A Comparative Analysis of the West African Hemorrhagic Fevers Caused by the Lassa and Ebola Viruses

Lassa fever (LF) and Ebola Hemorrhagic Fever (EHF) are viral diseases endemic to West Africa.The etiological agent of Lassa fever is an enveloped virus from the Arenaviridae family and was first discovered in 1969 when two missionary nurses died of a mysterious illness in the town of Lassa in Borno state, Nigeria.1 This virus is animal-borne (zoonotic) and is carried by the animal vector Mastomys natalensis (multimammate rat). The Ebola virus is also zoonotic originating from fruit bats belonging to the Pteropodidae family.2 The first reported case of Ebola Virus Disease (EVD) was a principal who was believed to have visited the Ebola river on his journey through the Democratic Republic of Congo. Annually, there are about 100,000 to 300,000 reported cases of Lassa fever, with about 5,000 deaths.1 Concurrently, the Ebola virus has raked in 11,310 reported deaths from about 28,616 suspected cases, 10% of which were health professionals.3 It is noteworthy, however, that the death toll associated with EVD is more sporadic and widespread than that of LF. Most infections can be attributed to person-person transmission in which healthy individuals get infected by coming in contact with the body fluids (urine, saliva, and semen) of the sick.1 Both the Lassa and Ebola viruses are pertinent in current public health discussions especially for their potential as bioweapons.1 ,2 Consequently, this paper seeks to discuss the structure and pathogenic mechanisms of both viruses, address current treatments and complications, and propose areas for further research and preventive measures

Technology – Enhanced Pathology Education: Nigerian Medical Students Perspectives

Background: The delivery of pathology education traditionally through instructor centred didactic lectures, small group tutorials, and practical demonstrations using microscope glass slides, gross pot specimens and autopsy sessions, is paving way for electronic learner-centred methods. Successful adoption and implementation of rapidly advancing educational technologies in the resource-constrained environment obtainable in most of sub-Sahara Africa requires a comprehensive analysis of the learners’ reflections on their use and effectiveness.Aims: This study aimed to evaluate the perspectives of medical students towards the ever-advancing ways of teaching and learning pathology in Nigeria.Materials and methods: Fifty-five fourth year medical students randomly selected from two universities were given survey questionnaire. The questionnaires enquired into opinions of the students on the various aspects of the use of ICT in pathology education.Results: Studying with microscope mounted glass slides was considered by the majority (33, 60%) of the 55 respondents to be the most effective method of learning pathology and 24 (43.6%) favoured the projection of the glass slide on a large screen using a camera-mounted microscope. Twenty-seven (49.1%) preferred projected computer based digital microscope images. Twenty students (36.4%) disagreed with the use of internet-based images during practical classes. Prior distribution of digital images to students’ hand – held devices days before classes was agreed to by 19 (34.5%) and strongly agreed to by 15 (27.3%) students. Annotated digital images, instead of glass slides, were favoured by 50, (91%) students.  Self-study with webinars was not supported by 26, (47.2%) students. Eleven (20%) students strongly agree, 25 (45.5%) agree, eight (14.5) are undecided, and 10 (18.2%) disagree that the use of digital microscope images reduces microscope handling proficiency. The use of digital images instead of mounted glass slides during objective structured practical examination was supported by 20, (36.4%) students. Forty-seven (85.5%) reported interrupted classes due to faulty equipment.Conclusion: The challenge of developing ways for better delivery of pathology curriculum content to future doctors compels medical educators to explore easier ways of teaching and learning. This study has demonstrated that medical students in Nigeria favour technology enhanced learning and the integration of new teaching methods into already existing frameworks. Keywords: technology-enhanced learning, pathology, pathology education, student perspective

Our experience with pre-operative haemostatic assessment of paediatric patients undergoing adenotonsillectomy at Federal Medical Centre, Makurdi

Background: In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, pre-operative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. However, because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in paediatric patients undergoing adenoidectomy, tonsillectomy or both in our centre. Patients and Methods: This is a 3½-year analysis of the data of 165 paediatric patients who had adenoidectomy, tonsillectomy or both over the study period. The data collected included age, sex, procedure done and detailed clinical bleeding history. Results: A total of 165 children had either adenoidectomy or tonsillectomy, or both. There were 76 males and 89 females giving a male to female ratio of 1:1.2. Their ages ranged from 10 months to 18 years. Eighty-five (51.5%) patients had adenotonsillectomy, 48 (29.1%) and 32 (19.4%) had only tonsillectomies and adenoidectomies, respectively. Only 11 (6.7%) families volunteered the history of either prolonged bleeding with minor injury on the skin or occasional slight nose bleeding. Six (3.6%) patients including 3 of the children with positive family history had posttonsillectomy bleed, out of which 4 (66.7%) were moderate whereas the remaining 2 (33.3%) were severe bleeding, which was not statistically significant (P = 0.041). The two cases of severe bleeding had fresh whole blood transfused whereas the rest that had no bleeding issues were discharged home 48 h postoperatively. Conclusion: Our experience in this study suggests that detailed bleeding history is necessary as well as pre-operative haemostatic assessment, if available and affordable for paediatric patients undergoing adenotonsillectomy

The profile of trauma-related mortality in Benue State University Teaching Hospital, Makurdi, Nigeria

Background: Trauma is globally associated with significant mortality with   developing count r ies bearing a disproportionately high burden. This study aims to elucidate the pattern of trauma-related deaths in Benue State University teaching hospital (BSUTH), Makurdi, Nigeria.Methods: A review of all trauma-related in-hospital deaths from July 2012 to December 2014 was carried out. Patients' socio-demographic and injury-related data were extracted and analyzed using IBM SPSS Statistics for Windows, Version 21.0.Results: One thousand and nine trauma patients were attended to during the study period of which 87 (8.7%) died during the hospital stay. Eighty-five trauma-related deaths were included in the study comprising of 67 males (78.8%) and 18 females(21.2%). The predominant age group involved was 20-29 years. Road traffic injuries (RTI) were the leading cause of fatal injuries accounting for 76.5% of deaths  (n=65). They were followed by burns (n=8, 9.4%) and gunshot injuries (n=6, 7.1%).. The  locations of deaths within the hospital were the Accident and Emergency Department (A&E) (n=60, 70.6%), wards (n=18,  21.2%) and intensive care unit (n=, 7.4%). The main causes of death were traumatic brain injury (TBI) (n=60, 71.4%), exsanguination (n=8, 9.5%), chest injury (n=5, 6.0%) and multiple organ dysfunction syndrome (MODS); n=3, 3.6. Fifty-three patients (62.4%) died within the first 24 hours of arrival at the hospital (early deaths). Patients with TBI were more likely to die within 24 hours of admission than those who have stayed for more than 24 hours in the hospital. (p = 0.001).Conclusions: Trauma-related mortality in BSUTH affected 20- 39 year old males predominantly. Majority of lethal injuries were caused by road traffic accidents with traumatic brain injury being the leading cause of death.Keywords: Trauma, Injury, Deaths, Pedestrians, Pediatric death