Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean deliv...Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean delivery rate at the Kogi State Specialist Hospital, Lokoja, Nigeria over a one-year period. Methods: This was a prospective assessment of the demographic characteristics of patients, indications, types, rates and outcomes of Caesarean delivery in Kogi State Specialist Hospital, Lokoja, Nigeria from December 15, 2020 to December 14, 2021. Data collected were analyzed using SPSS version 20.0 statistical package (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). The categorical data were displayed using tables and charts. Results: There was a total of 491 deliveries, out of which were 113 Caesarean deliveries and 378 spontaneous vaginal deliveries making the Caesarean delivery rate in Kogi State Specialist Hospital, Lokoja, Nigeria 23.0%. There were no instrumental deliveries during the study period. The commonest indication for Caesarean section was obstructed labour in 31% of cases. There was no maternal mortality. There were three early neonatal deaths due to severe birth asphyxia. Conclusion: The rate of Caesarean delivery in this study was 23.0% and obstructed labour was the leading indication in 31% of cases. The rate of Caesarean delivery in this study is high, albeit the overall outcome was good for both mother and child. Caesarean delivery, therefore, remains one of the means for reducing maternal and perinatal morbidity and mortality in Nigeria.展开更多
The historical dogma that bladder calculi comprise the main indication for prostatic surgery has recently been questioned.In this study,we aimed to predict which patients should undergo simultaneous prostate and bladd...The historical dogma that bladder calculi comprise the main indication for prostatic surgery has recently been questioned.In this study,we aimed to predict which patients should undergo simultaneous prostate and bladder calculi surgery or only bladder calculi removal by evaluating preoperative risk factors.One hundred and seventeen men with bladder stones and concomitant benign prostate enlargement(BPE)who had not received medical treatment before were included in the study.In the first step,only the bladder calculi of patients were removed and medical treatment was given for BPE.The patients who benefited from medical treatment during the follow-up were defined as Group 1 and the patients who required prostate surgery for any indication comprised Group 2.Risk factors for prostate surgery requirements were determined by comparing preoperative characteristics between the two groups with a cox regression model.In the follow-up of 117 patients with bladder stones removed and medical treatment initiated,49(41.9%)patients had prostate surgery indications.The indication for 33(67.3%)of 49 patients was medical treatment failure.The presence of intravesical prostatic protrusion(IPP;hazard ratio:2.071,95%confidence interval[Cl]:1.05-4.05,P=0.034),and high postvoiding residual urine volume(hazard ratio:1.013,95%Cl:1.007-1.019,P<0.001)were found to be preoperative risk factors for needing future prostate surgery.In patients who have not received medical treatment for BPE before,bladder calculi developing secondary to BPE do not always constitute an indication for prostate surgery.展开更多
Objective:To investigate the antibiotic resistance genes inserted into class I and class 2integrons in Acinetobacler baumannii[A.baumannii)isolates obtained from nine different cities in Turkey.Methods:A collection of...Objective:To investigate the antibiotic resistance genes inserted into class I and class 2integrons in Acinetobacler baumannii[A.baumannii)isolates obtained from nine different cities in Turkey.Methods:A collection of 281 A.baumannii clinical isolates were collected from nine diferenl state hospitals in Turkey and were confirmed as A.baumannU by conventional biochemical,API testing and bla_(-OXA-51)specific PCR.The isolates were examined by PCR for existence of class I and2 integron gene cassettes.Results:They were characterized by antimicrobial susceptibility testing and the highest resistance rates were determined for piperacillin(90.03%),ciprofloxacin(87.54%),cefepime and trimethoprim/sulfamethoxazole(81.13%).The lowest resistance rates was for cefotaxime(3.55%).class 1 integrons were detected in 6.4%(18/281)of A.baumannii strains and no class 2 integron was detected.The gene casselles of class 1 inlegrons AacCI-AAC(3)l-aadAI,AacCI-aadA1,AAC(3)-I,AAC(3)-I-AAC(3)-I-aadA1,TEM-1.AAC(3)-I-aadA1-AAC(3)-I-AAC(3)-I,AAC(3)-I-AAC(3)-I-AAC(3)-I-aadA1,AAC(3)-I-aadA1,AAC(3)-I-AAC(3)-I,AAC(3)-I-aadA1-AAC(3)-I-aadA1,AAC(3)-I-AAC(3)-I-aadA1-AAC(3)-I-aadA1 were detected in eighteen strains.The aac genes family were most frequently found integrated into the class 1 inlegrons and it was followed by aadA genes and TEM-1 genes.Conclusions:This is an extensive study on the distribulion of class 1 integron among A.baumannii in Turkey.In addition to these,two new alleles were observed.Their percentage rates of similarity to other cassettes are 95%aadA1(TK A18)and 89%,aadA 1(ANKA3).展开更多
Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the out...Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the outbreak. Methods:Visits were made to health facilities and affected communities.Cases were line-listed using specified forms and descriptive epidemiology carried out on collected data.Results:A total of 18 cases and 0 deaths were identified over a period of six weeks.Two of the cases(11%) were 【 9 months of age.The proportion of zero-dose children was 39%.Conclusion:Low herd immunity was suggested as the cause of the outbreak.展开更多
The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worl...The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.展开更多
Objective:To describe the pattern of admission-defining ailments and outcomes of care among people living with human immunodeficiency virus(HIV) /acquired immune deficiency syndrome(AIDS)(PLWHA) who presented for trea...Objective:To describe the pattern of admission-defining ailments and outcomes of care among people living with human immunodeficiency virus(HIV) /acquired immune deficiency syndrome(AIDS)(PLWHA) who presented for treatment at a tertiary health care institution in Nigeria.Methods:We reviewed the hospital records of all patients admitted for AIDS and AIDS-related illnesses at the University College Hospital,Ibadan, Nigeria,from January 2005 to January 2006.Results:Seventy-two PLWHA were admitted during the study period.There were 39 females(54.2%) and 33(45.8%) males.Sixty-seven(95%) PLWHA presented with AIDS.Only 12(17%) were already receiving highly active antiretroviral therapy before admission.Forty -three patients(60%) commenced antiretroviral(ARV) therapy on admission.Thirty-three patients(46%) had pulmonary tuberculosis,10(14%) had extrapulmonary tuberculosis,21(29.1%) had diarrhoea-related illnesses,20(28%) had anaemia,and nine(12.5%) presented with coma.Twenty-nine patients(40.3%) were discharged home,and 43(59.7%) died before discharge.Sixty-nine patients(95.6%) were judged to be indigent,and required financial support.The contributory causes of death included pulmonary tuberculosis in 21(48.8%),diarrhoeal diseases in five(11.6%),anaemia in five(11.6%),coma in nine(20.9%), and pneumonia in three(7.1%).Conclusion:Tuberculosis was the major admission-defining ailment among PLWHA.展开更多
Abstract： The pre and post analytical phase in a testing cycle contributes up to 93% of total laboratory errors. However, pre-analytical phase is primarily responsible for errors. Hence, it is of precise importance f...Abstract： The pre and post analytical phase in a testing cycle contributes up to 93% of total laboratory errors. However, pre-analytical phase is primarily responsible for errors. Hence, it is of precise importance for the laboratory to study error occurrence rates during the testing cycle and implement a quality improvement plan to release an accurate result. The present study was conducted during the period Jan-Nov 2014 in the Central Clinical Lab in Osmaniye State Hospital, Turkey. During period of 11 months, 626897 samples were monitored for major preanalytical problems at the receiving counter of the Central Clinical Laboratory. Among all preanalytic laboratory errors, 35.4% of the errors were associated with clotted sample, 25.5% errors with inadequate sample, and 25.3% errors with hemolysed sample in the laboratory. Assessment considering the departments showed that emergency unit had the highest error rates （hemolysis： 52.5%, lipemic： 42.9%, damaged： 34.6%, clotted： 34.2%, inadequate： 26.8%, wrong material： 17.6%, wrong barcode： 16.7%）. There was significant difference among the departments in terms of preanalytic errors （p 〈 0.001）. Based on these observations, major preanalytic errors are of great concern and needs corrective approach via proper educational programs to related personals. If this area is ignored, that can lead to negative patient outcome. However, a better specimen quality and patient satisfaction are achieved with the high quality personal-based education regarding pre-analytical errors.展开更多
BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine...BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine and well organized emergency departments(EDs) are an essential component of any developed health care system,emergency medicine as a specialty is relatively non-existent in Macedonia.DATA RESOURCES:A system assessment regarding presence,availability and capacity of EDs was completed from 2013-2015,based upon assessments of 21 institutions providing emergency care and information provided by the Ministry of Health.This assessment establishes a benchmark from which to strategically identify,plan and implement the future of emergency medicine in Macedonia.RESULTS:In general,emergency departments- defined by offering acute care 24 hours per day,7 days per week- were available at all general and university hospitals.However,care resources,emergency and acute care training,and patient care capacity vary greatly within the country.There is limited uniformity in acute care approach and methodology.Hospital EDs are not organized as separate divisions run by a head medical doctor,nor are they staffed by specialists trained in emergency medicine.The diagnostic and treatment capacities are insufficient or outdated by current international emergency medicine standards and frequently require patient transfer or admission prior to initiation.CONCLUSION:Most of the surveyed hospitals are capable of providing essential diagnostic tests,but very few are able to do so at the point or time of presentation.While emergency medical services(EMS) have improved system-wide,emergent care interventions by EMS and within all hospitals remain limited.Further system-wide acute and emergency care improvements are forthcoming.展开更多
Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards preven...Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards prevention, and health care seeking behaviours of parents or caregivers of children presenting with fever at the paediatric clinic of a secondary-level hospital in Maiduguri, Borno state, Nigeria. A cross-sectional study design was used to obtain information from the respondents. Data were collected using a structured questionnaire, from the parents or caregivers of children presented to the Paediatric clinic with history of fever, and analysed in SPSS. A total of 331 respondents were finally recruited into the study. The ages of the children ranged from one to fourteen years. Some of them (15.3%) were internally displaced persons (IDPs). As many as 90.7% and 91.9% of the respondents believed that malaria is a life-threatening illness, and ITNs could prevent malaria, respectively. Less than a half of them (42.3%) had immediately brought their children to the hospital once they detected the fever. At the hospital, only 202 (60.7%) of the children had had malaria parasite test done on them, of which 89.1% tested positive. Permanent residents were more likely to promptly take their children to the hospital, one they detected fever, compared to IDPs ( 2=12.401, df =1, p=0.002). There is the need for promoting early presentation of febrile children to health centres, and also promoting routine malaria tests for febrile persons.展开更多
Background: Intimate partner violence is a serious public health concern worldwide and is linked with serious mental and physical health consequences. Despite its commonality and attendant consequences, proper public ...Background: Intimate partner violence is a serious public health concern worldwide and is linked with serious mental and physical health consequences. Despite its commonality and attendant consequences, proper public healthcare intervention is rudimentary. The aim of this study was to assess the relationship between quality of life associated with intimate partner violence among females attending the HIV Clinic at Jos University Teaching Hospital, Jos, Plateau, Nigeria. Methods: This study employed a cross-sectional design and data was collected from 174 female patients attending the HIV Clinic who met the inclusion criteria with the aid of a 73-item semi-structured interviewer-administered questionnaire. This captured socio-demographic characteristics, knowledge and attitude towards intimate partner violence and their experiences of violence and quality of life using the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF). Results: Almost half of the respondents, 85 (48.9%) rated their quality of life as good. Respondents experiencing IPV reported poorer quality of life compared to those not experiencing partner violence in all the domains and it was statistically significant in the physical health (p Conclusion: IPV is common among females attending the HIV/AIDS Clinic and those affected reported significantly poorer quality of life.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
<strong>Background</strong> Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awarene...<strong>Background</strong> Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awareness, knowledge, attitude, perception, and practice of Covid-19 prevention among healthcare workers in Rivers State, Nigeria. <strong>Methods</strong> This was a descriptive cross-sectional survey carried out six weeks into Rivers State response that commenced on February 20, 2020, in the 23 Local Government Areas (LGAs). State Disease Surveillance and Notification Officers used multistage sampling to recruit 555 healthcare workers for the survey. A self-designed structured interviewer-administered questionnaire built into the Open Data Kit application for android phones was used for data collection. Descriptive data analysis was done, and outputs presented as frequency and percentages. <strong>Results</strong> There was a total of 372 (67.0%) female respondents. Majority of study participants had tertiary education 453 (81.6%). The mean age of study participants was 40.6 years (Standard Deviation = 7.8 years). Furthermore, 285 (51.4%) were Community Health Workers, and had over ten years practicing experience 393 (70.8%). Most healthcare workers 554 (99.8%) had heard about Covid-19, through radio 539 (97.1%), and television 445 (80.2%) yet 213 (38.4%) respondents did not know that it is caused by a virus. Most respondents 415 (74.8%) had good knowledge about Covid-19. However, only 148 (26.7%) would refer suspected cases to a facility and only 365 (65.8%) respondents demonstrated the correct hand washing technique. <strong>Conclusion</strong> There are some gaps in health worker knowledge, attitude, perception, and practice of Covid-19 prevention. Interventions to bridge these gaps are needed for effective containment of this pandemic.展开更多
Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For ...Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For the patient diagnosed with cancer and for his family, pain is the most feared aspect of cancer following the likelihood of failure to treat and death. Quality of life is severely impaired together with complaint of pain which arises high rates as 80% in advanced stage cancers.展开更多
Background: Many children in Nigeria suffer from detrimental, debilitating and lifelong neurologic disorders, many of which are highly preventable using simple, cost-effective interventions. Objective: To examine the ...Background: Many children in Nigeria suffer from detrimental, debilitating and lifelong neurologic disorders, many of which are highly preventable using simple, cost-effective interventions. Objective: To examine the pattern of neurological disorders among children presenting at the neurology unit of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Amaku, Awka, Nigeria. Methods: A retrospective review of the hospital records of children who presented at the Paediatric Neurology Unit between 1st March 2020 and 31st March 2022 was carried out. Data were abstracted using a proforma and analyzed using SPSS Version 21. Results: A total of 138 children aged 0 to 15 years were seen in the unit during the period under review. 115 (83.35%) of these children were diagnosed with chronic neurological disorders. Those with chronic neurological disorders had a male:female ratio of 1.9:1, and the majority (65%) of them were below 5 years of age. The most common presenting complaints were delayed milestones (43.4%), seizures (23.8%), and speech disorders (17.2%). The most typical diagnosis was cerebral palsy (CP) (34.7%), seizure disorder (29.8%) and attention deficit hyperactivity disorder (8.9%). Perinatal asphyxia (47.7%), neonatal jaundice (17.0%) and central nervous system infections (CNS) infections (12.5%) were identified as the major risk factors responsible for these neurologic disorders. Conclusion: Cerebral palsy and seizure disorders constitute the major neurological disorders among children seen in our institution. Efforts should be intensified at reducing the incidence and impact of perinatal asphyxia, neonatal jaundice and CNS infections, identified as the major culprits, to curb the menace of these debilitating lifelong neurologic sequelae.展开更多
Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integro...Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integrons and antibiotic susceptibility of clinical isolates of P. aeruginosa. Two hundred and five P. aeruginosa strains were collected from the seven general state hospitals in Turkey. They were characterized by antimicrobial susceptibility testing, screened for class 1 and class 2 integrons, and evaluated for the association between antibiotic resistance phenotypes and the presence of integrons. intI gene was amplified in 10 isolates (4.87%) by PCR and in seven isolates of them (70%) were found different gene cassettes. The aadA gene integrated into the class 1 integrons was most frequently found and it was followed by aac genes and blaOXA family genes. Sequence analysis of variable regions of the class 1 integrons showed five gene cassette arrays;aadA1(99%), aac(3)-Id(82%)-orf-aac(3”)-Ia(99%), aac(3)-Ie(83%)-blaoxa10(100%)- aadA1 (100%), aadA6(99%, 100%), aac(6’)-I(97%)-orf-aadA2(99%). No class 2 integron was detected. This study is the first multicenter study for class 1 integrons and it indicates the low rate of presence of class 1 gene cassette in P. aeruginosa.展开更多
We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of pat...We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.展开更多
Objective:To identify predictive factors for brucellosis by analyzing cases with and without focal involvement.Methods:This single-center retrospective study included adults(≥18 years)diagnosed with brucellosis at Ağ...Objective:To identify predictive factors for brucellosis by analyzing cases with and without focal involvement.Methods:This single-center retrospective study included adults(≥18 years)diagnosed with brucellosis at AğrıTraining and Research Hospital between January 1,2022 and December 31,2024.Patients were evaluated for organ involvement based on localized symptoms and classified accordingly.Logistic regression analysis was performed to identify demographic,clinical,and laboratory predictors of organ involvement.Results:A total of 210 cases were analyzed including 115 females(54.8%)and 95 males(45.2%).Among patients with focal involvement,the proportion of males was higher(54.4%),and comorbidities were also more common(34.4%).Days of complaints before hospital admission was significantly longer in patients with focal involvement(median 31 days)compared to those without focal involvement(median 20 days)(P=0.004).Lower back pain and testicular pain were more common in focal cases,with elevated levels of leukocytes,neutrophils,monocytes,C-reactive protein,and erythrocyte sedimentation rate(ESR).Osteoarticular involvement was found in 61/90 cases(67.7%).Logistic regression identified male sex(OR 2.56;95%CI 1.29-5.04),subacute(OR 3.74;95%CI 1.36-10.32)or chronic presentation(OR 29.01;95%CI 2.96-284.20),and elevated ESR(OR 1.03;95%CI 1.01-1.05)as independent risk factors for focal involvement.The model explained 33.9%of the variance,with 74.3%accuracy.Conclusions:Male sex,subacute or chronic brucellosis,and elevated ESR are key risk factors for focal brucellosis.展开更多
文摘Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean delivery rate at the Kogi State Specialist Hospital, Lokoja, Nigeria over a one-year period. Methods: This was a prospective assessment of the demographic characteristics of patients, indications, types, rates and outcomes of Caesarean delivery in Kogi State Specialist Hospital, Lokoja, Nigeria from December 15, 2020 to December 14, 2021. Data collected were analyzed using SPSS version 20.0 statistical package (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). The categorical data were displayed using tables and charts. Results: There was a total of 491 deliveries, out of which were 113 Caesarean deliveries and 378 spontaneous vaginal deliveries making the Caesarean delivery rate in Kogi State Specialist Hospital, Lokoja, Nigeria 23.0%. There were no instrumental deliveries during the study period. The commonest indication for Caesarean section was obstructed labour in 31% of cases. There was no maternal mortality. There were three early neonatal deaths due to severe birth asphyxia. Conclusion: The rate of Caesarean delivery in this study was 23.0% and obstructed labour was the leading indication in 31% of cases. The rate of Caesarean delivery in this study is high, albeit the overall outcome was good for both mother and child. Caesarean delivery, therefore, remains one of the means for reducing maternal and perinatal morbidity and mortality in Nigeria.
文摘The historical dogma that bladder calculi comprise the main indication for prostatic surgery has recently been questioned.In this study,we aimed to predict which patients should undergo simultaneous prostate and bladder calculi surgery or only bladder calculi removal by evaluating preoperative risk factors.One hundred and seventeen men with bladder stones and concomitant benign prostate enlargement(BPE)who had not received medical treatment before were included in the study.In the first step,only the bladder calculi of patients were removed and medical treatment was given for BPE.The patients who benefited from medical treatment during the follow-up were defined as Group 1 and the patients who required prostate surgery for any indication comprised Group 2.Risk factors for prostate surgery requirements were determined by comparing preoperative characteristics between the two groups with a cox regression model.In the follow-up of 117 patients with bladder stones removed and medical treatment initiated,49(41.9%)patients had prostate surgery indications.The indication for 33(67.3%)of 49 patients was medical treatment failure.The presence of intravesical prostatic protrusion(IPP;hazard ratio:2.071,95%confidence interval[Cl]:1.05-4.05,P=0.034),and high postvoiding residual urine volume(hazard ratio:1.013,95%Cl:1.007-1.019,P<0.001)were found to be preoperative risk factors for needing future prostate surgery.In patients who have not received medical treatment for BPE before,bladder calculi developing secondary to BPE do not always constitute an indication for prostate surgery.
基金Supported by Recep Tayyip Erdogan University(Grant No.BAP2012.102.03.4.and BAP-2013.102.03.4)
文摘Objective:To investigate the antibiotic resistance genes inserted into class I and class 2integrons in Acinetobacler baumannii[A.baumannii)isolates obtained from nine different cities in Turkey.Methods:A collection of 281 A.baumannii clinical isolates were collected from nine diferenl state hospitals in Turkey and were confirmed as A.baumannU by conventional biochemical,API testing and bla_(-OXA-51)specific PCR.The isolates were examined by PCR for existence of class I and2 integron gene cassettes.Results:They were characterized by antimicrobial susceptibility testing and the highest resistance rates were determined for piperacillin(90.03%),ciprofloxacin(87.54%),cefepime and trimethoprim/sulfamethoxazole(81.13%).The lowest resistance rates was for cefotaxime(3.55%).class 1 integrons were detected in 6.4%(18/281)of A.baumannii strains and no class 2 integron was detected.The gene casselles of class 1 inlegrons AacCI-AAC(3)l-aadAI,AacCI-aadA1,AAC(3)-I,AAC(3)-I-AAC(3)-I-aadA1,TEM-1.AAC(3)-I-aadA1-AAC(3)-I-AAC(3)-I,AAC(3)-I-AAC(3)-I-AAC(3)-I-aadA1,AAC(3)-I-aadA1,AAC(3)-I-AAC(3)-I,AAC(3)-I-aadA1-AAC(3)-I-aadA1,AAC(3)-I-AAC(3)-I-aadA1-AAC(3)-I-aadA1 were detected in eighteen strains.The aac genes family were most frequently found integrated into the class 1 inlegrons and it was followed by aadA genes and TEM-1 genes.Conclusions:This is an extensive study on the distribulion of class 1 integron among A.baumannii in Turkey.In addition to these,two new alleles were observed.Their percentage rates of similarity to other cassettes are 95%aadA1(TK A18)and 89%,aadA 1(ANKA3).
文摘Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the outbreak. Methods:Visits were made to health facilities and affected communities.Cases were line-listed using specified forms and descriptive epidemiology carried out on collected data.Results:A total of 18 cases and 0 deaths were identified over a period of six weeks.Two of the cases(11%) were 【 9 months of age.The proportion of zero-dose children was 39%.Conclusion:Low herd immunity was suggested as the cause of the outbreak.
文摘The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.
文摘Objective:To describe the pattern of admission-defining ailments and outcomes of care among people living with human immunodeficiency virus(HIV) /acquired immune deficiency syndrome(AIDS)(PLWHA) who presented for treatment at a tertiary health care institution in Nigeria.Methods:We reviewed the hospital records of all patients admitted for AIDS and AIDS-related illnesses at the University College Hospital,Ibadan, Nigeria,from January 2005 to January 2006.Results:Seventy-two PLWHA were admitted during the study period.There were 39 females(54.2%) and 33(45.8%) males.Sixty-seven(95%) PLWHA presented with AIDS.Only 12(17%) were already receiving highly active antiretroviral therapy before admission.Forty -three patients(60%) commenced antiretroviral(ARV) therapy on admission.Thirty-three patients(46%) had pulmonary tuberculosis,10(14%) had extrapulmonary tuberculosis,21(29.1%) had diarrhoea-related illnesses,20(28%) had anaemia,and nine(12.5%) presented with coma.Twenty-nine patients(40.3%) were discharged home,and 43(59.7%) died before discharge.Sixty-nine patients(95.6%) were judged to be indigent,and required financial support.The contributory causes of death included pulmonary tuberculosis in 21(48.8%),diarrhoeal diseases in five(11.6%),anaemia in five(11.6%),coma in nine(20.9%), and pneumonia in three(7.1%).Conclusion:Tuberculosis was the major admission-defining ailment among PLWHA.
文摘Abstract： The pre and post analytical phase in a testing cycle contributes up to 93% of total laboratory errors. However, pre-analytical phase is primarily responsible for errors. Hence, it is of precise importance for the laboratory to study error occurrence rates during the testing cycle and implement a quality improvement plan to release an accurate result. The present study was conducted during the period Jan-Nov 2014 in the Central Clinical Lab in Osmaniye State Hospital, Turkey. During period of 11 months, 626897 samples were monitored for major preanalytical problems at the receiving counter of the Central Clinical Laboratory. Among all preanalytic laboratory errors, 35.4% of the errors were associated with clotted sample, 25.5% errors with inadequate sample, and 25.3% errors with hemolysed sample in the laboratory. Assessment considering the departments showed that emergency unit had the highest error rates （hemolysis： 52.5%, lipemic： 42.9%, damaged： 34.6%, clotted： 34.2%, inadequate： 26.8%, wrong material： 17.6%, wrong barcode： 16.7%）. There was significant difference among the departments in terms of preanalytic errors （p 〈 0.001）. Based on these observations, major preanalytic errors are of great concern and needs corrective approach via proper educational programs to related personals. If this area is ignored, that can lead to negative patient outcome. However, a better specimen quality and patient satisfaction are achieved with the high quality personal-based education regarding pre-analytical errors.
文摘BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine and well organized emergency departments(EDs) are an essential component of any developed health care system,emergency medicine as a specialty is relatively non-existent in Macedonia.DATA RESOURCES:A system assessment regarding presence,availability and capacity of EDs was completed from 2013-2015,based upon assessments of 21 institutions providing emergency care and information provided by the Ministry of Health.This assessment establishes a benchmark from which to strategically identify,plan and implement the future of emergency medicine in Macedonia.RESULTS:In general,emergency departments- defined by offering acute care 24 hours per day,7 days per week- were available at all general and university hospitals.However,care resources,emergency and acute care training,and patient care capacity vary greatly within the country.There is limited uniformity in acute care approach and methodology.Hospital EDs are not organized as separate divisions run by a head medical doctor,nor are they staffed by specialists trained in emergency medicine.The diagnostic and treatment capacities are insufficient or outdated by current international emergency medicine standards and frequently require patient transfer or admission prior to initiation.CONCLUSION:Most of the surveyed hospitals are capable of providing essential diagnostic tests,but very few are able to do so at the point or time of presentation.While emergency medical services(EMS) have improved system-wide,emergent care interventions by EMS and within all hospitals remain limited.Further system-wide acute and emergency care improvements are forthcoming.
文摘Despite the very high burden of malaria among children in Borno state, the proportion of those who receive standard treatment has been very low. This study aimed to determine malaria knowledge, attitude towards prevention, and health care seeking behaviours of parents or caregivers of children presenting with fever at the paediatric clinic of a secondary-level hospital in Maiduguri, Borno state, Nigeria. A cross-sectional study design was used to obtain information from the respondents. Data were collected using a structured questionnaire, from the parents or caregivers of children presented to the Paediatric clinic with history of fever, and analysed in SPSS. A total of 331 respondents were finally recruited into the study. The ages of the children ranged from one to fourteen years. Some of them (15.3%) were internally displaced persons (IDPs). As many as 90.7% and 91.9% of the respondents believed that malaria is a life-threatening illness, and ITNs could prevent malaria, respectively. Less than a half of them (42.3%) had immediately brought their children to the hospital once they detected the fever. At the hospital, only 202 (60.7%) of the children had had malaria parasite test done on them, of which 89.1% tested positive. Permanent residents were more likely to promptly take their children to the hospital, one they detected fever, compared to IDPs ( 2=12.401, df =1, p=0.002). There is the need for promoting early presentation of febrile children to health centres, and also promoting routine malaria tests for febrile persons.
文摘Background: Intimate partner violence is a serious public health concern worldwide and is linked with serious mental and physical health consequences. Despite its commonality and attendant consequences, proper public healthcare intervention is rudimentary. The aim of this study was to assess the relationship between quality of life associated with intimate partner violence among females attending the HIV Clinic at Jos University Teaching Hospital, Jos, Plateau, Nigeria. Methods: This study employed a cross-sectional design and data was collected from 174 female patients attending the HIV Clinic who met the inclusion criteria with the aid of a 73-item semi-structured interviewer-administered questionnaire. This captured socio-demographic characteristics, knowledge and attitude towards intimate partner violence and their experiences of violence and quality of life using the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF). Results: Almost half of the respondents, 85 (48.9%) rated their quality of life as good. Respondents experiencing IPV reported poorer quality of life compared to those not experiencing partner violence in all the domains and it was statistically significant in the physical health (p Conclusion: IPV is common among females attending the HIV/AIDS Clinic and those affected reported significantly poorer quality of life.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
文摘<strong>Background</strong> Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awareness, knowledge, attitude, perception, and practice of Covid-19 prevention among healthcare workers in Rivers State, Nigeria. <strong>Methods</strong> This was a descriptive cross-sectional survey carried out six weeks into Rivers State response that commenced on February 20, 2020, in the 23 Local Government Areas (LGAs). State Disease Surveillance and Notification Officers used multistage sampling to recruit 555 healthcare workers for the survey. A self-designed structured interviewer-administered questionnaire built into the Open Data Kit application for android phones was used for data collection. Descriptive data analysis was done, and outputs presented as frequency and percentages. <strong>Results</strong> There was a total of 372 (67.0%) female respondents. Majority of study participants had tertiary education 453 (81.6%). The mean age of study participants was 40.6 years (Standard Deviation = 7.8 years). Furthermore, 285 (51.4%) were Community Health Workers, and had over ten years practicing experience 393 (70.8%). Most healthcare workers 554 (99.8%) had heard about Covid-19, through radio 539 (97.1%), and television 445 (80.2%) yet 213 (38.4%) respondents did not know that it is caused by a virus. Most respondents 415 (74.8%) had good knowledge about Covid-19. However, only 148 (26.7%) would refer suspected cases to a facility and only 365 (65.8%) respondents demonstrated the correct hand washing technique. <strong>Conclusion</strong> There are some gaps in health worker knowledge, attitude, perception, and practice of Covid-19 prevention. Interventions to bridge these gaps are needed for effective containment of this pandemic.
文摘Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For the patient diagnosed with cancer and for his family, pain is the most feared aspect of cancer following the likelihood of failure to treat and death. Quality of life is severely impaired together with complaint of pain which arises high rates as 80% in advanced stage cancers.
文摘Background: Many children in Nigeria suffer from detrimental, debilitating and lifelong neurologic disorders, many of which are highly preventable using simple, cost-effective interventions. Objective: To examine the pattern of neurological disorders among children presenting at the neurology unit of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Amaku, Awka, Nigeria. Methods: A retrospective review of the hospital records of children who presented at the Paediatric Neurology Unit between 1st March 2020 and 31st March 2022 was carried out. Data were abstracted using a proforma and analyzed using SPSS Version 21. Results: A total of 138 children aged 0 to 15 years were seen in the unit during the period under review. 115 (83.35%) of these children were diagnosed with chronic neurological disorders. Those with chronic neurological disorders had a male:female ratio of 1.9:1, and the majority (65%) of them were below 5 years of age. The most common presenting complaints were delayed milestones (43.4%), seizures (23.8%), and speech disorders (17.2%). The most typical diagnosis was cerebral palsy (CP) (34.7%), seizure disorder (29.8%) and attention deficit hyperactivity disorder (8.9%). Perinatal asphyxia (47.7%), neonatal jaundice (17.0%) and central nervous system infections (CNS) infections (12.5%) were identified as the major risk factors responsible for these neurologic disorders. Conclusion: Cerebral palsy and seizure disorders constitute the major neurological disorders among children seen in our institution. Efforts should be intensified at reducing the incidence and impact of perinatal asphyxia, neonatal jaundice and CNS infections, identified as the major culprits, to curb the menace of these debilitating lifelong neurologic sequelae.
基金supported by Recep Tayyip Erdogan University Research Fund Grants BAP-2013.102.03.12 and BAP-2013.102.03.13.
文摘Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integrons and antibiotic susceptibility of clinical isolates of P. aeruginosa. Two hundred and five P. aeruginosa strains were collected from the seven general state hospitals in Turkey. They were characterized by antimicrobial susceptibility testing, screened for class 1 and class 2 integrons, and evaluated for the association between antibiotic resistance phenotypes and the presence of integrons. intI gene was amplified in 10 isolates (4.87%) by PCR and in seven isolates of them (70%) were found different gene cassettes. The aadA gene integrated into the class 1 integrons was most frequently found and it was followed by aac genes and blaOXA family genes. Sequence analysis of variable regions of the class 1 integrons showed five gene cassette arrays;aadA1(99%), aac(3)-Id(82%)-orf-aac(3”)-Ia(99%), aac(3)-Ie(83%)-blaoxa10(100%)- aadA1 (100%), aadA6(99%, 100%), aac(6’)-I(97%)-orf-aadA2(99%). No class 2 integron was detected. This study is the first multicenter study for class 1 integrons and it indicates the low rate of presence of class 1 gene cassette in P. aeruginosa.
文摘We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.
文摘Objective:To identify predictive factors for brucellosis by analyzing cases with and without focal involvement.Methods:This single-center retrospective study included adults(≥18 years)diagnosed with brucellosis at AğrıTraining and Research Hospital between January 1,2022 and December 31,2024.Patients were evaluated for organ involvement based on localized symptoms and classified accordingly.Logistic regression analysis was performed to identify demographic,clinical,and laboratory predictors of organ involvement.Results:A total of 210 cases were analyzed including 115 females(54.8%)and 95 males(45.2%).Among patients with focal involvement,the proportion of males was higher(54.4%),and comorbidities were also more common(34.4%).Days of complaints before hospital admission was significantly longer in patients with focal involvement(median 31 days)compared to those without focal involvement(median 20 days)(P=0.004).Lower back pain and testicular pain were more common in focal cases,with elevated levels of leukocytes,neutrophils,monocytes,C-reactive protein,and erythrocyte sedimentation rate(ESR).Osteoarticular involvement was found in 61/90 cases(67.7%).Logistic regression identified male sex(OR 2.56;95%CI 1.29-5.04),subacute(OR 3.74;95%CI 1.36-10.32)or chronic presentation(OR 29.01;95%CI 2.96-284.20),and elevated ESR(OR 1.03;95%CI 1.01-1.05)as independent risk factors for focal involvement.The model explained 33.9%of the variance,with 74.3%accuracy.Conclusions:Male sex,subacute or chronic brucellosis,and elevated ESR are key risk factors for focal brucellosis.
