A Review of the impact of the health literacy status of patients on health outcomes.

Background: Providing quality health information is at the core of health service provision. Patients need access to impartial and high quality health information to make informed decisions on health matters. Poor health information can prevent people from making effective choices. Besides, lack of health information can be damaging for patients, their relatives, health professionals and the entire society. The objective of this review is to examine the extent and impact of low health literacy among patients by focusing on its health, economic and social impacts; it will also discuss the implications for health service providers and other stake holders by focusing on strategies that will help improve patients' health literacy status so that they can achieve good clinical outcomes.Methods: A search of some standard books and relevant articles on health literacy among patients and its implications for health service providers was done using the Google and Yahoo search engine as well as EMBASE and OVID MEDLINE data bases. Keywords employed were low health literacy, healthcare impact and health outcomes.Results: The Health literacy statistics report of the Institute of Medicine (IOM) 2004) shows that nearly half the United States of America population has difficulty understanding and using health information.Conclusion: Low health literacy incurs significant costs to society, investing in health literacy will improve population health outcomes and reduce health care costs.Key words: Low health literacy, healthcare impact, health outcomes

The Pattern of Cut Throat Injuries in the University of Port-Harcout Teaching Hospital, Portharcourt

The incidence of cut throat injuries irrespective of the cause is on the increase worldwide but they are underreported in Nigeria. The neck contains a lot of vital organs and great vessels which make the patientswith injuries to the neck to present most times as emergency. The management of cut throat injuries is bedeviled with complications which can be reduced to the barest minimum if managed by the specialists. Our aim and objectives are to determine the pattern of cut throat injuries as seen in University of Port-Harcourt Teaching Hospital (UPTH) and to highlight the factors responsible for the morbidity and the mortality associated with this condition. The study is a retrospective review of cut throat injuries that presented to the Ear Nose and Throat (E.N.T.) department of University of Port-Harcourt Teaching Hospital (U.P.T.H.) over a 10yr period (1995 to 2010). The accident and emergency department records; ward records and theatre registers were the main source of the information. Twenty four cases were recorded and analyzed. The data extracted for analysis were age, sex, occupation, clinical presentation, treatment, duration of stay and complications. All the patients were males; age range was 26-45 years. The commonest age group affected was 31-35years, suicide accounted for 60% of cases. Majority (62.5%) of patients were unemployed. Lacerations of the anterior aspect of the neck, aphonia with exposure of the thyroid cartilage were the commonest clinical features. Majority (58.3%) of the patients had complications following treatment while two patients had mortality. Cut throat injuries require a multidisciplinary approach and could be managed with better prognosis if the patients present early to the hospital and are given prompt attention. Poor socioeconomic status and poverty have been associated with a high incidence of cut throat injuries.Key words: Cut throat injuries, Suicide, Homicide, Multidisciplinary managemen

A Review of the Appropriateness of User Fees and Social Health Insurance to Fund the Health Care Systems in Low and Middle-Income Countries

Background: User fees and social health insurance (SHI) are key strategies of healthcare funding. These strategies which have been widely adopted in low and middle-income countries have been shown to be rarely beneficial to poor people. There has been doubt on their capability to facilitate improved access to healthcare services especially for the poor. Hence, this paper discusses the appropriateness of user fees and SHI in the funding of healthcare systems by critically appraising their strengthsand weaknesses. It will also draw attention of government to alternative methods that can help deal with healthcare funding especially for the poor population.Materials and Methods: A search of some standard books and relevant articles on the appropriateness of user fees and social health insurance to fund health systems was carried out using the Google, Yahoo search engine, EMBASE and OVIDMEDLINE data bases.Results: The main goal of a healthcare system is to improve the health of the whole population and meet the key needs of the healthcare system. User fees have been described as the most regressive way to pay for health. In countries where SHI is the predominant source of funding the poor people are likely to be excluded from participating because they do not have regular employment for meeting regular payments.Conclusion: User fees and SHI funding mechanisms seem inappropriate to fund healthcare systems of low and middle-income countries because of extreme poverty. Governments should explore other alternative methods of healthcare funding that can help tackle healthcare funding especially for the poor population.Key words: User fees, Social health insurance, Healthcare fundin

Pattern of corrosive ingestion injuries in Port Harcourt: A ten year review

Background: Corrosive substance ingestion is a Global health concern as it results in varied damage to the digestive tract, ranging from minor injury to strictures, and sometimes even death. In the developing world the morbidity of corrosive ingestion particularly corrosive esophageal burns remains a significant but overlooked problem. The objective of this study is to determine the pattern of corrosive ingestion as seen in University of Port- Harcourt Teaching Hospital (UPTH) over a ten year period.Methodology: This is a retrospective descriptive study of the patients who were admitted with a history of corrosive ingestion to the department of Ear, Nose and Throat (E.N.T) surgery of UPTH over a ten year period (March 2005 to March 2010). Demographic and clinical data was obtained from the clinical records of the subjects and analyzed.Results: Thirty cases were seen over the study period. Theage range of the patients was 2-47 years old with a mean of 23.9 ± 13.4 years. Among adults there was a high incidence in the third decade while in children there was a high incidence among the under five. The most common type of corrosive ingested was caustic soda in 40% of cases. The commonest complication was esophageal stricture (40%). Fifty percent of cases were due to suicide attempt, while 9 (30%) cases were accidental ingestion of which all were children. The commonest clinical presentation was odynophagia (30%) while mortality accounted for 10% 0f cases.Conclusion: Corrosive injury is still a major surgical emergency in our society which carries a major risk of several complications (mainly esophageal stricture). There is a need for preventive measures to avoid accidental ingestion especially in children.Keywords: Corrosive ingestion, esophageal stricture

Laryngoscopy: appraisal of 202 procedures carried out in two centers in Port Harcourt, Nigeria

Background: Laryngoscopy is a visual examination of the larynx and its related structures. It is an effective procedure for ascertaining the causes of laryngeal disorders, pain in the throat and difficulty in swallowing and should be used in all ENT clinics routinely.Aim and Objective: This study established the use of laryngoscopy in two otolaryngology clinics in Port Harcourt. It also analyzed the indications, findings and the role it played in the management of patients.Patients and Methods: This was a 2-year (1st January 2013 to 31stDecember 2014) prospective study of 202 laryngoscopy procedures done in the Ear, Nose and Throat (ENT) surgery clinics of University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt and Kinx Medical Consultants clinic in Port Harcourt. The researchers in a profoma prepared for the study, documented all laryngoscopies done. The data collected were bio-data (age and sex), presenting symptoms/indications for the procedure, types of laryngoscopy and findings at laryngoscopy /biopsy results. The data were entered into SPSS version 14 computer software and analyzed descriptively.Results: There were a total of 202 (60 males and 142 females) with M: F ratio of 1:2.4. The age range was 18-83 years with a mean of (54.5 ± 5.64) years and median age of 32 years. Age group 40-50 years had the highest number of procedures. The commonest type of laryngoscopy done was indirect laryngoscopy and the commonest indication was pre-operative evaluation for thyroidectomy. The commonest positive findings were hyperaemia and indurations in 25 cases.Conclusion: Indirect laryngoscopy using laryngeal mirror remains a very useful cost effective diagnostic procedure in the otorhinolaryngology clinics.Keywords: Laryngoscopy, laryngeal mirror, fibreoptic laryngoscopy, rigid laryngoscopy, hoarseness, globuspharyngeu

Patients’ satisfaction with healthcare: comparing general practice services in a tertiary and primary healthcare settings

Background: Patient satisfaction with healthcare is predictive of their likelihood of continuing use of available healthcare; comply with medical instruction and improvement in overall coverage and effectiveness of care. This research compared the level of patients’ satisfaction with general practice care delivered at physicians-manned General Outpatient clinics at tertiary and primary health centres in Rivers State.Method: This comparative cross-sectional study was conducted using the Patient Satisfaction Questionnaire (PSQ-18). A total of 1290 regular patients were recruited by systematic random sampling. Non-parametric analyses such as median satisfaction scores, Chi-square, Kruskal-Wallis and Mann-Whitney U test were conducted using SPSS version 20 statistical software. A p-value <0.05 was considered statistically significantResult: Study showed patients who received care at the comprehensive health Centre were significantly more satisfied in domains such as patient-doctor communication (p<0.001), interpersonal manner (p<0.001), accessibility and convenience (p<0.001), technical quality (p=0.006), financial aspects of care (p<0.001) and general satisfaction (p<0.001) than their counterparts at the tertiary Centre. There was no statistically significant difference with time spent during consultations in both centres (p=0.583). Other predictors of satisfaction were younger age, male gender, married, higher education, and those of the Moslem religious faith.Conclusion: Patients who sought general practice care from the health Centre were more satisfied that those who did at the tertiary Centre. We recommend increased sensitization on patients’ utilization of primary health care systems as first contact, continuing, comprehensive and efficient personal and non-personal healthcare needs.Keywords: General practice, Patients’ satisfaction, predictors of satisfaction, Primary health Centre, Tertiary health Centr

Cut Throat Injuries at a University Teaching Hospital in Northwestern Tanzania: A Review of 98 cases.

Cut throat injuries though rarely reported in literature pose a great therapeutic challenge because multiple vital structures are vulnerable to injuries in the small, confined unprotected area. A sudden increase in the number of cut throat patients in our centre in recent years prompted the authors to analyze this problem. This study was conducted in our local setting to describe the etiology, patterns and treatment outcome of these injuries. This was a combined retrospective and prospective study of cut throat injury patients who were managed at Bugando Medical Centre between February 2009 and January 2013. Statistical data analysis was done using SPSS software version 17.0. A total of 98 patients with cut throat injuries were studied. Males outnumbered females by a ratio of 2.4: 1. The median age of patients was 26 years (range 8 to 78 years). Majority of patients (79.6%) had no employment and most of them (65.3%) came from rural community. Homicide was the commonest (55.1%) cause, followed by suicidal attempts (34.7%) and accidental (10.2%) injuries. Interpersonal conflict (24.4%) was the most common motivating factor for homicidal injury whereas psychiatric illness (16.2%) and road traffic accidents (9.2%) were the most frequent motivating factors of suicidal attempt and accidental injuries respectively. The majority of injuries were in Zone II accounting for 65.3% of cases and most of them had laryngeal (57.1%) injury. Surgical debridement, laryngeal/hypopharynx repair and tracheostomy were the most common surgical procedures performed in 93.9%, 73.5% and 70.4% of patients respectively. Postoperative complication rate was 57.1%, the commonest being surgical site infections in 28.1% of patients and it was significantly associated with late presentation and anatomical zones (P < 0.001). The overall median duration of hospitalization was 12 days. Patients who had postoperative complications stayed longer in the hospital and this was statistically significant (p = 0.011). Mortality rate was 11.2% and was significantly associated with co-morbidities, delayed presentation and presence of complications (p < 0.001). The follow up of patients was poor. Cut throat injuries are a major cause of morbidity and mortality among young adult males in our setting. Addressing the root causes of violence such as poverty, unemployment, and substance abuse will reduce the incidence of these injuries in our environment

Does the Nigerian health care system need a primary gate-keeper?

No Abstract Availabl

Epistaxis in Port Harcourt

No Abstract. Nigerian Journal of Medicine Vol 15 (3) July-September: 298-30

The pattern of foreign body impactions in the tracheobronchial tree in University of Port Harcourt Teaching Hospital

No Abstract