Patterns of Ear, Nose and Throat Injuries in Ido Ekiti, Nigeria

Background/aim: Ear, nose and throat (ENT) injuries are a problem in children and adults worldwide. The aim of this study was to evaluate the patterns, etiological factors, management and outcomes of ear, nose and throat injuries in Ido Ekiti, Nigeria. Methods: This was a prospective study of consecutive patients with Ear, Nose and Throat injuries that presented through accident and emergency (A&E) unit and were managed at our Centre between June 2011 and May 2013 (24 months period). Data collected included patients’ demography; type and pattern of injuries sustained, clinical presentation, causes as well as outcome of treatment. Injuries recorded were classified based on their mechanisms into RTA, falls, assault, gunshot and burns related. Results: Out of 473 patients seen in Accident and Emergency that had trauma during the study period, a total of 116 patients had ear, nose and throat related injury. Out of these about 94 patients (81.0%) were males and 22 (19.0%) were females giving a male: female ratio of 4.3:1. Their age ranged was from 2-71 years with a mean of 35.89 ± 17.24 SD years. The highest number of injuries occurred within the age group of 21-40 years accounting for 53.4%. Traders/Business accounted for 31.0% of the injured patients. The commonest cause of injury was road traffic accident in 84 (72.4%). Majority (59.5%), of the patients presents in the accident and emergency unit within 6 h of injury. Nasal injuries were the commonest in 53.6% patients. Traumatic epistaxis was the highest presentation in nasal injury whereas Bruises, abrasions, lacerations and cuts were major injuries to the ear. Wound debridement/suturing and dressings were the commonest treatment offered in 69.8% of the patients. No mortality related to ENT injuries was recorded. Conclusion: Road traffic accidents (RTAs) remain the leading cause of ear, nose and throat injuries in our center. Nasal injuries were the commonest. Majority of these injuries can be prevented through health education, public enlightenment campaigns. Early presentation is recommended to reduce morbidity and mortality

A Survey of Hand Hygiene Facilities in a Tertiary Hospital in Nigeria

Introduction: Hand hygiene causes a significant reduction in the carriage of potential pathogen in the hand. Inadequate hand hygiene facilities is one of the factors affecting compliance with hand hygiene by health care workers. The objective of the study was to evaluate the availability and accessibility of hand hand hygiene facilities and supplies of hand hygiene agents in the inpatient wards of a tertiary hospital in Nigeria. Methods and Materials: The study was conducted in a federal tertiary hospital in Nigeria. A modified survey checklist that assessed the condition of hand hygiene sink and other facilities was adapted and pretested. Direct observations of existing hand hygiene facilities in all the inpatient wards were carried out by one of the authors. Results: Of the 28 sinks, 22 (78.6%) were accessible but 13 (46.4%) had blocked drain. All the taps were hand operated with only 4 (14.3%) working. Majority of the sinks (67.9%) had no soap and no sink had antiseptic solution. Only 8 (28.6%) sinks had hand drying material which was a cloth towel. No sink had hand hygiene instructions displayed on or close to it. Conclusion: There is gross inadequacy of hand hygiene facilities in Ido-Ekiti, Nigeria. There is an urgent need for health managers to give priority to provision of hand hygiene facilities at all levels of health care delivery. Infection Control Unit should be established and strengthened in each facility for effective implementation of infection control policies. [TAF Prev Med Bull 2012; 11(5.000): 571-576

A 5‑year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria: A retrospective observational study

Introduction: In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED). Materials and Methods: A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats. Results: Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%. Conclusions: The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, and Systems-based practice

Potential drug-drug interactions among elderly patients on anti-hypertensive medications in two tertiary healthcare facilities in Ekiti State, South-West Nigeria

Introduction: Drug-drug interactions remain a major cause of adverse drug reactions with great consequences such as increased morbidity and increased healthcare cost. In elderly patients with systemic hypertension, there is a tendency for them to be prescribed multiple medications and this may expose them to some drug-drug interactions (DDIs) especially in the context of physiological changes of ageing. The objective of this study was to evaluate potential drug-drug interaction among some Nigerian elderly hypertension. Methods: A cross-sectional study involving elderly hypertensive patients attending the general outpatient clinic of two tertiary healthcare facilities located in Ekiti State, South-West Nigeria. The information collected from the patients′ medical records included their ages, gender, diagnosis and list of prescribed anti-hypertensive medications. Potential drug-drug interactions were checked for using the Multi-Drug Interaction Checker (Medscape Reference) and Epocrates Drug Interaction Checker (San Mateo CA, USA). Results: A total of 350 elderly patients attended the clinics during the study period of which 208 (59.4%) hypertensive patients were identified and their records used for analysis. The fixed-dose combination drug Moduretic® (Amiloride /Hydrochlorothiazide)-25.7% was the most commonly prescribed antihypertensive followed by Lisinopril (16.6%), Amlodipine (13.2%) and Nifedipine (12.6%). The anti-platelet Acetyl-salicylic acid (ASA) was prescribed for 100 (48.1%) patients and represented 19.8% of all prescribed medications. A total of 231 potential DDIs were found among the patients giving a mean of 1.3 interactions per patient. The most common identified drug pairs with potential interactions were ACE inhibitors - Amiloride, followed by ACE inhibitors - Hydrochlorothiazide, ACE inhibitors - ASA and ARB - Amiloride. Conclusion: Potential drug-drug interactions, though common in this study comprised mainly of minor and moderate types. Notwithstanding, physicians need to be reminded of the potential for interactions when prescribing for elderly patient

Relationship between the Level of Spirituality and Blood Pressure Control among Adult Hypertensive Patients in a Southwestern Community in Nigeria

Background: Spirituality has been strongly associated with good blood pressure control as it forms a strong coping mechanism in hypertensive patients. This hospital-based cross-sectional study was done to determine the relationship between spirituality and blood pressure control among adult hypertensive patients in rural Southwestern Nigeria to achieve good blood pressure control.Method: The selection was done by systematic random sampling technique. Socio-demographic and clinical information were obtained through semi-structured interviewer-administered questionnaires. The level of spirituality was assessed using the Spiritual Perspective Scale. Data were analysed using the Statistical Package for Social Sciences version 20.0. Statistical significance was set at p ≤ 0.05.Results: The mean age of the respondents was 61.1 ± 11.1 years. More than half (52.6%) had a high level of spirituality and more than two-thirds (67.1%) of respondents had controlled blood pressure. Respondents with a high level of spirituality were 4.76 times more likely to have good blood pressure control {p < 0.001, 95% CI (1.05-14.99)} than those with a low level of spirituality. Conclusion: Proper understanding and effective utilization of this relationship will assist health professionals and researchers in the appropriate integration of this concept into patients’ holistic care with the aim of achieving better blood pressure control among hypertensive patients