Nigeria Teaching Hospital Research Articles

Effect of Diet Mediated Immune Optimization on Blood Pressure

Abstract Background: Good diet improves immune functionality and it is beneficial for blood pressure control. A personalized food avoidance dietary approach to stop hypertension (PFADASH) addresses primary and secondary immune intolerances of different individuals to different foods as well as exposures to toxic food substances responsible for inflammatory immune dysfunction that mediate hypertension. Objectives: We appraised the impact of diet mediated immune optimization on blood pressure. Materials and Methods: This was a longitudinal study and part of clinical trials to improve immune functionality via a personalized food avoidance dietary approach to stop hypertension (PFADASH) approved by the University of Nigeria Teaching Hospital Ethics Committee. A dietary compliance score of GOOD, FAIR, or POOR was based on the frequency of exposure to dietary ingredients suspected to drive adverse gene expression. Results: Study participants with poor dietary compliance had higher BP scores with higher variability compared to those with good dietary compliance, although the difference between the scores was not significant (P > 0.05). Conclusion: A PFADASH although may serve as an immune optimizer and a therapeutic adjunct for blood pressure control does not significantly reduce the BP scores.

Barriers to Accessing Affordable Anticancer Medications in Nigeria: A Patient-Centric Perspective

Background: Limitations to accessing affordable medications for cancer patients in Nigeria is increasing on a daily basis. Several government interventions have been established to address the affordability of drugs for patients at treatment centers. However, they haven’t been commensurate improvement in patient outcome due to barriers to accessing these medications. This manuscript provides a critical examination of the barriers to affordability of anticancer medications in Nigeria, offering a unique patient-centric perspective that is often underrepresented in healthcare research. Methodology: The study was a cross-sectional descriptive survey amongst patients that are 18 years and above with Cancers and other tumor diseases in the Oncology unit of the University of Nigeria Teaching Hospital (UNTH) who were willing to participate in the study. Interview based questionnaire distribution was utilized in data collection. 200 questionnaires were distributed, 180 were returned hence giving us (98% response rate) and making our sample size (n= 180). Data gotten was analyzed using descriptive statistics. The IBM statistical package for Social Sciences (SPSS) was utilized. Results: A total of 180 participants were included in the study, there was an unequal distribution of respondents’ gender (44.4% males and 55.6% females). Only about 36.7% of participants reported to be within the age range of (46- 55 years) which was the most participated age range. More than 60% of the study participants are married. Just about half of the study participants had their monthly incomes between fifty thousand to ninety-nine thousand naira while others earned less. Conclusion: In this study, barriers to accessing affordable anticancer medications were noted. Government aiding /subsidizing the cost of anticancer medication as well as availability of anti-cancer medicines in government hospitals should be improved.

Difficulty in financing fracture care in south-western Nigeria: a prospective cohort study of predictors and recommendations for improvement

BackgroundBone fractures remain a significant global public health issue despite preventive measures, leading to substantial health and economic consequences. Effective treatment options are difficult to access in most sub-Saharan African countries, leading to reliance on unqualified practitioners and resulting in serious complications that worsen poverty. In Nigeria, the main challenge is the need for out-of-pocket payment for healthcare, which is the primary method of health financing. However, anecdotal evidence suggests that some patients find it easier to finance their fracture care than others. This study aimed to identify the factors that predict difficult fracture-care financing among patients treated operatively for long-bone fractures (LBFs) in southwestern Nigeria.MethodsThe study collected socio-demographic and clinical data on 690 consecutive adult patients with LBFs treated with SIGN nails between July 2014 and June 2024 at a mission teaching hospital in southwestern Nigeria. A literature review and preliminary interviews were conducted with patients, caregivers, and hospital staff to understand potential risk factors for difficult fracture-care financing. The patients were divided into two cohorts – easy fracture-care financing (EF) and difficult fracture-care financing (DF) – based on their promptness in paying the in-patient care bills. Potential risk factors for DF identified in the initial univariate analysis were entered as covariates into a binary logistic regression to determine the significant predictors of DF.ResultsThe mean age of the patients was 45.1 years (SD = 17.52). The DF cohort comprised 321 (46.5%) patients. Significant predictors of DF included younger age (p = 0.018), male gender (p = 0.002), lack of formal education or low level of education (p < 0.001), residence in the hospital city (p < 0.001), absence of health insurance (p = 0.013), lack of extended family support (p < 0.001), previous traditional bone setting treatment (p = 0.005), concomitant injury (p = 0.017), and a post-operative hospital stay longer than one week (p = 0.036).ConclusionsThe findings suggest that improving people’s socioeconomic status through job creation, women’s empowerment, reduction of gender inequality, higher education, comprehensive health insurance coverage, and stronger family bonds, as well as preventive strategies to reduce the occurrence and severity of injuries, can improve fracture-care financing in low-resource settings.

Pharmacists’ knowledge, attitude and practice of HIV post-exposure prophylaxis: a cross-sectional comparative study in two Nigerian teaching hospitals

IntroductionPharmacists play an important role in HIV post-exposure prophylaxis. This study compared the knowledge, attitude, and practice (KAP) of HIV post-exposure prophylaxis (PEP) among pharmacists practicing in two Nigerian teaching hospitals.MethodsThis survey, which adopted a cross-sectional design, was conducted among pharmacists at Ahmadu Bello University Teaching Hospital (ABUTH) and the University of Nigeria Teaching Hospital (UNTH). Seventy-seven eligible pharmacists completed the standard questionnaire, which was analysed using SPSS Version 25 with appropriate descriptive (frequencies, percentages, mean) and inferential (t test) statistics. The structured questionnaire which was self-administered had four sections: Sect. 1 evaluated the sociodemographic characteristics of the participants, Sect. 2 evaluated their knowledge of HIV PEP, Sect. 3 evaluated their attitude towards HIV PEP, and Sect. 4 evaluated their practice of HIV PEP. A student’s t test was used to compare the knowledge scores of the respondents of the two hospitals. The same comparison was done for the attitude scores. Study participants were divided into two groups for each domain based on the group mean scores for each population: good versus poor knowledge and good versus poor attitude. Pharmacists scoring at or above the group mean in each domain were categorised as “good,” while those scoring below were categorised as “poor”. For all analyses, the confidence interval was set at 95%, with p values, less than 0.05 considered statistically significant.ResultsThere was a 100% response rate for the questionnaire. Pharmacists aged 26–35 years in ABUTH were 32 (60.4%), while those aged 36–45 years in UNTH were 11 (47.8%). B.Pharm/PharmD was the only qualification of 47 (87%) pharmacists in ABUTH, while 10 (43.5%) had the same qualification in UNTH. The mean knowledge of PEP scores for ABUTH and UNTH were 53.70 ± 1.90 and 56.52 ± 2.85 respectively. The mean knowledge of PEP score in both hospitals was 54.54 ± 1.59%. The mean attitude towards PEP scores for ABUTH and UNTH were 84.22 ± 1.54 and 85.12 ± 2.06 respectively. Their overall mean attitude of PEP score was 84.51 ± 1.23%. For the practice of PEP, 32 (41.56%) of the 75 pharmacists in both hospitals had never dispensed PEP drugs. In ABUTH, 3 (5.8%) pharmacists changed patients’ PEP drugs without consulting the prescriber.ConclusionWhile about half of the pharmacists in ABUTH had a good knowledge of PEP, only a few of their colleagues at UNTH had poor knowledge of PEP. However, the majority of the pharmacists at both hospitals had a good attitude and practice towards PEP, although pharmacists from UNTH performed better.

Knowledge of hand hygiene and evaluation of hand washing technique among nurses at the University of Nigeria Teaching Hospital

BackgroundHealthcare worker’s hands are route for cross-transmission of potentially harmful germs between patients in a healthcare facility. As hand washing is an established cost-effective measure for infection control, hand hygiene knowledge and compliance with the recommended steps are essential to control healthcare-associated infections (HCAI). We assessed the knowledge and practice of hand hygiene among nurses at the University of Nigeria Teaching Hospital (UNTH), Enugu.MethodsA cross-sectional study was carried out from 14th September to 24th December 2023 on all consenting nurses in UNTH. A modified World Health Organization (WHO) knowledge questionnaire structured to collect demographics and assess hand hygiene knowledge expressed as good(> 75%), moderately good(50–74%) and poor(< 50%) knowledge. Duration to completion of hand washing was timed while Glo germ gel with ultraviolet lamp were used to assess effectiveness of hand washing. Ineffective hand washing was graded as fair, poor, or very poor. The WHO checklist was used to assess steps in hand washing technique performed.ResultA total of 395 nurses participated in the study (mean age and standard deviation, 41.40 ± 8.82 years). Most were females (93.2%), married (80.8%), and functioned in the surgery department (38.5%). Moderately good knowledge of hand hygiene was demonstrated by 58.2% while effective hand washing occurred in 29.2% of them. Steps of hand washing technique most frequently missed were the use of towel to turn off faucet (94.3%), rubbing backs of fingers to opposing palms with fingers interlocked (89.8%), and wetting hands with water before applying soap(55.9%). Zones of hands not adequately washed were mainly the fingernails and perimeter of fingernails (38.4%), the palm (28.6%), and the dorsum of hand (22.9%). There was no significant difference in hand hygiene knowledge and effective hand washing across the different age groups, sex, nursing cadre, educational qualifications, and departments.ConclusionNurses at the UNTH had fair hand hygiene knowledge with the majority demonstrating ineffective hand washing; a finding suggesting sub-optimal infection prevention and control. Periodic hand hygiene training targeting nurses and other health personnel engaged in patient care while emphasizing frequently missed areas is paramount to improving hand hygiene knowledge and effectiveness.Clinical Trial NumberNot applicable.

Assessment of health-related quality of life of prostate cancer patients receiving chemotherapy in University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State

IntroductionEnsuring assessment of Health Status in research and clinical care enables improvement in treatment outcomes. This study aimed to evaluate the health status of prostate cancer patients at the University of Nigeria Teaching Hospital.MethodsThis study is a cross-sectional, descriptive survey involving 181 prostate cancer patients. The study was conducted in the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, over a period of five months (May to October 2023). Descriptive and inferential analyses were done using Statistical Package for Social Sciences, SPSS version 27. Correlation and post hoc tests were employed to examine the relationships between socio-demographic variables and Health status Data was collected using a 15D Health status instrument. P ≤\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\le $$\\end{document} 0.05.ResultsOut of the 181 prostate cancer patients interviewed, 45.3% were 60 years and above. More than half were married. Most were employed with university education as their highest level of education. The 15D instrument showed that above half of prostate cancer patients had problem staying asleep (50.8%) and also had marked problems with their bladder (32%). About 34.3% of patients with prostate cancer had severe physical discomfort from pain and ache etc. There general state of health has a considerable effect on sexual activity. The health-related quality of life (HRQoL) of prostate cancer patients also increases as the level of education increases. (Graduate; 0.6840 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm $$\\end{document} 0.16934). Age and level of education are important determinant of quality of life in prostate cancer besides other socio-demographic variables.ConclusionVitality and functional activities were the domains most affected by prostate cancer.

Prevalence of developmental dental hard-tissue anomalies among adolescents in southeastern Nigerian rural communities

Background and objectives: Dental anomalies are significant deviation in the normal size, structure, number, root formation or shape of a tooth. It can affect primary and permanent dentition. The aim of the present study was to determine the prevalence of developmental dental hard tissue anomalies in the permanent dentition of adolescents in two southeastern Nigerian rural communities. Materials and methods: This cross-sectional descriptive study was conducted among school children aged 12-13 years attending two public secondary schools. The schools were located in Nkanu-West and Udi Local Government areas in Enugu state. Oral examination for the presence or absence of developmental dental hard tissue anomalies was performed by a single examiner. Statistical analysis was done using SPSS Version 25. Results: A total of 61 (44.9%) males and 75(55.1%) females participated in the study. The age range of the children was 12 to 13 years with mean age of 12.49 ± 0.50 years. The prevalence of developmental dental hard tissue anomalies was 2.2%. Developmental dental hard tissue anomalies were seen only in females, higher among 13-year-old school children and school children from middle socioeconomic status. Enamel hypoplasia was seen more than peg shaped lateral incisor. There was no statistically significant association with sex (p = 0.25), age (p = 0.61), socioeconomic status (p= 0.25) and developmental dental hard tissue anomalies. Conclusion: The prevalence of developmental dental hard tissue anomalies was low in this study. Developmental dental hard tissue anomalies can affect aesthetics and quality of life. A visit to dental clinic for clinical assessment, preventive interventions and management is recommended. January 2025; Vol. 19(1):002. DOI: https://doi.org/10.55010/imcjms.19.002 *Correspondence: Obehi. O Osadolor, Department of Child Dental Health, University of Nigeria Teaching Hospital, Ituku- ozalla, Enugu State. Nigeria. E-mail: osadolorobehi@yahoo.com; © 2025 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0).

Physiotherapists’ knowledge, attitude and practice of clinical prediction rules in low-back pain

Background and aimClinical prediction rules (CPRs) are mathematical tools that are intended to guide clinicians in clinical decision making or predict a future outcome, but they seem rather unknown, under-utilized, or avoided by clinicians. This study aimed to assess knowledge, attitude, and practice of CPRs in low-back pain (LBP) among physiotherapists.MethodsA cross-sectional study involving 45 consenting specialist musculoskeletal physiotherapists from three public-funded teaching hospitals in Nigeria was carried out. An adapted validated questionnaire on facilitators and barriers to CPRs utilization, and a socio-demographic proforma were used to collect data. Descriptive and inferential statistics were employed to analyze data. Alpha level was set at p < 0.05.ResultsRespondents were mostly males (71.1%), married (64.4%) and first-degree holders (55.6%). Twenty-eight (62.2%) of the respondents had above-average knowledge of CPRs in LBP. Rates for positive attitude towards, and utilization of CPRs were 37.8% and 15.6%. Knowledge and attitude about CPRs in LBP were not significantly influenced by socio-demographic factors (p > 0.05). However, there was a significant association between the utilization of CPRs and years of experience (χ2 = 10.339 p = 0.016).ConclusionMost Nigerian physiotherapists had above-average knowledge, but a negative attitude and low utilization of CPRs in LBP. Clinicians’ years of clinical experience influence the usage of CPR. There is a need to incorporate training in CPRs into undergraduate and continuous professional development programmes.

Development and validation of situational judgement test for assessment of behavioural competencies required for effective medical practice in Nigeria

BackgroundThe personal qualities of health workers determine the way health services are provided to clients. Some key personal qualities (also called behavioural competencies) of physicians that contribute to quality healthcare delivery include ethical responsibility, empathy, patient-centeredness, diligence, good judgment, respectful, teamwork, team leadership/conflict management, ability to take correction and tolerance. In this study, we developed and validated clinical scenarios (dilemmas) for assessing priority behavioural competencies for medical practice in Nigeria.MethodsDrawing on prioritized competencies generated via a scoping review and nominal group technique (NGT) exercises in a previous study in the study series, Faculty members from the University of Nigeria Teaching Hospital were consulted to develop or adapt clinical scenarios that could be used to assess these competencies in a physician. The clinical scenarios and options were framed as situational judgement tests (SJTs) and these tests were administered to a random sample of 192 undergraduate and 111 postgraduate medical doctors in a tertiary hospital in Enugu State. Using Kane’s validity argument framework, we assessed scoring and generalization inferences of situational judgment tests (SJT) based on the developed scenarios.ResultScoring inference – difficulty and discrimination index – shows that most of the SJT items are good test items and can differentiate between high and low performers. The corrected point biserial correlations show positive correlation for most of the items. Generalization inference shows the items represent the domains of interest and are internally consistent. However, few items that show poor difficulty and discrimination index were subjected to re-evaluation and possible elimination.ConclusionThis study has produced a set of valid clinical scenarios that can be used to evaluate specific behavioural competencies among trainee medical doctors. It demonstrates that SJTs can be used to assess behavioural competencies for medical practice. However, further research is needed to establish the applicability of SJT beyond the immediate context, such as the medical school, in which it is developed.

Assessment of knowledge and attitude of healthcare professionals towards Mpox in a Nigerian hospital

Mpox is a zoonotic viral disease that presents significant public health challenges. Despite the pivotal role of healthcare workers, research on their knowledge and attitudes towards mpox is limited. This study aimed to assess healthcare workers’ knowledge, awareness and attitude regarding mpox as well as associated factors at Rivers State University Teaching Hospital in Nigeria. A descriptive cross-sectional study design was employed, utilizing a 34-item semi-structured questionnaire. Knowledge levels were categorized as good (> 70% score), fair (50–69%), or poor (< 50%), while attitudes were classified as positive (> 70% score), moderate (50–69%), or negative (< 50%). Statistical analyses included independent sample T-test, One-way Analysis of Variance, and Chi-square tests. Among a total of 227 healthcare professionals, majority were females (59%) and singles (54.2%). Over 79% correctly identified mpox as a viral infection, while 59.9% recognized its potential transmission through a monkey bite. Overall, 22.5% demonstrated good knowledge. Majority (61.7%) acknowledged the potential of mpox as a worldwide pandemic, with 89% agreeing it could strain affected countries’ healthcare systems. Healthcare workers exhibited moderate to positive attitudes towards mpox. Gender (Males, (p = 0.003), age (> 40 years (p = 0.008), years of experience (6–10 years; (p < 0.001), professional qualification (physicians, (p = 0.002), and previous mpox training (p < 0.001) significantly influenced knowledge levels, but no significant associations were found between demographic variables and attitudes. The study revealed a high level of awareness but low to fair knowledge among most participants. Healthcare professionals also demonstrated moderate to positive attitudes towards mpox. Factors such as gender, age, years of experience, professional qualification, and previous training on mpox influenced knowledge levels, but did not influence attitude in the study participants highlighting the importance of targeted educational interventions.

Characteristics of Breast Cancer Patients Who Refused Conventional Treatment in a Teaching Hospital in Southwestern Nigeria

Background Patients’ adherence to treatment recommendations is in the form of a spectrum: complete adherence or total rejection of the offered standard treatments. The aim of this study was to describe the characteristics of breast cancer patients who refused standard treatments in order to engender a focused intervention. Methods This was a retrospective study of breast cancer patients from 2017-2022. Data generated were analyzed using SPSS version 23.0. The results were presented using descriptive statistics. Inferential statistics for subgroup analysis was by chi-square test or risk difference with confidence intervals Results Among 343 patients, 86 (25% (95% CI 21-30) did not initiate conventional oncologic treatment. All were females and their age range was 33–83 years (mean, 49.9±12.0 years). The majority of the women were married (73%), educated (79%), low-income earners (69%), rural dwellers (63%) with advanced disease (81%). None of the patients had government insurance. The mean duration of symptoms was 11.9±9.7 months. Among 71patients with vital information, 50 (70% (95%CI 58-71) were confirmed dead in the last 3 years. The probability of death within 3 years was 38% (95%CI 8.0-68%) and was higher among those diagnosed as late-stage disease. Conclusions A large number of patients still fail to accept conventional treatments after breast cancer diagnosis. Understanding the patients’ characteristics may be necessary to recognize situations where active education and support can help patients accept standard treatment thereby prolonging survival.

Information seeking behaviour of informal caregivers at the premier tertiary teaching hospital in Nigeria

This study was conducted to examine the information behaviour of informal caregivers in a university college hospital in Ibadan, Nigeria. Informal caregivers in the teaching hospitals constitute critical pubic health care players whose information behaviours have not been studied. Data was collected from 208 caregivers using a questionnaire that consisted of structured and open-ended questions. The study found that healthcare providers were the primary source of health for caregivers, with 34.1% actively seeking information from them. The caregivers seldom utilised sources like the internet, community organizations, books, family, and friends. The preference for healthcare providers as sources is due to their accessibility and ability to provide prompt and accurate answers. Caregivers have diverse information needs, including medication-related information, first aid techniques, nutrition, exercise, mental health, and lifestyle choices. They seek this knowledge to make informed decisions that improve their loved ones’ well-being. The study also revealed that caregivers heavily rely on information technology for health information due to its accessibility and reliability. The study highlights the need for ongoing training and proactive information sharing by healthcare providers to better support informal caregivers in Nigeria, emphasizing the importance of integrated support systems within healthcare facilities. To meet diverse information needs, healthcare institutions should diversify dissemination strategies, including culturally sensitive materials and digital literacy programs, while developing tailored mobile applications and online support communities for caregivers. Policymakers must focus on creating supportive healthcare policies, funding caregiver programs, and expanding insurance coverage to alleviate financial burdens, ensuring that caregivers have access to necessary resources and information.

Orthodontist dressing: Its impact on patient perception and cooperation

Background and Aim: Communication skills, including non-verbal cues such as attire, play a significant role in patient perceptions of healthcare professionals. An orthodontist’s attire may influence patient cooperation during treatment. This study aims to investigate Nigerian orthodontic patients' perception regarding their orthodontists' dressing and its impact on patient cooperation. Materials and Methods: A cross-sectional descriptive study was conducted among orthodontic patients at the University of Port Harcourt Teaching Hospital in Nigeria. A structured, interviewer-administered questionnaire with 34 items was used to gather data from 131 participants. The questionnaire covered socio-demographic characteristics, understanding of the orthodontist's role, and preferences for the orthodontist's attire. Data were analyzed using IBM SPSS version 26, with significance set at p ≤ 0.05. Results: The study included 131 patients (82 females and 49 males), with a mean age of 19.2 ± 9.43 years. Most participants (88.6%) liked how their orthodontists dressed, with 50.4% stating that their orthodontists wore traditional white coats and 42.7% indicating that their orthodontists wore scrubs. When asked about the significance of the orthodontist's dressing, 46.6% indicated that it mattered to them, while the majority stated that it did not affect their cooperation or review appointments. Conclusion: The study reveals that while orthodontic patients have preferences for their orthodontists’ appearance, it does not significantly affect their cooperation or review attendance. These findings suggest that while maintaining a professional appearance is important, it may not be a determining factor in patient compliance.

Epidemiology of skin diseases among children attending the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State: a retrospective observational study

Background: Numerous studies have examined skin disease trends in Nigeria, revealing a shift towards increased allergic dermatoses. This research assessed the patient landscape at a clinic and satellite site in Obukpa, Nigeria. Methods: A retrospective study of patients seen in the skin clinic of the university of Nigeria teaching hospital (UNTH), Ituku Ozalla, and the rural outpost in Obukpa between November 2009 and 2018 was carried out. A total of 1851 patients' data were analyzed. Diagnosis was based on clinical findings. Results: There were more females (n=1007 [54.4%]) than males (n=844 [45.6%]). Most of the patients were of school age (6-12 years), and the most typical skin disease category was infectious disorders (32.5%), another categories/miscellaneous group (27.7%). Nearly all patients that presented to the rural outpost in Obukpa resided in the surrounding area of Nsukka (93.4%). Conclusions: Comparing the study findings with an earlier one from the same center, there is no change in pattern, with infectious disorders being the most common skin disease category. However, these are largely preventable and emphasize the need for public enlightenment campaigns and policies to discourage the over-the-counter purchase of prescription-strength corticosteroid creams and antibiotics by parents and caregivers, a prevalent practice before seeking medical attention for their children. In addition, there is an urgent need to strengthen dermatologic training in primary health care settings, especially among pediatricians in Nigeria, to improve access to care.

Evaluating the Serum Zinc and Testosterone Levels of Carpenters in Enugu Metropolis, South East Nigeria: A Cross-sectional Study

Background: Exposure to wood dust remains a pervasive occupational hazard with significant health implications Aim: This study aims to investigate the impact of occupational exposure to wood dust on the zinc and testosterone levels of carpenters and to explore its potential implications for their fertility. Materials and Methods: This cross sectional study employed simple random sampling to recruit forty carpenters and forty administrative staff after obtaining informed consent. The ethics committee of the University of Nigeria Teaching Hospital approved of the study. Serum zinc was analyzed with atomic absorption spectroscopy while testosterone was analyzed with the Fluorescence Immunchromatogarphy. Graph pad prism version 7 was used to analyze the data obtained from the study and a p value of 0.05 was used to ascertain statistical significance. Results: The mean zinc level of the test group (48.80 ± 0.83) µg/dl is statistically significantly lower than the reference group (52.40 ± 0.79) µg/dl, (p=0.003). The mean serum testosterone level of the test group (4.11± 0.10) ng/ml is statistically significantly lower than the reference group (4.51 ± 0.11) ng/ml, (p=0.010). Conclusion: These findings may suggest that occupational exposure to wood dust could potentially influence the serum levels of Zinc and testosterone levels.

Diagnostic Performance of Cystatin C in the Early Detection of Diabetic Kidney Disease at the University of Nigeria Teaching Hospital, Ituku-Ozalla.

There is an increase in the prevalence of diabetes mellitus (DM) globally. Individuals with diabetes mellitus are at higher risk of impairment of kidney function. This study evaluated the diagnostic performance of Cystatin C in the early detection of diabetic kidney disease (DKD). Across a sectional analytical study of 300 participants (200 study group and 100 control group). A relevant clinical history was obtained, and a physical examination was carried out. Venous blood was collected to assay for serum creatinine, serum albumin, serum cystatin C, serum urea, fasting blood glucose, and urine for the quantification of urine albumin excretion rate. The median age of the study group versus the control group was 62.50 for DM with proteinuria, 60.00 for DM without proteinuria, and 60.00 years for the control group (F = 3.524, p = 0.172). The laboratory parameters that were higher in the study group compared to the control group were FBG (141.0, 130, vs. 104 mg/dl, F = 68.456, p = <0.001), serum creatinine (109.0, 88.5, vs. 105.0 umol/l, F = 35.50, p = <0.001), serum cystatin C (1.24, 1.11, vs. 0.84 mg/L, F = 59.27, p = <0.001), and urine albumin excretion (230.0, 102.0, vs. 30.0 mg, F = 128.62, p = <0.001). The diagnostic performance of cystatin C using MDRD and cystatin C eGFR <60ml/min/1.73m2was 13% and 23%, respectively, for the study group without proteinuria. Also, when the diagnostic efficiency of the variables was compared using ROC, the AUC of creatinine eGFR (MDRD) was less than that of cystatin C eGFR between the cut-off levels of 30 mg and 300 mg of urine albumin excretion. Cystatin C eGFR had a strong negative correlation with urine albumin excretion when compared to creatinine eGFR (MDRD). This study showed the diagnostic performance of serum cystatin C in the early detection of DKD and that cystatin C-derived eGFR is more sensitive than serum creatinine-derived eGFR in detecting DKD early in people with DM.

Screening for pulmonary hypertension in pregnant women with sickle cell disease in sub-Saharan Africa

BackgroundSickle cell disease (SCD) has evolved from a condition predominantly fatal in childhood to a chronic illness impacting many adults, including women of reproductive age. For females with SCD, pregnancy represents one of the greatest health threats, exacerbating existing health challenges and introducing new risks. Despite advancements in healthcare, routine screening for existing complications like pulmonary hypertension (PH) remains inconsistent, particularly in low- and middle-income countries (LMICs), where the prevalence of SCD is highest. ObjectiveThis study aimed to assess the feasibility of screening for PH in pregnant women with SCD in LMICs, with the goal of enhancing maternal health outcomes in this vulnerable population. Study DesignA prospective multi-center feasibility study was conducted from September 2022 to February 2023 at teaching hospitals in Ghana and Nigeria. The study included pregnant women with SCD between 28 and 34 weeks of gestation. Screening for PH utilized a tricuspid regurgitation velocity (TRV) criterion (>2.5 m/s), with adherence to American Society of Echocardiography guidelines. Statistical analysis included descriptive statistics and proportions. ResultsAmong 3091 pregnant women attending antenatal care, 88 had SCD (2.8%), and 55 were eligible for the study. We recruited 44 participants (mean age 28.9 years, SD 4.8), with 48% (21/44) SS genotype and 52% (23/44) SC genotype. Most participants (95.3%) had normal TRV (<2.5 m/s), with only one showing elevated TRV, successfully referred. Protocol adherence was 100%. Antenatal outcomes showed 95% echo uptake and 95.7% retention to term whilst postnatal echo follow-up was 43.5%. Notably, 27.1% (10/37) of deliveries required neonatal intensive care unit admission, and 18.2% were preterm. The sole participant with PH required intensive care unit care and experienced a preterm delivery with neonatal death on day 5. ConclusionScreening and referral for PH in pregnant women with SCD in LMICs are feasible but face challenges in early diagnosis, healthcare personnel availability, and postnatal follow-up. Strategic planning is crucial to address these challenges and improve outcomes in this high-risk population

Priapism in South West Nigeria—Short and Intermediate-Term Outcomes

Abstract Background: Priapism is usually defined as penile erection that lasts more than 4 h beyond sexual stimulation and orgasm or is unrelated to sexual stimulation. The overwhelmingly more common low-flow priapism is typically painful, while high-flow priapism is typically painless. Interventions are varied depending on the aetiology and timing of the presentation. The outcome in most cases depends on the timing of the intervention. Objective: This study aimed to review the presentation and short- and intermediate-term outcomes of treatment of priapism in patients in Southern Nigeria. Materials and Methods: This was a retrospective 10-year study conducted from 2010 to 2019 of all adult patients diagnosed with priapism who were admitted to the adult urology units in two Government University Teaching hospitals in South West Nigeria. Results: The records of 61 patients were analysed. The mean age was 27.54 years ± 6.22 with a range of 15–56 years. The median duration of symptoms before presentation was 36 h with a range of 2 to 336 h. Eleven patients (18%) presented within 24 h of onset of symptoms. Sickle cell disease (SCD) and idiopathic aetiology were the most common causes of priapism, accounting for 44 (72.1%) and 8 (13.1%) respectively. Corporal aspiration resolved the priapism in 22 (36.1.%), while corpora–glandular shunt was the final treatment in 36 (59.1%). Fifty-seven per cent had erectile dysfunction (ED), while penile gangrene with autoamputation was observed in one patient (1.6%). Sixty-six per cent and 62% of patients who presented within &lt; 36 h and 36–72 h, respectively, experienced normal erection at 6 months after surgery. Erectile function got progressively worse after 72 h, with all patients with ischemic priapism lasting more than 1 week developing ED. There was no statistically significant relationship between the variants of SCD and the risk of ED in patients who presented within 72 h. Conclusion: The incidence of ischemic priapism was high, with sickle cell disease being the most common cause. The risk of ED was significantly worse after 72 h. The aetiology of priapism did not significantly influence the risk of ED.

Clinical Profile and Histopathological Pattern of Major Salivary Gland Tumors in a Nigerian Tertiary Hospital

Abstract Background: Varieties of tumors can arise from major salivary glands primarily or secondarily. Over 30 histological subtypes have been documented by the World Health Organization, serving as a guide in diagnosis and management. Objectives: To evaluate the clinical and histological pattern of presentation of major salivary gland tumors. Materials and Methods: This is a clinical retrospective study, done at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria, assessing records of patients with major salivary gland tumors seen between January 2018 and December 2022. Data obtained were analyzed using Statistical Package for Social Sciences version 26. The results were presented in tables and charts and comparisons were made using the Chi-squared test. Results: Out of the 57 patients with major salivary gland tumors studied, 30 (52.6%) were benign tumors, and 27 (47.4%) were malignant tumors. About 63.2% of patients were predominantly females, whereas 36.8% were males with a male-to-female ratio of 1:1.7. The most common presenting symptom was swelling. The average duration of symptoms before presentation was 24 and 12 months for benign and malignant tumors, respectively. The parotid gland (61.4% total) was the most common site of tumor presentation for both benign and malignant tumors followed by the submandibular and sublingual the least. The most common histological variant was pleomorphic adenoma (40.4%) for benign and mucoepidermoid carcinoma (28.1%) for malignant. Surgery was the first line of treatment given. Conclusion: The observed pattern of clinical and histological presentation of major salivary gland tumors will guide clinicians on the approach for the management.

QUALITY ASSESSMENT OF FUROSEMIDE TABLET GENERICS USED IN A TEACHING HOSPITAL IN NIGERIA

The use of ineffective and poor-quality drugs endangers treatment leading to treatment failure. For the desired therapeutic effect, drugs should contain the appropriate amount of active pharmaceutical ingredients and the required physicochemical properties. This study aimed to evaluate the quality as well as the physicochemical properties of different generics of furosemide tablets used in a teaching hospital in Nigeria. Five different generics of furosemide tablets were purchased from different pharmacy units in the hospital. Their qualities were assessed via identification, assay, weight variation, friability, disintegration and dissolution tests using British Pharmacopoeia standards. All samples contain the stated active pharmaceutical ingredients, however, only two generics have furosemide within the 95 – 105% BP official limit. The weight variation test results indicated that two generics failed to comply with BP specification limits. The generics were found to be able to withstand the rigour of transportation as indicated by their friability values of less than 1 %. The generics were also found to be immediate release tablets as showed by their rapid disintegration time of less than 2 minutes. All the generics released more than 80 % furosemide within 60 minutes. Only two out of the five furosemide generics passed the quality assessment and are therefore expected to yield the desired therapeutic effect.