Self-Assessment of Final Year Medical Students’ Proficiency at Basic Procedures

BACKGROUND: Procedural tasks are important in patient management, with varying degrees of proficiency expected at different levels of medical training. Little has been done in this region to assess the medical students’ proficiency at performing basic procedures.AIM: The aim of this study is to determine their self-assessed proficiency, degree of participation in performing these procedures and the use of skill-lab training.MATERIALS AND METHODS: The study is questionnaire-based, amongst final year medical students of University of Lagos, Nigeria.RESULTS: One hundred and forty students participated in the study.  A significant number (82{58.6%}) self-reported level of proficiency for venepuncture was above average or excellent; for IV line placement it was  a little less than half (65{46.4%}) and for urethral catheterisation 44 (31.7%); however it was quite low for the other procedures. Many students self-reported high level of participation for venepuncture (83{59.2%}); sixty one (43.6%) for IV line placement and 30 (21.7%) for urethral catheterization. The correlations between self-assessed levels of proficiency and participation were significant for all procedures. There was no exposure to the use of mannequins.CONCLUSION: Self-reported proficiency is lacking for basic procedures in a significant proportion of students with a low level of participation

Misoprostol, Magnesium Sulphate and Anti-shock garment: A knowledge, availability and utilization study at the Primary Health Care Level in Western Nigeria.

IntroductionNigeria has one of the highest maternal mortality ratios in the world. The nurses and midwives being the first point of contact play a central role in addressing these problems. This study was conducted to assess the knowledge and utilization of the technologies (misoprostol, anti-shock garment and magnesium sulphate) in the reduction of maternal mortality amongst the Primary Health Care (PHC) nurses and midwives in Lagos State, Nigeria. In addition, the availability of the technologies in the flagship Primary Health Centres (PHCs) was assessed.MethodsThis was a cross-sectional study among all the nurses and midwives at the flagship PHCs in Lagos state and a total of 230 were eventually studied. Data was collected using a self-administered, structured questionnaire and a checklist. Descriptive and inferential statistics were applied. Level of significance was set at 5% (pResultsAll the respondents were aware of the technologies but most (73.9%) had poor knowledge of them. Majority (74.8%) of the respondents had good knowledge of maternal mortality and its major causes. Most, 81.3% of the respondents have administered misoprostol, 37.0% magnesium sulphate while 52.2% have administered anti shock garment. Out of the 57 flagship PHCs, 27 (47.4%) had magnesium sulphate, 42 (73.7%) had misoprostol and 52 (91.2%) had anti-shock garments in their facilities. Respondents who were double qualified (nurse/midwife) had significantly better knowledge of maternal mortality and its major causes (p = 0.009) than the other cadres. Longer years of experience (p = 0.019), training in the use of misoprostol (p = 0.020) and training in the use of magnesium sulphate (p = 0.001) significantly improved knowledge of the technologies.ConclusionRespondents had good knowledge of maternal mortality and its major causes and poor knowledge of the technologies for maternal mortality reduction, despite the trainings attended. Of the three technologies considered, misoprostol was the most commonly used. Periodic refresher courses for the training and retraining of PHC nurses and midwives on the technologies for maternal mortality reduction is recommended

Lower Urinary Tract Symptoms: Prevalence, Perceptions, and Healthcare-Seeking Behavior amongst Nigerian Men

Purpose: The aim of this study was to determine the prevalence of lower urinary tract symptoms (LUTS) and the factors influencing the healthcare-seeking behavior of men with LUTS. Materials and Methods: A cross-sectional survey was performed of 658 men selected using multi-staged sampling techniques. They were interviewed about LUTS and their healthcare-seeking behavior. The data were analysed using PASW Statistics ver. 18. Associations between specific factors and healthcare-seeking behavior were examined using the chi-square and Fisher exact tests. Results: The overall prevalence of LUTS was 59.1%. Storage symptoms (48.2%) were more prevalent than voiding (36.8%) or post-micturition (29.9%) symptoms. Approximately a quarter (25.5%) had a poor quality of life (QoL) score. The average duration of symptoms before seeking help was 3.4 years. Almost half (46.8%) of the men with LUTS had never sought help. Perceptions of LUTS as an inevitable part of ageing, subjective feelings of wellness, financial constraints, and fear of surgery were the most common reasons for not seeking help. The most common reasons for seeking help were to moderate-severe symptoms, impaired QoL, and fear of cancer. Severe LUTS, impaired QoL, and the concomitant presence of erectile dysfunction, dysuria, or haematuria were clinical factors that positively influenced healthcare-seeking behavior. Conclusions: In this population-based study, we found that the prevalence of LUTS was very high amongst adult males. However, only about half of these men sought medical attention. Their healthcare-seeking behavior was influenced by severity of symptoms, QoL scores, and socio-demographic factors such as educational status

Knowledge, perceptions and practice of cervical cancer prevention among female public secondary school teachers in Mushin local government area of Lagos State, Nigeria

Introduction: Cervical cancer is the most common gynecological cancer and a leading cause of cancer death in women in Nigeria. This study was aimed to assess the knowledge, perception, and practice of cervical cancer prevention among female public secondary school teachers in Mushin, Lagos.Methods: This was a cross-sectional study carried out among female secondary school teachers in Mushin, Lagos. The participants were selected by a two-stage random sampling method and relevant data were collected with the use a self-administered questionnaire. Data entry and analysis were done using Epi-info version 7.2 statistical software and descriptive statistics were computed for all data.Results: The knowledge of cervical cancer and its prevention was 100.0% among the respondents. The most commonly known method of cervical cancer screening identified by the respondents was Papanicolaou smear (91.4%). More than half of the women (67.0%) have had at least one cervical cancer screening done previously. Only 2.2% of the respondents have had HPV vaccine given to their female teenage children in the past despite the acceptance rate for HPV vaccination being 76.2%.Conclusion: This study, unlike most previous studies in other regions of Nigeria and most part of sub-Saharan Africa, has demonstrated a relatively high level of awareness about cervical cancer, its cause, risk factors and prevention. However, conversely, the absence of a national health programme means that screening and vaccination centers are not available, accessible or affordable.Keywords: Cervical cancer, HPV vaccine, Lagos, Mushin, prevention, Papanicolao

Clinical experiences with the use of oxytocin injection by healthcare providers in a southwestern state of Nigeria: A cross-sectional study.

BackgroundPostpartum hemorrhage (PPH) is a leading cause of maternal mortality in Nigeria and in most low- and middle-income countries. The World Health Organization (WHO) strongly recommends oxytocin as effective, affordable, and the safest drug of first choice in the prevention and treatment of PPH in the third stage of labor. However, there are concerns about its quality. Very high prevalence of poor-quality oxytocin, especially in Africa and Asia, has been reported in literature. Excessive and inappropriate use of oxytocin is also common in low-resource settings.ObjectiveTo assess clinical experiences with quality of oxytocin used by healthcare providers in Lagos State, Nigeria.MethodsThis was a descriptive cross-sectional study conducted in 2017, with 705 respondents (doctors and nurses) who use oxytocin for obstetrics and gynecological services recruited from 195 health facilities (public and registered private) across Lagos State. Data collection was quantitative, using a pretested self-administered questionnaire. Data analysis was performed with IBM SPSS version 21. Statistical significance was set at 5 percent (pResultsOnly 52 percent of the respondents knew oxytocin should be stored at 2°C to 8°C. About 80 percent of respondents used oxytocin for augmentation of labor, 68 percent for induction of labor, 51 percent for stimulation of labor, and 78 percent for management of PPH. Forty-one percent used 20IU and as much as 10% used 30IU to 60IU for management of PPH. About 13 percent of respondents reported believing they had used an ineffective brand of oxytocin in their practice. Just over a third (36%) had an available means of documenting or reporting perceived ineffectiveness of drugs in their facility; of these, only about 12 percent had pharmacovigilance forms in their facilities to report the ineffectiveness.ConclusionThe inappropriate and inconsistent use of oxytocin, especially overdosing, likely led to the high perception of medicine effectiveness among respondents. This is coupled with lack of suspicion of medicine ineffectiveness by clinicians as a possible root cause of poor treatment response or disease progression. Poor knowledge of oxytocin storage and consequent poor storage practices could have contributed to the ineffectiveness reported by some respondents. It is necessary to establish a unified protocol for oxytocin use that is strictly complied with. Continuous training of healthcare providers in medicine safety monitoring is advocated