A look at risk factors of proteinuria in subjects without impaired renal filtration function in a general population in Owerri, Nigeria

Introduction: Proteinuria is a common marker of kidney damage. This study aimed at determining predictors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria. Methods: This was a cross-sectional study involving 136 subjects, consecutively drawn from Federal Medical Centre (FMC), Owerri, Nigeria. Relevant investigations were performed, including 24-hour urine protein (24HUP). Correlation and multivariate linear regression analysis were used to determine the association and strength of variables to predict proteinuria. Proteinuria was defined as 24HUP ≥0.300g and impaired renal filtration function as creatinine clearance (ClCr) <90mls/min. P<0.05 was taken as statistically significant. Results: Mean age of subjects was 38.58 ±11.79 years. Female/male ratio was 3:1. High 24-hour urine volume (24HUV) (p<0.001), high spot urine protein/creatinine ratio (SUPCR) (p<0.001), high 24-hour urine protein/creatinine ratio (24HUPCR) (p<0.001), high 24-hour urine protein/osmolality ratio (24HUPOR) (p<0.001), low 24-hour urine creatinine/osmolality ratio (24HUCOR) (p<0.001), and low spot urine protein/osmolality ratio (SUPOR) (p<0.001), predicted proteinuria in this study. Conclusion: The risk factors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria, included 24HUV, SUPCR, 24HUPCR, 24HUPOR, 24HUCOR and SUPOR. Further research should explore the relationship between urine creatinine and urine osmolality, and how this relationship may affect progression of kidney damage, with or without impaired renal filtration function.Pan African Medical Journal 2016; 2

Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria

Background and Objectives: Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria.Methodology: This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined.Results: The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p< 0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05).Conclusion: The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnor- mally low percentage predicted FEV1 and FVC were associated with PPCs.Keywords: Post-operative pulmonary complications, pre-operative assessment, risk factors, cough, shortness of breath, consol- idation, pneumonia, elective abdominal surgeries, Nnewi, Nigeria

Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria

Background and Objectives: Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria. Methodology: This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined. Results: The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p<0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05). Conclusion: The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and FVC were associated with PPCs. DOI: https://dx.doi.org/10.4314/ahs.v19i1.51 Cite as: Ufoaroh CU, Ele PU, Anyabolu AE, Enemuo EH, Emegoakor CD, Okoli CC, et al. Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria. Afri Health Sci. 2019;19(1). 1745-1756. https:// dx.doi. org/10.4314/ ahs. v19i1.5

Comparative Study of Knowledge on Team Building Between Healthcare Workers in Two Federal Tertiary Health Facilities in Different Geo-political Zones of Nigeria

Introduction: Team building has been found to improve effectiveness and efficiency of workforce in the healthcare system generally.The objective of this study was to compare knowledge of team building between healthcare workers in two federal tertiary health facilities in South-South and South-East geopolitical zones of Nigeria. Materials and Methods: This was a descriptive cross sectional study carried out using multistage sampling technique to select a total of 242 subjects from ten categories of health professionals working in South-East(SE) geopolitical zone (Nnamdi Azikiwe University Teaching Hospital, NAUTH Nnewi) and South-South(SS) geopolitical zone (Federal Medical Centre , FMC Asaba) with 121 subjects in each geopolitical zone. Respondents participated in the study using same self-administered questionnaire for both geopolitical zones. Results: A total of 242 respondents participated, 121 each from the two different geopolitical zones. Majority were in the age group of 41-50 years and 21-30 years for SE and SS zones respectively. Majority were female and had first degree education for SE and SS zones respectively. Seven variables of knowledge of team building were collected and analysed with SPSS version 22 with results for SE and SS zones respectively with statistical significance set at p< 0.01 . This consisted of respondents that heard of team in healthcare 74.4 % and 91.0% (p<0.01), those that heard of inter-professional team composition in healthcare 65.9% and 78.7% (p>0.01), those that defined correctly team building 75.6% and 91.0% (p< 0.01), those that defined correctly inter-professional team building to involve different professionals 73.5% and 81.4% (p>0.01), those with sources of information on team building in health healthcare 57.3%(mainly health publication) 65.1% (mainly lectures/conferences) (p <0.01), those that defined correctly a team 70.4% and 88.4% (p< 0.01), those that had good knowledge of competencies to possess to be an effective team member 65.9% and 69.6% (p>0.01). Conclusion and recommendations: Proportion of respondents for the seven variables were higher for the South-South geopolitical zone tertiary health facility than the South-East geopolitical zone tertiary health facility though with no statistical significant difference across all seven variables. It is ,therefore, recommended that needs assessment for team building knowledge be done for healthcare workers in health facilities located in different geopolitical zones before team building training and re-training institutionalization building in order to persistently improve their knowledge of team building as a mechanism to reduce inter-professional conflicts and ultimately improve health outcomes in line with the National Health Policy 2016 of the Federal Government of Nigeria. More research is needful to assess intra- and inter-departmental/ and -professional level of knowledge on team building among healthcare workers  in any health facility in a geopolitical zone. Keywords: Team building, Knowledge, Health facilities, Healthcare workers, Geo-political zones, Nigeri

Minor blunt injury‑induced rhabdomyolysis from a road traffic accident in Nigeria

Rhabdomyolysis, though not a common complication of minor blunt trauma, may result in life‑threatening acute kidney injury (AKI). Here is illustrated a case of a young male who sustained minor blunt injuries in a road traffic accident, which he overlooked and presented with features of severe AKI. The patient is a 24‑year‑old male, who presented with progressive weakness, difficulty in walking, and features of uremia, 14 days after he sustained minor blunt injuries and lacerations in a road traffic accident. Evaluation showed elevated serum creatine kinase, serum myoglobin, and severe azotemia. He was commenced on hemodialysis. He was also commenced on antibiotics, analgesic, and 5% dextrose/saline. He had three sessions of hemodialysis on alternate days. His condition improved remarkably after the first session of dialysis. He was discharged after 18 days on admission. Follow‑up in the clinic showed a normal renal function. This case report shows rhabdomyolysis from minor blunt injuries sustained in a road traffic accident and complicated by severe AKI. The patient almost recovered full renal function with management

Serum apolipoprotein B increased among tuberculosis patients compared to healthy subjects

Background The burden of tuberculosis (TB) and cardiovascular disease (CVD) is enormous worldwide. Public health programs have been challenged with the overlapping of TB and CVD epidemics.Mycobacterium tuberculosis (MTB) is also a main driver of atherogenesis, suggesting a potential pathogenic role of tuberculosis in cardiovascular disease. The objective of this study was to compare the serum levels of apolipoprotein B (apo B), apolipoprotein B48 (apo B48) and apolipoprotein B100 (apo B100) between patients with tuberculosis and healthy subjects. Methods A cross-sectional study was conducted involving 251 subjects consisting of 120 treatment naïve active TB patients [26 HIV co infected (TB+HIV+) and 82 TB+), 12 malaria parasite co-infected (TB+MP+)], 26 latent TB infected (LTB) and 105 healthy controls. Their body mass index (BMI) was calculated. Mycobacterium tuberculosis infection was determined by Ziehl-Nelseen (ZN) sputum smear microscopy and confirmed positive using GeneXpert. Latent TB was determined by Mantoux test, MP was evaluated by microscopy while HIV by immunochromatographic techniques using serial algorithm. Apolipoproteins were determined using spectrophotometry. A one-way ANOVA test and LSD’s post hoc multiple comparisons were used for statistical analyses. Results Significantly lower mean levels of BMI were observed in LTB, TB+, TB+HIV+ and TB+MP+ compared with the controls (p<0.005). The mean serum levels of apo B, apo B48 and B100 were significantly higher in LTB, TB+, HIV+TB+ and TB+MP+ compared with apparently healthy controls (p<0.05). Conclusion Elevated levels of apolipoproteins among infected TB individuals might predispose them to cardiovascular disease