Management of erectile dysfunction: perceptions and practices of Nigerian primary care clinicians

Erectile dysfunction (ED) is a prevalent health problem in many societies, but the diagnosis is seldom documented in primary care. The objective of this study was to investigate the perception and practices of clinicians regarding the management of ED in primary care settings in Nigeria. Methods A self-administered semi-structured questionnaire was applied to a purposive sample of clinicians attending conferences/workshops organised by the Society of Family Physicians of Nigeria and Update Courses of the Faculties of Family Medicine of the National Postgraduate Medical College of Nigeria and the West African College of Physicians. Information was obtained on their professional characteristics, experiences with the management of ED and possible barriers to the effective management of ED. Results A total of 187 completed questionnaires were analysed. Most (87.2%) of the respondents were general practitioners, while the rest were specialists in various fields (excluding sexual health) who worked at the primary care level. One hundred and forty-seven respondents (76%) reported that ED was common in their clinical practice. Over half (56.2%) of the respondents ascribed a high priority to ED management in their day-to-day clinical practice, while 33.2% and 10.6% of them ascribed medium and low priority to ED management respectively. Although 80.8% of the respondents agreed that ED patients could benefit from orthodox treatments, only 18% of them had ever prescribed any medication for affected patients; most (82%) of them either counselled or referred ED patients to secondary or tertiary care level for further management. Most of the clinicians (62%) would not take a sexual history unless the patient brought it up. The reported barriers to the management of ED include lack of a standardised protocol (64.2%), inadequate experience in ED management (85.6%), preference of patients for native medication (42.3%), and the high cost of modern medication (48.1%). Conclusion The clinicians acknowledged the high prevalence of ED in the primary care setting and recognised that they had a role to play in managing affected patients. The identified barriers to the management of the condition point to the need for education of both clinicians and patients, as well as the provision of guidelines for the management of ED in primary care settings.South African Family Practice Vol. 49 (9) 2007: pp. 1

Impact of Strategic Relationship Marketing on the Performance of Banks in Nigeria

The increasing patronage of non-bank institutions by customers exerts marketing pressure on the Nigerian commercial banks. Existing studies have not adequately addressed the gap created by this paradigm shift, hence the call for business philosophy that focuses on strategic relationship marketing (SRM) approach with the customers. Therefore, this study examines the influence of the SRM dimensions on customer retention of banks in Nigeria. The sample comprised 1500 commercial bank customers and marketing officers from 300 bank branches in Nigeria. Structured questionnaires were administered for data collection. Hierarchical regression model was fitted to the data collected. The findings revealed that strategic relationship marketing dimensions could lead to increased customer retention with adequate implementation of relationship acquisition strategy, and retention strategy. Further, inclusion of banking industry alignment strategy would make the banks to benefit maximally through customer linkage and also cause an optimal compensation or remedial system. The findings stressed the need for relationship acquisition, relationship maintenance and retention strategy as the strategic marketing tool to enhance customer retention of the banks. Keywords: strategic relationship, marketing, customer retention, banking industry alignment, banks DOI: 10.7176/JMCR/74-03 Publication date: December 31st 2020

Prevalence and correlates of psychiatric morbidity among caregivers of children and adolescents with neuropsychiatric disorders in Nigeria

Objective: To screen for psychiatric morbidity among caregivers of patients attending a child and adolescent psychiatric clinic. Method: A total of 155 patients and their caregivers were consecutively recruited over a 1 month period. Sociodemographic and clinical information on patients was obtained either from the hospital records or from the caregiver. Scoring on the Children’s Global Assessment Scale (CGAS) was done by clinicians. The caregivers were administered a sociodemographic questionnaire, GHQ-12, Zarit Burden interview, and the Columbia Impairment Scale. Results: Most caregivers observed in this study were females (80.5%) with mothers of the patients accounting for 78% of all the caregivers. A higher percentage of the patients were males (52.8%). Among the caregivers, 39.4% had GHQ Scores of 3 and above. Factors associated with psychiatric morbidity among caregivers include the high level of subjective burden of care, low level of functioning, high degree of impairment and low level of education among patients. Conclusion: The study reveals a high level of psychiatric morbidity among the carers of children and adolescents with mental health problems.Keywords: Psychiatric morbidity; Care giver; Children and adolescent

Hemoglobin and ferritin concentrations in subjects with metabolic syndrome

Background Metabolic syndrome (MetS), a clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity, has been linked with raised levels of serum ferritin (Sfr) concentrations. Objectives This study was carried out to compare hemoglobin (Hb) and Sfr concentrations in patients with MetS, regular donors and first-time donors. Materials and Methods A total of 102 subjects who were between 18 and 60 years were enrolled for the study. They were divided into three groups. The first group (n = 20) was made up of 5 males and 15 females, all who met the criteria that define MetS. The second group (n = 52; M = 34, F = 18) were regular donors, while the last group (n = 30; M = 16, F = 14) were first-time donors or those who had not donated before. Following an overnight fast, 20 mL of venous blood was drawn from each subject. About 5 mL of this was put into sodium ethylenediaminetetraacetate (EDTA) specimen bottles for the full blood count parameters with Sysmex KX-21N hematology analyzer (made in Japan). The remaining 15 mL had serum separated for Sfr assay using enzyme-linked immunosorbent assay (ELISA) with a commercial assay kit manufactured by Teco Diagnostics. Results Significant difference was found in the mean Sfr concentration of subjects with MetS (163 ± 136.92 ng/mL) and regular donors (41.46 ± 40.33 ng/mL), P = 0.001. The mean Sfr concentrations of subjects with MetS (163 ± 136.92 ng/mL) were also higher than that of first-time donors (102.46 ± 80.26 ng/mL), but it was not statistically significant, P = 0.053. The Hb concentrations of the three groups were not significantly different. Conclusion Sfr concentrations of regular donors were lower than that of subjects with MetS and first-time donors. The difference between regular donors and subjects with MetS was statistically significant. However, there is no significant difference in the Hb concentrations in the three groups. MetS is not associated with anemia or hyperferritinemia

Endocrine Admissions in a Tertiary Hospital In Nigeria: A 5-Year Review of Pattern and Trend

Hospital admission is a reflection of prevailing disease pattern in an environment, impact of services rendered in the outpatient department and preventative healthcare services in the community. The aim of this study was to determine the pattern and trend of endocrine related admissions at Ekiti State University Teaching Hospital, Ado-Ekiti. This was a retrospective analysis of health records of patients with endocrine related disorders admitted into the medical wards of the hospital between 2008-2012. The diagnoses, based on WHO ICD-10 were documented. Endocrine related admissions were subdivided into diabetes related, thyroid related and non-diabetes hypoglycaemia. Data of interest were compared with Pearson’s Chi-Square and Student’s t test. There were 3818 admissions out of which 457 (12.0%) were endocrine related. Majority of the endocrine admission were DM related (93.9%), representing 11.8% of the total admissions. There was increase in endocrine-related admissions from 9.1%-18.0% and a 10.6% increase in the DM related admissions from 2008 to 2012, but a decline in absolute number of endocrine admissions notably among females (X2 = 39.88, p<0.001). Poor glucose control (42.8%) was the commonest reason for diabetic admission, followed by hyperglycaemic emergencies (31.1%), diabetic foot disease (15.9%), sepsis (2.6%), stroke (2.3%), nephropathy/renal failure (1.6%), diabetic hand (0.9%), hypoglycaemia (0.9%), heart failure (0.7%). Between 2010-2012, hyperglycaemic crisis emerged as the commonest reason for diabetic admission, but overall, there was significant reduction in the number of hospitalizations for all diabetic complications (X2 = 128.69, df= 36, p=0.000). More resources need to be allocated for the management of diabetes mellitus while efforts to prevent its complications through educational activities and public awareness should be sustained

Cost Management Practice of Construction Firms and Its Influencing Factors: Lessons from Southwestern Nigeria

The growing need at maintaining steady cost projection of construction projects has been an issue of serious concern to both the clients and the construction practitioners on sites. Also, cost deviation from initial cost plan and cost budget has been prevalent on construction sites and no concerted efforts have been made at addressing this phenomenon. This study therefore examined the factors that are considered to be affecting the cost management practice of construction firms in the southwestern Nigeria and also proffered possible ways of ameliorating the factors. Using survey approach, one hundred copies each of structured questionnaires were distributed to clients, contractors and consultants on construction sites in the study area while 72, 77 and 78 copies were duly filled and returned by the respondents respectively. Relative Importance Index (RII) technique was used for the analysis. The results revealed that poor leadership and in appropriate management, inefficient deployment of resources, excessive wastage of materials on sites, complex payment mechanisms, theft of materials on sites and variation during construction works are the prevailing factors affecting construction cost management practice in the study area. It was concluded that extra focus should be placed on the identified factors with a view to reducing cost of construction, enhancing construction performance and building confidence within the construction industry in the study area

Coherent Parton Showers with Local Recoils

We outline a new formalism for dipole-type parton showers which maintain exact energy-momentum conservation at each step of the evolution. Particular emphasis is put on the coherence properties, the level at which recoil effects do enter and the role of transverse momentum generation from initial state radiation. The formulated algorithm is shown to correctly incorporate coherence for soft gluon radiation. Furthermore, it is well suited for easing matching to next-to-leading order calculations.Comment: 24 pages, 3 figure

A Positive-Weight Next-to-Leading-Order Monte Carlo for Heavy Flavour Hadroproduction

We present a next-to-leading order calculation of heavy flavour production in hadronic collisions that can be interfaced to shower Monte Carlo programs. The calculation is performed in the context of the POWHEG method. It is suitable for the computation of charm, bottom and top hadroproduction. In the case of top production, spin correlations in the decay products are taken into account.Comment: 18 pages, 12 figures. Few misprints corrected, references updated, final remarks adde

Single-top Wt-channel production matched with parton showers using the POWHEG method

We present results for the next-to-leading order calculation of single-top Wt-channel production interfaced to Shower Monte Carlo programs, implemented according to the POWHEG method. A comparison with MC@NLO is carried out. Results obtained using the PYTHIA shower are also shown and the effect of typical cuts is briefly discussed.Comment: 23 pages, 9 figure

Review of adult head injury admissions into the intensive care unit of a tertiary hospital in Nigeria

Background: Head injury is frequently associated with death and disability and imposes considerable demands on health services. Outcome after head injury is closely related to prompt management, including prevention of secondary brain injury and intensive care unit (ICU) management. This study aimed at determining the aetiological spectrum, injury characteristics, ICU admission patterns, and treatment outcomes of adult head-injured patients at a sub-Saharan tertiary hospital.Methods: A retrospective study on adult head-injured patients admitted to the ICU of a sub-Saharan tertiary hospital between July 2000 and June 2010.Results: A total of 198 head-injured adult patients were managed in the ICU during the study period. This included 128 males and 70 females with a male-to-female ratio of 1.8:1. The most common mode of injury was road traffic accident. All the patients admitted to ICU had either moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the patients had associated cervical spine injuries and 50% had various musculoskeletal and soft tissue injuries. Cranial computed tomography findings included brain contusions and intracranial haematomas. Mean duration of ICU stay was 18 days (range 24 hours-42 days), with 89.9% discharged out of ICU care. The overall mortality was 10.1%, although only 36.9% had satisfactory outcomes, as determined by the Glasgow Outcome Scale. Outcome had statistically significant (P < 0.05) relationship with severity of head injury and surgical intervention.Conclusions: Head injury management in the ICU requires an approach to ensure prevention of secondary brain injury; appropriate and early neuroimaging to diagnose lesions that would benefit from timely surgical intervention; as well as management of fluid, electrolyte and haematological derangements.Keywords: head injury; admissions; IC