Knowledge, attitude and practice of venous thromboembolism prophylaxis among medical practitioners in a teaching hospital setting

Background: Venous thromboembolism (VTE) is a common and potentially fatal clinical condition that is both preventable and treatable. The risk factors for the disease cut across patients and general population which underscores the need for prophylactic measures, early identification and prompt treatment. We aimed to assess the knowledge, attitude and practice of prophylaxis in venous  thromboembolism among medical doctors in Usmanu Danfodiyo University Teaching Hospital, Sokoto, North-West Nigeria.Methodology: The knowledge, attitude and practice of VTE prophylaxis among medical doctors was assessed using a validated self-administered questionnaire. The questionnaire consisted of two sections and a total of thirteen questions enquiring on knowledge and attitude/practice of VTE management.Results: A response rate of 80.5% was obtained following the administration of 200 questionnaires in this survey between July and December 2015. The majority of respondents were males (81.4%) and junior residents (41.6%) with a mean VTE prophylaxis knowledge score of 4.56±1.545. Importance of VTE prophylaxis in clinical practice received an overwhelming concordance among respondents (93.8%). However, about 55.9% admitted to ever prescribing VTE prophylaxis with 8.7% doing it routinely. Low molecular weight heparin was the most frequently used agent for VTE prophylaxis among respondents (40.4%), and there was paucity of knowledge on VTE prevalence in clinical practice among the respondents.Conclusion: Majority of the practitioners were knowledgeable about VTE and agreed that prophylactic measures are pivotal in preventing and/or reducing morbidity and mortality from the disease. Practice of VTE prophylaxis was suboptimal among the respondents, and the contributory factors included paucity of clear cut guidelines and inadequate knowledge of the disease magnitude. These underscore the need for guidelines towards VTE prophylaxis.Keywords: Pulmonary embolism, risk factors, health knowledge, preventivemeasure

Characteristics, predictors and prospects of lung function among male cigarette smokers in Sokoto Metropolis, North-West Nigeria

Background: Cigarette smoking is a major risk factor for airflow limitation in addition to its other multi-systemic deleterious effects. Peak expiratory flow (PEF) measurement offers an opportunity to assess ventilatory function abnormalities in cigarette smokers.Objective: The objective of this study is to determine ventilatory function using peak expiratory flow rate among adult male cigarette smokers in comparison with matched predicted value.Methodology: This is a cross-sectional study among 150 current cigarette smokers aged 18-60years that were consecutively sampled in Sokoto metropolis. Peak expiratory flow was measured using Mini Wright’s Peak Flow Meter and adapted questionnaire was used to record all measurements and relevant data. Comparison was made between the measured and predicted peak expiratory flow rate.Result: A total of 150 male subjects who were predominantly below the age of 40years (76%) with mean age of 34.27±8.91years participated in this study. The mean pack-years and cigarette smoking index were 8.71±8.92 and 163.98±192.62, respectively. While the mean age of cigarette smoking commencement was 16.90±4.17years (9-36years).The mean measured PEF was 405.63±76.5 with the age group mean consistently decreasing with advancing age. Similarly, the difference between measured PEF and predicted PEF was significant and the magnitude of difference increased with advancing age. There was a negative correlation between PEF and pack-years smoked.Conclusion: Cigarette smoking is associated with decline in ventilatory function. The intensity of cigarette smoking and advancing age were the main predictors that determine the airflow status among cigarette smokers.Keywords: Determinants, pack-years, tobacco use, ventilatory functio

Prevalence and risk factors associated with intradialysis mortality among renal failure patients in a tertiary hospital in a developing nation

Background: Hemodialysis is associated with potential risk of intradialysis death as a complication. We set out to determine some predialysis factors associated with intradialysis death in hemodialysis patients. Materials and Methods: We retrospectively reviewed the records of 457 patients who had hemodialysis at our facility over a 5-year period. Demographic and clinical data of patients who died during dialysis were compared with a control group made of the survivors of hemodialysis. Data was analyzed using SPSS IBM version 20. Numerical data were reported as mean ± SD. Comparison of means of continuous variables was done using student t-test. Chi square was used for comparing proportions. Multivariate logistic regression was done to determine the independent determinants of intradialysis mortality. P value < 0.05 was considered significant. Results: Of the 457 patients who had hemodialysis, 20 (4.4%) died while on hemodialysis during the review period. They were aged 47.35 ± 21.16 years (range, 16-85 years). The deceased were more likely to be elderly (P = 0.003), have pre dialysis hypotension (P < 0.004), depressed level of consciousness (P < 0.0001), predialysis pulmonary edema, and hospital admission (P = 0.047). Multivariate regression analysis identified low Glasgow coma scale (coma) as an independent risk factor for intradialysis death (P < 0.017). Conclusion: Intradialysis mortality risk is increased in a setting of elderly patients, impaired level of consciousness, pulmonary edema, and predialysis hypotension