Society for Endocrinology (SfE) guidelines for the diagnosis and management of post bariatric hypoglycaemia

Post-bariatric hypoglycaemia (PBH) is typically a post-prandial hypoglycaemia occurring about 2–4 h after eating in individuals who have undergone bariatric surgery. PBH develops relatively late after surgery and often after discharge from post-surgical follow-up by bariatric teams, leading to variability in diagnosis and management in non-specialist centres.AimThe overall aim was to improve and standardise clinical practice in the diagnosis and management of PBH. The objectives were: (1) to undertake an up-to-date review of the current literature; (2) to formulate practical and evidence-based guidance regarding the diagnosis and treatment of PBH; (3) to recommend future avenues for research in this condition.MethodA scoping review was undertaken after an extensive literature search. A consensus on the guidance and confidence in the recommendations was reached by the steering group authors prior to review by key stakeholders.OutcomeWe make pragmatic recommendations for the practical diagnosis and management of PBH, including criteria for diagnosis and recognition, as well as recommendations for research areas that should be explored.Plain English summaryPost-bariatric hypoglycaemia (PBH) is a condition that commonly affects people who have undergone weight loss surgery. In this condition, people develop low blood sugar occurring about 2–4 h after meals, leading to debilitating symptoms such as hunger, sweating, anxiety, palpitations and even blackouts and fainting. PBH is becoming more common as weight loss surgery is being taken up by more people to help with their weight and to help with diabetes. The condition often develops after the patient has been discharged from follow-up after their surgery, which can lead to inconsistent diagnosis and treatment in non-specialist healthcare centres. The lack of clear information and evidence in the existing scientific literature further contributes to the variation in care. To address this problem, the Society for Endocrinology has created new guidelines to help healthcare professionals accurately diagnose and manage this condition. The guidelines were developed with input from dietitians, surgeons and doctors specialising in weight loss, and hormone specialists

Challenges of residency training and early career doctors in Nigeria study (charting study): a protocol paper

Introduction: Early career doctors (ECDs) make up a significant proportion of the workforce of medical/dental practitioners in Nigeria. ECDs play pivotal roles in the Nigerian healthcare system. However, several factors affect ECDs in their career endeavours, ranging from poor remuneration to psychosocial problems (such as burn out, job dissatisfaction, etc.). While other countries have tried to investigate these factors and their impact, no national inquiry has been done yet in Nigeria. This demonstrates the critical need to conduct a nationally representativestudy exploring these factors, such as demographic, workplace and psychosocial factors, among ECDs in Nigeria. This article is a protocol paper for the challenges of residency training and early career doctors in Nigeria study; charting study to be conducted under the auspices of the Nigerian Association of Resident Doctors of Nigeria(NARD).Methods: The Charting Study would be a mixed study design, utilizing both qualitative and quantitative study designs and access data from structured questionnaire, focus group interview and secondary data available to the association.Conclusion: The outcome of this study will provide great insight into various issues affecting ECDs in Nigeria and make necessary recommendations.Keywords: Nigeria, early career doctors, junior doctors, physicians, dentists, workplace, psychosocial issue

Challenges of Residency Training and Early Career Doctors in Nigeria Phase II: Update on Objectives, Design, and Rationale of Study

Background: Early career doctors (ECDs) are a dynamic and highly mobile group of medical and dental practitioners who form a significant proportion of the health workforce in Nigeria. The challenges of residency training and ECDs in Nigeria CHARTING Phase I study explored limited challenges affecting ECDs under the broad themes of demography, workplace issues, and psychosocial issues. The CHARTING II was expanded to provide wider insight into the challenges of ECDs in Nigeria. Objective: This protocol aims to provide clear objectives including description of objectives, design, and rationale for the conduct of the proposed CHARTING II study which seeks to explore other components under the various themes of demographic, workplace, psychosocial issues affecting the ECDs in Nigeria, and which were not explored under CHARTING I.   Methodology: This shall be a mixed study design that will combine qualitative and quantitative methods, to investigate 27 subthemes among 2000 ECDs spread across 31 centers, accredited by the Nigerian Association of Resident Doctors. Participants shall be selected using the multistage sampling method. The primary data will be generated using structured proforma and validated questionnaires,while administrative sources would serve as a source of secondary data. Data will be entered and analyzed using appropriate statisticalsoftware. Conclusion: CHARTING II study would provide more robust data and insight into the problems encountered by ECDs in Nigeria. This would in turn build a platform for institutional engagement and advocacy in order to drive relevant policies to mitigate these challenges. Keywords: Early career doctors, Nigeria, residency, resident doctors, trainin