Improving undergraduate medical education in Nigeria: Insight into the past

The first three in the series of Society of Gynaecology and Obstetrics of Nigeria (SOGON) lectures on “Frontiers in Medical Education,” in honor of  Professor Linus Ajabor, had focused on internship and postgraduate medical education. This fourth lecture is about the evolution of undergraduate medical education in Nigeria from its rudimentary beginning in 1930 to the present. Lessons from the past include the desirability of tailoring medical education toward meeting national needs, doing proper needs assessment before planning and implementation, setting minimum standards for training institutions, and enforcing these standards through a credible process of accreditation. Recommendations for the future  include a harmonization of the guidelines on minimum standards published by the Medical and Dental Council of Nigeria (MDCN) and the minimum  academic standards published by Nigeria’s National Universities Commission (NUC), and the conduct of joint accreditation by both agencies to maximize efficiency and reduce waste. There should also be mandatory training in pedagogy for clinician teachers, periodic curriculum reviews must be enforced, and simulation laboratories should be provided in all accredited medical schools. Key words: Curriculum; medical education; Nigeria; pedagogy; undergraduat

Children within the Juvenile Justice System in Nigeria: Psychopathology and Psychosocial Needs

Background: Many children in Nigeria face a life of poverty, family instability, inadequate educational opportunities and poor physical andmental health which hinder their ability to develop into healthy adults, live an improved quality of life or fulfil their life aspirations. These factors have also been associated with juvenile delinquency and need for institutional care.Objectives: As a step toward providing comprehensive services for incarcerated children in Nigeria, this study aimed to identify the psychosocial needs as well as types of psychopathology among a groupof incarcerated children at the Ibadan remand home.Methods: A cross-sectional survey of children and adolescents at the Ibadan remand home was carried out using a semi-structured questionnaire.Results: A total of 59 children were assessed over a one year period. Majority (90%) were in need of care and protection. All (100%) had significant psychosocial needs presenting as difficulty with their primarysupport, economic, social environment, or educational systems. Majority (97%) also demonstrated significant psychopathology and anxiety, suicidal and depressive symptoms were the most commonly elicited.Conclusions: Incarcerated children in this study showed significant mental health needs which need to be addressed as a matter of urgency. This should be carried out through the collaborative efforts of mental health professionals with various stakeholders in child care.Keywords: Children, Psychopathology, Psychosocial, Nigeria, Juvenil

Comparison of Perceptual Reasoning Skills and Mental Health Problems between Deaf and Normal-Hearing Adolescents in a Semi-inclusive setting in Ibadan, Nigeria

Background: Adolescents with hearing loss are often faced with poor cognitive and executive functions, and increased prevalence of mental health problems. The study compared the perceptual reasoning skills (PRI) and mental health problems of deaf adolescents with those of their age- and sex- matched hearing counterparts.Methods: It was a comparative cross-sectional study of a total population (102) of deaf adolescents, who were matched for age and sex with 102 normal hearing adolescents. The PRI of the participants was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). Mental health problems were assessed with the parents’ and teachers’ versions of the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics, chi square test and correlation co-efficient were done. Significant level was set at p-value < 5%.Results: The PRI scores ranged from 41-106 across both groups; 58.8 % of the deaf and 41.2% of the hearing adolescents scored 69 and below on the WISC and this difference was statistically significant (p = 0.033). The PRI scores had no significant relationship with the audiometric scores of the deaf participants (r = -0.177; p = 0.076). The PRI scores in the deaf participants were inversely related to hyperactivity assessed by the teacher (r = -0.354), emotional difficulty assessed by both teachers (r = -0.221) and parents (r = -0.280) and peer problems assessed by the teachers (r = -0.329).Conclusion: Deaf participants in this study showed significantly lower level of nonverbal IQ and higher level of behavioural difficulties compared with their hearing counterparts

Traumatic splenic rupture in pregnancy with favourable pregnancy outcome: Case report

Trauma complicating pregnancy is one of the causes of deaths that are not captured in the maternal mortality ratio, yet it occurs in about 1 in 15  pregnancies. This is a report of a case of splenic rupture occurring after a vehicle hit a pregnant woman who was a pedestrian. Splenectomy was done and, in spite of having a hemoperitoneum of about 2 litres, she recovered without further complication and was able to sustain the pregnancy to term, with the delivery of a healthy female infant. Clinicians should seek to exclude splenic rupture in cases of blunt trauma to the abdomen during  pregnancy because of the risk of severe haemorrhage, shock, and possibility of pregnancy loss. Key words: Haemoperitoneum; Pregnancy; Splenectomy; Trauma

Term quadruplet pregnancy: a case report

Higher order multiple pregnancies are rare and often associated with complications. Term delivery is uncommon. This is a report of a 22 years old G3 p2 + 0 (1 alive) teacher who had quadruplet pregnancy following ovulation induction is presented. She had elective caesarean section at term with the delivery of two live male and two live female infants with birth weights ranging between 1750gram and 2850grams. Term delivery in quadruplet pregnancy is possible as demonstrated in this case, and has the advantage of improved perinatal outcome. Bed rest early detection and management of antenatal complications, and planned elective delivery are probably the keys to a successful outcome

AI-Driven Data Analysis of Quantifying Environmental Impact and Efficiency of Shape Memory Polymers

This research investigates the environmental sustainability and biomedical applications of shape memory polymers (SMPs), focusing on their integration into 4D printing technologies. The objectives include comparing the carbon footprint, embodied energy, and water consumption of SMPs with traditional materials such as metals and conventional polymers and evaluating their potential in medical implants, drug delivery systems, and tissue engineering. The methodology involves a comprehensive literature review and AI-driven data analysis to provide robust, scalable insights into the environmental and functional performance of SMPs. Thermomechanical modeling, phase transformation kinetics, and heat transfer analyses are employed to understand the behavior of SMPs under various conditions. Significant findings reveal that SMPs exhibit considerably lower environmental impacts than traditional materials, reducing greenhouse gas emissions by approximately 40%, water consumption by 30%, and embodied energy by 25%. These polymers also demonstrate superior functionality and adaptability in biomedical applications due to their ability to change shape in response to external stimuli. The study concludes that SMPs are promising sustainable alternatives for biomedical applications, offering enhanced patient outcomes and reduced environmental footprints. Integrating SMPs into 4D printing technologies is poised to revolutionize healthcare manufacturing processes and product life cycles, promoting sustainable and efficient medical practices

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) Among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants, parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational  attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area, across two different settings: home and school.Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state, south eastern, Nigeria completed the school version of ADHD rating scale-IV, and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale-IV.Results: Of the 18 symptoms of the condition, there were significant differences in the rate of identification in eight symptoms. These symptoms include ‘being easily distracted’ (p=0.0427), ‘difficulty following through on instruction’ (p=0.0026), ‘fails to give close attention to details (p=0.0001), ‘avoids tasks necessary for tasks’ (p=0.0013), ‘difficulty playing quietly (p=0.0059 ) , ‘talks excessively’ (p=0.0023), ‘intrudes on others’ (p=0.0004), and ‘seems not to listen when spoken to directly’ (p=0.0002). They were all consistently more manifest in school settings than in their homes.Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women

<p>Abstract</p> <p>Objective</p> <p>to compare the pre and post hysterectomy mental ill health (MIH) status and also, to determine whether there is any association with the surgical indication.</p> <p>Methodology</p> <p>An observational study, conducted among women scheduled for hysterectomy at the University College Hospital, Ibadan from January till June 2005. The MIH morbidities were assessed using a validated general health questionnaire (GHQ) before and after the surgery by trained research assistant. The score of 4 and above was used as the cut off. Cross tabulations were performed to detect any association and also to compare pre and post hysterectomy mental health status. The level of statistical significance was set at P < 0.05.</p> <p>Results</p> <p>Of the 50 women recruited, 45 participated in the study. The age range of the participants was 35 to 63 years with a mean of 48.6 (SD = 0.6) years. Anxiety related disorder was present in 20 (44.4%), and depression in 3 (6.7%) before hysterectomy. Post surgery, there was significant increase in those with anxiety by 6.8% and a reduction in the proportion of depressive illness by 2.3%. Uterine fibroid as a preoperative diagnosis, had significant association among those with anxiety related disorder (68.4%) and depression (10.5%).</p> <p>Conclusion</p> <p>This study suggests that mental ill health may complicates hysterectomy for benign uterine pathology among Nigerian women, and that anxiety related disorders increases after operation with the highest proportion in those with clinical diagnosis of Uterine Fibroid. We recommend adequate preoperative counseling using properly trained psychologists when affordable to minimize these morbidities.</p

Building capacity for public and population health research in Africa : the consortium for advanced research training in Africa (CARTA) model

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region’s socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA’s program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTA’s focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative’s goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems