Tertiary Hospital In Southwestern Nigeria Research Articles

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Profile of Paediatric Refractive Errors in a Tertiary Care Hospital of South Western Nigeria

Refractive errors are part of the priority areas for Vision 2020, a global initiative for the elimination of avoidable blindness introduced by W.H.O. (World Health organization). The presence of refractive errors in children is a cause for concern for the overall development and not only the vision of the child. It may also constitute a form of disability if left unattended to. This study therefore aims to determine the pattern of refractive errors and its associations with selected variables among children presenting to a tertiary hospital. This is a cross-sectional retrospective study conducted in the Ophthalmology Department of Ekiti State University teaching hospital which is a tertiary hospital in South-western Nigeria. Children of ages 5years - 16years with diagnosis of refractive error were recruited for the study. The medical records between Jan 2018- December 2020 were reviewed and patients’ data including age, gender and type of refractive error were extracted. Data obtained was analysed with SPSS version 20(inc.) and results are shown by frequency, tables and figures. Measure of association of the variables was done using chi square and P value =0.005. A total of 193 children with various refractive errors were seen during the period of study. There was a slight male preponderance. M: F (1.2:1) and highest frequency of refractive error was seen in children of ages between 5-7years. The most common refractive error seen was astigmatism in 140(36.2%) patients, most of the patients (46.4%) presented with moderate refractive error.

Chronic Subdural Hematoma: Predicting Postoperative Recurrence Using a Correlation of Computerized Tomographic Volume with Intraoperative Volume.

Chronic subdural hematoma (CSDH) recurrence is the most common complication following surgery. To predict postoperative recurrence of CSDH using a correlation of the calculated preoperative brain computerized tomographic (CT) volume with the intraoperative volume. A prospective study was conducted over 14 months in a tertiary hospital in southwestern Nigeria. History with focused examination findings and patient grading using Markwalder classification were documented preoperatively. Preoperative CSDH CT volume was documented and compared with the intraoperative volume. Patients were followed up clinically for features of recurrence at 1, 3, and 6 months postoperatively, and repeat brain CT was done when recurrence was suspected clinically. Forty-seven out of 51 patients recruited completed the study, and four were lost to follow-up. Thirty-three (70.2%) were males, and the average age was 51.4 years. Most of the patients were in the 5th and 7th decades of life. Three patients had recurrence (6.5%), and one patient died (2.1%). Trauma was the most common cause of CSDH (35 out of 47 [74.5%]), spontaneous in 11 (23.4%), and anticoagulant related in 1 (2.1%) patient. Most patients (37/47; 78.7%) presented with headache. The mean brain CT volume and intraoperative volume of CSDH were 102.58 ± 54.13 and 87.74 ± 46.6 mL, respectively, with no significant difference between them (P = 0.104). The receiver operating characteristics curve of intraoperative volume predicted the recurrence of CSDH at a volume >130 mL, with a sensitivity of 66.7%. The calculated preoperative CT volume had a positive linear correlation with intraoperative volume. Intraoperative CSDH volume >130 mL was associated with an increased risk of recurrence.

Metastatic Breast Cancer in a Tertiary Hospital in South-Western Nigeria

Metastatic Breast Cancer in a Tertiary Hospital in South-Western Nigeria

Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria

Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria

Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria.

Maternal health is the mother's state of well-being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State. This study is a cross-sectional survey. One hundred and eighty-eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self-designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product-moment correlation at 0.05 level of significance. From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women. Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.

Intervention Study on Pharmacists’ Knowledge and Counselling on Ophthalmic Preparations in a Tertiary Hospital in South-Western Nigeria

The study aimed to assess hospital pharmacists’ knowledge and counselling on ophthalmic preparations before and after an educational intervention was carried out. A cross-sectional study was carried out among 83 pharmacists working at the University College Hospital, Ibadan, Nigeria. A 30-item semi-structured questionnaire was administered to participants to assess their background knowledge and counselling points on use of ophthalmic preparations. An educational intervention was carried out among the pharmacists to address the gaps discovered. Post-intervention assessment of the pharmacists’ knowledge and counselling on ophthalmic preparations was done a month after the educational intervention to evaluate the impact of the intervention. Data obtained was summarised using descriptive statistics and inferential statistics. Level of significance was set at p &lt; 0.05. Response rate was 79% (83/105). Fifty-six (67.5%) participants were female and 38 (45.7%) had other educational qualification(s) aside from the basic Bachelor of Pharmacy qualification. The average knowledge scores of the pharmacists on ophthalmic preparations increased from 2.55 ± 1.602 at baseline to 7.93 ± 2.879 post-intervention (p &lt; 0.001). Also, the average counselling scores of the pharmacists on ophthalmic preparations increased from 8.12 ± 1.603 at baseline to 11.46 ± 1.0277 post-intervention (p &lt; 0.001). Years of working experience and postgraduate education were predictors of participants’ knowledge and counselling on ophthalmic preparations. The study addressed the knowledge and counselling gaps identified and there was significant improvement in the knowledge and counselling of the study participants, vis-à-vis ophthalmic preparations.

836 Value of Clinical and Ultrasonic Parameters as Preoperative Predictors of Risk of Developing Hydrocephalus Post Myelomeningocele Repair: A Cohort Study

INTRODUCTION: The risk of developing hydrocephalus after myelomeningocele repair may be determined by using preoperative clinical and transcranial ultrasound parameters. METHODS: A prospective longitudinal cohort study from November 2016 to October 2018, that involved 28 patients with myelomeningocele who presented to a tertiary hospital in southwestern Nigeria. Transcranial ultrasound was done before myelomeningocele repair and patients followed up for six months to detect hydrocephalus. Analysis of the state of the anterior fontanelle, the occipitofrontal circumference (OFC), ventricular index, bicaudate diameter, lateral ventricular ratio, thalamo-occipital distance and maximum transverse lateral ventricular diameter were done to determine their predictive values for the development of hydrocephalus after myelomeningocele repair. RESULTS: Age range was 1 -120 days with a mean of 20 days and the average age at the time of myelomeningocele repair was 23 days. There were 16 (57.1%) females and 12(42.9%) males in the study. OFC range at presentation was 31- 42cm with a mean of 34.7cm ±2.6 SD. The probability that a patient will develop hydrocephalus after myelomeningocele repair increased by 1.74 times for every1cm increase in the OFC above 34.5cm before myelomeningocele repair, p= 0.03. However, the state of the anterior fontanelle as well as the trans cranial ultrasound parameters were not found to be predictors of hydrocephalus post myelomeningocele repair. CONCLUSIONS: The OFC of the patients before myelomeningocele repair was predictive of development of hydrocephalus post repair, but the state of the anterior fontanelle and pre-operative trans fontanelle ultrasound parameters were not.

Foot care practices among patients with diabetes mellitus in South-Western Nigeria

Introduction: Diabetes foot care is an evidence-based means of preventing diabetes foot ulcer. The components of diabetic foot care include yearly comprehensive foot examination, prompt identification of risk factors to diabetic foot ulcer, diabetes foot education, and standard footwear practices. This study is aimed at evaluating the foot care practices of patients with diabetes in a tertiary hospital in South-Western Nigeria. Methods: It is a cross-sectional study that employed standardized pretested structured questionnaire to obtain data from 100 participants. The study was conducted at the diabetes clinic of a tertiary hospital in South-Western Nigeria. Ethical approval was obtained from the Institutional Review Board of the hospital. Data were presented in tables and charts. Descriptive and analytical statistics was done with Statistical Package for the Social Sciences (SPSS) version 22. Results: The mean age of the participants was 58.8 ± 11.8 years. There were 66 females and 34 males. The study showed that 77% of the participants were not having yearly comprehensive examination although 94% of the respondents did daily foot inspection at home. Only 16% had continuous foot education. Moreover, only 11% of the respondents wear recommended shoes, but 88% inspected their shoes before wearing them. Sadly, 11% of the respondents walked barefooted at home. The health-seeking behavior of respondents in an event of foot ulceration was significantly associated with their educational status. Conclusion: Foot care practices of the respondents were sub-standard. So, there is an urgent need to reinforce foot care education so as to improve these subpar practices.

Misconception on oxygen administration among patients and their caregivers in Ado Ekiti, Nigeria.

Appropriate oxygen administration is a life-saving therapy; however, patients and their caregivers could decline such therapy for several reasons. Poor perceptions may delay consent to oxygen therapy. There is a lack of data on the perception of oxygen use among patients and caregivers in our setting. Hence, this study was aimed at evaluating the perception of patients and their caregivers toward emergency oxygen use in a tertiary hospital in Nigeria. This survey was a descriptive cross-sectional study conducted between December 2017 and May 2018 at a tertiary hospital in southwestern Nigeria. We administered a structured questionnaire to 334 eligible patients and their 539 caregivers while on admission. A significant proportion of the patients compared to their caregivers have had oxygen therapy in the past 40.6% versus. 6.9% P < 0.0001. The majority of the participants (patients vs. caregivers 84.7% vs. 81.1% P = 0.511) believed oxygen therapy to be beneficial and safe for use (patients vs. caregivers 79.4% vs. 78.6%; P = 0.8949). However, 21.1% of patients and 19.5% of caregivers believed it is solely for terminally ill patients. More than 50% of patients and caregivers thought oxygen can cause adverse effects and fire outbreaks. Most of the respondents considered oxygen therapy as expensive (patients vs. caregivers; 78.2% vs. 87.2%; P = 0.0176) which was regarded as a possible barrier to treatment (patients vs. caregivers 81.9% vs. 85.0% P = 0.3893). <1% of both patients and their caregivers have had any form of training in basic life support. The misconceptions about oxygen use require urgent attention by raising community awareness and knowledge toward improving the acceptability of this life-saving intervention.

Review of the demographic pattern and outcomes of acute chemical poisoning in patients in a tertiary hospital in South-western Nigeria

Introduction: Acute chemical poisoning is a public health problem especially in developing countries where there is unrestricted access to chemical products, underreporting and absence of poisoning registers. Despite its importance, there is limited information on acute poisoning among adult population in Nigeria. The study was aimed at determining the demographic pattern and short term outcomes of acute chemical poisoning in patients in a tertiary health institution in South-western Nigeria over a 2 year period.Methodology: Records of cases of acute chemical poisoning over a 2-year period were retrieved and the following information extracted: socio-demographic data of patient, type of substance ingested, type of poisoning, reason for poisoning, intervention, and outcome of treatment. Results:There were 58 patients with a M:F ratio of 1:1.1. The mean age was 28.53±13.47 years. The most commonly ingested chemical was organophosphate seen in 31(53.4%). Poisoning was deliberate in 43 (74.1%); 36 patients (62.1%) had atropine; 16 patients (27.6%) had gastric lavage; one patient (1.7%) was dialyzed and 2 patients (3.4%) were admitted into ICU. Mortality rate was 8.6%. Conclusion: Deliberate acute chemical poisoning was common in young adults. Organophosphate is the most commonly ingested chemical. Government should enforce laws that that would restrict access to potentially harmful chemicals.&#x0D; French title: Schéma et résultats à court terme d'une intoxication chimique aiguë dans un hôpital tertiaire du sud-ouest du Nigéria&#x0D; Introduction : Les intoxications chimiques aiguës sont un problème de santé publique en particulier dans les pays en développement où il existe un accès illimité aux produits chimiques, une sous-déclaration et l'absence de registres des intoxications. Malgré son importance, il existe peu d'informations sur les intoxications aiguës parmi la population adulte au Nigéria.Objectif de l'étude: Déterminer le schéma démographique et les résultats à court terme des intoxications chimiques aiguës chez les patients d'un établissement de santé tertiaire du sud-ouest du Nigéria sur une période de 2 ans.Méthode de l'étude : Des dossiers de cas d'intoxication chimique aiguë sur une période de 2 ans ont été récupérés et les informations suivantes extraites : données sociodémographiques du patient, type de substance ingérée, type d'intoxication, raison de l'intoxication, intervention et résultat du traitement.Résultat de l'étude : Il y avait 58 patients avec un rapport M : F de 1:1,1. L'âge moyen était de 28,53 ± 13,47 ans. Le produit chimique le plus couramment ingéré était l'organophosphate vuswzsw3 dans 31 (53,4 %). L'empoisonnement était délibéré dans 43 (74,1 %); 36 patients (62,1%) avaient de l'atropine ; 16 patients (27,6 %) ont eu un lavage gastrique ; un patient (1,7%) a été dialysé et 2 patients (3,4%) ont été admis en réanimation. Le taux de mortalité était de 8,6%. Conclusion : Les intoxications chimiques aiguës délibérées étaient fréquentes chez les jeunes adultes. L'organophosphate est le produit chimique le plus couramment ingéré. Le gouvernement devrait appliquer des lois qui restreindraient l'accès aux produits chimiques potentiellement nocifs.

Early Outcome of Endoscopic Third Ventriculostomy With Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunt as Primary Treatment of Hydrocephalus in Children With Myelomeningocele: A Prospective Cohort Study.

Myelomeningocele is associated with hydrocephalus in 35% to 90% of cases. Hydrocephalus is usually treated with insertion of ventriculoperitoneal shunt; however, there is growing evidence that endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is an alternative. To compare the success rate and morbidity of ETV with CPC and ventriculoperitoneal shunt (VPS) as the primary treatment of hydrocephalus in patients with myelomeningocele. A prospective study from January 2016 to February 2019, involving 46 patients with myelomeningocele who developed hydrocephalus after repair in a tertiary hospital in southwestern Nigeria. Biodata and preoperative features of hydrocephalus were documented. ETV+CPC or VPS was done using standard operative techniques. Patients were followed up monthly for 6 mo. There were 23 patients in the ETV+CPC arm and 22 patients in the VPS arm. Morbidities were cerebrospinal fluid leak, 8.3% in the ETV+CPC arm and 4.5% in the VPS arm, wound dehiscence, 13.6% in the VPS arm, none in the ETV+CPC arm. At 6-mo follow-up, success rate for ETV+CPC was 60.9% and 59.1% for VPS, P=.9. ETV+CPC had similar success rate with VPS at 6 mo with lower morbidity. ETV+CPC should be considered a viable alternative when treating patients with myelomeningocele and hydrocephalus.

Correlation of Plasma Magnesium with Insulin Resistance in Type 2 Diabetes

Introduction: Insulin resistance (IR) is a core component of the pathophysiology of type 2 diabetes mellitus (DM). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is the most commonly used marker of IR. Plasma magnesium is a relatively cheap analyte and has been linked with the pathophysiology of IR. This study primarily was aimed at evaluating the possible use of plasma magnesium as a surrogate marker of IR in type 2 diabetes. Materials and Methods: The study was a hospital-based cross-sectional study carried out at a tertiary hospital in South-western Nigeria between March and September 2018. The study was conducted on 70 persons with diabetes, and age- and sex-matched 70 controls who met the eligibility criteria were recruited into the study. Ethical approval was obtained and informed consent was obtained from the participants. Fasting plasma glucose, fasting plasma insulin, and plasma magnesium were measured using standard protocols. HOMA-IR was determined using the appropriate formula. Data analysis was carried out using the Statistical Package for Social Sciences software, (SPSS) version 22. Results: The mean age of the participants was 53.34 ± 9.57 years and that of the gender-matched controls was similar. Frequency of hypomagnesemia was significantly higher in the participants compared with controls (25.7% vs. 5.7%; P &lt; 0.001). Similarly, a significantly greater proportion of the study participants (62.9%) had IR as expected compared with just 8.7% of the controls. The mean plasma magnesium (mg/dL) among the participants was significantly lower than that of the controls (1.73 ± 0.16 vs. 1.87 ± 0.14; P &lt; 0.001). As expected, the mean HOMA-IR in the participants was significantly higher than that of the controls (2.64 ± 0.91 vs. 1.71 ± 0.32; P&lt;0.001). There was a statistically significant negative correlation between plasma magnesium and IR among the participants (r=−0.443; P&lt;0.001). However, among the controls, there was no statistically significant correlation between plasma magnesium and HOMA-IR (r=−0.034; P = 0.778). Conclusion: Plasma magnesium was found to correlate significantly with IR and may be used as a surrogate marker of IR in persons with type 2 DM but not in the general population.