Tertiary Hospital In South West Nigeria Research Articles

Clinicopathological profile and management challenges of congenital encephaloceles in a tertiary hospital in southwest Nigeria.

A congenital encephalocele is the herniation of intracranial contents through skull defects of various sizes. Depending on the site, content, and size, it is associated with significant morbidity and mortality in children. There is a paucity of recent and comprehensive local clinical data regarding this anomaly. Understanding the peculiarities, clinical-pathologic profiles, and management challenges will help prevent and effectively manage congenital encephalocele to improve outcomes. This was a retrospective study of all cases of congenital encephalocele managed between July 2000 and December 2023 at a tertiary hospital in the southwest region of Nigeria. Relevant demographic, clinicopathological, and management data were retrieved and analysed. There were 31 females and 11 males. Their ages ranged from 3hours to 24years. Sixteen (35.3%) were delivered in a non-health facility. Birth asphyxia was reported in 5 babies. Few mothers (4.8%) used preconception folic acid. Anaemia (n = 5) and sepsis (n = 4) were the common preoperative morbidities. All patients had definitive surgery, with 18 operated on within the first month of life. Cerebrospinal fluid (CSF) leak was the most common postoperative complication and was significantly observed in the sincipital group (p = 0.018). Thirty-one patients (73.8%) presented for follow-up after surgery, and the mean follow-up duration was 26.6weeks. Mortality was recorded in a patient (2.4%) due to Klebsiella meningitis. Congenital encephaloceles are relatively common in our setting. Therefore, there is a need to address the associated poor maternal and neonatal health conditions. Early surgery can be performed with a favourable outcome.

Clinicopathological study of otomycosis in a tertiary hospital in South-west Nigeria.

Otomycosis is common in environments with hot, humid weather, and it may be challenging to manage. To profile common clinical presentations, the pathogenic fungi, the treatment modalities with responses, and explore clinical factors associated with having positive fungal culture in Otomycosis. Retrospective review of patients with Otomycosis. Demographic and clinical parameters, otoscopic findings and mycological study results were recorded. The treatment modalities used and treatment response were summarized. Comparative statistical analyses of associated factors to positive fungal culture were performed with Chi square test, and Student's t-test, using SPSS version 22.0. Total of 71 patients with M: F=1:1.8, mean age 38.5±19.8 years. Average duration of symptoms was 5.4 ±4.6 weeks; common presenting complaint was itchy ear (33.8%). Majority of patients (85.9%) had unilateral ear involvement, 50.0% applied ototopic medications before presentation, 8.5% had multiple co-morbidities. 20 patients had positive fungal culture results; common fungal isolate was Aspergillus niger 9 (45.0%).Clinical factors associated with positive culture of fungus were age, non-previous use of ototopic drugs, and presence of co-morbidity. The most common treatment was local ear debridement and use of topical antifungal creams. Majority (91.5%) of the patients responded with resolution of fungal infection. Complications rate was 8.4%. Otomycosis commonly present with itchy ears, the pathogenic fungi commonly being Aspergillus species. The factors associated with positive fungal culture were age, non-usage of ototopic agents and presence of co-morbidity. Treatment modality used was local debridement and topical antifungal agents, which produced favourable response in most patients.

Knowledge, attitude and readiness to use contraceptives among postpartum women at a tertiary hospital in southwest Nigeria.

Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women’s knowledge, attitude, belief and readiness to contraceptive use.
 Methods: This descriptive cross-sectional study was conducted in the postnatal clinic of the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire among one hundred and ninety-four consenting recently delivered women. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05.
 Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%). The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives, however, only 54(34.4%) were willing to adopt a method at the postnatal clinic visit. The most preferred contraceptive methods were implants (23.4%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001) and of the Christian religion (p=<0.001) had statistically significant associations with good knowledge of contraception. 
 Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt a method at the postnatal clinic. Robust prenatal counselling may help to increase the uptake of postpartum contraception.

Pattern of inappropriate antibiotic use among patients in the medical wards of a tertiary hospital in southwest Nigeria

Background: The inappropriate use of antibiotics results in the emergence of antimicrobial resistance and adverse clinical and economic outcomes in hospital in-patients. A lack of institutional and national antibiotic guidelines promotes inappropriate antibiotic use. The objectives of this study are to evaluate the appropriateness of antibiotic prescribing, and the quality of antibiotic use in medical wards of the Lagos University Teaching Hospital, Lagos, Nigeria.
 Methodology: This was a descriptive cross-sectional study of patients admitted and placed on antibiotics in the medical wards of Lagos University Teaching Hospital between July 2013 and August 2014. The appropriateness of antibiotic therapy was determined by compliance with the guidelines of the Infectious Diseases Society of America (IDSA).
 Results: A total of 350 hospitalized patients on antibiotic therapy during the period of the study were reviewed, including 197 (56.3%) males and 153 females (43.7%). The mean age of the patients was 48.7±17.6 years and a total of 539 initial antibiotics were empirically prescribed. Antibiotic therapy was considered inappropriate in 290 (82.9%) patients, of which 131 (37.4%) patients had no evidence of infection. Pneumonia (23.1%) was the most common indication for antibiotic use, out of which 59.3% had inappropriate antibiotic therapy. Overall, the most frequently prescribed initial empirical antibiotic classes were imidazole derivatives (32.4%) and cephalosporins (22.0%), while the most frequently prescribed inappropriate antibiotic classes were carbapenems (100.0%) and quinolones (89.3%). 
 Conclusion: The study revealed a high rate of inappropriate antibiotic therapy. There is an imperative need to establish antimicrobial stewardship programmes to curb the inappropriate use of antibiotics in the hospital.
 
 French title: Modèle d'utilisation inappropriée d'antibiotiques chez les patients des services médicaux d'un hôpital tertiaire du sud-ouest du Nigeria
 
 Contexte: L'utilisation inappropriée d'antibiotiques entraîne l'émergence d'une résistance aux antimicrobiens et des résultats cliniques et économiques défavorables chez les patients hospitalisés. L’absence de directives institutionnelles et nationales sur les antibiotiques favorise une utilisation inappropriée des antibiotiques. Les objectifs de cette étude sont d'évaluer la pertinence de la prescription d'antibiotiques et la qualité de l'utilisation des antibiotiques dans les services médicaux de l'hôpital universitaire de Lagos, Lagos, Nigeria.
 Méthodologie: Il s'agissait d'une étude transversale descriptive portant sur des patients admis et placés sous antibiotiques dans les services médicaux de l'hôpital universitaire de Lagos entre juillet 2013 et août 2014. La pertinence de l'antibiothérapie a été déterminée par le respect des directives de l'Infectious Diseases Society. d'Amérique (IDSA).
 Résultats: Au total, 350 patients hospitalisés sous antibiothérapie au cours de la période de l'étude ont été examinés, dont 197 (56,3%) hommes et 153 femmes (43,7%). L'âge moyen des patients était de 48,7±17,6 ans et un total de 539 antibiotiques initiaux ont été prescrits de manière empirique. L'antibiothérapie a été jugée inappropriée chez 290 (82,9%) patients, dont 131 (37,4%) patients ne présentaient aucun signe d'infection. La pneumonie (23,1%) était l'indication la plus courante d'utilisation d'antibiotiques, dont 59,3% avaient un traitement antibiotique inapproprié. Dans l’ensemble, les classes d’antibiotiques empiriques initiales les plus fréquemment prescrites étaient les dérivés de l’imidazole (32,4%) et les céphalosporines (22,0%), tandis que les classes d’antibiotiques inappropriés les plus fréquemment prescrites étaient les carbapénèmes (100,0%) et les quinolones (89,3%).
 Conclusion: L’étude a révélé un taux élevé d’antibiothérapie inappropriée. Il est impératif d’établir des programmes de gestion des antimicrobiens pour lutter contre l’utilisation inappropriée des antibiotiques à l’hôpital.

Faecal carriage of extended spectrum β-lactamase producing Enterobacterales (ESBL-PE) in children under five years of age at a tertiary hospital in southwest Nigeria

Faecal carriage of extended spectrum β-lactamase producing Enterobacterales (ESBL-PE) in children under five years of age at a tertiary hospital in southwest Nigeria

Co-occurrence of Modifiable Risk Factors for Cardiovascular Disease amongst Diabetic Patients in Lagos State, Nigeria.

Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors. This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme. The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep - <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients. A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.

Modelling female nurses’ career sustainability towards career competency development and teamwork using self-efficacy as a mediator

The current state of the healthcare sector in developing countries such as Nigeria has resulted in a significant number of highly skilled health workers migrating overseas for a more fulfilling career. Stakeholders are concerned about this development, emphasizing its impact on healthcare service delivery. While some studies point to role conflict and a lack of family support as the primary causes of female nurses' unsustainable careers, others claim that individual, contextual, and institutional factors can all impact career sustainability. Various factors influence an individual's career sustainability, such as their career skills, ability to work in a team, and confidence in performing tasks successfully. This study aimed to investigate the relationships between these variables and their impact on the sustainability of careers among female nurses. The study is grounded on the Social Cognition Career Theory as its theoretical foundation. This quantitative study analyzed a sample of 292 female nurses from a tertiary hospital in southwest Nigeria using IBM SPSS 28 and Smart PLS. The data was obtained from a questionnaire and analyzed through measurement and structural models. The study found that the professional development of career competence had a significant and positive causal relationship with the career sustainability of female nurses. However, teamwork had a negative effect on the career sustainability of the female nurses surveyed. Furthermore, the mediation analysis revealed that self-efficacy played a positive mediating role in the relationship between teamwork, competence development, and career sustainability. Study findings provide insight into how stakeholders in Nigeria's healthcare system might improve career sustainability by boosting professional career competence, increasing team effectiveness, and encouraging career self-confidence among nurses. To maintain a stable career, this study recommends that nurses focus on enhancing skills, working effectively in a team, and building self-confidence.

Management Outcomes of Hand Dermatitis in a Tertiary Hospital in Southwest Nigeria.

Hand dermatitis (HD) is inflammation of the skin of the hands. It ranges in severity and has a significant impact on quality of life (QoL). The physical and psychosocial burden of the disease is comparable with psoriasis in impairment of the QoL of the patient and depression. Quality of life correlates with disease severity. To evaluate the management outcome of HD with a disease severity tool by the physician and quality of life index. This was a cross-sectional study of a cohort of patients with HD over 24 weeks in the dermatology clinic of a tertiary hospital in Nigeria. Disease severity and quality of life were measured using the physician global assessment (PGA) and dermatology life quality index (DLQI), respectively. These were re-administered 6 weeks after treatment. Results were collated and analyzed. One hundred and seventy-seven (13.3%) of 1,329 patients had HD with F/M ratio of 1.2: 1; a mean age of 34.6 ± 7.4 years. Comparing PGA scores at baseline and 6 weeks, a statistically significant improvement was noted P < 0.001. The mean DLQI score at baseline was 10.38 and reduced to 3.02 post-treatment. The difference between the two means of the DLQI was ≥5 from baseline signifying improved quality of life. The domain of symptoms and feelings was the most affected at baseline and most improved afterward. HD has a significant impact on its sufferers and this correlates with disease severity. Appropriate management improves disease outcome and patients' quality of life.

Pattern and Clinical Characteristics of Cystic Kidney Disease Patients in a Tertiary Centre, South-West Nigeria: A Retrospective Study

Background: Cystic kidney disease is a group of disorders that are characterized by the formation of cysts in the kidneys.It is a major cause of end-stage renal disease (ESRD) worldwide. Objectives: This study aimed to determine the pattern and clinical characteristics of patients with cystic kidney disease who presented at a tertiary hospital in South-West Nigeria. Methods and Materials: We reviewed the records of patients admitted with cystic kidney disease over an 8-year period at Ekiti State University Teaching Hospital. Data extracted included patients’ demographics, clinical presentations, and treatment outcomes. We compared the data between patients with ADPKD and other types of kidney cysts and summarised the treatment outcomes among the patients. Result: The prevalence of cystic kidney disease was 9.2% and the mean age of the patients was 52.87 years with a male predominance. The most common type of kidney cyst was simple renal cysts (53.2%), followed by ADPKD (40.4%). Incidental findings with no symptoms were the most common mode of presentation (61.7%), followed by abdominal pain (38.3%) and palpable abdominal swelling (36.2%). Nephrolithiasis was documented in 4.3% while the frequency of hypertension, haematuria and urinary tract infection was 55.3%, 14.9% and 8.5 %respectively. More than one in five ADPKD patients (21.1%) developed end-stage renal disease. Overall, the majority 41(87.2%) were managed conservatively. Conclusion: This study contributes valuable insights into the pattern and clinical features of cystic kidney disease in SouthWest Nigeria, further enriching the existing data on this condition within the region.

Maximal Respiratory Mouth Pressures Assessment in Stable Chronic Obstructive Pulmonary Disease Patients in a Tertiary Hospital in Southwest Nigeria

Objective: This study aimed to assess the respiratory muscle strength in stable chronic obstructive pulmonary disease (COPD) patients, via measuring maximal respiratory mouth pressures [maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax)] to determine its association with disease severity and quality of life.Material and Methods: The study was a cross-sectional comparative study. A hundred and forty subjects (70 COPD patients and 70 controls) were recruited. Measurements of PImax, PEmax and spirometry were then performed. The health-related quality of life, severity of obstruction and dyspnea in the COPD patients were assessed using the COPD Assessment Test (CAT), post-bronchodilator Forced Expiratory Volume in 1 second (FEV 1) and the modified Medical Research Council (mMRC) dyspnea scale, respectively. Data was analyzed using Statistical Package for the Social Science (SPSS) version 25.0 (SPSS IL USA.).Results: The mean (±S.D.) PImax and PEmax of the COPD patients (31.78±14.40 cmH2O and 54.80±18.89 cmH2O, respectively) were significantly lower (p&lt;0.001) than the controls (80.40±7.50 cmH2O and 95.44±12.52 cmH2O, respectively). Both the PImax and PEmax correlated positively with the FEV1 of the COPD patients (r=0.658 and 0.534, respectively, p&lt;0.001). The PImax and PEmax decreased as the mMRC dyspnea grade worsened (p&lt;0.001). There was a negative correlation between PImax; PEmax and the CAT score of the COPD patients (r=-0.704 and–0.583, respectively, p&lt;0.001).Conclusion: There was significant respiratory muscle weakness in the COPD patients compared with the controls. The respiratory muscle weakness worsened as the airflow obstruction and dyspnea worsened. Respiratory muscle weakness may also add to the negative impact COPD has on the health status of COPD patients.

A decennial cross-sectional review of assisted reproductive technology in a Tertiary Hospital in Southwest Nigeria

BackgroundThe World Health Organization recommends that Assisted Reproductive Technology be complementary to other ethically acceptable solutions to infertility. Whereas fertility centres are increasing in number in urban regions of Africa, published reports of their performance are sparse. We present a 10-year review of assisted reproductive technology performed in a public tertiary centre in Lagos, Nigeria.MethodsThis was a hospital-based, retrospective, cross-sectional review of 604 women, over a 10-year period that had in-vitro fertilization or in-vitro fertilization with intra-cytoplasmic sperm injection at the Institute of Fertility Medicine, Lagos State University Teaching Hospital. Data obtained were expressed in descriptive statistics and Pearson correlation was used to determine the strength of linear relationship between two continuous variables at a significance level of p < 0.05.ResultsThe mean age of the women was of 37.7 ± 6.2 years and 89.7% had no previous parous experience. About 27.2% of the male partners had normal seminal fluid parameters while 4.6% had azoospermia. Median serum follicle stimulating hormone of the women was 8.1 IU/L and median serum anti-mullerian hormone was 6.3 pmol/L. There was weak positive correlation between age and serum follicle stimulating hormone (r = 0.306, p < 0.001); weak negative correlation between age and serum anti-mullerian hormone (r = -0.48, p < 0.001) and very weak correlation between body mass index and serum follicle stimulating hormone (r = 0.173, p = 0.011). In-vitro fertilization and intra-cytoplasmic sperm injection was the method of fertilization used in 97.4% of the cases and 81.8% of embryos formed were of good quality. Most women (94.5%) had 2 embryos transferred and 89.9% had day-5 embryo transfer done. About 1 in 4 of the women (143/604, 23.7%) had clinical pregnancy and 49.7% of women who got pregnant had delivery of a live baby at term while 11.9% had preterm delivery of a live baby.ConclusionDespite increasing use and success of assisted reproductive technology in south-western Nigeria, there is room for improvement in clinical pregnancy rates and live birth rates post- assisted reproductive technology. Complication rates are desirably low.

COVID-19 vaccination acceptability among type 2 diabetes mellitus patients in a tertiary hospital in Southwest Nigeria: a cross-sectional study

Background: The mortality from COVID-19 is higher in diabetes mellitus (DM) patients compared to the general population, hence it is highly desirable that DM patients are vaccinated against COVID-19 infection. The aim was to determine the willingness of type 2 DM patients to accept COVID-19 vaccine and associated factors.&#x0D; Methods: This was a cross-sectional descriptive study that involved DM patients. Multivariable logistic regression was used to assess factors ssociated with willingness to be vaccinated.&#x0D; Results: A total of 302 DM patients participated in the study. About 90% of the respondents perceived COVID-19 to be a serious disease; however, 33.5% of the patients considered themselves to be at risk of contracting COVID-19 despite having DM. About 70.0% of the DM patients were willing to receive the vaccine. Factors associated with willingness to be vaccinated were perception of COVID-19 as a severe disease (Adjusted odds ratio (AOR), 6.09; 95% CI, 4.96- 12.27), previous vaccination (AOR, 1.58; 95% CI, 1.04- 2.98), and higher education (AOR, 2.36; 95% CI, 1.04- 6.86).&#x0D; Conclusion: About a third of the study participants were not willing to receive COVID-19 vaccination. There is need to educate the at-risk population about the importance of COVID-19 vaccination.

Determinants of early Post-natal Blood Pressure among Term Healthy Babies Seen in A Tertiary Hospital in Southwest Nigeria

Background: Neonatal blood pressure varies considerably in the early days of life. To correctly interpret blood pressure measurements or predict the expected blood pressure of a newborn, the factors that influence neonatal blood pressure must be taken into consideration. This study aimed to identify the factors that influence blood pressure (BP) in the early neonatal period. Method: This is a sub-analysis of research work on the blood pressure pattern of asphyxiated neonates and apparently healthy neonates. It is a hospital-based observational study that was conducted at the Ekiti State University Teaching Hospital [EKSUTH], Ado-Ekiti, Nigeria. 12 blood pressure readings were taken serially from each baby in the first 24 hours after birth using oscillometric device. Relationships between blood pressure and physical parameters were established using regression analysis. Differences in blood pressure with respect to gender, gestational age, weight categorization, maturity for age, socio-economic status, and civil status were established using independent t-test and analysis of variance where appropriate. Result: 1476 blood pressure readings from 123 healthy newborns were analyzed. The mean (standard deviation) (SD) BP in mmHg on day 1 were 69.5 (6.5), 39.2 (5.1), and 49.3 (4.6) for Systolic blood pressure (SBP), Diastolic blood pressure (DBP) and Mean Arterial pressure (MAP) respectively. Systolic blood pressure showed a positive linear relationship with weight (R=0.488, P=0.000) and length (R =0.304, P= 0.001). There were also significant differences in the mean (SD) of SBP with respect to gender (P = 0.015), civil status (P = 0.023), and maternal hypertension (P = 0.043). DBP (P= 0.001) and MAP(P=0.001) also had significant differences with respect to Maternal hypertension. Conclusion: Systolic blood pressure correlated significantly with birth weight and length. Only maternal hypertension had a significant effect on diastolic blood pressure.

Computer Skills and Electronic Health Records (EHRs) in a State Tertiary Hospital in Southwest Nigeria.

Adopting change is something that is often resisted, as is often the case in the adoption of electronic health records (EHRs) in healthcare organizations. Embracing this will require computer knowledge to handle the system for the management of patients and their care. This study aims to determine the computer skills required for the uptake of electronic health records (EHR) by healthcare workers in an annex of the state teaching hospital, Okela Health Centre (OHC) Ado-Ekiti. The study uses a cross-sectional research design with a structured questionnaire distributed to 30 healthcare workers across seven disciplines working in the hospital. Descriptive statistics of frequency tables and percentages were used to ascertain the relationship between computer skill usage and the adoption of EHR. The majority of respondents were only efficient in Microsoft Word (MW), email, and WhatsApp, with efficiency rates of 63.4%, 76.6%, and 73.3%, respectively. The majority were not efficient in Microsoft Excel (ME) and Microsoft Access (MA), at 56.7% and 70%, respectively. Computer appreciation is an important basis for the adoption of EHR in hospitals.

Malaria treatment failure after Artemisinin-based combination therapy: A case series of children managed at a private tertiary hospital in southwest Nigeria

Malaria treatment failure is the inability to clear parasitaemia after antimalarial drug administration. There are reports of treatment failure with artemisinin-based combination therapy (ACT) in Nigeria but few reported among children. We report three paediatric cases of treatment failure with ACT admitted at a private tertiary hospital in Nigeria in early 2022. All three were ‘under-fives’ admitted for open-heart surgery, major flame burns, and cerebral malaria respectively. They had symptomatic Plasmodium falciparum infection but one had mixed P. falciparum and Plasmodium vivax infections. Cases 1 and 2 were initially given oral artemether-lumefantrine while case 3 received intravenous artesunate. Despite appropriate antimalarial drug compliance, all the 3 still had fever with heavy parasitaemia. They subsequently received intravenous quinine, with improvement within the first 24 hours of therapy, and no longer had fever at the fourth week of follow-up. Although ACT resistance was not established, poor drug quality may have contributed to treatment failure. There is a need for pharmacovigilance of anti-malarial in Nigeria. &#x0D; &#x0D; French title: Échec du traitement du paludisme après une polythérapie à base d'artémisinine: une série de cas d'enfants pris en charge dans un hôpital tertiaire privé du sud-ouest du Nigeria&#x0D; L'échec du traitement du paludisme est l'incapacité à éliminer la parasitémie après l'administration d'un médicament antipaludique. Il y a des rapports d'échec de traitement avec la thérapie combinée à base d'artémisinine (ACT) au Nigeria, mais peu ont été signalés chez les enfants. Nous rapportons trois cas pédiatriques d'échec de traitement avec ACT admis dans un hôpital tertiaire privé au Nigeria au début de 2022. Tous trois étaient des « moins de cinq ans » admis pour une chirurgie à cœur ouvert, des brûlures graves par la flamme et un paludisme cérébral, respectivement. Ils avaient une infection symptomatique à Plasmodium falciparum mais un avait des infections mixtes à P. falciparum et Plasmodium vivax. Les cas 1 et 2 ont initialement reçu de l'artéméther-luméfantrine par voie orale tandis que le cas 3 a reçu de l'artésunate par voie intraveineuse. Malgré une bonne observance des médicaments antipaludiques, tous les 3 avaient encore de la fièvre avec une forte parasitémie. Ils ont ensuite reçu de la quinine par voie intraveineuse, avec une amélioration dans les 24 premières heures de traitement, et n'avaient plus de fièvre à la quatrième semaine de suivi. Bien que la résistance à l'ACT n'ait pas été établie, la mauvaise qualité des médicaments peut avoir contribué à l'échec du traitement. Il y a un besoin de pharmacovigilance des antipaludéens au Nigeria.

The Radiologist at the Center of Breast Conservation in the Management of Breast Cancer: A Case-Based Narrative Review of the Literature

The management of breast cancer involves a multidisciplinary team approach involving the surgeon, radiologist, pathologist, radiotherapist, and clinical oncologist. Radiology in the management of breast cancer patients allows for lesion detection and characterization, confirmation of diagnosis with image-guided biopsy, post-biopsy placement of clip marker, confirmation of patients’ eligibility for breast conservation surgery, image-guided localization, staging, evaluation of response to therapy before surgery, and follow-up after treatment for breast cancer. This narrative review is based on a case of a 35-year-old woman offered breast-conserving therapy for stage IIB breast cancer in a tertiary hospital in Southwest Nigeria. This case-based review highlights the radiologist’s vital role in breast conservation in the management of breast cancer, elaborating on the radiological management of this patient.

The pattern of malignancies and associated factors among type 2 diabetes mellitus patients in a tertiary hospital in Southwest Nigeria

The pattern of malignancies and associated factors among type 2 diabetes mellitus patients in a tertiary hospital in Southwest Nigeria

Prevalence and correlates of sleep-disordered breathing in patients with heart failure at a tertiary hospital in South-west Nigeria: a cross-sectional study

Prevalence and correlates of sleep-disordered breathing in patients with heart failure at a tertiary hospital in South-west Nigeria: a cross-sectional study

Real-world effectiveness and costs of vertical oscillatory pressure manipulation for low back pain

IntroductionReal-world evidence studies using routinely collected data, such as patient clinical records, are innovative ways of generating insight into the effectiveness of healthcare interventions. This study examined the effectiveness of vertical oscillatory pressure (VOP) on selected clinical outcomes for patients with low back pain (LBP) using routinely collected data.MethodsRetrospective analysis was carried out on the medical records of patients diagnosed with LBP in a tertiary hospital in south-west Nigeria over a 10-year period. Clinical outcomes (pain intensity and functional disability) in patients who received VOP (&lt;i&gt;n&lt;/i&gt; = 201) for their LBP were compared with controls that had traditional physiotherapy (TP) (&lt;i&gt;n&lt;/i&gt; = 138) in a routine clinical setting. Total costs of intervention were estimated in terms of direct and indirect costs.ResultsThere were significant differences within group (from baseline to 4th and 8th week of intervention) for the VOP group in pain intensity (&lt;i&gt;p&lt;/i&gt; = 0.001) and functional disability (&lt;i&gt;p&lt;/i&gt; = 0.001). However, TP group showed no significant differences in pain intensity and functional disability across baseline and week 8 of the study. There was a significant difference in pain intensity (2.95 ± 1.38 vs. 4.16 ± 2.48; &lt;i&gt;p&lt;/i&gt; = 0.013) between VOP and TP at week eight. A higher direct and indirect costs associated with VOP compared with TP (both &lt;i&gt;p&lt;/i&gt; = 0.042).ConclusionsThe findings of this study suggest that VOP is an effective intervention for LBP in the ‘real-world’. VOP is more effective compared to TP on its effect on pain intensity over time.

Computed Tomography Assessment of Cephalic Index and Sella Turcica Dimensions and Morphology in a Nigerian Population

Cephalic index (CI) is the percentage of biparietal diameter to the occipitofrontal diameter of the skull and can be used in forensic investigations in cases of disputed identity where only fragments of the head/skull are available. The sella turcica houses the pituitary gland whose hormones regulate the functions of many other glands and systems of the body. Abnormal sizes of sella turcica could indicate sella/pituitary pathology with health implications. This study aimed to assess CI, head shapes and sella turcica dimensions and morphology of the Yoruba tribe of Nigeria. The objectives are: to relate CI and head shapes with sella turcica dimensions and morphology, to use CI and head shape to identify and distinguish the Yoruba tribe from other tribes, to use CI and head shape to distinguish between genders. Skull/head and sella turcica dimensions were measured on 321 retrospectively enlisted normal cranial Computed Tomography (CT) images of Yoruba subjects, mean age 55 (SD ± 17) years, in a Tertiary Hospital in South-West Nigeria between January 2020 and April 2021, and then CI calculated. Data was analyzed using IBM SPSS 27(IBM Corp. Armonk, NY, USA, 2019). Predominant head shape of the studied group was dolichocephalic. Mean CI was 70.0 ± 3.7 and showed no statistically significant difference between gender (P = 0.097). Mean sella length, depth; and anteroposterior diameter was 1.22 ± 0.24 cm, 0.80 ± 0.15 cm, 1.34 ± 0.25 cm respectively. Mean sella length and depth showed significant difference between gender (P = 0.0001; P = 0.032) respectively. Head shape has no association with sella dimensions and morphology. Head shape and CI may stratify populations in forensic practice and surgical planning.