University Teaching Hospital In Nigeria Research Articles

Effects of cotton plant (Gossypium herbaceum Linn.) extracts on some vancomycin and methicillin-resistant pathogenic bacteria

Bacterial resistance to antibiotics is a serious global problem, hence attention is being turned to plants as alternative source of antimicrobial to combat the menace of antibiotic resistance among pathogenic microorganisms. This study explores the antibacterial properties of Gossypium herbaceum leaf extracts against a spectrum of antibiotic-resistant bacteria such as Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, sourced from clinical isolates at Don Bosco Catholic Laboratory and Obafemi Awolowo University Teaching Hospital in Nigeria. The research utilized cold extraction methods with methanol and n-hexane solvents to prepare the extracts, which were then analyzed for their phytochemical composition, revealing the presence of flavonoids, steroids, tannins, terpenoids, and glycosides. Antibacterial activity was assessed using the disc diffusion method, with the extracts showing varying zones of inhibition; n-hexane extracts produced zones between 21.35 mm and 4.10 mm, while methanol extracts showed zones between 18.75 mm and 5.05 mm at a concentration of 200mg/mL. Minimum inhibitory concentrations (MIC) were determined, with n-hexane extracts ranging from 25 mg/mL to 6.25 mg/mL and methanol extracts from 50 mg/mL to 6.25 mg/mL. Further analysis of the bioactive fractions was conducted through Fourier Transform Infrared Spectroscopy (FTIR), which identified six distinct bioactive compounds in the methanol extract, including alkenes, alcohols, amines, phenols, nitro compounds, and alkanes. Plasmid profiling indicated the presence of plasmids in clinically significant pathogens like P. aeruginosa and S. aureus, suggesting a potential mechanism for their antibiotic resistance. Overall, the study highlights the significant antibacterial activity of G. herbaceum extracts against resistant bacteria and suggests their potential as alternative antimicrobial agents in combating antibiotic resistance, which is a growing global health concern.

Nursing Students’ Perception and Compliance with Clinical Nursing Placement at a Selected University Teaching Hospital in Nigeria

Aim: To investigate nursing students’ perceptions of their clinical training at a selected university teaching hospital in Nigeria. Method: This was a descriptive cross-sectional design. A simple random sampling technique was used to select 198 nursing students at Babcock University in Ilishan-Remo, Ogun State, Nigeria. An interviewer-administered questionnaire was used to collect data from the respondents. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS Version 25) and presented in tables and charts. Results: This study reveals that 73.23% of the respondents had high knowledge of clinical nursing training, and 78.8% of the respondents had a good perception of clinical nursing training. Furthermore, respondents often complied with clinical posting (mean = 3.35, STD = 0.768), and the study shows that factors relating to clinical supervision and the support accessible during clinical placement influence nursing students’ compliance with clinical nursing practice (mean = 4.06, STD = 1.031). Conclusion: The findings from the study conclude that the perception of nursing students towards clinical nursing training was positive, though some factors affected compliance with clinical nursing practice. Hence, the study recommends the implementation of preclinical orientation, explicit dissemination, and clarification of clinical learning objectives to enhance compliance rates among students during their clinical placements.

Molecular characterization of antimicrobial resistance and virulence factors in coagulase – negative staphylococci nasal isolates among adult patients in a tertiary hospital in North-Western Nigeria

Coagulase-negative staphylococci are harmless microorganisms that can become pathogenic when the host resistance is impaired. Their ability to exhibit multidrug-resistance and form biofilm limit treatment options and contributes to the health and financial burden on health care systems worldwide. This study aimed to provide data on the acquisition and expression of genetic elements associated with resistance and virulence in the organisms from nasal colonization of adults admitted to a University Teaching Hospital in Nigeria. One hundred and twenty-three presumptive staphylococci isolates were obtained from the medical microbiology laboratory of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. The isolates were characterized, and the antibiotics susceptibility pattern assessed. Biofilm formation was evaluated by the micro-titre plate method, and polymerase chain reaction was used to detect resistance genes (mecA and ermB), virulence gene (psm-mec) and adhesin genes, (icaAB, icaC and icaD) in the isolates. Out of the 60 coagulase-negative staphylococci isolates, 50 (83.3%) were strong biofilm formers, 5 (8.3%) were moderate biofilm formers and 5 (8.3%) were weak biofilm formers. For the 14 isolates that were characterized by PCR, mecA and ermB resistance genes were detected in 78% and 71% of the isolates respectively. Twenty-one percent had psm-mec virulence gene while biofilm adhesin genes, icaAB and icaD were detected in 36% and 57% respectively, icaC gene was not detected. This study confirmed formation of biofilm, carriage of resistance and virulence genes which have been shown to play a role in pathogenesis. This study shows the necessity of the periodical monitoring of the drug resistance pattern and virulence factors of coagulase-negative staphylococci.

Urinary Incontinence among Female Health Workers in a Tertiary Health Facility in Enugu, Nigeria

Background: Female urinary incontinence (UI) impacts female workers’ quality of life and working life. Objectives: This study aims to determine the prevalence of UI among female health workers in Enugu, Nigeria, and its impact on their quality of life. Materials and Methods: A cross-sectional study of female health workers at the University Teaching Hospital in Nigeria. A structured self-administered questionnaire was used for data collection. The first section contained socio-demographic information, whereas the second section consisted of items derived from the UK English Version of the International Consultation on Incontinence Questionnaire on Urinary Incontinence (ICIQ-UI Short Form). Results: Two hundred and fifty-six (256) women filled out the questionnaires. The mean age of the respondents was 36.6 ± 3.2 years (ranging from 19 to 56 years). Of the 256 respondents, 115 women had UI giving a prevalence of 44.9%. Older female health workers (>39 years old) compared to younger female health workers were significantly more likely to have UI (odd ratio 6.387, 95% confidence intervals 3.684–11.045, P < 0.001). Types of female UI seen were urge UI (39.1%), stress UI (29.6%), and mixed UI (31.3%). Most women (50.4%) leaked about once a week and had small amounts of leakages (62.8%). The impact on quality of life was mild (39.0%) and moderate (32.2%) for most of the female health workers, with 19% reporting severe impact. Conclusion: The prevalence of female UI is high among female health workers in Enugu, Nigeria and it impacts greatly on their quality of life.

A Conversation with Francis Enyi: Bridging the healthcare deficit via IVR

Ubiquity's senior editor Dr. Bushra Anjum chats with Francis Enyi, a senior program analyst with the Information and Communication Technology Department at Delta State University Teaching Hospital in Nigeria. They discuss how Enyi and his team of computer software developers, medical personnel, and linguists are working toward bridging the deficit of healthcare personnel in remote and rural areas in Africa. The conversation also details the team's flagship service, interactive voice response (IVR) software, providing access to quality non-surgical medical care information to the populace, made available via the GSM telephone network.

Prevalence and factors associated with disrespect and abuse among women who delivered in a University Teaching Hospital in Nigeria

To determine the prevalence and factors associated with disrespect and abuse during childbirth among women who delivered in a University Teaching Hospital using a validated tool. This was a cross-sectional study conducted at the Department of Obstetrics and Gynecology, University of Benin Teaching Hospital. Participants included women who presented for the 6-week postnatal visit. The primary outcome was the experience of disrespect and abuse by the women in any of the thematic domains in the tool, namely friendly care, abuse-free care, timely care, discrimination-free care, abandonment, and non-consented care. In all, 200 participants were enrolled in the study. The prevalence of disrespect and abuse among the study population was 36.5%. Verbal abuse and untimely care were the commonest (15.5%). Nurses were mostly the perpetrators of disrespect and abuse. Maternal age, parity, and marital status among others were not significantly predictive of disrespect and abuse by respondents. Disrespect and abuse from health workers during childbirth is a prevalent problem among women who delivered in the hospital. This undesirable experience of childbirth needs to be addressed by stakeholders in maternal health.

Computed Tomographic Assessment of the Pattern of Head Injuries in a Developing Country: A Retrospective Review in a University Teaching Hospital in Nigeria

Abstract Background: Globally, head injury (HI) constitutes a major cause of morbidity and mortality. In many developing countries, there is inadequate access to diagnostic computed tomography computed tomography (CT) scan for assessment of suspected cases of HI. This study was aimed at assessing the pattern of HI presentations in a referral health facility in a developing country setting. Materials and Methods: Retrospective review of CT scans done for suspected cases of HI seen for 12 months in a Nigerian University teaching hospital. Chi-square and Fisher’s exact tests were used to identify factors associated with the severity of HI. Results: Seventy-nine cases of HI were seen. Most subjects were males (75, 94.9%) and within 21–30 years (31.6%). Majority of subjects (76.0%) had moderate-to-severe forms of HI. Road traffic accident (RTA) was the most common cause of HI (59, 74.7%). The most common pathology was hematoma (60, 75.9%) and was commonly in single locations (36, 60.0%). Skull fracture was the second-most common pathology (42, 53.2%) and was commonly in multiple locations. RTA, skull fracture, and multiple hematomas were associated with moderate-to-severe forms of HI. Conclusion: RTA was the most common cause of HI in the hospital. The incidence of HI was higher in males than females, who were largely in the most productive age group. The most common abnormalities were hematoma and skull fractures, and they were associated with severe forms of HI, thus, justifying the need for the availability and use of cranial CT scan in head trauma.

Influence of Workplace Violence on Turnover Intention among Nurses in a University Teaching Hospital in Nigeria

Globally, workplace violence is one of the negative workplace behaviors to which nurses are most vulnerable to. There is nevertheless a paucity of research on workplace violence and turnover intention among nurses in Nigeria.

Hand Hygiene Compliance during COVID-19 Pandemic among Neonatal Nurses in a Federal University Teaching Hospital in Nigeria

Introduction: Compliance with Hand hygiene (HH) has been considered as a simple and the most efficient strategy to reduce hospital-acquired infections (HAIs). Compliance with this practice is not often assessed in Nigeria and thus posed a significant risk to the quality of care and patient safety and especially in this era of the COVID-19 pandemic. The study aimed to assess neonatal nurses’ compliance to “my five moments for HH”. Method: A cross-sectional observational study was carried out in a Nigerian federal hospital, using an adapted version of a standardized observational WHO tool of ‘’my five moments of HH’’. A Chi-square test was employed to examine the relationship of HH compliance across units, shifts, and “my five moments for HH” opportunities. Results: The observer recorded 425 HH opportunities and the total HH compliance rate was (62.8%). There was no association between the units, working shifts, and nurses’ HH compliance. Compliance to HH was dependent on the five moments of HH (p < 0.000), better compliance was seen after body fluid exposure (100%), followed by after newborn contact (86.3%), and after contact with newborn surroundings (63.4%), while compliance before newborn contact (28.5%), and before an aseptic procedure (9.1%) were poor. Conclusion: The findings of this study showed a significant gap with the HH compliance among neonatal nurses, suggesting multiple opportunities for neonatal infections despite the current awareness of HH in the Covid-19 pandemic. Hence, there is a need to intensify infection control practices in Nigeria, especially on HH practice.

Reduction in seroprevalence of viral transfusion-transmitted infections in southwest Nigeria in children with sickle cell disease using an enhanced screening strategy.

Blood transfusion is an integral component in the management of children and adults with sickle cell disease (SCD). Concerns about blood safety due to the high risk of bloodborne infections in sub-Saharan Africa limits the application of this cost-effective strategy in the management of individuals with SCD. In a single-centre, retrospective, longitudinal study in southwest Nigeria, we hypothesised that the use of stringent blood donor selection, along with very sensitive enzyme-linked immunosorbent assay (ELISA) screening methods would reduce transfusion-transmitted infections (TTIs). Among 45 002 eligible blood donors at the Lagos University Teaching Hospital in Nigeria, over a 5-year review period (2015-2019), the seroprevalence rate of viral TTIs was 9.83%. The seroprevalence rates for human immunodeficiency, hepatitis B, and hepatitis C viruses were 1.37%, 6.2%, and 2.25% respectively. Among 172 children with SCD, 71% (122/172) on regular blood transfusion and 29% (50/172) who had never been transfused or had less than two transfusions per lifetime, none acquired any TTIs using our enhanced screening approach during the study period. Thus, safe blood transfusion practices can be provided for children with SCD in sub-Saharan Africa with the use of stringent donor selection protocols and fourth-generation ELISA kits for TTI screening.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents

The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem. A significant correlation was found between self-esteem and self-perceived smile (r=0.294; P < 0.001) and dental aesthetics (r=0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem. The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

Evaluation of Repeat Analysis and Dose Burdens of Patients Examined in the Radiology Department of a Medical University Teaching Hospital in Nigeria

The objectives of this study was to examine the repeated examinations carried out and dose burdens of patients examined in the radiology department of a tertiary institution teaching hospital in Nigeria. A standard daily record keeping method (accepted and rejected films compiled by Radiographers) was used to collect data after viewing by a Radiologist. Raw data collected were sorted with the aid of Tally Chart. Descriptive statistics was employed to analyze the data collected with the help of Excel software. The specific repeat rates (SRRs) for different examinations are as follows: chest PA (CXR-6.68 %); lumbosacral (LS-10.90%); skull/head (S/H-15.08 %); abdomen (ABD-12.97 %); pelvis/hip (PE/H-7.77 %); cervical spine/neck (SP/NK-5.56 %); thoracic spine (TS-7.14 %); extremities (EXT-1.64 %); shoulder joint (SHJ-2.22 %); knee joint (KNJ-2.99 %); elbow joint (ELB-2.53 %); ankle joint (ANK-2.77 %); and hysterosalpingography (HSG-7.35 %). The highest causal reject rates (CRRs) was found to be as a result of under-penetration (34.3%) in this study. This is followed in succession by over-collimation (22.90 %) and processing artifact (20.50 %). The excessive population doses of the exposed patients resulting from repeats for some examinations are: chest PA (CXR-103.60 mGy); lumbosacral AP (LS-23.00 mGy); skull/head PA (S/H-71.10 mGy); abdomen AP (ABD-33.48 mGy); thoracic spine AP (TS-2.52 mGy); shoulder joint AP (SHJ-1.89 mGy); knee joint AP (KNJ-2.00 mGy); ankle joint AP (ANK-0.76 mGy); hysterosalpingography (HSG-1.95 mGy). The selected exposure parameters could also be examined and adjusted to prevent under-penetration.

Obstetric Risk Assessment and Referral Cascade as Predictors of Perinatal Morbidity and Mortality

Background: Using an evidence-based guideline for obstetric risk assessment in the primary and secondary healthcare settings in Nigeria has been shown to aid appropriate referral cascade of patients to tertiary centres. Aim: To assess the impact of inappropriate obstetric risk assessment and late referral to tertiary care facilities in Rivers State on perinatal morbidity and mortality. Material and methods: The study was of prospective cross-sectional design involving 475 patients who were referred from primary and secondary healthcare facilities to the labour ward of Rivers State University Teaching Hospital in Nigeria. The appropriateness of their obstetric risk assessment and referral cascade to a tertiary centre was assessed, using a preformed evidence-based guideline and the results were associated with the perinatal morbidity and mortality. Data were analysed using Epi Info 2020. Results: The perinatal outcome in women that needed to be referred in the first trimester to tertiary centres was worse than that in those women who were appropriately referred and the differences were statistically significant in terms of birthweight less than 2500 grams [170(54.66%) versus 8(24.24%), X2 = 9872 p&lt;0.002]; birth asphyxia [78(19.02%) versus 0(0%), X2 =7.926 p&lt;0.0003]; admission to SCBU [85(20.73%) v 0(0)%); X2=8.916 p&lt;0.0001] and foetal death [77 (18.78%) v 0(0%); X2=7.787 p&lt;0.0003r]. The differences were also worse in terms of the number of patients who had preterm birth at 28-37 weeks, FGR and large for date (LFD) babies but the differences were not statistically significant. Furthermore, the perinatal outcome in women that needed to be referred in the first trimester to tertiary centres was also worse than that in those who needed an earlier referral to tertiary centres and the differences were statistically significant in terms of birth asphyxia (X2=2.341, p&lt;9.045); admission to SCBU (X2=2.699, p&lt;0.055) and foetal death (X2=2.291, p&lt;0.047). The differences were also worse in terms of the number of patients who had preterm births, neonatal birth weight, LFD babies and FGR but not statistically significant. Conclusion: Perinatal morbidity and mortality were worse in patients who needed to be referred to a tertiary centre from a primary and secondary healthcare facilities than in those who were appropriately referred and those that needed an earlier referral. There is therefore an urgent need for adoption of evidence-based guideline for obstetric risk assessment and referral cascade in Nigeria.

Molecular characterization of ESBL- producing uropathogenic Escherichia coli recovered from urine samples of patients attending a University Teaching hospital in Nigeria.

Infection of the urinary tract ranks as one of the most common infections affecting people worldwide and its treatment is made complicated by the rising incidence of antibiotic resistance. This study aimed to detect extended spectrum beta-lactamase (ESBL) genes and antibiotic resistance profile of uropathogenic Escherichia coli (E. coli) recovered from patients attending a University Teaching hospital in Nigeria. Uropathogenic E. coli isolates were obtained from the culture collection of Department of Microbiology and Parasitology of the University Teaching hospital for a period of four months (October 2019-January, 2020). Antibiotic susceptibility testing was done using the disc diffusion method while phenotypic ESBL production was detected using double disc synergy test (DDST). Detection of β-lactamase genes was done using Real-Time PCR. Forty-nine E. coli isolates were recovered from 120 urine samples, with 24 (49%) being ESBL positive. The resistance to antibiotics in the ESBL producers was: ciprofloxacin (100%), cefotaxime (100%), cefpodoxime (100%), tetracycline (95.7%), ceftazidime (56.7%), amoxicillin-clavulanate (50%), gentamicin (33.3%), and imipenem (0%). All the ESBL producers carried blaTEM, blaCTX-M-1 and blaCTX-M-9, 75% (18/24) carried blaSHV, while blaCTX-M-2, blaCTX-M-8 and blaCTX-M-25 groups were detected in 20.8% (5/24) of the isolates. There was co-occurrence of CTX-M, SHV and TEM β-lactamases in 79.2% (19/24) isolates, while five isolates (20.8%) co-harbored blaCTX-M and blaTEM. This study showed a high level of multidrug resistance and ESBL gene carriage in uropathogenic E. coli obtained in this study, suggesting a likely review of therapeutic options in the treatment of UTI to clamp down on the rising cases of antibiotic resistance.

BACTERIAL CONTAMINATIONS OF USED FACE MASKS COLLECTED FROM DIFFERENT CLINICAL SECTIONS IN A UNIVERSITY TEACHING HOSPITAL DURING COVID -19 PANDEMIC CRISES IN NIGERIA

This study was carried out to identify and characterize the bacteria and fungi present in used face masks, obtained from some clinical sections of University Teaching Hospital in Nigeria. The phenotypic; microbiological and biochemical identifications of the microorganisms were determined by the pour plate techniques using, nutrient agar according to established standard protocols. The results recorded a mean total bacterial count that ranged from 1.75 ± 0.12 log10 CFU/ml to 4.36 ± 0.28 log10 CFU/ml. However, the samples collected from the Anatomy section recorded the lowest bacterial count (1.75 ± 0.12 log10 CFU/ml) while samples obtained from the Nursing section had the highest bacterial load (4.36 ± 0.28 log10CFU/ml). The overall screening test showed the presence of three bacterial isolates: Peptococcus, Pseudomonas and Staphylococcus; Consequently, from the total 64 counted bacterial colonies, the frequency of occurrence was predominated by the Pseudomonas 40 (62.5 %) while, mild counts were respectively reported for Staphylococcus and Peptococcus 18 (28.1 %) and 06 (9.40 %). Succinctly, this work has highlighted that, the underlying illnesses such as lung abscesses, asthma, otitis, pneumonia and sinusitis associated with the isolated organisms in this experiment are also directly linked or similar to the symptoms displayed in mild and severe cases of COVID-19 patients.

Urological emergencies in a Nigerian teaching hospital: Epidemiology and treatment.

Urological emergencies constitute a significant part of emergency presentations in various referral centers. Data on the prevalence of these emergencies in West African sub-region are sparse. The study is aimed at determining the pattern of urological emergencies in our center and is geared towards bridging the gap in knowledge of the epidemiology of urological emergencies in this sub-region as a means of achieving efficient use of scarce resources. It was a retrospective study of all urological emergency cases that presented over six years in a Federal University Teaching Hospital in Nigeria. Data were collected from emergency register and theatre logs. Data analysis was done using SPSS version 25. A total of 267 patients presented with urological emergencies during the period of study with 258 (96.6%) men and 9 (3.4%) women. The mean age of the patients was 50.6 ± 20.8 years. Urinary retention was the most common urological emergency accounting for 159 (59.6%) cases followed by Fournier's gangrene 23 (8.6%) and testicular torsion 23 (8.6%). Bladder and ureteral injuries accounted for 5 (55.6%) of the urological emergency presentations in women while both injuries accounted for only 4 (1.6%) in men (P = 0.000). Urethral catheterization was the most commonly performed procedure 139 (52.1%), followed by percutaneous suprapubic cystostomy (SPC) 31 (11.6%). Urological emergencies have varying presentations in both sexes. Urinary retention, and acute scrotum were the most common urological emergencies in our facility. This knowledge can be used in emergency preparedness planning which involves personnel training and resource allocation.

Awareness and prevention of anemia among pregnant women attending antenatal clinic at a University Teaching Hospital in Nigeria

Objectives: During pregnancy, the fetus requires iron for blood formation so does the mother, this increases the iron requirement which is higher than that of non-pregnant women. This study assessed the level of awareness and prevention of anemia among pregnant women attending the antenatal clinic at Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Material and Methods: A descriptive cross-sectional study was conducted among 182 pregnant women attending the antenatal clinic at LUTH in Lagos, Nigeria. A balloting system was done to select the respondents in the clinic that runs 4 times a week, with an estimated number of 70 pregnant women per clinic. Data were collected using a structured self-administered questionnaire and analyzed with the Statistical Package of the Social Sciences version 22. Descriptive and inferential statistics were used for analysis, Chi-square test was done for the association between the variables at P &lt; 0.05 level of significance. Ethical approval was obtained from the Human Research Ethical Committee of LUTH with approval number (ADM/DCST/HREC/APP/2589). Informed consent was taken and respondents were reassured of the privacy and confidentiality of the information obtained. Results: The highest percentage (33.3%) of the respondents was within the range of 26–30 years with a mean age of 28.18 ± 0.84 years. Majority of the women had a good level of awareness of anemia (68.89%) and good overall practices (73.89%) of prevention of anemia in pregnancy. There was no significant relationship between the respondents’ level of awareness of anemia and its prevention (χ2 = 1.533, P = 0.216). Conclusion: The study has shown that even though awareness and prevention practices were good, there is a need to create more awareness among pregnant women and also to give adequate health education on prevention of anemia to produce favorable outcome in pregnancy for both the child and mother.

Obstructive uropathy and intrinsic renal disease in patients with benign prostatic obstruction: analysis of burden and associations in a university teaching hospital in Nigeria

Background: Benign Prostatic Hyperplasia (BPH) is a disease of the elderly. Some of the patients with this pathology could develop renal impairment due to the direct effect of obstruction or as a result of intrinsic renal disease. This study aimed to determine the burden and associations of obstructive uropathy and intrinsic renal disease in patients with benign prostatic obstruction in a university teaching hospital in Nigeria. Methods: This was a retrospective study of patients with BPH in our center. Glomerular Filtration Rate (GFR) was calculated and the severity of renal disease computed. Patients were classified as normal or those with obstructive uropathy and intrinsic renal disease. Patients’ age, diabetes mellitus presence and treatment given were also documented. Results: Obstructive uropathy and intrinsic renal disease occurred in 14 (15.1%) and 12 (12.9%) of the patients respectively. Nephropathy in the setting of obstruction occurred in four (4.3%) of the patients while the GFR was at stage 2 in obstructive uropathy patients who did not have renal impairment. Eight (10.4%) of the patients without nephropathy had diabetes mellitus. There was a significant inverse relationship between the age of presentation and the GFR (P = 0.001, odds ratio = −1.129). Initial urinary drainage delayed definitive surgery in all patients with obstructive nephropathy. Conclusion: The burden of nephropathy in BPH patients is quite considerable. A proportion of those without renal impairment harbour diabetes mellitus which could rapidly tilt obstructive uropathy patients into renal failure.

Pharmacist’s contribution to medication adherence among patients with type 2 diabetes in endocrinology clinic

Background: Elderly people are prone to have chronic diseases requiring continuous medications. Adherence is a key factor in managing these patients. Improved adherence to medicines has a positive impact on the reduction of their hospital visits and health-related quality of life. Objective: This study investigated the potential of the pharmacists to improve medication adherence and to optimize treatment outcomes among patients with type 2 diabetes. Materials and Methods: A randomized controlled study comprising patient- and physician-focused intervention was carried out at the endocrinology clinic of Olabisi Onabanjo University Teaching Hospital in Nigeria. At baseline and six months, each group had 75 eligible patients. Patient’s self-reported adherence level to medications was assessed with modified Morisky four-item adherence scale, clinical variables were determined, and the likely reasons for nonadherence and required information were assessed. Outcome measures: Variation in adherence scores, mean clinical variables and improved patients’ knowledge base. Results: No significant differences were observed in adherence scores between control and intervention groups at baseline. High and low adherence scores in both groups were 33.3% versus 36.0% (P = 0.873) and 26.7% versus 25.3% (P = 1.000), respectively. Patients’ response at the end of intervention revealed significant score differences across board between the groups. High and low adherence scores in both groups were 34.7% versus 88.0% (P = 0.001) and 21.3% versus 2.7% (P = 0.002), respectively. Conclusion: The intervention was successful in improving adherence scores, clinical variables, patients’ knowledge base, and indication of pharmacists’ potential to bring about positive outcomes among patients with chronic diseases. There is a need for professional collaboration in disease management for the improved outcomes of patients.

Clinicopathological characteristics of benign prostatic hyperplasia and prostate cancer in a University Teaching Hospital in Nigeria

Introduction: Benign prostatic hyperplasia and prostate cancer are common pathologies of the prostate which could lead to morbidity and quality of life problems in urological patients. The study aimed to determine and compare the demographic, clinical, and pathologic characteristics of patients histologically diagnosed with these pathologies in our center. Methods: This was a prospective study carried out in 105 consecutive patients with the histological diagnosis of benign prostatic hyperplasia or prostate cancer over a period of 1 year. Information on demographic details, clinical presentation, prostate volume, prostate-specific antigen level, and histopathologic data was obtained. Data were analyzed using the Statistical Package for the Social Sciences with P