Pattern of medical admissions at the Federal Medical Centre, Asaba - a two year review

Atwo-year retrospective evaluation of the pattern of medical admissions at the FederalMedical Centre (FMC),Asaba,Delta State,Nigeria. Case notes of all admissions and deaths in the medical wards between November 2005 and October 2007 were retrieved and reviewed. Themean, standard deviation and percentages of relevant data were derived and presented in simple descriptive statistics. One thousand, eight hundred and sixty patients were admitted over the study period. One thousand and eight of these [1008; 54.2%], were male, while eight hundred and fifty two [850; 45.8%] were female, making a female/male ratio of 1:1.18.The patients ages ranged between fifteen and ninety years, with amean of 51.56 ± 18.35 years.The age range ofmale patients ranged from16 to 88 years,with amean of 55.55 ± 17.99 years,while that of the female patients ranged from15 to 90 years,with amean of 57.14 ± 13.79.The length of stay in theward ranged from1 to 97 days,with amean of 10.32 ± 10.93 days.Therewere 23.25 patients per bed per year and a bed occupancy rate of 65.74%. There were 240 deaths [12.90% of total admissions]. The interval between admission and death ranged between 1 and 31 days, with a mean of 7.14 ± 6.7 days. One hundred and twenty four patients [124; 6.7%] were referred to other health facilities, while ninety six [96; 5.2%] left against medical advice.The commonest causes of admission in males was hypertension, diabetes mellitus and HIV, while in females, it was HIV, hypertension and diabetes mellitus. Commonest causes of death in males were hypertension, HIV and diabetes, while in female subjects, itwasHIV, hypertension and diabetes. Non-communicable diseases- [hypertension, diabetesmellitus] and HIV/AIDS were themajor causes of admissions and death in both genders.Keywords: Pattern, Medical admissions, Asab

Evaluation of the Effect of Duration of Diabetes Mellitus on Peripheral Neuropathy Using the United Kingdom Screening Test Scoring System, Bio-thesiometry and Aesthesiometry

Background: and Objectives: Risk factors predisposing to foot ulceration in diabetic subjects are multiple. Long duration of diabetes mellitus is a major risk factor, likewise peripheral neuropathy (PN), which globally, is recognized as the commonest risk factor for foot disease in diabetic subjects. Objectives: To evaluate the effect of duration of diabetes mellitus on peripheral neuropathy using the United Kingdom Screening Test (UKST) Scoring System, Bio-thesiometry and Aesthesiometry, in Nigerian diabetic subjects without current or previous foot ulceration. Subjects and methods: One hundred and twenty (120) diabetes mellitus (DM) subjects with and without symptoms of peripheral neuropathy receiving care at the medical outpatient department (MOPD) and the diabetic clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria, were recruited consecutively as they presented. Data collected included subjects age (years), gender, age at first diagnosis of DM, duration of DM (years) and baseline fasting venous plasma glucose. The United Kingdom Screening Test (UKST) symptom score was used to separate the participants into two groups those with symptoms of PN and those without and the subjects further assessed by three methods the UKST Signs score, Bio-thesiometry and Aesthesiometry to determine the presence of PN. Results: Among the 120 diabetic participants, 83(69.2%) had neuropathic symptoms (the symptomatic participants) while 37(30.8%) were asymptomatic (the asymptomatic participants). The different methods of diagnosing PN increasingly detected PN with increasing duration of diabetes. For the symptomatic group, the UKST method detected PN least in those with duration of DM 15 years while for the asymptomatic group, it detected PN in 25.0% of those with duration of DM 15 years. For the symptomatic group, Aesthesiometry detected PN in 65.2% of those with duration of DM 15 years. For the asymptomatic group, it  detected PN in 29.2% of those with duration of DM 15 years. Likewise, for the symptomatic group, Bio-thesiometry detected PN in 47.8% of those with duration of DM 15 years. For the asymptomatic group, it detected PN in 16.7% of those with duration of DM 15 years.Conclusion: Long duration of diabetes mellitus and peripheral neuropathy are risk factors for foot complication in Nigerians with diabetes mellitus. Diabetic subjects with long duration of diabetes (>10 years) almost always have associated peripheral neuropathy, and should be recognized as a special group at high risk for foot disease from DM. Specific preventive programs should target this group to reduce the rate of avoidable loss of limbs to diabetes.Key Words: Diabetic foot ulceration, peripheral neuropathy, United Kingdom Screening Test, Aesthesiometry, Biothesiometry