Assessment of students' satisfaction with university health care services in a medical university in southern Nigeria

Objectives: Assessment of patients' satisfaction with health services helps to identify deficiencies in health care delivery and provides invaluable feedback to health care providers. Level of satisfaction of students with the health services provided by a University in Southwest Nigeria was assessed with the aim of providing feedbacks to the health workers.Methods: The study is a cross-sectional descriptive study that assessed satisfaction of students with University health services between April 2016 and March 2017 using the Short Assessment of Patient Satisfaction (SAPS) questionnaire. Data generated was analyzed using the statistical package for social sciences version 17.0.Results: One hundred and forty-one students participated in this study with male: female ratio of 1:1.6 and mean age of 18.70±3.25 years. Their mean SAPS score was 18.70±3.25. One-hundred and ten (78%) of the respondents were satisfied with the effect of the treatment received, 95(67.4%) were satisfied with their communication with the doctors, 102(72.4%) were satisfied with physical examination by their doctors, 105(74.6%) were satisfied with their involvement in decision making concerning their health, 83(58.9%) were satisfied with the respect accorded to them by the doctors, 57(40.4%) were satisfied with duration of time spent by the doctor with them. Overall satisfaction using the total SAPS scores showed that 73(51.7%) were satisfied with the care.Conclusion: About half of the respondents were satisfied with the health services received. Domains with the lowest scores were those related to short duration of time spent with patients during consultation and respect for patients.Keywords: Students, satisfaction, University, healthcare, service

A study of some peculiar tropical risk factors for proteinuriaas marker of chronic kidney disease in a rural community in Ondo state, south-west Nigeria

Background: The role of herbal remedies and Non-Steroidal Anti-inflammatory Drugs in the development and progression of chronic kidney disease are yet to be fully studied in our environment despite their indiscriminate use. We set out to determine the prevalence and pattern of use of herbal remedies and NSAIDs and their relationship (if any) to chronic kidney disease.Methods: Adults at a screening exercise in a village in Ondo State, Nigeria were studied. Their bio-data, history of herbal usage and NSAIDs, cigarette smoking, alcohol intake, diabetes mellitus and essential hypertension were obtained. Their blood pressure and anthropometry were measured. Urinalysis was conducted with Combi-Uriscreen®. Data was analysed using SPSS 20.Results: One hundred and sixteen subjects were studied (M:F, 1:1.8). 51.7% were farmers. Their mean age was 42.5±14.7 years (range, 17-78 years). Their mean systolic and diastolic blood pressures were 125.2±20.4mmHg and  77.3±12.3mmHg respectively. Their mean body mass index was 26.2±6.0 kg/m2. Usage of herbs was found among 78.4% of subjects. 68.1% used NSAIDs, 11.2% had a history of cigarette smoking, 25.0% used alcohol, 50.0% had  pre-hypertension, 28.0% had essential hypertension and 7.8% had diabetes  mellitus. Undiagnosed hypertension was present in 24.1%. Proteinuria (ranging between 100mg/dl and 500mg/dl) was present in 12.5% of the subjects. Central obesity was present in 21.9% of the subjects. There was a significant association between proteinuria and use of herbs (p=0.023, chi square 5.188), use of NSAIDs (p=0.01, chi square 6.722), and pre-hypertension (p=0.039, chi square 4.261).Conclusion: The rates of use of herbal remedies and NSAIDs in the rural community are high. Our study suggests that they may cause significant proteinuria among users. There is therefore a need to conduct more high powered studies on this subject.Keywords:herbal concoction, renal failure, tropics, proteinuria, Nigeri

A case report of emphysematous cholecystitis associated with pneumobilia in a diabetic patient

Background: Emphysematous cholecystitis is an uncommon variant of acute cholecystitis that could be life threatening if not promptly diagnosed and managed.Case report: We report a 65 year old male diabetic who wasadmitted through the surgical emergency unit of Trauma and Surgical Centre, Ondo City on account of eleven day history of right sided upper abdominal pain and vomiting. Investigation showed elevated randomblood glucose of 24mmol/l, glycated hemoglobin of 9.5%, hematocrit of 20% and white blood count of 6,700 cells/mm3. Abdominal computerized tomography scan showed air in the wall and lumen of gallbladder and common bile duct thereby confirming a diagnosis of emphysematous cholecystitis associated with pneumobilia.He was transfused andtreated with intravenous antibiotics and insulin. Hethereafter had an emergency open cholecystectomy without any postoperative complication.Conclusion: This case highlights an unusual presentation of this rare condition and the need for high index of suspicion in order to prevent associated morbidity and mortality.Keywords: Emphysematous, Cholecystitis, Diabetes mellitu

Cardiovascular determinants of renal dysfunction among children and adolescents in South West Nigeria

Background: New evidences reveal significant association of cardiovascular risk factors to development of chronic kidney disease among children and adolescents but there is paucity of data from Africa. Objectives: We examined the association of cardiovascular risk factors to renal dysfunction among Nigerian pediatric subjects. Materials and method: This was a prospective, cross-sectional study of pediatrics aged 2 to 17 years. Blood pressure, body mass index, serum lipids and creatinine were determined. Their glomerular filtration rate was calculated using the revised Schwartz equation. Data was analyzed with SPSS 20. Test of association was by Chi square at P <0.05. Results: We studied 114 children and adolescents. There were 55 (48.2%) males and 59 (51.8%) females with mean age of 8.99±4.26 years. There were 68 (53.5%) children and 53 adolescents (46.5%). Four (3.5%) subjects had proteinuria ≥1+. Renal dysfunction (eGFR <60ml/ min/1.73m2) was found among 9 (7.9%) participants. Renal dysfunction was higher among children than adolescents (13.1% v 1.9%) (p = 0.027). The presence and clustering of risk factors were higher among subjects with renal dysfunction (p value 0.466, 95% CI 0.19-28.3). Low HDL-c (44.4%), prehypertension(22.2%) and overweight (22.2%) were the most prevalent risk factors among those with renal dysfunction. Only age demonstrated relationship to renal dysfunction in terms of mean difference (p value 0.007, 95% CI, 1.125-6.818). Conclusions: The prevalence and clustering of cardiovascular risk factors is higher among children with renal dysfunction. Age showed association  to renal dysfunction. Dyslipidemia and high body mass have propensity to influence the development of pediatric CKD. Keywords: Cardiovascular risk factors, renal dysfunction, association, pediatrics, Nigeria, Africa