Tertiary Hospital In South West Research Articles

Satisfaction among patients attending oncology clinic in a tertiary hospital in South West, Nigeria

Objective: This study determined patients' satisfaction with health care received at the oncology clinic in a tertiary hospital in Lagos, South West of Nigeria. Methods: A descriptive cross-sectional study was carried out among patients attending the oncology clinic in Lagos State University Teaching Hospital, Ikeja, Lagos. A total of 143 patients were recruited using a systematic random sampling and interviewer administered questionnaire was used to collect data. Analysis was done using Statistical Package for Social Sciences (SPSS version 20). Test of significance was performed using a 95% confidence interval and the level of significant set at p = 0.05. Results: More than half 123 (86.1%) reported that they got the kind of service they wanted, 125 (87.5%) reported almost all their needs had been met. Majority (92.3%) of the respondents were satisfied with the level of care received while 2.8% were indifferent and 7 (5%) were dissatisfied. The level of satisfaction was statistically significantly associated with age, marital status, level of education and average monthly income (p<0.05). Conclusion: Majority of patients were satisfied with the health care services at the oncology clinic. Regular satisfaction survey is recommended Keywords: Patient satisfaction, oncology, tertiary hospital

Factors Associated with Successful Resuscitation after In-Hospital Cardiac Arrest: an prospective observational study performed in a tertiary hospital in south west of China

Factors Associated with Successful Resuscitation after In-Hospital Cardiac Arrest: an prospective observational study performed in a tertiary hospital in south west of China

Insulin resistance and plasma glucose tolerance abnormalities in Nigerians with chronic liver disease

AimsGlucose tolerance abnormalities are frequently observed in patients with chronic liver disease (CLD). Insulin resistance (IR) has been suggested to be a major factor responsible for these abnormalities in CLD. However studies relating IR with severity of CLD are scarce in Nigeria. This study assessed insulin resistance and glucose tolerance abnormalities in CLD and their relationship with the severity of CLD in a tertiary hospital in South-West, Nigeria. MethodsThis cross sectional study involved 100 subjects with CLD. Ethical clearance was obtained and informed consent was granted by participants. Participants were interviewed using a structured proforma; physical examination and relevant investigations were performed. Insulin resistance was measured using the homeostasis model assessment (HOMA-IR) Data was analysed using Statistical Package for Social Sciences version 20.0 and p value of <0.05 was considered significant. ResultsMean age of the study participants was 51.9 ± 11.9 years, and mean duration of CLD was 15.9 ± 5.8 months. Glucose tolerance abnormalities were present in 66 subjects (66%) and increased from 16.1% in Child Pugh's class A to 90.0% in class C.HOMA-IR positively correlated with age, body mass index, serum blood glucose, duration and severity of CLD. Increasing age, presence of hepatocellular carcinoma, Child Pugh's class B and class C were associated with glucose tolerance abnormalities. ConclusionGlucose tolerance abnormalities and insulin resistance were highly prevalent among chronic liver disease subjects studied and seemed to parallel the severity of CLD, determined by the Child Pugh's score.

Self-Esteem, Optimism and Burden of Care among Relatives of Cardiovascular Disease Patients in Selected Tertiary Hospitals in Southwest, Nigeria

Self-Esteem, Optimism and Burden of Care among Relatives of Cardiovascular Disease Patients in Selected Tertiary Hospitals in Southwest, Nigeria

Carbapenem-Resistant Enterobacteriaceae among In-Patients of Tertiary Hospitals in Southwest, Nigeria

The study assessed the incidence and risk factor associated with the occurrence of carbapenem-resistant Enterobacteriaceae (CRE) among hospitalized patients at three tertiary hospitals in Southwest, Nigeria. A cross-sectional study was performed over a six-month surveillance period in the locations with a total of 300 blood and urine samples. A structured close-ended questionnaire was also administered to all subjects for review of demographics and potential risk factors. Fifty-nine isolates belonging to genera Escherichia (52.5%), Enterobacter (23.8%), Klebsiella (10.2%) and Proteus (13.6%) were isolated. All the isolates were multi-drug resistant with a notable resistance (100%) to cephalosporins and significant sensitivity to nitrofurantoin. A total of 23 isolates including Escherichia coli (n = 8), Enterobacter aerogenes (n = 9), Klebsiella pneumoniae (n = 1) and Proteus mirabilis (n = 5) exhibited resistance to one or both of imipenem and meropenem. The overall incidence of CRE in the three locations at the time of study was 7.7%. Age (p = 0.01) and exposure to invasive devices were significant risk factors for CRE colonization. Although at low incidence, the occurrence of CRE among this group calls for active monitoring because of its implication fatality of infections as well as the propensity to spread.

Introduction Pages

Notulae Scientia Biologicae (http://www.notulaebiologicae.ro), Issue 3, Volume 10, 2018: The papers published in this issue (http://www.notulaebiologicae.ro/index.php/nsb/issue/current) represent interesting novelties in different topics of life science. Among the exciting researches, we invite readers to find news about: activities of certain serum enzymes and levels of some biochemical parameters in spent horses with liver damage; carbapenem-resistant Enterobacteriaceae among in-patients of tertiary hospitals in Southwest, Nigeria; an ethnobotanical study of plant species used for medicine by the Eegun indigenous tribal group of Lagos State, Nigeria; essential oil composition and antimicrobial activity of Achillea biebersteinii Afan. (Asteraceae) from Erzincan Region, Turkey; regulatory network identification, promoter and expression analysis of Arabidopsis thaliana NPR1 in defense responses against stresses; influence of extraction scheme on the antioxidant potential of Caralluma tuberculate; phytogeographical affinities of tree species of Similipal Biosphere Reserve, Odisha, India; vegetation dynamics and species diversity in a Saharan Oasis, Egypt; fungal and insect pests of the edible mushroom Pleurotus ostreatus; yellow rust (Puccinia striiformis), a serious threat to wheat production worldwide; biochemical markers of salt stress in European larch (Larix decidua) etc.

Urinary tract infections and antibiotic sensitivity pattern of uropathogens in a tertiary hospital in South West, Nigeria

Background: Urinary tract infection (UTI) is one of the factors implicated in morbidity among patients. Early diagnosis and treatment of UTI could be pivotal in overall treatment outcome. Aims: The aim of this study was to determine the prevalence of UTI, identify common isolates in UTI cases, and their in vitro sensitivity and resistance patterns to common antibiotics. Materials and Methods: This was a retrospective descriptive study of 181 patients with microbiological indications for UTI conducted between April 2014 and September 2015. Results: Out of 181 patients aged 20–86 years with a mean age of 51.43 ± 17.2 years, 79 (43.6%) had positive bacterial growth for uropathogens. Most common predisposing factors were urethral catheterization (32.5%), diabetes mellitus (23.7%), and urinary tract obstruction (18.7%). UTI was found to be more predominant among females (55.7%). The common isolates were Escherichia coli 30 (37.9%), Klebsiella pneumoniae 27 (34.2%), Pseudomonas aeruginosa 10 (12.7%), Proteus mirabilis 8 (10.1%), Enterococcus faecalis 3 (3.8%), Acinetobacter baumannii 1 (1.3%). The isolates were sensitive to nitrofurantoin and ciprofloxacin and ofloxacin while they were highly resistant to cotrimoxazole and tetracycline. Conclusions: UTI is common among patients affecting 43.6% of the participants in this study with E. coli being the most common uropathogen. ciprofloxacin, ofloxacin, and nitrofurantoin could therefore be recommended as the first line of drugs to clinicians for empirical treatment while awaiting sensitivity results. To prevent the emergence of resistant strains, rational use of drugs is encouraged.

Prevalence and predictive factors of birth traumas in neonates presenting to the children emergency center of a tertiary center in Southwest, Nigeria

Background: Although the majority of birth injuries are minor and often unreported, occasionally birth injuries may be so severe as to be fatal or leave the child with a permanent disability or even death.Objective: This study aimed to document the patterns and predictive factors of birth injuries in neonates presenting at the emergency center of a tertiary hospital in South west, Nigeria. Patients And Methods: This was a cross-sectional study of neonates who presented at the Olikoye Ransome-Kuti Children Emergency Center of the Lagos University Teaching Hospital between October and December 2016. All neonates admitted for treatment at the center for any clinical condition were included in the study after initial review or resuscitation/treatment for their primary complaint, and consent was obtained from their caregivers. The babies were examined by at least a senior resident and any abnormality documented. Any underlining medical conditions such as asphyxia and neonatal sepsis were properly investigated and treated. Statistical analyses were performed by chi-square, student's t-test, using SPSS version 20.0. P ≤ 0.05 was considered statistically significant. Results: A total of 134 neonates were reviewed during the study period with majority, 84 (62.7%), being males. The mean age at presentation was 65.2 ± 89.2 h (median 24 h). Caput succedaneum (22.2%) and subconjunctival hemorrhage (22.2%) were the most frequent injuries observed, while cranial nerve injury the least. One patient had multiple injuries (cranial nerve injury with fractures humerus). Conclusions: Overall prevalence and pattern of birth injuries in neonates presenting at our emergency center was consistent with various studies from other centers. Parity of the mother, significant maternal medical history, duration of labor, mode of delivery, and skill of attending personnel at delivery were significant factors associated with birth injuries

English

Urinary catheters are used to relieve urinary retention. Its prolonged use has been associated with poor quality of life (QoL) and psychosocial distress among patients. We sought to evaluate the QoL and prevalence of depressive symptoms among patients on prolonged indwelling urinary catheters. A cross- sectional study of patients with indwelling urinary catheters at an outpatient urology clinic of a tertiary hospital in South west, Nigeria. One hundred and fifty-six patients completed a structured questionnaire. QoL was assessed with adapted quality of life assessment index question of International prostate symptoms score. Patients were screened for depressive symptoms using Patient Health Questionnaire 9(PHQ-9). Bi-variate analysis of QoL with route of urinary catheterization and type of bladder drainage; and correlation of duration of catheterization, QoL and PHQ-9 scores were done using chi- square and Spearman Rank&rsquo;s correlation respectively with p value at 0.05. All patients were males with urinary retention as the major indication for urinary catheterization. Average duration of catheterization was 21 months. Poor QoL reported in majority of the patients, worse in younger age group and patients on urethral catheters. The prevalence rate of depressive symptoms was 46.1%. A weak negative correlation exists between duration of catheterization and QoL scores; and between duration of catheterization and depressive symptoms; however, strong correlation existed between QoL scores and depressive symptoms. Prolonged indwelling urinary catheter was related with poor QoL worsened in younger age group and those on urethral catheters with a high prevalence rate of depressive symptoms which correlated with the QoL. Key words: &nbsp;Urinary catheterization, quality of life, depressive symptoms, Nigeria.

Legal Issues in the Management of Patients’ Records in Tertiary Hospitals in Nigeria

This study investigated the legal practices practiced by records managers in the management of patients' records in tertiary hospitals in Nigeria, so as to know how legal issues influenced the management of patients' records in Nigeria tertiary hospitals. The correlation research design was adopted for the study. The population consisted of all the 282 records managers in the 10 tertiary hospitals in South-West, Nigeria. Data generated through questionnaire were analysed using descriptive statistics, simple correlation analysis at 0.05 alpha level. Findings revealed that record managers paid much attention to records creation, records storage and considerable actions in health records departments. Finding also deduced that legal considerations existed in tertiary hospitals in South-West, Nigeria. The study concluded that there was a significant positive relationship between records managers' legal issues and the management of patients' records in tertiary hospitals in South-West, Nigeria (r = .418, N= 230, P <.0.05). The study therefore recommended that federal government should promulgate law on management of patients' records that will cut across the federal, state and local government so as to provide uniform practice and enhance good standard of records management practice. Finally, violators of rules concerning patients' records and rights of privacy abuses should be made to face the wrath of the law, so as to serve as deterrent to others.

Aetiologies and Short-term Outcomes of Acute Kidney Injury in a Tertiary Centre in Southwest Nigeria.

Acute kidney injury (AKI) has become a global health problem and is associated with increased morbidity, mortality and overall health expenditure. Information on the epidemiology and outcomes of AKI will help to audit practice and advocate for policies that will reduce this burden. This study determined aetiologies, short term outcomes and their predictors in AKI patients in a tertiary hospital in Southwest Nigeria. This was an 18-month retrospective study that involved 91 patients with AKI. The socio-demographic information, aetiology, severity and the treatment given to patients were recorded. Outcomes and their predictors were determined using multivariate analysis. P value < 0.05 was taken as statistically significant. The mean age of the study population was 45.12 ±20.67 years. Common causes of AKI were sepsis in 50(54.9%), hypovolaemia in 23(25.3%), cardiac failure in 7(7.7%) and eclampsia in 6(6.6%). Fifty-seven (62.6%) presented with stage 3. Thirty-one (34.1%) had haemodialysis. Forty-eight (52.7%) had complete renal recovery, 35(38.5%) died and 3(3.3%) left against medical advice while five (5.5%) were referred to other hospitals. Stage 3 AKI (Adjusted odd ratio: 6.79, confidence interval: 1.21:38.04, p = 0.029) and age ≥ 65 years (Adjusted odd ratio: 4.14, confidence interval: 1.32-13.04, p = 0.015) were significant predictors of mortality in AKI patients. Sepsis and hypovolaemia were the commonest causes of AKI. The associated mortality is still high and factors associated with mortality were late presentation and older age. Early presentation, treatment and making haemodialysis affordable are key to improving AKI outcomes.

Hospital Acquired Infection in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwest, Nigeria: A Ten Year Review (2000-2009)

Surveillance and proper hygiene have been identified as key components in the fight against HAIs and antimicrobial resistance in hospital setting. This study assesses the pattern of hospital acquired infections (HAIs) and state of hygiene in a tertiary hospital in southwest, Nigeria. Data collected routinely between January 2000 and December 2009 by the infection control committee on HAI and primary data generated on hygiene in the wards were analysed using appropriate statistical techniques. A total of 37,957 patients were admitted during the period under review and 1129 cases (3.0%) of HAI were reported. The highest prevalence of 9.0% was reported in 2006. The Intensive Care Unit (ICU) had the highest period prevalence of 14.7% followed by Orthopaedics ward (7.7%). Surgical ward contributed the highest number of cases with 433. Gram negative organisms were the most implicated (78%) of which Klebsiella species was 38% while Staphylococcus aureus was the only Gram positive organism identified (28%). Hand washing was practised universally by health workers but facilities for proper hand washing were inadequate. The pattern of HAI has not changed significantly in the past 10 years and Klebsiella was the most implicated organism in HAIs and ICU. Facilities for proper hand washing are suboptimal. We recommend the introduction of hand washing policy for the hospital and the provision of an environment conducive for its implementation by the hospital management as well as adequate support for the infection control committee in the discharge of her duties. Keywords: Hand washing, Hospital-acquired, Hygiene, Infection control