|Year : 2021 | Volume
| Issue : 12 | Page : 1861-1869
Abstracts Presented at the 2021 BDM
|Date of Web Publication||9-Dec-2021|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Abstracts Presented at the 2021 BDM. Niger J Clin Pract 2021;24:1861-9
| Assessing Awareness, Acceptability and Willingness to Pay for Hepatitis B Immunoglobulin among Pregnant Women in Enugu Metropolis: A Cross-Sectional Study|| |
JT Enebe1, NO Enebe2, O.E Onwujekwe3,4
Department of 1Obstetrics & Gynaeoclogy, Enugu State University of Science and Technology, Enugu, 2Department of Community Medicine, University of Nigeria Teaching Hospital Enugu, 3Department of Health Administration and Management University of Nigeria, Enugu Campus, Enugu 4Health Policy Research Group, University of Nigeria, Nsukka, Enugu State, Nigeria
Background: The awareness and acceptability of hepatitis B immunoglobulin may affect its willingness to pay and these facts were not well studied in Nigeria. Objective: To determine the level of awareness, acceptability and willingness to pay for hepatitis B immunoglobulin among pregnant women in Enugu metropolis. Methods: A cross-sectional study of 379 pregnant women selected through a multi-staged sampling technique in health facilities in Enugu metropolis was undertaken. A structured pre-tested interviewer-administered questionnaire was used for data collection. Data was analysed using SPSS version 23. Results: The overall knowledge of the respondents on hepatitis B infection was poor; only 26.6% of the respondents had good knowledge of the viral infection. Only 25.6% of the respondents have heard of hepatitis B immunoglobulin. Majority of the respondents (93.1%) were both willing to accept to give the vaccine to their babies and recommend the vaccine to their relatives and their close contacts. Majority of the respondents (86.2%) were willing pay for the hepatitis B immunoglobulin. The mean maximum amount WTP was ₦23178.34 (62.64 USD). Price of HBIG (48.8%) was a major hindrance WTP and 36.9% of the respondents believed that government should pay for the vaccines. Predictors of average WTP amount were education and occupation of the Participants. Conclusion: Despite the poor knowledge of hepatitis B and hepatitis B immunoglobulin among the study participants, the acceptability of hepatitis B immunoglobulin was high. The mean WTP for hepatitis B immunoglobulin was far below the market value of hepatitis B immunoglobulin.
Keywords: hepatitis B, immunoglobulin, willingness to pay, pregnant, women
| Psychological Morbidity among Family Caregivers of Women with Advanced Breast Cancer in Nigeria|| |
IE Jite1, AA Adetunji1, AM Folasire2, JO Akinyemi3, S Bello3
1Department of Family Medicine, University College Hospital, Ibadan, 2Department of Radiation Oncology, 3Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria
Background: Late presentation of female breast cancer in Nigeria is a lingering poor health-seeking behavior with increasing psychological impact on the family caregivers of these women. Objective: To determine psychological morbidity among family caregivers of women with advanced breast cancer. Methods: This was a cross-sectional descriptive study. Data was collected from 157 eligible family caregivers of women with advanced breast cancer attending the radiation oncology clinic of the University College Hospital, Ibadan. This was through an interview-administered questionnaire which included the 12th version of the General Health Questionnaire (GHQ-12); and the Zarit Burden Interview (ZBI). Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Logistic regression was used to determine the factors associated with psychological morbidity. All statistical tests of significance were carried out at 5% level of probability. Results: Males constituted 53% of the family caregivers. The mean GHQ-12 score was 3.52 ± 2.8. The prevalence of psychological morbidity was 58%. Longer hours spent per week in caregiving (> 48 hours) was a predictor of psychological morbidity in the family caregivers (OR= 3.83, 95% CI = 1.60-9.14). Conclusion: Family caregivers of women with advance breast cancer in Ibadan are at risk of psychological distress. There is an urgent demand on the formal healthcare sector to institutionalize strategies aimed at mitigating the negative psychological impact of the caregiving role on this subset of the population.
Keywords: Family caregivers; psychological morbidity, Advanced Breast cancer, Ibadan, Nigeria
| Artificial Intelligence in Medical Education: Evaluating the Medical Student's Perspective|| |
Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt
Dr ED Robinson
Background: Artificial Intelligence (AI) is a technological advancement that enables machines to sense, analyse and function at high intelligence level. Objective: The aim of this study is to evaluate the perspective of medical students on the role of artificial intelligence in medical education. Methods: A cross-sectional descriptive study design was adopted using pretested structured and open-ended self-administered questionnaires which were distributed to medical students at the University of Port Harcourt and PAMO University of Medical Sciences using the Google forms. A total of 311 completed questionnaires were retrieved, collated, entered into SPSS version 22.0 for analysis. The results were presented in frequency tables and charts. Results: Males and females constitute 164 (52.77%) and 147 (47.27%) respectively with a mean age (+SD) of 23.33+3.11years. Students in basic medical sciences class were 43.09%, while those in basic clinical and clinical sciences classes were 21.22% and 35.69% respectively. Majority agrees that AI will improve learning (n=272;87.46%), while others thought it will decrease mentorship (n=89; 28.62%), and will reduce the teaching staff in the near future (n= 21; 6.75%). Approximately ninety per cent of the respondents opined that there are no practical applications of AI in their University and most of the learning environments are not IT compliant. Poor power supply and lack of adequate IT training will prevent their aligning with the new reality of AI. Conclusion: The introduction of AI in medical education will improve learning. However there is the fear of reduction in mentorship and teaching staff in the future.
Keywords: Artificial Intelligence, Medical education, Medical students, machine learning
| Sociodemographic Characteristics and Histologic Subtypes of Breast Cancer at a Quaternary Hospital in North Central Nigeria|| |
AS Sani1,2, OP Oluwole3
1Department of Surgery, 2Breast and Endocrine Surgery Unit, 3Department of Pathology & Forensic Medicine, College of Health Sciences, University of Abuja, Abuja, Nigeria.
Background: Breast cancer is one of the most challenging diseases affecting mankind. Morbidity and mortality from the disease has remained significantly high particularly in Sub-Saharan Africa, due to delay in presentation and poor access to cancer care. Among Nigerian women, breast cancer generally is diagnosed at an advanced stage, and survival is very poor. Approximately 1 in 8 women will be diagnosed with invasive breast cancer in their lifetime and 1 in 39 women will die from breast cancer. Targeted therapies has remained difficult due to tumor biology, differentiation, heterogeneity and varying molecular subtypes. Objective: To determine the histologic subtypes of breast cancer in our institution. Methods: A retrospective study undertaken to explore the sociodemographic and histologic subtypes of breast cancer, at the Breast and endocrine surgery clinics, a Division of General Surgery in University of Abuja Teaching Hospital, Abuja, between 1st January, 2014 and 31st December, 2019: A 5-year period, using a structured questionnaire. Results: The study population had a mean age of was 44.50±10.72 years with majority in the 4th& 5th decade of life.Invasive ductal carcinoma accounted for the commonest histologic subtype of breast cancer and majority of the women were triple negative. Conclusion: Majority were premenopausal women in their 4th and 5th decade of life, with predominantly invasive ductal carcinoma. Lack of facilities for immunohistochemistry makes patients' characterization difficult, and negates targeted therapies or personalized treatment models for breast cancer.
Keywords: Breast cancer, histologic subtypes, receptor status.
| Biventricular Hypertrophic Cardiomyopathy in a 26-Year-Old Nigerian|| |
A Aje1, OS Ogah1,2,3, OA Orimolade1*, V Obasuyi1, BT Osibowale1, A Adebiyi A1,2, AO Falase2
1,2 Cardiology Unit, Department of Medicine, 3Institute of Advanced Medical Research and Training, University College Hospital Ibadan/College of Medicine, University of Ibadan, Nigeria
Cardiac disorders are found in about a half of cases of Turner's and Noonan's syndromes, two diseases with the same phenotype but different genotype. Biventricular hypertrophic cardiomyopathy is very rare in these conditions. We report a case of biventricular hypertrophic cardiomyopathy in a 26-year-old Nigerian female with the phenotype.
The patient presented with dyspnoea on exertion which started at the age of 7-years and has progressively worsened. There is associated precordial chest pain and palpitation.
The 12-lead ECG showed biventricular hypertrophy with strain pattern. The echocardiogram showed features in keeping with biventricular hypertrophic cardiomyopathy. Sample has been taken for cytogenetics for her genotype.Bilateral HCM is rare in these two genetic conditions. Patients with typical dysmorphia should have full cardiac evaluation to look for these anomalies.
Keywords: Turner's syndrome, Noonan's syndrome, Dysmorphia, Hypertrophic cardiomyopathy.
| Pattern of Diagnoses and Proportion of Missing Diagnoses at the Accident and Emergency Department of a Teaching Hospital in South West Nigeria|| |
OO Avwerhota1, MA Adesokan1, AS Adelanwa1, LI Akhaba1, F Okorie1, AO Lawal2, A Makanjuola3, OS Michael4. MA Adeoye5, JA Otegbayo5
1Department of Total Quality Management, 2Department of Oral Pathology, 3Department of Psychiatry 4Department of Clinical Pharmacology, 5Department of Medicine, University College Hospital, Ibadan
Dr OS Michael
Background: Accident and Emergency (A/E) departments receive patients with different health conditions. We conducted a one-year (2019) review of A/E patient care records. Objective: The objective of the study was to determine the pattern of diagnosis and missing diagnoses on patient care records at the A/E department. Methods: A retrospective review of records of all patients who presented at the A/E department was done. Data for the review included demography and diagnosis by attending emergency physicians. All cases in which a diagnosis was not recorded in A/E treatment card were categorized under missing a diagnosis. Diagnoses with percentages less that 0.1 were categorized under other diagnoses. Results: A total of 9,880 patients were attended to in 2019. About half (4,868/9880, 49.3%) were male while (4,987/9880, 50.5%) were female with a small number without gender specified (25/9880, 0.2%). The median age of the patients was 38 years with inter-quartile range of 27 to 54 years. Medical emergencies were the leading types of emergencies (5737/9880, 58.1%) followed by surgical emergencies (3047/9880, 30.8%). The five leading diagnoses were cardiovascular diseases (1057/9880, 10.7%), Road Traffic Accidents (951/9880, 9.6%), Malaria (802/9880, 8.1%), Head Injury (408/9880, 4.1%) and Fractures (408/9880, 4.1%). A high percentage of missing a diagnosis (1260/9880, 12.9%) was recorded. Conclusion: Cardiovascular conditions and road traffic accidents were the major diagnoses at presentation at the A/E department of the tertiary hospital studied. In addition, there was a high number of missing diagnoses which points to a need for further improvements in routine data gathering.
| Physician's Response on Level of Care Given to Haemophiliacs in South Western Nigeria.|| |
WA Shokunbi1, OW Dairo2, SP Aworanti1, FA Ogundeji1, P Fehintola3, T Olatunji4, T Fakunle5, T Ojo 4, S Yuguda6, L Ibijola7, K Iwara8, C Ajuba9
1Department of Haematology,2 Department of Epidemiology and Medical Statistics, 3Department of Pharmacology and therapeutics, University College Hospital, Ibadan, Nigeria, 4Department of Haematology, Obafemi Awolowo University Teaching Hospital, Sagamu Ogun State, 5Department of Haematology, Bermuda Hospital Board, Caribbean Island. 6Department of Haematology, Federal Teaching Hospital, Gombe, 7Department of Haematology, Federal Medical Centre, Ido-Ekiti, 8National Health Insurance Scheme, Headquarter, Abuja, Nigeria, 9Nnamdi Azikiwe University Teaching Hospital, Awka, Nigeria
Dr. SP. Aworanti,
Background: Data obtained from an initial survey in 2013 on the number and types of replacement therapy for Haemophilic patients was found not to be comprehensive, hence, this further attempt at expanding the survey on haemophilia care in Nigeria. Objective: The objective of this study was to determine the extent of haemophilia care in the southwestern part of the country as part of a nationwide survey in 2016, and also, to determine the type of haemostatic support given to haemophiliacs and challenges encountered in managing the patients. Methods: A self-administered questionnaire was developed for physicians in order to assess their experience on Haemophilia care in Nigeria. The responses from the Doctors were entered into SPSS (version 23) using the Data Dictionary. Coded table was prepared along with the questionnaire. Results: The self-administered questionnaires were retrieved from 215 physicians in south west, Nigeria. The distribution of those who responded is as shown in Fig 1, 2A and Fig 2B. as per qualifications, states and type of health facility respectively. Fig 3 depicts the number of physicians who have never managed haemophiliacs. Fig 4 and Fig 5 shows the types of blood products employed in the treatment of either Haemophilia A or B. Inadequate supply of Factor concentrates is the most encountered challenge in Haemophiliac care. Conclusion: The care of haemophiliacs in Nigeria needs to be standardized, as this study shows that most physicians have no contact with haemophiliacs and the current standard treatment for some of our haemophiliacs is not being given.
Keywords: Haemophilia, Physician response, Care
| Nutrition-Related Knowledge and Attitude of Practicing Nigerian Medical Doctors to Nutrition Counselling during COVID-19 Pandemic|| |
OF Folasire1,2, T Ilori,2,3, JKA Madaki4
1Human Nutrition Department, University of Ibadan, Nigeria, 2Department of Family Medicine, University College Hospital, Ibadan, Nigeria, 3Family Medicine Unit, Department of Community Medicine, University of Ibadan, Nigeria, 4Department of Family Medicine, University of Jos, Nigeria/Jos University Teaching Hospital, Nigeria.
Dr. T Ilori;
Background: Adequate nutrition is needed to enhance the immune system, especially at the time of COVID-19 pandemic for disease prevention and treatment. Objective: The study aimed to assess the knowledge of physicians to nutrition-related issues of COVID-19 infection and explore their attitudes to offering nutritional counselling to patients. Methods: This was a cross-sectional online study conducted among doctors in private and public institutions across the six (6) geo-political zones in Nigeria using the social media online platforms of the Nigerian Medical Association (N.M.A.). A categorisation of the knowledge score into sufficient and insufficient was done using the mean (sd) knowledge score. The attitude score was categorised into positive and negative using the median (IQR) attitude score, and bivariate analysis was used to test for associations. Results: Responses were received from a total of 176 doctors over six weeks of data collection. Majority (55.1%)were females, and 47.7% had practised for between 11 and 20 years. Majority (54.0%) had insufficient knowledge while majority (72.7%) of the respondents had a negative attitude to nutrition counselling of patients as regards COVID-19. There was a significant difference, p=0.004 in the knowledge of respondents based on gender. However, there was no significant difference in the attitude of the respondents based on professional cadre, gender, place of practice, years of practice. Conclusion: Respondents were deficient in the knowledge of common food items containing relevant nutrients essential for boosting immunity. Hence, there is a need to encourage physicians training in nutrition and nutritional counselling.
Keywords: Nutrition, Knowledge, Attitude, Physicians, Nigeria.
[TAG:2]Clinical Profile of Dilated Cardiomyopathy in Ibadan [/TAG:2]
OS Ogah1,2, AT Adeyanju1*, OA Orimolade1, AA Adebiyi1,2 A Aje1, AM Adeoye1,2, OO Oladapo1,2
1Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria, 2Cardiology Unit, Department of Medicine, 3Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria
Dr. OS Ogah,
Background: Dilated Cardiomyopathy is a primary myocardial disease of unknown cause characterized by left ventricular or biventricular dilatation and impaired myocardial contractility. Cardiomyopathies (hypertrophic, restrictive and arrhythmogenic right ventricular cardiomyopathy), contributes 21.4%(18.2-40.2%) to the global burden of heart failure of which DCM is a major cause of Heart Failure. A large proportion of patients with heart failure in Ibadan present with DCM and it is pertinent to determine their clinical profile. Objective: The objective of the study is to explore the pattern of DCM at the University College Hospital Ibadan. Methods: This is an analysis of a prospectively collected data over a period of 5 years (Aug 1 2016July 31 2021). Data was collected on the biodata and clinical echocardiographic features. Results: During this period, a total of 118 cases of DCM were seen, 89 males (75.4%) and 29 females (24.6%) aged 50.30 ± 14.8 years (range, 17 to 86 years). More than 80% of them had one form of formal education. 102(86.4%) were married. History of current or past alcohol consumption was documented in 50%. Conclusion: Our data show that DCM, a form of heterogeneous cardiomyopathy contributes to the burden of heart failure at the University College Hospital, Ibadan.
Keywords: Dilated Cardiomyopathy, Heart Failure, Left ventricular failure
| Appropriate Test Utilization: A Review of Physician Usage of Plasma Glucose Tests for the Diagnosis of Diabetes Mellitus|| |
MA Kuti, OT Bamidele, CT Udeh, BJ Eseile, OA Ogundeji
Department of Chemical Pathology, University College Hospital, Ibadan
Dr. MA Kuti
Background: Diabetes Mellitus (DM) is a growing epidemic in Africa. Its diagnosis relies exclusively on evidence provided by laboratory tests which differ in the clinical circumstances in which they are best used. Objective: The study described differences between the reasons for ordering plasma glucose tests and criteria published in international guidelines. Methods: We conducted a 6-month review of the requisition forms for plasma glucose studies received by our laboratory. Included forms had to have clinical information. The appropriateness of the tests, as well as the potential for inappropriate action, was defined by comparing diagnostic criteria as published by the American Diabetes Association to the clinical information provided. Results: Four hundred and twenty-three requisition forms were included with the majority from the medical specialities (72.3%), and the most commonly stated reason for testing was as part of evaluation of hypertension (28.6%). Fasting plasma glucose at 59.8% was the most commonly requested test. One hundred and sixteen (27.4%) of the requests were potentially inappropriate with requests for 2-hour postprandial plasma (2hPP) glucose the most common (71.6%). Requests from surgical units were more likely to be inappropriate. 2hPP plasma glucose results with >11.1 mmol/L seen in 20 persons (17.2%) may have initiated an inappropriate clinical action. Conclusion: A third of glucose tests requested for screening for DM may have been inappropriate. Twenty percent of the results of such testing potentially triggering inappropriate clinical action. For quality of care and economic reasons, laboratories should have programs to guide the appropriate utilisation of their services.
| Are there Regional Differences in the Clinical Profile of Chronic Heart Failure in Nigeria?|| |
OS Ogah1*, H Seidu2, KM Karaye3, R Adebayo4, A Mbakwem5, UG Adamu6, SO Adebayo7,OA Orimolade1, AM Adeoye1, A Aje1, A Adebiyi1, T Sogade8,MU Sani3
1Cardiology Unit, Department of Medicine, University of Ibadan/ University College Hospital Ibadan, 2Cardiology Unit, Bayero University / Murtala Muhammed Specialist Hospital, Kano, 3Cardiology unit, Bayero University / Aminu Kano Teaching Hospital, Kano, Nigeria 4Cardiology Unit, Obafemi Awolowo University/ Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, 5Cardiology Unit, University of Lagos/ Lagos University Teaching Hospital, Lagos, Nigeria, 6Cardiology Unit, Federal Medical Centre, Bida, Nigeria, 7Cardiology Unit, Federal Medical Centre, Lokoja, Nigeria (currently at Cardiology Unit, Federal Medical Centre, Abeokuta, Nigeria), 8Cardiology Unit, University of Uyo/ University of Uyo Teaching Hospital, Uyo, Nigeria.
Dr. OS Ogah
Background: Regional differences in clinical profile and characteristics of heart failure have been demonstrated in many parts of the world. This data is not available in Nigeria. Objective: The objective of this study was to compare the demographics and clinical characteristics in northern and southern Nigeria. Methods: In eight participating centres in the country we recruited 1269 unselected real-world patients with chronic HF in a national registry. Heart failure was diagnosed according to the ESC guidelines, based on signs, symptoms and structural and/or functional cardiac abnormalities. We obtained information on diagnostics, treatment and co-morbidities were recorded. Results :There were 710 subjects from the North and 559 subjects from the southern regions of the country. Southern patients were about 10 years older than those from the north (56.3 (15.7) vs. 46.2 (18.5 years) There were significant differences in the sociodemographic characteristics of HF subjects from the two regions. Hypertension as an aetiological risk factor for HF tends to be commoner in the South while cardiomyopathies especially peripartum cardiomyopathy and ischaemic heart disease appears to be commoner in the North.Although symptoms and signs of HF were worse in patients from the North, echocardiographic structural alterations appears to be worse in patients from Southern Nigeria. Conclusion: Chronic HF patients from Northern and Southern Nigeria differ significantly in their demographics and clinical characteristics. These differences underscore the importance of region-specific HF prevention and management strategies.
Keywords: Cardiac failure, Heart failure, LV dysfunction, Epidemiology of heart failure, Global health, Nigeria
| Randomised Control Trial of Oral Morphine and Intramuscular Pethidine for Post Caesarean Analgesia at Federal Medical Centre Abeokuta, Nigeria|| |
RT Lemboye-Bello1, DO Awonuga1, AA Odewabi2, OS Jimoh1, TA Ogunfunmilayo1, OA Aderinwale1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, 2Department of Anaesthesia, Federal Medical Centre, Abeokuta, Nigeria.
Dr Saheed Olanrewaju Jimoh
Background: Intramuscular opioid induces pain at the site of injection and its repeated administration proved to be more demanding for caregivers. Oral opioids especially morphine have become increasingly accessible in our environment and may be more effective than the conventional parenteral opioids for post-caesarean analgesia.
Objective: To compare the efficacy of multiple doses of 10mg oral morphine with that of 50mg intramuscular pethidine in treatment of post-caesarean pain among parturients. Methods: The study was a randomized controlled trial among parturients who had elective caesarean section in Abeokuta between November 2019 and August 2020. A total of 136 consenting and eligible pregnant women were randomized into two groups. Group A received multiple doses of 10mg oral morphine while group B had multiple doses of 50mg intramuscular pethidine. The Summed Pain Intensity Difference (SPID) of the two groups was calculated and compared using the chi-square and p-value < 0.05 was significant. Results: The mean±SD of SPID at rest for morphine group and pethidine group were 6.00±76.25 and 8.51±77.60 respectively (t= -0.439 p=0.662); the mean±SD of SPID on movement for morphine and pethidine group were 29.13±75.25 and 25.52±28.47 (t=0.139, p=0.890). The median maternal satisfaction reported was similar in both groups (χ2=2.773, p=0.4963) and somnolence was experienced in 3.1% of parturients in morphine group. Conclusion: The efficacy and maternal satisfaction of oral morphine in the control of post-caesarean section pain was similar to that of intramuscular pethidine. Hence, oral morphine is an acceptable alternative to intramuscular pethidine in management of pain following Caesarean section.
Keywords: Morphine, Pethidine, Intramuscular, Caesarean section, Analgesia
[TAG:2]Influence of Socioeconomic Status and Knowledge on Patients' Preference for Root Canal Treatment or Extraction [/TAG:2]
AO Sulaiman1, MA Soyinka1, OF Olawale2
1Department of Restorative Dentistry (conservative unit), University college hospital, Ibadan, 2Department of restorative dentistry (Prosthodontics unit), University college hospital, Ibadan.
Dr AO Sulaiman
Background: Pulpal pain is one of the most intense noxious stimuli that compel patients to seek urgent treatment for relief.1 Root canal treatment (RCT) or extractions are treatment options for irreversible damaged pulp.2 Tooth loss have grave impact on oral health, which is the reason why dentists advise on retaining the tooth/teeth, when it is indicated. The choice to have RCT or an extraction of a tooth varies according to the socioeconomic status (SES).3 Objective: To determine the role of SES as they influence patients' preference for RCT or extraction. Methods: Questionnaire was administered on the patients. Section A contains the demographic data. The SES was calculated using the modified Kuppuswamy Scale. Data generated were entered into SPSS version 23, statistical test such as frequency, percentage, and Chi square were employed. Results: Questionnaires of 105 out of 200 participants were analyzed due to completeness. The demographic characteristics of the subjects was summarized, and the study group consisted of 66.6% female and 33.3% male with a mean age of 47.97 ± 16.37. The distribution of the study population according to their SES, treatment preferences after knowledge of the cost, and there concern about RCT procedure, showed that the participant preferred extraction over RCT. The association of patient preference for RCT with SES, showed that individual in the high SES had a higher preference for RCT with a statistical significant difference <0.001. Conclusion: Conclusively, it was deduced that SES played crucial role in patient's' preference for treatment option for RCT or Extractions.
Keywords: root canal treatment, extraction, socioeconomic status
| Clinical Profile and Outcomes of Acute Heart Failure at the University College Hospital,Ibadan|| |
O Adebayo1, OS Ogah1,2, A Adebiyi1,2, OA Orimolade1, TA Adeyanju1, O Oluwasanjo1, V Obasuyi1, E Adebowale1, A Duduyemi1, MA Adeoye1,2, A Aje1, OO Oladapo1,2
1Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, 2Department of Medicine, College of Medicine, University of Ibadan, Ibadan.
Dr O Adebayo
Background: The burden of Acute heart failure (AHF) is increasing globally. Notwithstanding, there are few studies of AHF in Nigeria and among black populations generally. Objective: This study described the clinical features, conventional management and six-month outcome after discharge of patients admitted for acute heart failure at the University College Hospital, Ibadan, South-Western Nigeria. Methods: The study was a longitudinal observational study. One hundred and sixty consecutive AHF patients admitted into the Cardiology Unit of the Department of Medicine, University College Hospital, Ibadan, were recruited. Socio-demographic details, clinical history, basic laboratory parameters were assessed. Relevant electrocardiographic and echocardiographic variables were acquired. The recruited participants were followed up for six months after discharge to ascertain death or readmission. For all statistical tests, a two-sided p-value <0.05 was considered to be significant. Results: The mean ± standard deviation (SD) age of all the patients was 58.0 ± 15.1 years. The majority of the subjects were males (59.3%), while the commonest cardiovascular risk factor was hypertension (77.5%). One hundred and thirty-four subjects (83.8%) were in New York Heart Association functional classes III or IV. The commonest AHF type was Heart failure with reduced ejection fraction. Hypertensive heart disease was the commonest aetiology of heart failure in the study population. The median length of stay during admission, intrahospital mortality and mortality at six months after discharge were 11 days, 6.3% and 25.6%, respectively. Conclusion: This study provided real-world data of AHF at UCH, Ibadan. There was high mortality among these AHF subjects, similar to previously published AHF studies. There is a need for more strategy in our environment for preventing AHF and its adverse outcomes.
Keywords: Acute Heart failure, Heart disease, Heart failure.
| Clinical Profile and Characteristics of Hypertensive Heart Failure in Ibadan|| |
OS Ogah1,2,3, OA Orimolade1*, A Adebiyi 1,2, A Aje2, AM Adeoye1,2, OO Oladapo1,2.
1Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria, 2Cardiology Unit, Department of Medicine, University of Ibadan, Ibadan, Nigeria, 3Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria.
Dr. OS Ogah, Email:
Background: Hypertension remains a major public health problem globally. It is associated with significant morbidity and mortality. Hypertensive heart disease is a constellation of abnormalities such as left ventricular hypertrophy (LVH), systolic and diastolic dysfunction, as well as their clinical manifestations (arrhythmias and symptomatic heart failure). Majority of our heart failure patients in Ibadan has hypertensive heart disease. Objective: To describe the characteristics of heart failure caused by hypertensive heart disease in Ibadan, Nigeria. Methods: This is an analysis of a prospectively collected data over a period of 5 years (Aug 1, 2016 - July 31, 2021). Data were collected on the biodata, as well as clinical and echocardiographic features. Results: A total of 753 patients were consecutively studied, mean age 60.3 ± 13.2 with age range between 18 – 98 years, 58.2% (438) were males. Most patients (92.2%) presented with New York Heart Association functional class II and III and 26.9% had preserved systolic function (HFpEF). Conclusion: Hypertension is the most common aetiological risk factor for heart failure in Nigeria. Our study showed that hypertensive heart failure is commoner in males and most patients present in their 5th decade of life with left ventricular dysfunction.
Keywords: Heart failure, Hypertensive heart disease, Left ventricular failure
| Periprosthetic Fractures following Total Knee Arthroplasty in Awka, Nigeria: A 7-Year Review|| |
A Nwachukwu1, U Nagare2
1Department of Surgery, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria,2Deenanath Mangeshkar Hospital and Research Centre, Pune, India
Dr. A Nwachukwu
Background: Periprosthetic fractures after total knee replacement occurs at the supracondylar femoral area of the femur, the patella and the proximal tibia. Several causes have been identified which include minor fall, road traffic crash and direct violence. It commonly occurs at the supracondylar area of the femur. Implant loosing and failure can occur following this problem and complications have been noted following the fixation of this fracture. It commonly occurs amongst the elderly due to falls, however, younger population are not left out. Objective: Our aim was to look at the occurrence of periprosthetic fractures in this environment and the management outcome of this treatment. Methods: Out of 104 patients with 156 knees were diagnosed with severe arthritis. Total knee arthroplasty was done in the last 5 years only 3(1.92%) returned with periprosthetic fracture. Their mean age was 65years. Their mean weight was 84kg.They all had supracondylar femoral periprosthetic fracture. Minor fall was the cause of all the fractures. Xray and intraoperative findings showed no knee implant loosening. They were all treated with clover-leaf plate. The limbs were all supported with casts which were removed at 8weeks. Results: Radiological union was noted at an average time of 12weeks. Partial weight bearing was at 8weeks while full weight bearing was started at a mean time of 8months. There were no complications. Conclusion: Periprosthetic fractures are not common. Cobra plate is sufficient treatment with good outcome.
Keywords: Fracture, Periprosthetic, knee,Supracondylar
| Factor Analysis of Motivational and Deterrent Factors among Voluntary Non-Remunerated Blood Donors in Ibadan, Nigeria|| |
SP Ogundeji, OW Aworanti, TS Akingbola.
Department of Haematology, University College Hospital, Ibadan.
Dr. O.W. Aworanti
Objective: The aim of this study was to establish which motivational, deterrent and socio-demographic factors that would engender long-term commitment to voluntary, non-remunerated blood donation. Methods: A cross-sectional sample survey of blood donors who participated in the June 14, 2021 world blood donor day in Ibadan, Nigeria, was conducted. Donors filled in a self-administered questionnaire during donation. Data on motivation and deterrent were analyzed using factor analysis. Results: The majority of the blood donors were aged 21-40years and they had donated 0-53 times in the past. Three-quarters had donated at least 10 times previously. Four dimensions of blood-donor motivation were identified with factor analysis. These were: altruism and empathy; social reasons (such as the influence of friends and family); strengthening of one's self-esteem; positive and a moral obligation to donate. The most important deterrent factors for blood donation was 'hate sight of blood” and time taken to donate. Conclusion: The huge demand for blood and blood products in this environment could be met if young people in school who are altruistically motivated are recruited and retained in the donor pool. Donation process should be as short as possible and close to residence of potential donors.
Keywords: factor analysis, blood donation, motivation for donating blood, deterrents to blood donation.
| Serum adipocytokines in Nigerian men with nuchal fat fold|| |
KS Akinlade1, BB Eni2, OS Ogah2, SK Rahamon3
1Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria, 2Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria, 3Department of Immunology, College of Medicine, University of Ibadan, Ibadan, Nigeria
Dr. B.B. Eni
Background: The factors associated with upper body fat deposition (UBFD) in the development of insulin resistance and cardiovascular diseases (CVDs) are not well understood. Thus, the understanding of the roles of adipocytokines in UBFD-associated pathologies could be of clinical significance. Objective: The objective of the study was to assess the levels of selected adipocytokines in men with nuchal fat fold (NFF). Methods: Eighty-six males (43 with NFF and 43 without NFF) were enrolled into this study. Serum levels of tumour necrosis factor-alpha (TNF-a), resistin and adiponectin were assessed with ELISA. Results: Adiponectin level was found to be significantly higher in NFF compared with the controls. On the other hand, resistin and TNF-a levels were significantly lower in the former. TNF-a significantly correlated with systolic blood pressure (SBP. Adiponectin significantly correlated with the waist-hip ratio (WHR). Stratifying based on the obesity status, the mean body weight, BMI, waist circumference (WC), hip circumference (HC), WHR, neck circumference (NC), NFF and diastolic BP were significantly higher in NFF with obesity compared to those without obesity, although levels of TNF-a, resistin and adiponectin were similar between the two groups. Conclusion: Our result indicates that NFF is associated with elevation in adiponectin level and increased CVD risk and may therefore, serve as an index of early onset of cardiometabolic diseases.
Keywords: Nuchal fat fold, Obesity, Insulin resistance, cardiovascular disease.
| Triplex Sonographic Evaluation of Portal Vein Indices Amongst Adults in Port Harcourt Nigeria.|| |
GJ Aderibigbe, C Agi, ED Robinson
Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt
Dr ED Robinson
Background: Chronic liver disease is characterized by progressive hepatic fibrosis and changes in hepatic vascular haemodynamics. Sonography is a readily available tool in the assessment of the hepatic hemodynamic alterations that occur in chronic liver diseases. Objective: The study was aimed at sonographically determining the portal vein indices in apparently healthy adults by estimating the portal vein diameter, cross-sectional area and portal vein velocity. Methods: This was a prospective cross-sectional study carried out among 62 apparently healthy individuals. The subjects underwent gray scale and Doppler ultrasonographic examinations of the portal vein. Data was analyzed using statistical package for the social sciences (SPSS) IBM Corp. version 23.0 (Armonk, NY: USA). Comparison of means of two groups was with the unpaired t-test, and level of significance was set at 5% (p<0.05). Results: Forty-six (74.2%) of the 62 subjects recruited were males and 16 (25.8%) were females. Subjects were aged 18-65 years with a mean age of 39.90±10.34 years. The means of portal vein diameter, cross-sectional area and portal vein velocity are 1.15±0.12cm,0.88 ± 0.18cm2 and 18.37 ± 2.04cm/s respectively. There was no statistically significant difference of all portal vein ultrasound parameters between males and females, except portal vein flow velocity which was higher in males, t-Test = 2.273 and P value = 0.027 (> 0.05). There was no significant correlation between age and ultrasound parameters P value > 0.05. Conclusion: The normal values of portal vein diameter, cross-sectional area and portal vein velocity were established. Keywords: Portal vein diameter, portal vein cross-sectional area, portal vein flow velocity, Ultrasound, Doppler
| Rate of Tooth Movement in Resolution of Anterior Segment Crowding|| |
FG Nkwocha1, OT Temisanren1, OO Dacosta2 , OO Denloye1
1Department of Child Oral Health, University College Hospital Ibadan, 2Department of Child Dental Health, Faculty of Dental Sciences, College of Medicine, University of Lagos
Dr. FG Nkwocha
Background: Dental crowding presents displacement of the contact points of teeth, impaired facial aesthetics, compromised oral health and function, and psychological impacts. Orthodontic treatment for crowding is commenced with thin, flexible arch wires such as; Nickel Titanium (NiTi) and Copper Nickel Titanium (CuNiTi) arch wires This study set out to investigate the clinical efficiency of NiTi and CuNiTi arch wires in relation to tooth alignment in anterior segment crowding. Objective: To present rate of tooth movement as a means of assessing resolution of crowding and to compare this rate when using NiTi and CuNiTi arch wires in the initial alignment phase of treatment of anterior segment crowding. Methods : A randomized control trial at the orthodontic clinic of the University College Hospital Ibadan. Participants with a Little's Irregularity Index score (LII) of at least 4mm, were randomly allocated into 2 groups (group 1-NiTi arch wire group; group 2- CuNiTi arch wire group). NiTi and CuNiTi arch wires of 0.014; 0.016 sequence used for initial alignment; the participants were reviewed every six weeks until alignment was achieved. The rate of alignment was calculated by plotting a regression curve for the LII scores over the review period using the Grapher™ Version 8, Golden Software. Results: Thirty-two (32) arches each were treated with NiTi and CuNiTi arch wires. There was no statistically significant difference in the mean pretreatment LII between the arch wire groups (NiTi=8.75±3.78mm; CuNiTi =7.83±3.07mm; p-value=0.42. The rate of alignment was similar between the arches treated with CuNiTi (0.94mm/week) and those treated with NiTi arch wires (0.91mm/week) with no statistically significant difference. p-value =0.19. Conclusion: Rate of tooth movement / reduction in irregularity index over time has been presented as a means of assessment of resolution of anterior segment crowding. The more expensive CuNiTi arch wires do not offer a significant advantage over the cheaper NiTi wires in producing faster rate of tooth movement when used in initial alignment for anterior segment crowding.