Tertiary Hospital In Nigeria Research Articles

Evaluation of the pattern and quality of referrals from inpatient wards to hematology department of a tertiary hospital in Nigeria

Background: The overall quality of care may be hampered by poorly written referrals. Referral letters should be detailed to elicit prompt response by the invited unit. This will enhance ideal management of cases that are referred. Aim: The aim of the study is to determine the quality (content and usefulness) of referral letters received from inpatient clinical wards of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla by hematology department of the hospital. Materials and Methods: This was a retrospective study of all referral letters received in hematology department of the hospital over a 1-year period (January to December, 2019) using a validated questionnaire. Results: A total of 231 referral letters were received and evaluated. The median age of the patients was 35 (range: 20–59) years with male-to-female ratio of 1:1.3. Initial statement identifying the reason for the referral was observed in 88.7% (n = 205). Majority (176/213, 82.5%) of the referrals did not include the results of investigations the patients did before the referral. Less than a quarter of the referrals (41/231, 19.3%) contained information on the treatment given to the patient. More than one-tenth (24/231), 11.3%) of the referrals were unhelpful while 13.6% (n = 29) were helpful. Conclusion: The referrals sent to the hematology department were deficient in quality. These deficiencies could be ameliorated by tutoring the younger doctors on the content of an ideal referral letter. Furthermore, a well-structured “referral form” with prompts for easy filling could be designed by hospitals as a guide to physicians for writing appropriate referral letter.

Knowledge of the glasgow coma scale among physician interns in a Nigerian tertiary health facility

Background: The Glasgow coma scale (GCS) is the most utilized level of consciousness scale globally. Insufficient working knowledge of the GCS by physicians may contribute to poor outcomes in patients with altered levels of consciousness. Aim: This study aims to assess the knowledge of the GCS among the physician interns, also known as house officers, in a rural tertiary health facility in Nigeria. Materials and Methods: This was a questionnaire-based survey among physician interns in a rural tertiary hospital in Nigeria. Results: All the 77 respondents graduated from medical school within 2 years of the study. Seventy-two (93.5%) of the participants had been actively involved in the management of patients at the hospital's accident and emergency department within a month before the study, while 71.4% had been involved in emergency care outside the accident and emergency department within a month prior. Seventy-five (97.4%) conceded to having received didactic lectures on the GCS in the course of their medical training. About three-quarters (74.03%) of the respondents correctly defined GCS as GCS; about 85.7% were able to correctly identify all the clinical variables of the GCS, while only 15.6% could correctly describe and score all the parameters of the grading scale. The eye-opening response was the most correctly remembered (64.9%), followed by the verbal response (42.9%), while the motor response was remembered by 29.9% of the respondents (P = 0.04). Only 36 (46.8%) participants were aware of any subsequent modification to the original GCS score. Conclusion: The working knowledge of GCS is poor among physician interns surveyed in this study. The clinical variable of the GCS with the highest number of items, the motor response, was the least correctly remembered.

Evaluation of the clinico-laboratory manifestations of newly diagnosed multiple myeloma

Background: Multiple myeloma (MM) is a very common hematological malignancy and constitutes about 10% of hematological malignancies. Laboratory investigations including haematological, biochemical, and molecular studies play an important role in the diagnosis, monitoring of response, and relapse in patients with MM. Objectives: The objectives of this article were to assess the initial clinical features, hematological profile, and biochemical parameters of newly diagnosed patients with MM. Materials and Methods: This was a retrospective study of MM patients seen from February 2010 to January 2020 at a tertiary hospital in Nigeria. A total of 51 patients’ case notes were retrieved from the Medical Records Department of the hospital. The socio-demographic data were collected using a Microsoft Excel Sheet. Data on age, sex, hematological parameters, presence of bone lesions (fractures, and osteolytic findings from radiographs), and biochemical parameters were extracted and analyzed. Results: The median age was 60.5 years, and the mean age was 59.6 ± 9.3 with a range of 35–89 years and a male-to-female ratio of 1.7:1. Only 1 (2.0%) patient was aged below 40 years, and the rest 50 (98.0%) were above 40 years of age. The 61–70 age group had the highest number of cases, 31 (60.8%). The mean hemoglobin, white cell count, and platelet count were 7.96 ± 2.2; 6.76 ± 0.6; and 213.50 ± 98 respectively. Serum protein was >80 g/L in 33 (64.7%) and <80 g/L in 18 (35.3%) patients. Two-thirds of the patients, 34 (66.7%) had albumin level <35 g/L. The mean albumin and globulin levels were 36.2 ± 10.9 and 59.2 ± 1.9 respectively, giving an albumin–globulin ratio (AGR) of 0.611. The mean calcium level was 2.6 ± 0.29 mmol/L. The overall mean urea and creatinine levels were 8.02 ± 3.2 (mmol/L) and 169.5 ± 89.4 (μmol/L), respectively. The most common clinical presentations were weakness, pallor, and bone pains with a proportion of 49 (96.1%), 47 (92.2%), and 45 (88.3%), respectively. Conclusion: The physicians should be alerted on the possibility of MM when an elderly patient presents with weakness and bone pains. The AGR is commonly low, connoting a poor prognosis.

Frequency of occurrence of odontogenic lesions of the jaws in a tertiary hospital in Nigeria

Frequency of occurrence of odontogenic lesions of the jaws in a tertiary hospital in Nigeria

Discharge Against Medical Advice (DAMA) in Adult Emergency Department of a Tertiary Hospital in Nigeria

Background: Patients who discharge against medical advice are at increased risk of morbidity and mortality as well as posing a serious burden for the hospital especially when re-admitted.&#x0D; Aim: To determine the demographics, prevalence, clinical diagnosis and reasons for discharge against medical advice adult Emergency Department.&#x0D; Methods: This was a retrospective descriptive study, carried out over one year period from June 2018 to May 2019 at University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Patients who requested for Discharge Against Medical Advice (DAMA) were asked to fill a data collection form after adequate counselling. Data analysis was carried out using IBM SPSS version 21.&#x0D; Results: A total of 476 patients signed the DAMA form. There was male predominance with a male to female ratio of 1.4: 1. The average age of the patients was 42 ± 21 years. Surgical diagnosis accounted for 287 (60.3%) cases while the rest were medical. The most common reasons for DAMA were "To go closer home and financial constraint".&#x0D; Conclusion: Discharge against medical advice was more prevalent among male patients with surgical cases accounting for more than half of the cases. Financial constraints and going home were the two common reasons for DAMA.&#x0D; Keywords: Adult Emergency Department; Clinical diagnosis andReasons for DAMA; DAMA; Demographic features; Prevalence.

Use of Complementary and Alternative Therapies among Adult Glaucoma Patients Attending a Tertiary Hospital in Nigeria

Use of Complementary and Alternative Therapies among Adult Glaucoma Patients Attending a Tertiary Hospital in Nigeria

Predictors of Antenatal Depression in a Tertiary Hospital in Nigeria

Background: Antenatal depression is very common in pregnant women all over the world. Women in the developing and poor countries are more at risk. Several risk factors have been identified and some of them may lead to unbearable pregnancy situations, that pose a threat to mother and the baby. If pregnancy must be made pleasurable for mothers, then the risk factors which predict depression in pregnancy must be identified and considered in antenatal care.&#x0D; Objective: To identify risk factors which are predictors to antenatal depression in pregnant women.&#x0D; Methods: Within the months of January and February 2021, all the pregnant women who registered for antenatal care in the teaching hospital, who met the study inclusion criteria were assessed for depression using the English version of Edinburgh Postnatal Depression scale (EPDS) and a study designed risk factor questionnaire, which contained socio-demographic variables and other factors. Data obtained were analyzed using the statistical package for social sciences (SPSS) version 23. Variables were compared using chi squared and t-tests and p values &lt; 0. 05 were statistically significant.&#x0D; Results: Five hundred (500) respondents completed the study, 158 (31.6%) were depressed. Risk factors of co-habiting, threats to life, and/or pregnancy, fight with spouse and other forms of abuse, previous abortions and child health challenges, were predictors of antenatal depression.&#x0D; Conclusion: Depression in pregnancy should be part of routine antenatal care by obstetricians noting the predictors.

Detection of NDM-1 in Metallo-Beta-Lactamase-Producing Strains of Pseudomonas aeruginosa isolates from a Tertiary Hospital in Southwest Nigeria

Background: Metallo-beta-lactamase producingPseudomonas aeruginosa (MBL-PA) infections pose a major healthcare concern globally due to the associated extended morbidity, increased cost of treatment and high mortality.&#x0D; Objectives: This study aimed to determine the prevalence of circulating MBL-PA strains and evaluate probable risk factors associated with the carriage of MBL-PA among patients in a selected South-western tertiary hospital in Nigeria.&#x0D; Methods: One hundred and forty-four isolates recovered from diverse clinical specimens were identified as Pseudomonas aeruginosa by conventional methods. Eight antibiotics were tested on the isolates using Kirby-Bauer disc diffusion technique. All carbapenem resistant isolates were phenotypically screened for MBL-production using the combined disc synergy test. The MBL-producing strains were evaluated for the presence of three MBL genes blaIMP, blaVIM-2 and blaNDM1 by Polymerase chain reaction (PCR).&#x0D; Results: Fourteen (9.7%) isolates were positive for metallobeta-lactamase production by combined disc synergy test. The MBL-producing strains were more commonly resistant to all the tested antibiotics except to piperacillin tazobactam and imipenem compared with the non MBL producing strains (p&lt;0.05). Antibiotic use and the occurrence of multidrug resistance phenotype were significantly associated with MBLcarriage (p&lt;0.05). Four (28.6%) MBL-PA isolates carried NDM-1 gene, while IMP and VIM-2 genes were not detected in any of the isolates.&#x0D; Conclusion: The study demonstrated a low prevalence of NDM-1 in P. aeruginosa circulating among patients in this environment. This may be because carbapenems are seldom prescribed in our hospital or probably due to the existence of other MBL genes and non-enzymatic resistance mechanisms that we did not investigate. Studies that evaluate the level of carbapenem resistance via non-MBL production route could assist and improve future surveillance of these fast spreading genes.&#x0D; Keywords: IMP; MBL-PA; Metallo-beta-lactamase; NDM1; VIM.

BREAST CONSERVING SURGERY AWARENESS AND ACCEPTANCE AMONG FEMALE NURSES IN IRRUA SPECIALIST TEACHING HOSPITAL

Introduction: Breast Conserving Surgery (BCS) is oncologically safe for eligible patients with breast cancer and has enormous physical and psychological benefits. Despite this, the mastectomy rate in many centres is still very high. Nurses are frontline staff in healthcare settings and have great contact with the patients. The level of their awareness would have a great impact on patients eligible for breast conservation seeking expert opinion. This study explored the awareness, perception and acceptance of BCS among female nurses in a rural Nigeria tertiary hospital.&#x0D; Methodology: A quasi-structured self-questionnaire was distributed to 235 nurses using a convenient sampling method. The responses on 219 adequately filled questionnaires were entered into an IBM SPSS Statistics Data Document (version 21.0) for analysis. Categorical variables were presented in counts and percentages. Association between the acceptance of BCS versus its awareness, equivalence to TM and years of nursing practice were tested using Chi-square probability test and a p-value of &lt;0.05 was considered statistically significant.&#x0D; Result: The 219 participants had a good representation of junior and senior nurses among whom 80.4% were at least 45 years old and 82.2% were married. The nurses were mostly general nursing practitioners (76.7%) and 49.3% of the nurses had practised for a duration not less than 10 years of age. The 126 (57.5%) nurses, who described BCS as the surgical removal of a cancerous breast lump short of mastectomy, were considered to be aware of BCS irrespective of their understanding of complementary treatment modalities, eligibilities, comparative advantages to TM and certainty of its oncologic safety. The lack of ready access to radiotherapy centres (54.3%) and delay/overcrowding of these facilities (42.5%) were recognised respectively as major local challenges to BCS practices. The equivalence of BCS to TM was affirmed in 44.3% of the nurses and 35.6% had participated in managing breast cancer patients using the conservative surgical approach. 57.1% were willing to accept BCS or recommend it for an eligible friend or relative and no statistically significant association was observed among those who accepted BCS when matched with the level of awareness or the duration of nursing practice. A higher and significant level of acceptance of BCS was noted among those aware of its oncologic equivalence to TM (p-value = 0.000)&#x0D; Conclusion: This study demonstrated gaps in knowledge of BCS among nurses who are stakeholders in assisting patients make the right decision. This knowledge gap in the perception of BCS will interfere with the ability of the nurse to adequately counsel patients in need of their expert opinion. The awareness of the oncologic equivalence of BCS to TM increased its acceptance significantly. An increase in public awareness and education of nurses is required to improve the acceptance rate of BCS in our practice. Caregivers should also devise effective means of communication to encourage eligible patients for breast conservation

THE PRACTICE AND IMPLEMENTATION OF RADIATION MONITORING OF RADIOGRAPHERS IN TERTIARY HOSPITALS IN SOUTHEASTERN NIGERIA: A REASSESSMENT

Background: Radiation monitoring is an essential radiation safety practice that helps to determine the cumulative radiation dose absorbed by radiographers, ensuring that it does not exceed permissible limits. Failure in practice and implementation of radiation monitoring exposes radiographers to stochastic effects of radiation exposure, increasing the hazard radiation workers are exposed to. Objective: To reassess the practice and implementation of radiation monitoring of radiographers working in south-eastern tertiary hospitals in Nigeria. Methods: This was a cross-sectional survey involving 102 radiographers from 5 selected South-Eastern tertiary hospitals. Proportional stratified random sampling was used to select the radiographers from each tertiary hospital while a semi-structured questionnaire in line with the specific objectives was used as the method for data collection. Information obtained from the respondents was related to established radiation monitoring requirements and tables were used for data presentation. Results: With a perfect response rate from the 102 respondents, personnel radiation monitoring was available to only 31% (n = 32) of the respondents with 59% (n = 19) using Thermoluminiscent dosimeters. Even though a majority (71.9%, n=23) wore their dosimeters daily, only half (50%, n = 16) of those monitored had routine device retrieval and feedback of reading at the appropriate time. Employees did not demand radiation monitoring history from the radiographers before employment and only 10% (n = 3) of those monitored claimed they had dosimetry records. Lastly, only 6.3% (n = 2) of radiographers have been on leave as a direct result of over-exposure to radiation. Conclusion: Personnel radiation monitoring practices of radiographers in South-Eastern tertiary hospitals still remain below internationally acceptable standards. Comparing the findings of this study with a similar study carried out 10 years ago, there has been little improvement in the radiation monitoring of radiographers. The management of tertiary health institutions should ensure that personnel monitoring devices are made available to radiographers, and stricter rules should be placed on the daily wearing of dosimeters.

Pneumatization Patterns of the Sphenoid Sinus in Adult Nigerians and Their Clinical Implications.

The variant pneumatization patterns of the sphenoid sinus have significant surgical implications due to their associated inconsistent neurovascular relations. This study aimed at evaluating the pneumatization patterns of the sphenoid sinus in adult Nigerians. This was a retrospective study conducted at the Radiology Department of a Tertiary Hospital in Nigeria after obtaining institutional ethical approval. Brain Computed Tomography images of 336 patients (137 females, 199 males) aged ≥20 years were studied for the variant pneumatization patterns of the sphenoid sinus. Statistical Package for Social Sciences version 23 was used for data analysis. Chi-square test was used to assess for the association of the variants with gender and side. Pvalue was considered significant at <0.05. The predominant pneumatization pattern in relation to the seller turcica was the sellar type (181;53.9%) followed by the presellar type (65;19.3%), post-sellar (62;18.5%), and lastly the conchal type (28;8.3%). The most prevalent clival recess was the subdorsal type (25;7.4%) followed by the dorsal (18;5.4%), combined (7;2.1%), and lastly occipital (3;0.9%). The frequency of pneumatized anterior clinoid process, greater wing of sphenoid and pterygoid process was 76;22.6%, 60;17.9% and 141;42% respectively and these showed significant side difference (P=0.001 each). None of the pneumatization patterns showed a significant gender difference. Sphenoid sinus agenesis was not observed. The pneumatization patterns in our study varied from the findings in previous Nigerian studies and other populations. There is therefore the need for preoperative evaluation before endoscopic transsphenoidal surgical procedures.

Birth prevalence of congenital heart disease among newborns in a tertiary hospital in Benin City, Nigeria.

Congenital heart disease (CHD) is an important cause of childhood morbidity. The birth prevalence and distribution of CHD among neonates in a tertiary hospital in Nigeria was determined. This descriptive, cross-sectional study involved consecutive neonates in the neonatal and postnatal wards of the hospital. Bedside echocardiography was conducted on all neonates. Data entry and analysis was done with IBM-SPSS version 20.0. A total of 2 849 neonates were recruited, consisting of 1 482 (52.0%) males. Forty-one neonates had CHD, giving a birth prevalence of 14.4/1 000 live births. Of the 41 with CHD, 21 (51.2%) were male. Thirty-six (87.8%) neonates had acyanotic CHD, of which the commonest was isolated ventricular septal defect [11 (26.8%)]. Transposition of the great arteries [3 (7.3%)] was the commonest cyanotic CHD. The birth prevalence of 14.4/1 000 live births in this study is high and buttresses the need for strengthening existing cardiac services in Nigeria.

Efficacy and safety of dual intravenous artesunate plus quinine compared to intravenous artesunate for cerebral malaria in a triple blinded parallel multisite randomized controlled trial in Nigerian children: DUAL PAQ TRIAL Protocol

BackgroundEvidence exists as to the criticality of the first 24 h in the management of cerebral malaria. The morbidity and the mortality rate (35%) with the current intravenous monotherapy for the initial treatment of cerebral malaria are unacceptably high. Combination therapy and a shorter course of effective medication have been shown to improve outcomes in human participants in the treatment of other diseases. This study outlines a protocol to conduct a triple blinded parallel randomized controlled trial on cerebral malaria using dual intravenous medications compared to the current standard of monotherapy.MethodsThis is a parallel multi-site randomized controlled superiority triple blinded trial consisting of intravenous artesunate plus quinine and a control arm of intravenous artesunate only. Eligible and assenting children aged 6 months to 17 years will be recruited from 4 tertiary hospitals by random selection from the list of tertiary hospitals in Nigeria. Participants will be randomized and assigned in parallel into two arms using random numbers generated from GraphPad Prism (version 9) by a clinical pharmacologist who has no link with the investigators, the patients, or the statistician. The primary measurable outcome is survival at 12, 24, and 48 h post-randomization. A composite secondary outcome consists of the number of children that regained consciousness, parasitaemia and defervescence at 12 and 24 h post-randomization and haematological and inflammatory markers at 24 and 48 h post-randomization. Adverse events both solicited and unsolicited are recorded all through the study post-randomization. The study is approved by the State Research Ethics Review Committee. Data analysis will be performed in GraphPad Prism version 9.DiscussionThe outcome of this analysis will give insight into the efficacy and safety of dual intravenous antimalaria in the treatment of cerebral malaria among Nigerian children compared with the standard of care. The safety profile of this intervention will also be highlighted. This may help inform physicians on the optimal treatment for cerebral malaria to improve outcomes and reduce recrudescence and treatment failure.Trial registrationPan Africa Clinical Trial Registry PACTR202102893629864. 23/02/2021.

Dental auxiliaries in tertiary hospitals in Nigeria; oral hygiene practices and dental service utilization

&#x0D; &#x0D; &#x0D; &#x0D; Objective: This study was aimed at determining the oral self-care practices and dental service utilization among dental auxiliaries in teaching hospitals in Nigeria, and also to assess the dental utilization of their relatives.&#x0D; Methods: This was a descriptive, cross-sectional multicenter study conducted among dental auxiliaries from three teaching hospitals in Nigeria, namely; University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, Rivers State, Lagos University Teaching Hospital (LUTH) Idi-araba, Lagos State and University College Hospital, (UCH) Ibadan, Oyo State Nigeria. Self-administered questionnaires were used to obtain information on participants’ sociodemography, oral hygiene practices and dental service utilization. The self-rated oral health status was used to assess their oral health behavior (frequency of brushing, regular check-up and fluoride application). Statistical analysis was done using the IBM SPSS version 20.0. Statistical significance level was considered at p ≤ 0.05.&#x0D; Results: A total of 101 participants were enrolled into the study, consisting of dental nurses (16[15.8%]), dental technicians (21[20.8%]), dental technologists (46[45.5%]) and dental therapists (18[17.8%]). The mean age of the participants was 35.12 ± 8.89 years. Female: Male ratio was 2.26: 1. Most (90.1%) of the study participants rated their oral hygiene as excellent. Slightly over half (57.4%) brushed twice daily; 25% of the dental nurses, 52.4% of the dental technicians, 58.7% of the dental technologists and 88.9% of the dental therapists, this was statistically significant (p=0.002). Frequency of dental check-up for six months among the participants was low (31.7%). Only 31 (30.7%) of the participants had scaling and polishing done in the last 6 months. More of the dental nurses (93.8%) and technicians (71.4%) had invited their relatives for scaling and polishing compared to the other dental auxiliaries (p=0.0019).&#x0D; Conclusion: Even though the dental therapists had better tooth brushing practices in this study, the oral hygiene practices and utilization of dental services by the dental auxiliaries were generally less than optimal. There was a disparity between the self-rated oral health status and oral health practices of the dental auxiliaries. There is need for better motivation of dental auxiliaries towards optimal oral hygiene behavior.&#x0D; &#x0D; &#x0D; &#x0D;

Postpartum Depression and Physical Activity Among Women Attending Postnatal Clinics in a Tertiary Hospital in Nigeria

Background: The reproductive years come with their own share of mental health issues with childbirth and the postpartum period being a particularly vulnerable time for mothers leading to an increase in the risk of depressive disorders. Postpartum depression has a huge public health effect on the mother with long-term consequences on the child and family. Research has shown that physical activity is beneficial; however, such studies are lacking in Nigeria. Therefore, this study sought to look at the association between postpartum depression and physical activity and determine its prevalence among women in a tertiary hospital in Nigeria. Methods: This cross-sectional study was conducted among 401 women attending immunization and postnatal clinics at the University College Hospital Ibadan. The data were collected using a self-administered questionnaire containing a self-developed socio-demographic section, Edinburgh postnatal depression scale to measure postpartum depression, and an International physical activity questionnaire (short type) to as sess physical activity. Analysis was done using the Chi-square test and multivariate analysis to determine independent factors. Significance was set at 0.05. Results: More than a third of the respondents (37.8%) had postpartum depression. Physical activity level was high (72.1%). High levels of physical activity increased the odds of postpartum depression compared to lower levels (95% CI= 0.797-0.97). Gender of the child, marital relationship satisfaction, and age of the child were independently associated with postpartum depression. Conclusion: This study showed that the prevalence of postpartum depression is greater than previously reported in past studies in southwest Nigeria and high levels of physical activity may increase the risk of postpartum depression.

A dual-modality quantification of scattered radiation from head to female breasts during radiological investigations in a tertiary hospital in Nigeria

BackgroundTo quantify the amount of scattered radiation reaching the breasts during x-ray and CT investigations of the head in order to find appropriate justification for an intended change in practice involving torso shielding.ResultsScattered radiation from the head reached the breasts in both procedures. The range and mean dose were (CR 1.02–3.61/1.94 ± 0.63 mGy) and (CT 2.20–8.50/3.74 ± 2.28 mGy). Both breasts had enormous dose difference in CR (72.3%) and CT (51.4%) which were statistically significant (p < 0.05). Correlation of dose with anthropometric parameters gave weak results.ConclusionDespite dose mitigation strategies such as software and hardware modifications in radiological modalities, use of anti-scatter grid, appropriate collimation and dose optimization by radiographers, scattered radiation still traveled from the head to the breasts. These were, however, significantly reduced when shielding was applied. For a dose-safe practice, radiographers are urged, in addition to current strategies at mitigating scatters, to adopt torso shielding during examinations involving contiguous anatomies to the breast.

Medication reconciliation knowledge among hospital pharmacists in Nigeria: A non-randomised controlled trial

Background: Medication reconciliation (MR) is a patient-centred evolving role of pharmacists that improves patient’s health outcomes. Aim: To assess the effect of an educational intervention on pharmacists’ MR knowledge in two Nigerian tertiary hospitals. Methods: A two-arm parallel non-randomised controlled trial was carried out at two tertiary hospitals in Nigeria, one as intervention and the other as control site. Pharmacists’ MR knowledge was assessed pre-intervention and at one-, three- and six-month post-intervention. The intervention consisted of seminar and role-plays. Data were summarised with descriptive and inferential statistics. Results: A total of 75 pharmacists completed the study. Scores for pre-intervention out of a total of 38 was 19.31±4.76 in the intervention group and 17.50±6.86 in the control group. Post-intervention assessment scores (University College Hospital vs University of Ilorin Teaching Hospital) at one, three and six months were 29.82±5.01 vs 25.97±5.31, 31.53±4.99 vs 26.10±5.20, and 31.69±4.10 vs 23.07±3.98, respectively (p &lt; 0.01). Conclusion: The educational intervention led to improved pharmacists’ MR knowledge.

Knowledge and practices of physicians on blood component therapy: a cross-sectional study from two tertiary hospitals in Nigeria.

Comprehension of blood component therapy (BCT) has profound impact on transfusion outcomes. Variations from the standards in practices of BCT may jeopardize patient care. To assess the understanding and implementation of BCT by physicians. The study was carried out at two tertiary health care centres. It was a descriptive cross-sectional study using a self-administered, questionnaire comprising of 30 questions. A total of 265 physicians responded from various clinical specialties. Physicians studied showed remarkable knowledge (98%) of BCT. Nevertheless, 92.8% of the respondents' were inclined to prescribing whole blood and the commonest reason given was ready availability at the blood bank. More than half of the respondents' have prescribed BCT with sedimented red cells and platelet concentrates being the most frequently prescribed blood components. Non-availability of blood components and cost implications were some of the identified limitations to the use of BCT. Majority of the physicians have a good knowledge concerning BCT. Nonetheless, there was a knowledge-practice mismatch attributable to the unavailability of the various blood components limiting optimal practice of BCT. Strategies should be formulated to overcome these identified challenges to ensure quality transfusion services in our healthcare facilities.

Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents' Perspective.

Background There is a dire need for paediatric critical care (PCC) services, but their availability in tertiary hospitals in Nigeria is not well defined. Objective We evaluated self-reported PCC practice, resources, and perceived challenges in various zones of the country, using paediatric residents' perspective. Methods This is a descriptive cross-sectional survey, carried out at an Intensive Course in Paediatrics at the University of Benin Teaching Hospital, Nigeria. Participants' PCC practice and perceived adequacy of PCC resources and services were assessed using a 100 mm uncalibrated visual analogue scale (VAS). A comparison between northern and southern zones was done. A 2-sided p value < 0.05 was considered significant. Results A total of 143 residents participated in the study, 37.1% of them were male, and 62.9% were female. Their mean age was 34.6 ± 3.2 years. They were mainly (86.7%) from federal institutions across the country. Less than a half (46.7%) of the trainees attended to critically ill children daily, but only 4 out of every 10 respondents stated that such severely ill children survived till hospital discharge; 12.1% of the trainees had PICUs in their institutions. Financial constraints hindered PICU admissions. PCC staff were relatively fewer in northern zones than southern zones (p < 0.05). Their perceived adequacy of PCC equipment and services were low (VAS scores 32.7 ± 2.6 and 30.9 ± 2.8, respectively) with a strong positive correlation between the two measurements (r = 0.839; p < 0.001). Conclusion There is an unmet need for PCC practice in Nigerian tertiary hospitals with a resultant low survival rate of critically ill children. PCC training curricula and improved critical care resources are desirable in the setting.

A Review of Blood and Blood Products Requisition and Utilization in Post-neonatal Ward of a Tertiary Hospital in South Western Nigeria

Background: Blood and its products ordering is a common practice in paediatrics. The ready availability of blood and blood components has resulted in liberal use. Inappropriate use of blood and blood products exposes patients to the risk of transfusion transmissible diseases and allergic and haemolytic reactions.&#x0D; Objective: To assess blood and blood products requisition and utilization in a post-neonatal ward in a semi-urban tertiary hospital in Nigeria&#x0D; Methods: Retrospective analysis of medical records of all transfused post-neonatal patients during the study period from 1st July 2015 to¬ 31st December 2016 to calculate the cross-match to transfusion ratio, transfusion probability and transfusion index.&#x0D; Results: The units of blood cross-matched were 98 and 90 blood units transfused. The cross-match to transfusion ratio was 1.09 indicative of significant blood usage. The transfusion probability was 100% indicative of significant blood usage. The transfusion index was 1.10 indicative of significant blood utilization.&#x0D; Conclusion: Transfusion of blood and blood products in the post-neonatal ward of our setting meet the standard criteria for quality indicators for blood utilization.