eterminants of seizure occurrence in preeclampsia before commencing and during treatment with magnesium sulphate

Background: Eclampsia is considered as a consequence of severe preeclampsia, with magnesium sulphate regarded as gold standard in seizure treatment and prophylaxis. Convulsions have however been noted when criteria for severe preeclampsia were not met and in patients undergoing treatment with magnesium sulphate.Methods: A secondary analysis of data obtained from a prospective cross sectional study, involving assessment of clinical and biochemical markers of preeclampsia including magnesium in 75 patients with severe preeclampsia who were given magnesium sulphate using the Pritchard regimen.Results: Headache (p = 0.002), vomiting (p = 0.005) and prior occurrence of seizures before presentation (p = 0.001), were significant risk factors for occurrence of convulsions. In addition, serum magnesium levels were significantly lower (1.61±0.32 mg/dL) among patients who had seizures than in those who did not (2.01±0.25 mg/dL), (p<0.001). Systolic blood pressure (p = 0.22), diastolic blood pressure (p = 0.29), mean arterial blood pressure (p = 0.17) and proteinuria (p = 0.18) however did not determine the occurrence of seizures. Only 3/49 (6.1%) of the patients with severe hypertension (MAP≥125 mmHg) fitted, compared to 6/26 (23.1%) with mild hypertension (MAP<125mmHg) who convulsed (p = 0.04). Convulsion during treatment with MgS04 was associated with significantly lower levels of serum magnesium (4.04±0.5 mg/dL), than 4.63±0.5 mg/dL observed among patients with severe preeclampsia who did not convulse (p = 0.04).Conclusions: Headache, vomiting, prior convulsion and low serum magnesium levels preceded the occurrence of fits before treatment while, prior convulsion and low serum magnesium level consistently preceded the occurrence of fits during treatment of preeclampsia with magnesium sulphate

Assessment of Resident Doctors’ Perception of Postgraduate Medical Education in Nigeria Using the SPEED Tool: A Pilot Study

Background: Obtaining feedback from trainees is important in the evaluation and evolution of Postgraduate Medical Education (PME), and policies made based on their felt needs would go a long way in making residency training a worthwhile experience. This pilot study aimed to assess resident doctors’ perception of the training content, atmosphere, and organization using the Scan of Postgraduate Educational Environment Domains (SPEED) tool. Methodology: This was a cross-sectional study conducted amongst resident doctors at Babcock University Teaching Hospital (BUTH) in Nigeria, between May and August 2019. A self-administered questionnaire was used to collect participants’ sociodemographic data, their perception of PME in their respective departments, as well as the strengths and weaknesses of the training programmes. Validity and reliability indices were assessed, and descriptive, inferential, and correlational analyses were run where appropriate. Results: The mean score for the resident doctors’ perception of training content, atmosphere, and organization was 4.0 ± 0.4, 4.2 ± 0.5 and 3.69 ± 0.60 respectively, out of a maximum of 5, indicating a positive perception of training in BUTH. The major strengths perceived by most residents were good inter-personal relations between residents and their trainers, as well as conducive learning and work environment; while the weaknesses include poor remuneration and limited staffing which hampers rotations. Conclusion: Resident doctors in BUTH mostly had a positive outlook on their training. This study serves as a reference point for local policy change (in BUTH), and a framework from which future studies on PME can emerge