Preferências de carreira entre graduandos de medicina no sudoeste da Nigéria

Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±+SD) de 23,5 (±+1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais.Medical students have many different options of academic and professional undertakings after graduation. The aim of this study is to determine the career preferences of students in their final year of medical school and to determine the factors that contributed for such decision. This is a descriptive cross-sectional study involving the final-year medical students of Afe Babalola University, Ekiti State, Nigeria. A well-structured questionnaire was used for data collection. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics included frequency tables, charts, means and standard deviations. A total number of 100 final-year medical students participated in the study, out of which 29 (29.0%) were males and 71 (71.0%) were females, with a male to female ratio of 0.4 to 1. The age range of the respondents was 21 to 30 years, with a mean(±+SD) of 23.5(±+1.4). 72% of the respondents planned to pursue a postgraduate academic qualification after graduating from medical school, mostly in the United Kingdom, and a Master of Public Health was the most sought qualification. Similarly, 76% of the respondents planned to pursue a postgraduate medical fellowship after medical school, also mostly in the United Kingdom. The specialty most soughtafter is Obstetrics and Gynaecology (43%), followed by Surgery (40%), Family Medicine (34%), Community Medicine (33%), Paediatrics (25%), and Internal Medicine (23%) while the least sought-after specialty is Chemical pathology (28%), followed by Medical Microbiology (27%) and Morbid Anatomy (24%). The most important factor considered by the respondents in choosing a particular specialty is their personal interest in that specialty, followed by financial prospects, comfortable lifestyle, and flexible working hours. Master of Public Health degree and postgraduate fellowship in Obstetrics and Gynaecology specialty are the career preferences for most of the final-year medical students in this study, and this is largely informed by their personal interest in these fields

An 8-year retrospective review of gastrointestinal medical emergency conditions at a tertiary health facility in Nigeria

Background: Globally, gastrointestinal emergency conditions constitute a considerable proportion of the medical emergency cases seen in the emergency room.Objective: This study investigated the spectrum of gastrointestinal medical emergency conditions seen in the emergency room of Federal Teaching Hospital Ido-Ekiti, Nigeria.Materials and Methods: The emergency room admission register was used to obtain the following information: Age, Sex, Diagnosis, Year of admission and the Outcome. The period under review was 1st January 2009 to 31st December 2016. The data was analyzed using the SPSS version 21.0 software package.Results: A total number of 5,912 patients with medical emergency conditions were admitted into the emergency room during the period under review, out of which 813(13.7%) were gastrointestinal medical emergency conditions. The age range of the patients was 15 to 100years with a mean(±SD) of 47.32±18.938. Acute exacerbation of acid peptic disorders(29.3%) was the most common indication for emergency room admission followed by acute gastroenteritis(26.8%) and decompensated chronic liver disease(14.3%). Decompensated chronic liver disease and upper gastrointestinal bleeding were the conditions with the highest mortality  being 31.8% and 29.5% respectively.Conclusion: Gastrointestinal medical conditions are common indications for emergency admission. Measures should be taken to avoid these preventable conditions in a bid to reduce their morbidity and mortality

Clinical and biochemical manifestations of severe sickle cell anemia in adult patients in steady state in Ile-Ife, Nigeria

Background: There are documented established markers (indices) of disease severity in patients with sickle cell anemia (SCA) and they determine the course of the disease. This study investigated the pattern and prevalence of some of these markers of disease severity in adult patients with SCA in steady state attending the hematology clinic of a federal tertiary teaching hospital in Ile-Ife, Nigeria.Materials and Methods: This was a descriptive study. Basic demographic data and relevant clinical information was obtained using a well-structured questionnaire and the case files (hospital records) of 50 consecutive SCA (HbSS) patients.Results: The study group comprised of 21(42%) males and 29(58%) females. The age range was 18–45years with a mean(±SD) of 27.6±7.607. Hepatomegaly (64%), frequent episodes of vaso-occlusive crisis, that is, ≥ 3 episodes per year(30%) and Dactylitis in infanthood(26%) were the most common clinical parameters identified in these patients while a high serum total bilirubin of > 51μmol/L(26%) was the most common laboratory parameter seen in these patients.Conclusion: Markers of disease severity were identified in the patients with SCA inthis study. The presence of these markers in an SCA patient connotes severe disease and they determine the course of the disease. Therefore, there is a need to pay more attention to these patients by following them up more closely.Keywords: disease severity, markers, sickle cell anemia, steady state, adults, patient

Clinical and Biochemical Manifestations of Severe Sickle Cell Anemia in Adult Patients in Steady State in Ile-Ife, Nigeria

Background: There are documented established markers (indices) of disease severity in patients with sickle cell anemia (SCA) and they determine the course of the disease. This study investigated the pattern and prevalence of some of these markers of disease severity in adult patients with SCA in steady state attending the hematology clinic of a federal tertiary teaching hospital in Ile-Ife, Nigeria. Materials and Methods: This was a descriptive study. Basic demographic data and relevant clinical information was obtained using a well-structured questionnaire and the case files (hospital records) of 50 consecutive SCA (HbSS) patients. Results: The study group comprised of 21(42%) males and 29(58%) females. The age range was 18–45years with a mean(±SD) of 27.6±7.607. Hepatomegaly(64%), frequent episodes of vaso-occlusive crisis, that is, ≥ 3 episodes per year(30%) and Dactylitis in infanthood(26%) were the most common clinical parameters identified in these patients while a high serum total bilirubin of > 51µmol/L(26%) was the most common laboratory parameter seen in these patients. Conclusion: Markers of disease severity were identified in the patients with SCA in this study. The presence of these markers in an SCA patient connotes severe disease and they determine the course of the disease. Therefore, there is a need to pay more attention to these patients by following them up more closely

Removal of an Impacted Foreign Body from The Upper Airway with a Gastroscope in a Tertiary Hospital in South-West Nigeria – A Case Report

Foreign body ingestion and food bolus impaction are encountered commonly in clinical practice and are a common endoscopic emergency. A wide variety of objects could be ingested which could get impacted, and the site of impaction is commonly the oesophagus but can also be the airway depending on the nature of the substance ingested, the age of the patient and the presence of a neurologic disorder. The predominant clinical features of a patient will depend on the site of impaction of the foreign body; the airway or the oesophagus. Endoscopy remains the gold standard for the diagnosis and management of foreign body ingestion of which there are different modalities and equipment types. For foreign body in the airway laryngoscopy, tracheoscopy and bronchoscopy are the modalities indicated and there are also different types of retrieval devices some of which include standard biopsy forceps, retrieval graspers, retrieval forceps and polypectomy snares. The management of foreign body ingestion cuts across different specialties including Pulmonology, Otorhinolaryngology, General surgery, Cardiothoracic surgery and Gastroenterology all of which are involved in various different endoscopic procedures and their endoscopy equipment have a lot of similarities and in certain instances they can be adapted to perform varying roles. Foreign bodies in the airway require urgent endoscopic removal because it can become rapidly life threatening with associated high morbidity and mortality, therefore the available equipment should be immediately deployed to save lives. We present a case of foreign body impaction in the upper airway (larynx) that was removed with a flexible video Gastroscope using a polypectomy snare

Preferências de carreira entre graduandos de medicina no sudoeste da Nigéria

Resumo Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±SD) de 23,5 (±1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais

International health regulations and pre-travel health practices of international travelers at Nigerian airport: a cross-sectional study

Abstract Background International Health Regulations (IHR) were developed by the World Health Organization (WHO) to curb the trans-border spread of epidemics. To our knowledge, no airport-based studies have assessed travelers’ health practices against a combination of diseases subject to IHR 2005. Therefore, we aimed to generate and describe the baseline travelers’ pre-travel health practices towards Cholera, Yellow Fever (YF), and Plague at Murtala Muhammed International Airport (MMIA) in Nigeria. Methods A cross-sectional study was employed to collect data from 486 international travelers using a multistage sampling technique. Pre-travel health practices (a combination of pre-travel consultation, pre-travel vaccination, and preventive measures against insect bites) were assessed using an interviewer-administered questionnaire. Logistic regression models were used to estimates the association between selected variables and pre-travel health practices. Statistical significance level was set at 5%. Results A total of 479 complete questionnaires were analyzed. The median age of respondents was 34.0 years Interquartile range (IQR) = 28.0, 44.0). Of the total respondents, 311 (64.3%) were aware of pre-travel health consultation and sources of information, amongst others, including friends/relatives in 180 (37.6%) travelers, social media/internet in 155 (32.4%) travelers, and health professionals in 102 (21.3%) travelers. Two hundred and seventy-one (56.6%) had pre-travel consultation, 156 (32.6%) had YF vaccination, and 226 (47.2%) were prepared to use preventive measures against insect bites. Only 10.6% had good pre-travel practices against the diseases subject to 2 International Health Regulations (IHR). Travelers with bachelor/college degrees, when compared to those with secondary/high education, had 2.91 times higher odds of having good practices when adjusting for other factors (95% C.I: 1.10, 7.70; p < 0.03). Also, those traveling to destinations endemic for YF infection, when compared to those who are not traveling to endemic countries/areas, had 48% lower odds of having good practices after adjusting for other factors (95% C.I: 1.41, 7.77; p < 0.01). Conclusions Our study revealed a low prevalence of good pre-travel health practices among participants. Educational level and endemicity of YF at the destination were predictors of pre-travel health practices. Introducing topics on travelers’ health into schools’ curriculums may have a ripple positive effect on health practices among international travelers. Also, there is a need for public enlightenment programs on pre-travel health practices using social media platforms