Medical students' perception of their learning environment at a Nigerian University

Background: The medical learning environment is an interactive network of factors that affect the medical student's academic progress and learning outcomes.This study was designed to assess the overall student's  perception of their learning environment, identify the weak aspects of the environment, determine the effects of age, gender year of study on  student's perception and recommend measures to further enhance students' learning experiences.Method: This is a cross-sectional study and cluster sampling technique was used to recruit respondents. The Dundee Ready Education Environment Measure (DREEM) questionnaire was applied to medical students of Ebonyi State University Abakaliki, to assess the following areas; student's perception of learning, student's perception of course organizers, student's academic selfperception, student's perception of atmosphere, and student's social self-perception. Completed questionnaires were analyzed with the SPSS software, version 17.Results: 180 questionnaires were analyzed. The mean global score was 120.4/200 (60.2%).It was noted to be significantly higher in the second year of study than in the fifth year of study. Further analysis of the subdomain revealed that students in their second year of study had significantly higher scores in all the subdomains except in the academic self-perception. Analysis of the individual items in the DREEM questionnaire showed that the students perceived the environment as not being relaxed during lectures, and that there was poor support system for students that get stressed in their course of study.Conclusion: Students' perception of their educational environment was  positive but there was poor support system for students who get stressed. The school management needs to work on some aspects of social factors to improve on the perception and quality of teaching and learning.Key words: Medical, Students, Perception, Learning, Environmen

Iron Deficiency Anemia in Pregnancy in Nigeria—A Systematic Review

Anemia in pregnancy is a public health problem in Nigeria and it is more than likely that iron deficiency is the major cause. This study aimed to  review relevant publications in order to summarize the prevalence of iron deficiency anemia, risk factors associated with iron deficiency, anemia in pregnancy as well as factors associated with compliance to routine iron therapy. MEDLINE Entrez PubMed search was performed in August 2017 and studies that investigated iron deficiency anemia in pregnancy in Nigeria from 1968 to 2017 were sought. Search keywords included “iron deficiency anemia, pregnancy, Nigeria.” Only studies that provided information on the prevalence of iron deficiency anemia, risk factors associated with iron deficiency anemia and risk factors associated with compliance to routine iron therapy in pregnancy in Nigeria were eligible and were  selected. Inclusion criteria were original scientific investigations, not reviews, studies conducted in Nigeria between 1968 and 2017 and studies written in the English language. A total of six relevant studies that fulfilled the study inclusion criteria were identified out of 36 studies found. All the studies reported a high prevalence of iron deficiency anemia among pregnant women and risk factors associated with iron deficiency anemia in pregnancy include multiparity, third trimester of pregnancy, and low socioeconomic status. Risk factors associated with noncompliance to routine  iron therapy include poor utilization of antenatal services, low educational attainment, distance to a health facility, single or teenage pregnancy, increasing age of the pregnant women, and living in the rural areas. The prevalence of iron deficiency anemia among pregnant women was reported to be high. Awareness creation and education on the importance of family planning and proper utilization of antenatal care services should be encouraged. There should be economic empowerment of women, provision of health facilities to areas where they are absent to  encourage early booking and utilization of antenatal care services. Keywords: Anemia, iron deficiency, pregnanc

Challenges in the management of bleeding disorders in Nigeria

Background: Bleeding disorders (BDs) are characterized by abnormal bleeding for which effective management requires a combination of skill, workforce, diagnostic facilities, and adequate therapeutic options. Objectives: The objectives of this study were to determine the capacity of Nigerian hematologists to handle BDs and to assess availability of required infrastructure, equipment, and treatment options. Materials and Methods: This descriptive study was conducted during the 2016 scientific conference of the Nigerian Society for Hemetology and Blood Transfusion. A structured questionnaire was distributed to hematologists in attendance. Data were analyzed with SPSS version 21.Results: A total of 55 (76.4%) hematologists from 27 centers responded. The most frequently carried out tests to assess  bleeding were hemoglobin or packed cell volume (100%), full blood count (96.3%), and prothrombin time/international normalized ratio and activated partial thromboplastin time (77%). Many centers did not have a coagulometer (47.8%) or cold centrifuge  (43.4%) and none had thromboelastography or rotational thromboelastometry. Fresh whole blood was the most accessible  (88.5%) and up to one‑third of the centers did not have access to component therapy. Only 39.1% centers had factor   concentrates available.Conclusion: Facilities required for diagnosing and treating BD are significantly deficient in most centers in Nigeria. Funding to provide facility and training is required to improve on this inadequacy.Keywords: Bleeding, hemophilia, thrombocytopenia, whole bloo