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

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

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

Foreign bodies in the nose

No Abstract. Nigerian Journal of Medicine Vol 15 (3) July-September: 301-30

Histopathological results of nasopharyngeal masses of adult patients: a study from two centres in Port Harcourt, Nigeria

Background: Nasopharyngeal masses in adult patients in most cases are considered to be tumours unless proven otherwise.Aim: To determine the histopathological results of nasopharyngeal masses seen in adult patients in Port Harcourt Nigeria. It will also highlight the management outcomes of these patients.Methods: A prospective (January 2010 to December 2013) study of 45 patients with both clinical and radiological evidence of nasopharyngeal masses seen at the Ear Nose and Throat (ENT) surgery clinics of University of Port Harcourt Teaching Hospital (UPTH) and Kinx Medical Consultants clinic in Port Harcourt. All the patients had examination under anaesthesia (E/U/A) of the nose and nasopharynx and biopsy.  The data collected were documented in a proforma designed for the study by the researchers. The data are bio-data, clinical features, investigations, histopathological findings, treatment, complications and management outcome. The data were entered into an SPSS version 14 computer soft ware and analyzed descriptively.Results: Forty five adult patients had E/U/A of the nose and nasopharynx and biopsy of nasopharyngeal masses. They all had history of chronic rhinorrhoea, snoring and nasal obstruction. Age range was 18-72 years. There were 20 males and 25 females with male to female ratio of 1:1.25. The commonest histopathological diagnosis was adenoidal hyperplasia (n=36, 80%) followed by non-Hodgkin lymphoma (n=5, 11.11%).Conclusion: Even though the predominant histopathological result of nasopharyngeal masses in adult patients we encountered was adenoidal hyperplasia, all tissues from the nasopharynx irrespective of their benign macroscopic appearances should be subjected to histopathological examination to avoid missing out more sinister diagnosis.Keywords: Examination under anaesthesia, Nasopharyngeal masses, Non-Hodgkin lymphoma, Adenoidal hyperplasia, Squamous cell carcinom

The perception of patients of doctor-patient relationship in otorhinolaryngology clinics of the University of Port Harcourt Teaching Hospital (UPTH) Nigeria

Background: The doctor-patient relationship is central to the practice of medicine and is essential for the delivery of high quality healthcare in the diagnosis and treatment of diseases. Recently, patient participation has gained increasing prominence in healthcare delivery.Aim: To explore the perceptions of Nigerian adult patients who attend the University of Port-Harcourt Teaching Hospital (UPTH) Otorhinolaryngology clinics with regard to relation with their doctors during consultations.Methods:&nbsp; This is a descriptive cross-sectional study; the duration of the field work was two weeks. The study population consisted of adult patients who attended the otorhinolaryngology clinics. Data collection was carried out using interviewer-administered semi-structured questionnaires that explored the perception of patients of doctor-patient relationship. Forty patients were selected for the study and the sampling was purposeful. An average of twenty interviews was conducted per clinic day. Each interview took approximately 15 minutes.Results:&nbsp; The majority (95%) of patients' treatment was decided by the doctors. The majority of the patients (87.5%) welcomed the opportunity to have more involvement in making treatment decisions. Most of the patients (67.5%) were not satisfied with the services received from their doctors.Conclusion: This study established paternalistic model as the dominant pattern of doctor-patient relationship in UPTH otorhinolaryngology clinics. The patients preferred a more cordial relationship. Keywords: Perceptions, Doctor-patient relationship, Otorhinolaryngology, University of Port Harcourt&nbsp; Teaching Hospita