OCULOPLASTIC TRAINING AND ITS ROLE IN EYE CARE SERVICES IN A NIGERIA TERTIARY HOSPITAL

ABSTRACT Oculoplasty subspecialty in Ophthalmology was barely 7 years in Nigeria. National statistics show an increased number of cases that should have benefitted from this expertise that is rare. As a result of this deficit, a consultant ophthalmologist was sent to Sankara Nethralaya Eye Hospital, Chennai, India for 3 months oculoplastic training with the help of International Council Ophthalmology (ICO). To evaluate the role of oculoplastic training in eye-service care in our hospital, all patients seen at our oculoplastic unit during the 8 months period from April to November 2017, had information extracted from their medical record. The data obtained was analysed using SPSS version 20. Out of 53 patients seen 30 (56.65) were males and 23 (43.4%) were females. Majority 10 (18.9%) were diagnosed with a traumatic irreparable ruptured globe, while 10 (18.9%) had congenital nasolacrimal duct obstruction. Page 7 of 23 https://mc.manuscriptcentral.com/sljbr Sierra Leone Journal of Biomedical Research Oculoplastic training and its role in eye care services in a Nigeria tertiary hospital for Review Only 2 Thirty-six (67.9%) patients had surgery and 10 (18.9%) were successfully managed with lacrimal sac massage for congenital nasolacrimal duct obstruction in children. Majority 10(18.9%) of the surgery were evisceration with primary ocular implants. One patient with clinically significant orbital floor fracture was referred. Four cases of congenital ptosis declined surgery. This expertise resulted in increased patient turnout by 30% and income to the department, while it saves cost to patients who need not be referred. The skills acquired from oculoplastic training have help in rendering oculoplastic services to the people of Kebbi State and its environs at a reduced cost. Also, there is improved internally generated revenue to the hospital. The importance of skill transfers and subspecialty training is underscored. Keywords: oculoplastic; subspecialty training; Kebbi State; tertiary hospita

Subspecialty training in Ophthalmology; How far?

No Abstract

Smoking and Non-Communicable Diseases in Sub-Saharan Africa: The Nigeria Scenario

Smoking remains a strong factor in the emergence of Non-Communicable Diseases (NCDs) and it contributes to the development of cardiovascular diseases, cancers, diabetes mellitus and chronic respiratory disease which are the four leading NCDs worldwide. Non-Communicable Diseases has been implicated in about two thirds of the global premature deaths. However despite the strong evidence of link of smoking to NCDs, the prevalence of smoking is still high among the youths and adults, with an attendant adverse health effects. Nigeria, though a signatory to WHO Framework Convention on Tobacco Control (WHO FCTC) of 2005, and its recent domestication in National Tobacco Act of 2015, effective operationalization and implementation is still a mirage

Stroke Subtypes, Risk Factors and Treatment Outcomes at A Tertiary Hospital Situated in Rural Southwestern Nigeria: A Five- Year Restrospective Observational Study

Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), p = 0.005)], low income earners [(AOR = 0.452; 95% CI: (0.230-0.888), p = 0.021)], obesity [(AOR = 0.080; 95% CI: (0.019-0.347), p= 0.001)], heart failure [(AOR= 9.152; 95% CI: (2.325-41.266), p < 0.001)], atrial fibrillation [(AOR = 0.136; 95% CI: (0.068-0.891),p = 0.001)], tobacco smoking [(AOR = 0.350; 95% CI: (0.137-0.891), p = 0.028)], and poorly controlled blood pressure [(AOR = 0.107; 95% CI: (0.033-0.348), p <0.001)]. The mortality rate was 10.1%. Conclusion: The results of this study further support the argument on the higher prevalence of stroke admission in rural areas of Southwestern Nigeria. There may be need for public awareness on primary stroke prevention and early identification of the risk factors in order to reduce the prevalence and mortality of stroke in the rural Southwestern Nigeria

Stroke Subtypes, Risk Factors and Treatment Outcomes at A Tertiary Hospital Situated in Rural Southwestern Nigeria: A Five- Year Restrospective Observational Study

Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), p = 0.005)], low income earners [(AOR = 0.452; 95% CI: (0.230-0.888), p = 0.021)], obesity [(AOR = 0.080; 95% CI: (0.019-0.347), p= 0.001)], heart failure [(AOR= 9.152; 95% CI: (2.325-41.266), p < 0.001)], atrial fibrillation [(AOR = 0.136; 95% CI: (0.068-0.891),p = 0.001)], tobacco smoking [(AOR = 0.350; 95% CI: (0.137-0.891), p = 0.028)], and poorly controlled blood pressure [(AOR = 0.107; 95% CI: (0.033-0.348), p <0.001)]. The mortality rate was 10.1%. Conclusion: The results of this study further support the argument on the higher prevalence of stroke admission in rural areas of Southwestern Nigeria. There may be need for public awareness on primary stroke prevention and early identification of the risk factors in order to reduce the prevalence and mortality of stroke in the rural Southwestern Nigeria

Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria

Background: Intimate partner violence (IPV) is a significant public health problem. Despite being a phenomenon that occurs globally, few studies have reviewed the issue of intimate partner violence among pregnant women as it relates to disclosure of abuse. This study sets out to determine the prevalence and pattern of disclosure of intimate partner violence among pregnant women attending antenatal clinic in Oyo East Local Government of Oyo State. Methods: A descriptive cross-sectional study among pregnant women aged 18–49 years. A total of 350 pregnant women in the sole secondary health care facility and 3 out of the 18 primary health care facilities randomly selected by balloting were consecutively recruited. A pre-tested semi-structured questionnaire adapted from the WHO Multi-Country Study on Women’s Health and Domestic Violence was used to collect data. Data were analysed with SPSS® version 16. Results: Of 252 (72.0%) women who had been exposed to violence by their partner in pregnancy, 72 (28.6%) disclosed their IPV experience. The experience was disclosed to relatives, friends and religious leaders. Of the 72 that disclosed their IPV experience, 31 (43.1%) reported for the purpose of seeking redress through religious or local leaders, healthcare professionals and law enforcement agencies. Conclusion: Intimate partner violence is common among pregnant women, but a culture of silence still persists, making identification of the exposed difficult. These data may encourage healthcare providers to include screening for IPV in the curriculum of the antenatal care. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.127224

Family functioning and adherence to medication: A study of hypertensive in a tertiary hospital, South Western Nigeria

Background: Hypertension is one of the most important risk factors for coronary heart disease, stroke, heart failure, and end-stage renal disease. It remains an important public health challenge, despite effective medical therapies for its management, patients' poor adherence remains a global problem. Aim: The main objective of this study is to determine the relationship between family functioning and medication adherence among hypertensive, attending a tertiary care center in South-West Nigeria. Materials and Methods: This was a descriptive cross-sectional study. The systematic sampling method was used to select 420 patients attending the outpatient clinic of the tertiary hospital. Relevant data were collected using interviewer-administered pretested semi-structured questionnaires. Results: Four hundred and twenty people participated in the study. The mean age of respondents was 60.97 ± 11.28 years, and a slight female preponderance (M:F = 1:1.7). Three hundred and forty-nine (83.1%) were married, 273 (65.0%) were from a monogamous family and 375 (89.2%) had a family size of >4. More than half of the study participants had a functional family (66.4%) and were adherent (61.2%) to their medication. Increased medication adherence proportion was observed in patients with a functional family. Adherence to medication is three times (odds ratio = 2.585, 95%CI = 1.636, 4.084) higher among patients with functional family. Conclusion: The structure and nature of family relationships, both of which determines family functioning, are important to medication adherence. A functional family enhances adherence to medication. Primary care physicians should create a positive treatment alliance with their patients to better family functioning

Knowledge of morphine use in the management of pain in cancer patients among physicians in a resource-constraint setting

Introduction: The use of morphine is viewed as an integral part of pain management in cancer patients. Theresponsibility for pain treatment lies with physicians. Therefore, this study assessed the knowledge of clinicaluse of morphine in the management of pain in cancer patients among physicians working in KebbiState, Nigeria.Material and method: A self-administered questionnaire was distributed to all the 110 participants inattendance at the Continuing Medical Education meeting organized by the Nigerian Medical Association,Kebbi State Branch. Data were analyzed using SPSS version 20.Result: A total of 95 physicians participated, including 12 consultants (12.6%), 38 registrars (40.0%),35 medical officers (36.8%), and 7 house officers (7.4%). Only 30 respondents (31.6%) had ever receivedprofessional training on pain management or analgesic use. Overall, only 10 (10.5%) respondents hadgood knowledge of pain management in cancer patients and morphine use.Conclusion: Physicians knowledge of pain management in cancer patients and clinical use of morphine ispoor. There is a need to improve active professional analgesic education programs

Malaria infection and its association with socio-demographics, preventive measures, and co-morbid ailments among adult febrile patients in rural Southwestern Nigeria: A cross-sectional study

Objectives: The study determined the prevalence of malaria infection and its association with socio-demographics, environmental, housing, and co-morbid ailment factors. Methods: The study was a cross-sectional of 330 consented adult febrile patients who were recruited at a tertiary health facility in rural Southwestern Nigeria. The standardized interviewer-administered questionnaire sought information on their socio-demographics, environmental, housing, and co-morbid ailment factors. Venous blood samples were collected and processed for malaria parasite detection, retroviral screening, glycated hemoglobin, and hemoglobinopathy. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using odds ratio and 95% confidence interval with a significant level (p value <0.05). Results: The prevalence of malaria parasitemia was 63.3% (95% confidence interval: 57.9%–68.5%). Being a farmer (p=0.002), lack of formal education (p=0.043), low-income earners (p=0.031), presence of bushes (p=0.048), stagnant water (p=0.042), not sleeping under long-lasting insecticide-treated nets (p<0.001), and sickle cell disease (p=0.041) were significantly associated with malaria infection. Conclusion: The study revealed that there is a high prevalence of malaria infection in rural Southwestern Nigeria. There may be a need to pay greater attention to adult populations in rural areas for malaria intervention and control programs

Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria

Background: Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. Methods: A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. Results: Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. Conclusion: The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections