management Professionals were randomly selected from Obafemi Awolowo Teaching Hospital. The result revealed that majority of Health Information Management Professionals agree that computer science is of high importance in Health Information Management as it was seen as critically important for effective clinical documentation and patients’ management care. It was recommended among others that governments at all level should provide adequate and updated facilities for hospitals to enhance effective Electronic Health Records (EHRs) with required training for Health Information Management Professionals.

Effect of Intravenous Fluid on Perioperative Plasma Sodium Concentration in Paediatric Surgical Patients

Background: There have been various publications on the risk of developing iatrogenic hyponatraemia following intravenous fluid administration in the pediatric age group. The aim of this study was to determine the suitable maintenance fluid that sustains normal plasma sodium levels in children in the perioperative period by comparing 4.3% dextrose in 0.18% saline with Ringer’s lactate when either is administered as maintenance fluid. Method: This study was carried out at the paediatric surgery unit of the Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria between 1st September 2014 and 31st October 2015. This study is a comparative prospective study. There were 25 children in each group. One group received 4.3% dextrose in 0.18% saline, while the other group received Ringer’s lactate as maintenance fluid in the perioperative period. Serial blood and urine samples were collected before, during and after the surgery up till the first 24 hours. These samples were analyzed for sodium and creatinine concentration. Fractional excretion of sodium was calculated. Results were analyzed using SPSS software version 22. Results: There was no statistical significant difference between the two groups (p0.49) in term of age. The proportion of patients that developed hyponatraemia in the group that received hypotonic fluid was 32% (8/25), while it was 8% (2/25) in the group that received isotonic fluid (p=0.034). The patients who received Ringer’s lactate as maintenance fluid also had a higher mean plasma sodium concentration during the study. Conclusion: Ringer’s lactate was found to be a better fluid in terms of preventing hyponatraemia in children who are five years and below during the perioperative period compared to 4.3% dextrose in 0.18% normal saline.

Developing a breast cancer tissue biobank in low and middle income countries (LMICs): A research program-based approach for improving molecular profiling.

e12585 Background: Breast cancer incidence and mortality is increasing in LMICs especially in sub-Saharan Africa, attributed to changes in lifestyle and possible biological differences. To study putative relationships among lifestyle factors, tumor biology, and the microenvironment, we aimed to develop a breast cancer tissue biobank linked with clinicopathologic and patient reported data in this resource constrained setting. Methods: We prospectively enrolled patients undergoing mastectomy at Obafemi Awolowo University Teaching hospital in Ile-Ife, Nigeria. Pre-operatively, a locally validated survey tool assessed lifestyle factors (diet and exercise); BMI and body composition (by bioimpedence) were measured. Fresh breast tissue was frozen or preserved in 10% neutral buffered formalin, or RNA later for future metabolomic work. Immunohistochemistry (IHC) for ER/PR and HER2 status was performed and read in Nigeria by a locally-trained pathologist, and Memorial Sloan Kettering. The primary outcome was feasibility assessed by successful collection of tissue, clinicopathologic data, and survey completion. Secondary outcomes were completion rate of tumor receptor IHC compared to historic rates and concordance of local vs MSK IHC. Results: From April 2018 to June 2019, 50 patients were enrolled (49 treatment and 1 risk reduction mastectomy). Clinicopathologic, body composition, and survey data, along with breast tissue were collected from all 50 patients. Patient characteristics in table below. Receptor IHC was complete in all patients (100%) compared to a historic rate of 29% (83/286) between 2010-17. Concordance of IHC between sites was 86%, 81% and 84% for subtypes (ER/PR/HER2). Conclusions: Establishing a tissue biobank with clinicopathologic and lifestyle data using locally-adapted protocols is feasible in Nigeria. Patient enrolment is ongoing and updated data will be presented. This initiative also increased local capacity for breast tumor phenotyping, which has critical implications for improving patient care. [Table: see text]

Cardiac diseases in pregnancy: A 10-year review in a tertiary hospital in South-west Nigeria

Background: The superimposition of the morbidity of cardiac diseases on the physiological demands of pregnancy could impact adversely on pregnancy outcomes. Therefore, contemporary information is for appropriate clinical management. Objective: To determine the management outcomes of cardiac diseases in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Methods: A retrospective review of the hospital records of patients with cardiac diseases in pregnancy between January 2006 and December 2015 was conducted. The age, parity, gestational age at admission, NYHA class, clinical diagnosis, the results of investigations, complications of cardiac diseases, and maternal and foetal outcomes were recorded. Results: There were 33 women with cardiac diseases in pregnancy and 11,352 deliveries within the period, giving an incidence of 2.9 per 1000. Further analysis was based on 24 women with complete records. The mean age of the patients was 29.2±5.5 years. Twenty (83%) of the women were Para 2 or less, while 13 (54%) presented postpartum. The majority of the women (15; 62.5%) had peripartum cardiomyopathy, while 17 (71%) had NYHA Class III or IV disease. Thirteen (54%) women had vaginal delivery. There were four perinatal and two maternal deaths, with a perinatal mortality rate of 166/1,000 total births and maternal mortality ratio of 8,333/100,000 live births. Conclusion: Cardiac diseases in pregnancy are associated with high perinatal and maternal mortality rates at the OAUTHC, Ile-Ife. However, with early diagnosis and appropriate care, the majority of the patients had a satisfactory clinical outcome. Early presentation and advocacy to improve health-seeking behaviour are recommended.

Clinicopathologic characteristics of epithelial ovarian tumours in Ile-Ife, Nigeria

Background: Epithelial ovarian tumours (EOT) have complex clinicopathologic characteristics and biological behaviours. There are benign, borderline and malignant ovarian tumours and the commonest ovarian tumours in many regions are of epithelial origin. Many studies have described the histomorphological characteristics of the tumours. Objective: To describe the clinical and histopathological features of epithelial ovarian tumours. Methods: This was a retrospective review of the histopathology reports of all epithelial ovarian tumours specimens submitted to the Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife from January 2005 to December 2014. The EOT cases were described in terms of age, clinicopathological characteristics and distribution of histological types. Results: The frequencies of benign, borderline and malignant EOTs were 41.2%, 3.9% and 54.9% respectively and the patients were aged 23 to 94 years (mean 46.5±2.6 years). The majority of cases were often asymptomatic. Conclusion: Abdominal swelling was the most common presenting complaint while serous ovarian tumours were the most preponderant histological types.

Patterns of chronic illness among older patients attending a university hospital in Nigeria.

The rising burden of chronic diseases has attracted the attention of public health researchers and policymakers worldwide. To assess the demographic, morbidity and outcome patterns of chronic illness among the older patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Retrospective study. Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Seven hundred and eighty-eight (788) adults (60 years and over) hospitalized between 2010 and 2014 in the hospital. None. The age of the selected study population ranged from 60 to 99 years with a mean of 76.08(±10.42). More than half (53.0%) were between 60-69 years, with a subsequent decline. Male patients accounted for 64.0%, but females were more frequent among patients 80 years and older. The most common health conditions were heart diseases (22.5%), neoplasm (13.2%), cerebrovascular accident (12.4%), and gastrointestinal diseases (14.5%). The records showed that 14.9% were referred to other institution for various reasons (including further management, lack of space, industrial action by workers, discharged against medical advice or dead). Heart diseases were the major chronic illnesses among the older adults followed by neoplasm conditions, while musculoskeletal conditions were the least. It also found that there was a poor outcome of conditions among older adults in this setting. Therefore, efforts should be made towards the prevention and reduction of chronic illnesses, as well as improving the outcome of care. Doctoral Fellowship from Consortium for Advanced Research Training in Africa.

SUN-008 ACUTE KIDNEY INJURY IN PATIENTS WITH PREGNANCY INDUCED HYPERTENSION: A SINGLE CENTRE EXPERIENCE

Pregnancy induced hypertension (PIH) remains a major cause of feto-maternal morbidity and mortality especially in developing countries. The severe forms (severe pre-eclampsia and eclampsia) are potentially life threatening and may be accompanied by multi-organ involvement. AKI is one of the complications of PIH. We present a single center, 8 year retrospective review of 223 patients with PIH. We aim to determine the spectrum of renal dysfunction in patients with PIH. Clinical records of cases managed for pregnancy induced hypertension at the Obafemi Awolowo University Teaching Hospitals’ Complex, Ile Ife between Jan 2008 and Jan 2016 were retrieved. A proforma was used to collect information on their demographics, obstetric data, and laboratory parameters, length of hospital stay as well as maternal, renal, and fetal outcomes. Patients with history or clinical evidence of hypertension before 20 weeks gestation; diabetes mellitus, or chronic kidney disease prior to pregnancy were excluded from the analysis. Renal outcomes were defined as Acute Kidney Injury (AKI) or the need for renal replacement therapy (RRT). Data obtained were analyzed using Statistical package for Social Sciences (SPSS) version 22. There were a total of 223 cases admitted for PIH during the 8 year study period. Mean age at presentation was 29.0 (±5.8) years. Estimated gestational age (EGA) at presentation ranged between 24 – 44 weeks with a mean EGA of 35.2(±4.1) weeks, 48.8% had severe pre-eclampsia while 40.8% of the study population had eclampsia. Mean systolic and diastolic BP at presentation were 172±24 mmHg and 110±17 mmHg respectively. Fifty one patients (22.9%) had an admission serum Cr ≥ 90µmol/L. Thirty two patients developed AKI (14.3%). Their mean serum creatinine at presentation was 204.1± 76.5µmol/L. Of the 32 patients with AKI, 18 (56.3%) had oliguric AKI. Four patients (12.5%) required RRT only, 6 (18.8%) required both RRT and ICU admission while the remaining 22 (68.7%) were managed conservatively. All our patients had at least 1+ proteinuria by dipstick at presentation. Majority of the patients were delivered at term by emergency caesarian section. AKI remains an important complication of PIH and oliguric AKI is the commonest presentation in the studied population.

Intracranial abscesses in children at Ile-Ife, Nigeria: a case series and review of literature.

Central nervous system (CNS) infections are significant causes of morbidities and mortalities in children with some being prone to the development of abscesses which can either be within the brain parenchyma or located in extracranial structures. We aimed to describe the clinical profile and outcome of children with cranial abscesses at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Consecutive cases presenting at the Children Emergency Ward of OAUTHC Ile-Ife were recruited. The pattern of presentation, predisposing factors and outcome of these children were studied. Among the 641 children admitted within a 6-month period, six were diagnosed with cranial abscess giving a hospital prevalence of 0.9%. The mean duration of symptom prior to presentation was 12.7 ± 13.4days. Five (83.3%) of the patients had intracranial abscesses which were multiple in two (33.3%) children. One patient had Pott's puffy tumour following frontal sinusitis. Surgical management was done for two (33.3%), and this was by craniotomy and evacuation. Two of the patients died with a case fatality rate of 33.3%. Though uncommon, cranial abscesses remain life threatening in children especially in resource-poor settings. Early presentation and early treatment of local infections will improve outcome.

Aflatoxin Detection and Quantification in Stored Cowpea Seeds in Ibadan, Nigeria

Aflatoxins were reportedly detected in the kidney of 58% of deceased children caused by kwashiorkor at Obafemi Awolowo University Teaching Hospital, Ile-Ife. The incidence of kwashiorkor in West Africa has since been associated with aflatoxin contamination of human diets. Although, more researches need to be conducted to proper ascertain the level of menace caused by Aflatoxin ingestion in humans, the frequency of occurrence on stored cowpea seeds in Nigeria was the aim of this research. The procedure described by Association of Official Analytical Chemists AOAC [1] was used in the detection and quantification of Aflatoxins present in stored cowpea seeds in Ibadan, Nigeria. Aflatoxins B1, B2, G1 and G2 were detected in all cowpea samples analyzed. Samples collected from Oja-Oba market were found to contain the highest amount Aflatoxins i.e. B1 (1.5 × 10-2 µg/g), B2 (0.80 × 10-2 µg/g), G1 (0.60 × 10-2 µg/g), and G2 (1.0 × 10-2 µg/g) compared to those found in other market locations, the control setup and WHO [2] standards (P ≤ 0.05). The result of this study calls for public health concern due to the high level of Aflatoxins found in cowpea seeds from local markets in Ibadan, Oyo State, Nigeria. Utmost care should be taken to minimize or totally eliminate postharvest pathogens that produce mycotoxins in stored grains and pulses.

Abstracts presented at the 12th Scientific Conference of Society for Gastroenterology and Hepatology in Nigeria (SOGHIN) held on July 11-12, 2019 at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria

Abstracts presented at the 12th Scientific Conference of Society for Gastroenterology and Hepatology in Nigeria (SOGHIN) held on July 11-12, 2019 at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria

A Southwest Nigerian tertiary hospital 5-year study of the pattern of liver disease admission

Background: Liver disease is a major cause of morbidity and mortality globally. Its pattern varies with different geographical locations and these variations are determined by lifestyle, environmental, and genetic factors. This study determined the pattern, clinical presentations, risk factors, and determinants of morbidity and mortality in patients with liver disease admitted into a tertiary hospital in Ile-Ife, Nigeria, over a 5-year period; 2013–2017.Methods: Case records of patients admitted into the medical wards of Obafemi Awolowo University Teaching Hospital, Ile-Ife, with a diagnosis of liver disease were retrieved and information relating to demographics, risk factors, and types of liver disease as well as the results of relevant investigations, duration, and outcome of admission was extracted. Data were entered into SPSS version 20 and analyzed using frequencies and percentages which are presented in tabular form.Results: A total of 5,155 patients were admitted, liver diseases accounted for 324 (6.3%) of medical admissions within the period, with hepatocellular carcinoma (HCC) accounting for 52.8%, liver cirrhosis (LC) – 27.2%, acute hepatitis – 10.38%, metastatic liver disease – 4.1%, autoimmune hepatitis – 1.7%, DILI – 0.7%, liver abscess – 1%, abdominal tuberculosis – 1.4%, and unclassified etiology – 1.76%. A total of 139 cases were HBsAg positive, 64 took alcohol, 67 took herbs, while 57 took self-prescribed medications. Mortality among all patients admitted through the emergency compared with the medical clinic was 81.9% versus 18.1%. Elevated creatinine, coagulation disorder, hypoalbuminemia, and hypokalemia contributed to mortality.Conclusion: HCC and LC accounted for the majority of liver diseases in hospitalized patients with high mortality among all patients admitted through the emergency department and those with elevated creatinine, coagulopathy, and low potassium and albumin. Major etiologic factors were hepatitis B virus infection, alcohol, and self-prescribed medications.

The Burden of Visual Impairment and Blindness from Vitreoretinal Diseases: A Nigerian Tertiary Hospital Retina Unit Experience.

Objective:The objective of this study is to determine the burden of visual impairment and blindness from vitreoretinal diseases in the retina unit of a Nigerian tertiary hospital.Methodology:A prospective, cross-sectional study on all consecutive new patients presenting with vitreoretinal diseases (VRD) at the vitreoretinal (VR) clinic at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from May 2011 to April 2014. Patient's bio-data, presenting complains, Snellen's or tumbling E-chart visual acuity unaided, slit-lamp examination of the vitreous and fundus with +90/+78D, binocular indirect ophthalmoscopy as well as slit-lamp examination of anterior segment, and applanation tonometry findings were recorded in predesigned pro forma. Visual acuity was categorized using WHO/ICD. The data were analyzed using the SPSS software version 16 for simple frequencies and presented.Results:Of 2025 eyes reviewed, 112 (49.8%) eyes were visually impaired and 67 (29.8%) were blind. Eight (5.2%) patients were bilaterally blind. Diabetic retinopathy was the most common cause of bilateral blindness (25%), and concurrently, the most common VRD (29.8%). All categories of visual loss were more prevalent among the aged ≥65 years. More males (62.2%) were blind from VRD. Cataract was the most common ocular comorbidity seen (43.6%).Conclusion:The burden of visual impairment and blindness from VRD is large; eye health education for early presentation for eye care as well as the development of VR care with infrastructure upscale to include optical coherence tomography, laser, and surgical care for prompt diagnosis and treatment will be of benefit in reducing the burden.

Cardiac autonomic neuropathy in adult epilepsy patients in a tertiary hospital in South-Western Nigeria.

Cardiac autonomic neuropathy (CAN) resulting from seizures has been implicated in sudden unexpected death in epilepsy in persons with epilepsy (PWE), however, there are no previous studies of CAN in PWE from Nigeria. This study sought to determine the frequency and pattern of CAN in adult PWE in a tertiary hospital in South-western Nigeria and to determine the relationship between seizure variables and CAN. A cross-sectional study of 80 adult PWE and 80 matched controls aged between 18 and 60 years was carried out between March 2012 and June 2013 at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Demographic and clinical data were obtained from all the study participants. Anxiety was excluded using the Hamilton Anxiety Scale. Those with conditions that could affect autonomic function, such as chronic renal failure, heart failure, Parkinson's disease, diabetes mellitus, anxiety, and psychiatric disorders and pregnant women were excluded. Five bedside cardiovascular reflex tests were performed on each subject after baseline heart rate and blood pressure (BP) had been recorded. The mean age of onset of epilepsy was 19 ± 10 years, whereas the mean duration of epilepsy was 10 ± 8 years. The mean seizure frequency was 14 ± 30 per month (median three seizures per month). Of the 80 patients evaluated, 42 (52.5%) had CAN, whereas none of the controls had CAN. Majority (69%) of the PWE with CAN had purely parasympathetic dysfunction, whereas 3% had purely sympathetic dysfunction and 10% had combined autonomic dysfunction. The PWE in this study had significantly lower tilt ratios and diastolic BP change with Isometric Hand grip as well as significantly higher systolic BP change on standing than the controls. Patients who had more than four seizures per month had higher odds of CAN than those with less frequent seizures (odds ratio 0.275, P value 0.023). Also, patients who had received treatment for less than 10 years were found to have greater odds of CAN than those who had received treatment for a longer period (odds ratio 11.676, P value 0.046). CAN is common in adult PWE in South-Western Nigeria and the major predictors are short duration of treatment and frequent seizure episodes. Routine screening of these patients may help with early detection of autonomic dysfunction and provide an opportunity for intervention.

Rifampicin-resistant tuberculosis in a toddler: A report of a rare paediatric case in obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

The emergence of resistant strains of mycobacterium tuberculosis (TB) to antituberculous drugs has compounded the management of the chronic infection. More than 90% of rifampicin (RIF)-resistant isolates are also isoniazid resistant; hence, rifampicin resistance (RR) is a surrogate marker for multidrug resistant TB (MDR-TB). Although there are limited reports of pediatric RR/MDR-TB in Nigeria, there had not been similar report in our hospital until now. A 2-year-old girl was admitted with 2-month history of fever, cough with dyspnea, and progressive weight loss. There was no known contact with adult who had chronic cough; the toddler and her parents have not been treated for TB in the past. Her chest X-ray showed nodular opacities, while gastric washout for GeneXpert MTB/RIF confirmed RIF-resistant TB. The parents declined screening for TB despite counseling. The patient was subsequently referred to a specialized center for the management of drug-resistant TB, but the parents failed to go for the treatment. Young children are at risk of developing TB disease and MDR/RR-TB, which is more complex to manage than drug-susceptible TB due to longer treatment duration, increased toxicity, as well as poor parental compliance to the demand of treatment.

Comparative study of endoscopic band ligation versus injection sclerotherapy with 50% dextrose in water, in symptomatic internal haemorrhoids.

Haemorrhoids are common anorectal conditions seen in surgical practice, with various treatment modalities. This study compared the short-term outcome of injection sclerotherapy with 50% dextrose in water and rubber band ligation in the management of second-and third-degree haemorrhoids, in terms of symptoms improvement, complications, recurrence rate, retreatment rate and acceptability. This was a prospective comparative study that was carried out in the endoscopic unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, in southwestern Nigeria. Sixty consecutive patients with second- and third-degree haemorrhoids, who consented, were recruited into the study and were randomised into two groups. Group A had endoscopic injection sclerotherapy and Group B had endoscopic rubber band ligation. With regard to anal protrusion, more patients consistently reported either complete (16 [64.4%]) or partial (9 [40.9%]) resolution of symptoms in Group B, compared to Group A which had 7 (28.0%) and 5 (22.7%) cases, respectively (P = 0.03). Resolution of anal bleeding was initially more in Group B than A (22 [95.7%] vs. 17 [77.3%] patients, respectively), in the first 24-h post-treatment; however, within the 1st week, this ratio was reversed (P = 0.07). The retreatment rate for Group A and B was 23.3% and 13.3%, respectively,P = 0.34. More patients in Group B experienced severe pain post-treatment compared to Group A (P = 0.01). Three-month post-treatment, two (11.8%) patients in Group A and one (4.5%) in Group B had recurrence of anal bleeding (P = 0.42). There was no recurrence in anal protrusion in both treatment groups. Endoscopic rubber band ligation had a significantly higher success rate than endoscopic injection sclerotherapy, in terms of resolution of anal protrusion, but with higher pain score.

Distribution of Medical Conditions among Dental Patients.

Aims:The aim of the study was to determine the distribution of medical conditions among dental patients in our local environment.Settings and Design:This is a descriptive cross-sectional study conducted at the Oral Diagnosis (OD) Clinic of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State.Materials and Methods:Participants were selected using a simple random method from the pool of dental patients who presented at the OD Clinic of OAUTHC during the study period. Information was obtained from each participant using a structured questionnaire organized into sections. Section 1 collected information on participants' biodata such as age, sex, and weight. Section 2 recorded data on the history of the presence of relevant oral and systemic symptoms, while section 3 collected information on findings from intraoral and extraoral examination.Statistical Analysis Used:The results were analyzed using STATA 13 statistical software.Results:Of the 1503 patients who visited dental hospital during the study period, 176 (11.7%) had medical problems. The mean age of patients with medical problems was 48.5 ± 21.0 years. The mean age was higher in men compared to women (P = 0.013). More than one-fifth (21.6%) of the patients were first diagnosed in the dental clinic. Hypertension was the most frequently seen medical condition, closely followed by peptic ulcer and diabetes mellitus. Patients whose medical problems were first diagnosed following dental consultation were significantly older than those with known medical conditions.Conclusions:Prevalence of medical conditions in dental patients is high. Hypertension is the most frequently associated systemic conditions among dental patients. Medical conditions were common among older age group (>50 years), males, and those with gum problems.

Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation

The public health impact of the COVID-19 pandemic cannot be overstated. Its impact on the cost of surgical and obstetric care is significant. More so, in a country like Nigeria, where even before the pandemic, out-of-pocket spending (OOPS) has been the major payment method for healthcare. The increased cost of surgical and obstetric care occasioned by the pandemic has principally been due to the additional burden of ensuring the use of adequate/appropriate personal protective equipment (PPE) during patient care as a disease containment measure. These PPE are not readily available in public hospitals across Nigeria. Patients are therefore compelled to bear the financial burden of procuring scarce PPE for use by health care personnel, further increasing the already high cost of healthcare. In this study, we sought to appraise the impact of the COVID-19 pandemic on the cost of surgical and obstetric care in Nigeria, drawing from the experience from one of the major Nigerian teaching hospitals- the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State. The cost of surgical and obstetric care was reviewed and compared pre- and during the COVID-19 pandemic, deriving relevant examples from some commonly performed surgical operations in our centre (OAUTHC). We reviewed patients' hospital bills and receipts of consumables procured for surgery. Our findings revealed that the cost of surgical and obstetric care during the COVID-19 pandemic had significantly increased. We identified gaps and made relevant recommendations on measures to reduce the additional costs of surgical and obstetric care during and beyond pandemic.

Gender analysis of nurses' attitude towards care of the elderly with dementia in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria

ABSTRACTThis study assessed nurses’ knowledge and attitudes by gender toward the care of elderly patients with dementia and explored gender differences in attitudes and associated factors in Obafemi Awolowo University Teaching Hospital, Ile-Ife. The study adopted a sequential explanatory mixed method design to obtain data from 100 nurses selected through a multistage sampling technique. Data analysis was done at univariate, bivariate, and multivariate levels with a significance at P < .05. Findings revealed that a majority of the nurses have good knowledge and attitudes toward the care of elderly patients with dementia. Previous experience in a specialized unit (Odd = 2.879, CI = 0.013–8.287, P = .047) was the main predictor for the nurses’ attitude.

Five-year review of diabetic foot ulcer admissions at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigera

Five-year review of diabetic foot ulcer admissions at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigera