Olabisi Onabanjo University Teaching Hospital (OOUTH) (formerly called, Ogun State University Teaching Hospital (OSUTH) is situated at Sagamu, Ogun State, South West Nigeria. The teaching hospital was established in the year 1986 with primary aim of teaching medical students from Olabisi Onabanjo University and provision of healthcare service to the indigene of Ogun state and Nigeria as a whole.
BACKGROUND:Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for the treatment of type 2 diabetes mellitus and obesity. Although gastrointestinal adverse effects are common, gastroparesis is an under-recognised but clinically important complication. This systematic review summarises published evidence on the presentation, diagnosis, management, and outcomes of gastroparesis associated with GLP-1RA therapy in real-world clinical practice. METHODS:A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase, Scopus, and Web of Science were searched from inception to October 2025 for reports of symptomatic gastroparesis associated with GLP-1RA use. Eligible studies included case reports, case series, observational studies, and clinical trials involving adults treated with GLP-1RAs for diabetes or weight loss. Data extraction focused on patient characteristics, GLP-1RA exposure, clinical presentation, diagnostic findings, management strategies, and outcomes. Methodological quality was assessed using the Joanna Briggs Institute checklist for case reports. RESULTS:Twelve case reports describing 13 patients met inclusion criteria. Most patients were female and had type 2 diabetes mellitus, though cases also occurred in non-diabetic individuals. Semaglutide was the most frequently implicated agent, followed by liraglutide, dulaglutide, and exenatide. Symptom onset ranged from hours to several months after treatment initiation, commonly following dose escalation or inappropriate re-initiation. Presentations varied from acute to chronic. Reported symptoms included nausea, vomiting, abdominal pain, bloating, early satiety, and oral intolerance. Diagnostic evaluation often demonstrated gastric distension or retained gastric contents on imaging or endoscopy in the absence of mechanical obstruction. Gastric emptying scintigraphy confirms delayed emptying in selected cases. Management primarily involved supportive and symptomatic care. Discontinuation of the offending GLP-1RA led to symptom resolution in all reported patients. CONCLUSION:GLP-1 receptor agonists may induce or worsen gastroparesis in both diabetic and non-diabetic patients, particularly following rapid dose escalation or inappropriate dosing. Awareness of this association is essential for timely diagnosis and management. Withdrawal of the causative agent is central to treatment and is associated with favourable outcomes and reversibility of gastric dysfunction. Careful patient selection, gradual dose titration, and monitoring for persistent gastrointestinal symptoms are recommended to optimise the safe use of GLP-1RAs.
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is characterized by the congenital absence or hypoplasia of the uterus and the upper two-thirds of the vagina in 46, XX females, who exhibit normal secondary sexual characteristics. Type II MRKH syndrome includes associated anomalies, most commonly renal malformations. We report a 21-year-old student with primary amenorrhea and a blind vaginal pouch. Imaging and diagnostic laparoscopy confirmed the presence of a rudimentary uterus, a blind vaginal pouch, and a right pelvic kidney. The karyotype was 46, XX, and the hormonal profile was normal. Comprehensive management included reproductive counseling, options for vaginal reconstruction, and psychological support. We discussed the differential diagnosis, highlighted the psychosocial burden of MRKH syndrome and the need for multidisciplinary care. Increased clinician awareness and integrated services are essential for early detection and holistic management.
ABSTRACT Background: Cirrhosis is characterized by complications, including hepatic encephalopathy (HE), hepatorenal syndrome (HRS), and acute variceal bleeding, Glucagon-like peptide-1 (GLP-1) analogs, have shown potential benefits in reducing liver inflammation and lowering cirrhosis-related complications. This study aims to provide insights into the effect of GLP-1 therapy on mortality and clinical outcomes in patients with cirrhosis. Methods: We conducted a retrospective analysis using TriNetX research network. The cohort comprised patients ≥18 years old with a diagnosis of cirrhosis. Patients who were started on GLP-1 analogs after the diagnosis of cirrhosis were identified. Primary outcomes included all-cause mortality, HE, HRS, and portal hypertensive bleeding. Variables such as age, sex, race, comorbidities (e.g., diabetes, obesity, chronic kidney disease, hypertension), and lifestyle factors underwent 1:1 propensity matching to reduce confounding. Cox proportional hazards regression analysis was utilized to analyze the matched cohorts, and hazard ratios (HR) with 95% confidence intervals. Results: GLP-1 analog use was significantly associated with a reduced risk of several cirrhosis-related complications. Patients treated with GLP-1 analogs exhibited a significantly lower risk of all-cause mortality (HR 0.374, 95%CI 0.359-0.392), HE (HR 0.900, 95%CI 0.843-0.959), and HRS (HR 0.554, 95%CI 0.496-0.619). Additionally, there was reduced rates of portal hypertensive bleeding among GLP-1 users (HR 0.487, 95%CI 0.444-0.533). Conclusion: This study demonstrates that GLP-1 analog use is associated with a significantly lower risk of all-cause mortality and cirrhosis-related complications. Furthermore, the reduced rate of portal hypertensive bleeding might correlate with subsequent decrease in hospitalizations.
Background:Antimicrobial resistance (AMR) is a major global public health threat, disproportionately affecting low- and middle-income countries such as Nigeria. Clinical healthcare students represent a critical target for antimicrobial stewardship (AMS), as prescribing behaviours developed during training often persist into practice. However, evidence on AMR and AMS knowledge across multiple health disciplines in Nigerian clinical training settings is limited. This study aimed at assessing AMR and AMS knowledge among clinical students and identify factors associated with poor knowledge. Methodology:A descriptive cross-sectional study was conducted among 422 clinical students in Medicine, Pharmacy, and Nursing at a Nigerian College of Health Sciences. Data were collected using a structured questionnaire adapted from the WHO AMR awareness tool. Knowledge was assessed using a 13-item score and categorized as good (≥70%), fair (50-69%), or poor (<50%). Associations were tested using chi-square, while independent predictors were identified using multivariate logistic regression. Results:Most participants were aged 21-25 years (68.0%) and female (62.1%). Although 96.9% recognised AMR as a global health problem and 92.4% correctly identified the purpose of stewardship, important gaps were identified. Only 47.2% correctly defined AMR, 36.0% recognized poor infection prevention and control as a driver, and misconceptions persisted regarding antibiotic use in viral infections (40.8%) and uncomplicated malaria (41.7%). Overall, 5.0% had good knowledge, 73.0% fair, and 22.0% poor. On bivariate analysis, level of study (χ2=15.358, p<0.001), department (χ2=7.981, p=0.018), and awareness of Nigeria's National AMR Action Plan (χ2=6.496, p=0.011) were significantly associated with knowledge. Higher level of study (AOR=0.438; p=0.001) and awareness of the national AMR action plan (AOR=0.497; p=0.012) were independently associated with better knowledge. Conclusion:Despite high awareness of the AMR threat, significant knowledge gaps and misconceptions persist among clinical students. Strengthening AMR education through integrated curricula, active learning approaches, and improved dissemination of national policies is essential.
