Pattern of respiratory diseases seen among adults in an emergency room in a resource-poor nation health facility

Background: There is a paucity of information on utilisation of emergency medical services in Nigeria. This study was conducted to determine the pattern of respiratory diseases seen among adults in an emergency room(ER) and their mortality within twenty- four hours in a health facility in Nigeria. Methods: We carried out a retrospective study on adult patients that presented with respiratory condition from November 2004 to December 2010 at the emergency room of Federal Medical Centre Ido-Ekiti, south western, Nigeria. Results: A total of 3671 cases were seen, 368 were respiratory cases accounting for 10.2 % of the total emergency room visitations. The male to female patients ratio was 1.2:1 and their mean was 49 9 ± 20.3 years. Pneumonia (34.5%) was the most common cases seen in the ER, followed PTB (29.4%), acute asthma (24.5%) , acute exacerbation of COPD (10.3%), upper airway tract obstruction and malignant pleural effusion were 0.5% respectively. Fourteen of the PTB cases (3.8%) were complicated by cor-pulmonale, 9(2.5%) by pleural effusion, 4(1.1%) by massive haemoptysis and 2(0.5%) by pneumothorax. Twenty-four hours mortality was 7.4% and 44.4% of the death was due to PTB, 37.0% was due to pneumonia and 14.8% due to acute asthma attack. The overall mortalities also had a bimodal age group distribution as the highest death was recorded in ages 30-39 and ≥70 years. Conclusion: Pneumonia and PTB were the leading respiratory diseases among adults causing of emergency room visit and early mortality in this health facility in Nigeria.Key words: Disease pattern, Respiratory Disease, Resource-poor country, Emergency Room, Nigeri

Knowledge, attitude, perceptions of adult males towards childhood immunizations in southwest Nigeria

Background: Immunisation is a cost effective public health intervention in reducing morbidity and mortality from vaccine preventable diseases worldwide. In Nigeria, childhood immunisation against poliomyelitis is still bedeviled by setbacks which are multifactorial. Objectives: The objective of the study was to determine the knowledge, attitude and perceptions of adult males towards childhood immunizations in Nigeria. Methods: The research was a descriptive crosssectional study of adult males in the Ido-Osi local government area of Ekiti state, southwest Nigeria. Multistage sampling method was used to select 320 adult males for the study, and a pre-tested semi-structured questionnaire was used to collect quantitative data. Statistical analysis was done using the Epi Info 4. P value <0.05 was considered asstatistically significant. Results: Mean age (±SD) of the respondents was 48.4±12.6 years with range of 20-95 years. About half (50.6%) of the respondents were in the age group 40-59 years. 79.7% were married while only 2 were single with about two-thirds of the married respondents in monogamous family type. 82.3% were willing to support childhood immunization. The association between respondents’ religion and education, and willingness to support childhood immunization was found to be statistically significant: (x 2 =51.53; df=6; p=0.0000) and (x 2 =65.48; df=6; p=0.0000) respectively. Conclusion: The study showed that the knowledge of adult males about childhood immunization was high. The perception of childhood immunization as a means of protection from certain illnesses was also common and most men were willing to support it. The support for childhood immunization was significantly affected by religionand level of education

Chylous Ascites in HIV/TB Co-Infections: Case Report, Challenges of Management in a Resource-Poor Setting and Literature Review

Chylous ascites is an uncommon clinical condition characterized by extravasation of milky chyle into the peritoneal cavity usually as a result of either blockage of the lymphatics or leakage from inadvertent trauma during surgeries. This is a report of a case of chylous ascites in a 32-year old Nigerian with HIV/TB co- infections. The report also highlights the challenges associated with management of chylous ascites in a resource-poor setting. The patient was managed conservatively with diuretic therapy, salt and fluid restrictions and elevation of the lower limbs. Although, the ascites re-accumulated initially, it finally resolved and she was followed up for at least six months with no recurrence

Awareness and practice of self breast examination among female nurses at the federal teaching hospital ido ekiti, nigeria

Breast cancer is the most common female malignancy linked with high levels of morbidity and mortality in developing countries due to delayed diagnosis.This research assessed the knowledge of signs and risk factors of breast cancer and practice of self breast examination (SBE) among female nurses in a rural tertiary Hospital. Eighty-five nurses ages 20 to 60 years were sampled by simple randomization over a period of eight weeks through a self-administered semi-structured questionnaire. The analysis was done using statistical package for social science version 17. Sixteen (15.3%) nurses had adequate knowledge of breast cancer, having a relative with breast cancer (51.8%) and a woman of any age (56.5%) were recognized by majority as risk factors for breast cancer. Majority (68.2%) were not practicing monthly SBE and not confident on how to do it. This study pointed out the gaps in the knowledge and awareness of breast cancer and practice of SBE among the nurses. Opportunity should therefore be sought in various health facilities to educate nurses who are supposed to be closer to the patients