Background: Mentorship or mentoring is 'the process whereby an experienced, highly regarded, empathic person (the mentor), guides another individual (the mentee) in the development and reexamination of their own ideas, learning and personal and professional development.Aim: This study aims at ascertaining Resident doctors' experiences of mentorship in their respective institutions and what they recommend as ways of bridging the gap between them (the mentees), and their trainers (mentors).Methods: The study was a cross-sectional descriptive study using a 19-item self-administered questionnaire. The study population consisted of all Resident Doctors attending the mandatory update courses of the Postgraduate Colleges. Statistical analysis was performed using SPSS version 20.Results: Four hundred and thirty-seven doctors fully completed the questionnaires. There were 262 and 175 males and females respectively, giving a male to female ratio of 1.5 to 1. One hundred and eleven (25.4%) respondents claimed that their institutions had a structured mentorship program.Conclusion: Although the understanding of the concept of mentorship is widespread among resident doctors, there is a dearth of mentoring experiences among resident doctors in Nigeria due to the lack of formal mentoring schemes. The integration of formal mentoring programmes into the postgraduate medical curriculum may increase its prevalence. Keywords: mentorship, resident doctors, postgraduate, mentor, mentee
Background: Lack of quality control (QC) programmes on X-ray machines contributes to image quality deterioration, film wastage and to increase in irradiation for patients and radiographers.Aim: To assess the status of quality control/quality assurance and to determine the accuracy of light beam diaphragm (LBD) in X-ray facilities in Lagos state.Methods: A mixed methods study design was used to determine QC tests being carried out on X-ray machines while LBD accuracy test was carried on Xray machines.Results: In 50% of facilities studied, X-ray machines were ≥ 10 years old, 30 years old after 1st installation. Although radiographers said that QC tests were performed in 70% of the centers, it was only in 40% of the centers that they reported the existence of a QA committee. Misalignment of LBD was >2.0% in most X-ray centers while lack of coincidence between the light and X-ray field increased significantly (p = 0.005) as the age of the Xray machine increased.Conclusion: The status of QC/QA in X-ray facilities in Lagos state during the period studied was characterized by lack of understanding of the context, content and modus operandi of quality assurance in diagnostic radiography among many experienced radiographers. In particular, LBD was inaccurate in most X-ray facilities in Lagos state in the period studied. We found evidence in the present study to suggest that the practice of arbitrarily increasing the light field size by radiographers when there is LBD misalignment in order to offset the effect of anticipated mechanical cut-off appears to be counterproductive. Keywords: Ionizing radiation, Light beam diaphragm accuracy; Quality control, Misalignment test
Background: Low back pain (LBP) is pain and discomfort felt below the intercostals margin and above the inferior glutei folds with or without referred leg pain. Nurses in developing countries have a higher incidence of work-related back pain due to lack of equipment and planes of work. This study was aimed at assessing perception, attitude and selfmanagement for LBP among nurses in Lagos.Methods: This cross-sectional quantitative study utilized a multistage sampling method and selfstructured questionnaire with four sections, Socio- Demographic, Perception, Attitude and Self-care Management of LBP. Collected data were analyzed using SPSS computer software version 20. Descriptive data were presented in tables and charts, inferential statistic were tested with chi-square at a significant level of p ≤ 0.05.Results: The study found that the mean age of participants was 38.13±8.19, (90%) of the participants were female, mean of years of practice in the current institution was 10.98±9.33, years of experience in nursing profession was 14.07±10.21 and participants experienced LBP with prevalence of 66.2%. Majority 86.3% and 75% have positive perception and attitude toward LBP respectively. The self-management discovered to be adopted by participants include medication 60%, while 75% indicated bed rest. The participants identified the different components of a preventive exercise programme but only 25% mentioned ergonomic principles while 62.5% indicated general fitness exercises. There was a significant association between perception of low back pain and attitude, among nurses in Lagos with p = 0.02.Conclusion: The prevalence of LBP among clinical nurses in the study was high, also they have positive perception and attitude towards LBP. The study highlighted some self-management measures used by the nurses in order to address LBP in Lagos Key Words: Low Back Pain, Nurses, Perception, Attitude, Self-Care Management
Background – Clubfoot can be assessed using Pirani scoring system.Ponseti protocol was used in the management of all the patients. The aims of the study were to evaluate outcome of management of idiopathic clubfoot, to correlate outcome with the initial Pirani score and the value of Pirani score in predicting outcome.Methods- Forty-one children (64 clubfeet) with idiopathic clubfoot were recruited into the study. The children were two years old and less. They were initially assessed using Pirani scoring system and subsequently managed with serial manipulation and cast application weekly with or without tendoachilles tenotomy according to Ponseti protocol. And then followed up for 3 months.Results- Tenotomy was done in 51.56% of feet. There was a statistically significant difference between the midfoot contracture score, hindfoot contracture score and initial scores in the tenotomy and 'non-tenotomy' groups. The initial Pirani score has a strong positive correlation to the number of casts required. The group that required tenotomy required more cast and as such longer duration of treatment than the 'no tenotomy' group. There was a relapse rate of 2% in the feet of the compliant group while the relapse rate was 69% in the group that were not compliant with use of foot abduction brace. The hindfoot score is a better predictor than both the initial total score and midfoot scores for relapse.Conclusion- The Pirani scoring system is reliable, quick, and easy to use. The initial Pirani score correlates with duration of treatment. Hindfoot score is a better predictor of tenotomy than midfoot contracture score.
Background of the study: Populations around the world are rapidly ageing with emphasis placed on long term care necessary for the dependent fastgrowing members of the population with geriatric conditions.Objectives: To assess the perception of elderly about old people's homes and determine the factors influencing its utilization in selected centres in Lagos. Materials and Methods: This was a descriptive, quantitative cross-sectional study. Self-administered questionnaires were distributed to all the 52 elderly in the two selected homes for the elderly in Lagos. Data was analysed with SPSS version 20 and presented as tables using descriptive and inferential statistics.Results: They were mainly females (65.4%) with widowed (65.1%). The mean age was 73 years ± 11.86. Majority of respondents (92.3%) have a positive perception about old people's home. Above half (55.8%) got information about the homes from their children and a good number (34.6%) have spent more than 5 years in the home. Culture, children perspectives and children occupation were the major factors agreed by the elderly influencing their utilization of the old people's homes. There were no statistically significant association between Sociodemographic variables (age, gender, ethnicity) of the respondents and the utilization of the home with 'p' = 0.501.Conclusion and recommendation: Even though the elderly had positive perception about the utilization of the old people's home but their children perspectives had altered their participation in the homes which outrightly affected their health status. The nurses should therefore ensure optimal health of the elderly to improve their participation in the home. Keywords: Utilization, Perception, Old People's Homes, Elderly.
Background: The prevalence of male infertility is currently on the increase and, to an extent, has drawn significant attention globally. The decline is most evident in reduced sperm quality and quantity which has been linked, among other things, to lifestyle such as poor night sleeping patterns This study was, therefore, designed to evaluate the effect of D-ribose- L-cysteine (RibCys) and Zinc (Zn) on testicular steroidogenesis and sperm quality in paradoxical sleep-deprived (PSD) rats.Material and Method: Twenty five (25) adult male rats were randomly assigned to 5 groups of 5 rats each. The PSD group was subjected to sleep deprivation only; while PSD+RibCys, PSD+Zn, and PSD+RibCys+Zn groups received 100 mg of RibCys, 10 mg of Zinc and combination of RibCys plus Zn (normalized for Kg body weight of rat) respectively in addition to subjection to PSD. The last group served as the Control. PSD lasted for 20 hours per day for 14 days, using the modified multiple platform method. After 14 days, the levels of follicle-stimulating hormone (FSH), testicular testosterone (TT), and sperm quality and quantity were evaluated and compared within the five groups.Results: Analyses of our data reveal that PSD significantly disrupts reproductive hormonal balance and impairs the quantity and quality of sperm production. However, there were no significant differences observed in the levels of FSH and TT in the PSD groups treated with RibCys and/or Zn compared with the control group. A significant reduction was observed in the progressive sperm motility of all the groups compared with the control. Compared with the control group, there was no significant difference in the sperm concentration between the control and PSD+RibCys+Zn group.Conclusion: This study provides evidence that indicates that treatment with RibCys and/or Zinc is effective in ameliorating the damaging capacity of sleep deprivation on testicular biology. Keywords: Paradoxical sleep deprivation (PSD), Steroidogenesis, Sperm, Zinc, D-ribose-L-cysteine.
Background: Accidental foreign body ingestion is a common cause for emergency treatment. Dentures can be accidentally ingested.Objective: This study investigated accidental denture ingestion, and management outcome.Materials and Methods: A prospective study involving patients at 2 teaching hospitals in south-west Nigeria, who presented in the emergency room within a period of two years (2016-2018) with a previous history of wearing dentures were included. Information collected included patients' demography, presenting complaints, investigations done, type of dentures/prostheses, surgical procedure performed and outcome.Results: A total of 20 cases were seen during the period of the study. The age range was from 28-75 years. More males 16 (80.0%) presented than females 4(20.0%). Patients presented with pain on swallowing 9(45.0%), while 11(55.0%) gave a positive history of ingesting dentures. Dentures ingestion occurred more frequently while taking medications 12(60.0%). Most patients (80.0%) presented with denture impaction in the upper oesophagus, while 3 (15.0%) were lodged in the hypopharynx. All dentures ingested were more often upper dentures 13(65.0%) and made of acrylic with no metallic attachment. Most dentures were used for more than five years (76.5%). Radiographs showed widened prevertebral shadow in 13(65.0%) patients, air trapping and widening of hypopharynx in 3(15.0%). Seventeen of the 20 ingested dentures were successfully removed without complication. Complications included oesophageal perforation with secondary mediastinitis, and oesophageal mucosal tear without perforation.Conclusion: Denture use after more than 5years, with or without signs of lack of retention have a higher tendency to be ingested accidentally, leading to impaction in the upper oesophagus. The impacted denture can be successfully removed through oesophagoscopy. Key words: Dentures, Accidental Ingestion, Impaction.
Background: The burden of diabetes mellitus (DM), as well as that of chronic kidney disease (CKD) is increasing globally. Currently, diabetes mellitus is the leading cause of CKD worldwide, and Africa including Nigeria is not spared from this scourge.Objective: This study was conducted to determine the proportion of type 2 DM patients with CKD and the associated risk factors for developing CKD.Methods: This was a cross – sectional study consisting of 105 type 2 DM patients recruited in the endocrinology clinic of the University of Calabar Teaching Hospital from April to July, 2019. Clinical and anthropometric data were collected. Relevant investigations were performed, including serum creatinine and other relevant blood investigations. CKD was defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2. Data was analysed using SPSS version 18.0Results: The mean age of the study participants was 60.63±10.16 years. The overall prevalence of CKD was 34.3%. However, of the 36 patients with CKD, 63.9% and 36.1% were in patients with DM alone and concurrent DM with hypertension respectively. Older age, presence of obesity and longer duration of DM predicted CKD in DM patients.Conclusion: The prevalence of CKD in patients with type 2 diabetes mellitus is high and comparable to previous studies from Africa. Older age, presence of obesity and longer duration of DM were significantly associated with CKD. Keywords: Chronic kidney disease, cross-sectional study, predictors, Type 2 diabetes mellitus
Background and aim: Ricinus communis plant, a perennial shrub which grows throughout the tropics, has a wide range of uses. The seed is used in traditional and complementary medicine as a laxative agent and to prevent conception. To date, there is limited available information as regards its toxicological profile in different systems. Therefore, the potential toxic effects and antioxidant activities of the seed extract in-vitro and in-vivo are evaluated.Experimental procedure: Toxicity studies was carried out using Brine shrimp lethality test and Organisation for Economic Cooperation and Development guidelines 423 respectively. Antioxidant activities were determined in vitro by Diphenyl picrylhydrazine (DPPH) and nitric oxide radical scavenging assays. Levels of various antioxidant enzymes in liver and kidney organs were estimated following standard procedures.Results and Conclusion: Phenols constituted a greater percentage of phytochemicals present (52.30mg/100g ) whereas alkaloids and anthraquinones were absent. The LC50 and LD50 values were determined to be 0.40μg/ml and 2000mg/kg respectively. There were no alterations to hematological and biochemical parameters in female rats while ALP and hemoglobin levels were significantly increased in male rats. Ricinus communis seed ethanolic extract (RCSE) exhibited good in vivo antioxidant capacity as it increased renal catalase levels significantly. Furthermore, histological assessment did not reveal damage to vital internal organs of the heart, brain, lungs, liver and kidney. Hence, RCSE is a good source of antioxidants and is safe for consumption at doses up to 2000mg/kg. Keywords: Catalase; Lipid-Peroxidation; R. communis; Rats; Acute-toxicity
Background: Pneumonia, a life-threatening lung disease of mankind and a major contributor to childhood morbidity and mortality in developing countries including Nigeria, is responsible for a quarter of all deaths in children under the age of five. Its more damaging effects in children is attributed to the status of their less matured lungs. The response to early diagnosis and appropriate treatment, has been a great consolation in the management of childhood pneumonia. Its diagnosis is usually based on clinical symptoms, signs and findings on chest radiographs. Advocacy on careful and judicious use of Conventional Radiography, an imaging modality that requires hazardous ionizing radiation for image acquisition, has been on the increase, propounding its avoidance in the growing child. This, coupled with the fact that a clear chest radiograph in pneumonia does not imply the absence of pneumonia, has necessitated the search for a more sensitive and less hazardous diagnostic imaging modality for diagnosis of pneumonia in children. Ultrasonography, a relatively new imaging modality which utilizes ultrasound for image acquisition and which when used in prescribed specifications for imaging has till date, recorded no deleterious effects, is safe for diagnostic and follow-up purposes, requirements in management of pneumonia, in this age group. Other advantages of ultrasonography are its affordability, availability, accessibility with images produced displaying features close to cut-sections', the equipment availability in variable sizes, some, small enough for use at the bedsides of very sick children, obviating the need to wheel them on their cots or beds, along hospital corridors towards Radiology Departments. The major limitation being that it is reliable only in well trained hands, which is not an absolute limitation as the Authors are willing to build capacity in the use of this invaluable imaging modality. Though Ultrasonography has been in clinical use since the early 1950s, it was not considered appropriate for use in imaging the lungs until recently, the challenge being lung's air-filled nature, air being a very poor sound conductor. This same limitation however is being leveraged upon for sonographic evaluation of lung diseases, since pneumonic changes involve replacement of air in the lung alveoli with inflammatory collections, thus distinguishing normal from abnormal lung appearances in ultrasonography. This novel and safe diagnostic imaging modality for assured use will need its reliability in diagnosis and follow-up of childhood pneumonia tested, hence the aim of this research, hoping the findings will add significantly to the knowledge of effective and efficient management of pneumonia in these frail children.Aim and Objective: To determine the usefulness of lung ultrasonography (LUS) in diagnosing pneumonia in paediatric patients.Methodology: This study was carried out on 150 children with clinical symptoms suggestive of pneumonia (such as fever, cough and respiratory distress), admitted via the Children's Emergency Unit of a tertiary hospital and from whose parents or guardians written Informed Consents had been obtained and codes given, to ensure confidentiality. Following clinical evaluation, diagnostic evaluations were independently carried out on lung ultrasound and chest radiography by the Researcher and Radiology Units on duty, findings from each imaging modality, blinded to each other.Results: Of the 150 research participants whose chests were evaluated, chest radiography was able to detect pneumonia in 138 patients while lung ultrasonography detected pneumonia in 144 patients, the sensitivity and specificity of lung ultrasound findings being 91.67% and 33.33% respectively; the positive predictive value and negative predictive value are 97.06% and 14.29% respectively. The overall probability that a patient with pneumonia is correctly diagnosed by lung ultrasound is 89.33%.Conclusion: Both imaging modalities (Chestradiography and Lung ultrasonography) and negative predictability, but higher diagnostic accuracy for the detection of pneumonia in children was observed with lung ultrasonography compared to chest radiography. Its safety, portability and bedside imaging possibility, makes LUS a robust diagnostic imaging modality in childhood pneumonia. Keywords: Childhood pneumonia, lung ultrasound, chest radiography
There are limited reports on presentation patterns and treatment options for carious molars in Nigerian children. Such reports are beneficial towards development of protocol on best clinical practices, development and implementation of oral health awareness program for children and caregivers.Objectives: Assessment of pattern of presentations and treatments of primary and permanent first molars at a Paediatric dental clinic of the Lagos University Teaching Hospital.Methodology: A retrospective study utilizing a pretested questionnaire to collate information from case notes of eligible children aged 5 to 15 years. The questionnaire was in 3 parts: Part A on bio-data and socio-economic demographics. Part B on presentation and diagnosis. Part C on treatment plan and restorative options for carious molars. Data was analysed using Statistical Package for Social Science (SPSS version 20) and significance was set at p <0.05Results: A total of 90 case notes were assessed, 47 (52.2%) males and 43 (47.8%) females. (M:F ratio = 1.09:1). Mean age was 8.18 years (±1.98). The modal age was 8 years and the commonest age group seen was 7 – 9 years (57.8%). Information on 195 carious molars was retrieved. Pain was the commonest presenting complaint, 62.2%. Periapical radiographs were the diagnostic tools in all the cases. Periapical pathology was observed in 14.1% of cases. Pulp Therapy was carried extraction in 23%. Glass Ionomer Cement was the most frequently used restoration in carious molars, 45(57.7%). Space Maintainers and amalgam restorations were done in 10(12.8%) cases respectively.Conclusion: Glass Ionomer Cement was the most frequently used restoration in the study, with a minimal number of amalgam restorations. Most patients presented to the clinic only when they had pain. Majority of those that sought dental care for their wards were University graduates. Keywords: Children, Carious molars, Restorative options
Angiomyolipoma (AML) of the liver is a rare benign, mesenchymal neoplasm that is composed of an admixture of blood vessels, smooth muscles, and variable adipose tissue. Hepatic AML poses a differential diagnostic challenge with other liver tumours. Awareness of the diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis. Hepatic AML has an extremely low risk of malignant transformation. Hepatic AML is usually under recognized by clinicians and is seldom included in differential diagnosis of focal liver lesions. This disease is rare in neonates. We report a rare case of congenital hepatic AML in a term male Nigerian neonate who until histology report was being managed for probable hepatoblastoma. To the best of our knowledge, this is the first report of hepatic angiomyolipoma in a neonate in Africa. This report is to create awareness for congenital hepatic AML and tendency for its misdiagnosis in neonates. Keywords: Congenital; Hepatic angiomyolipoma; Neonate Key Messages: Occurrence of hepatic angiomy olipoma is rare in the neonatal period and the diagnosis poses a challenge with other liver tumours. Histology is essential to confirming the diagnosis and providing appropriate treatment.
Background: Indiscriminate use of substance abuse is gradually becoming a major problem in Nigeria. There are concerns that this may impact some deleterious effects on their overall wellbeing. This study thus aim to evaluate haematological and haemostatic changes in adults on drug abuse in Lagos Nigeria. Methods: A total of 250 participants comprising 150 users of substance abuse and 100 apparently healthy non-users of substance abuse participated in this study. The latter served as control group for this study. Whole blood was taken into EDTA and was used for full blood count and platelet count determination using Beckman coulter-5 part auto analyzer, erythrocytes sedimentation rate using Westergren method. Sodium citrate sample was evaluated for coagulation parameters. Results: The mean red blood cell (RBC), haematocrit, and white blood cell values were higher (p <0.001) among substance abuse users when compare with the control. On the other hand, mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC) values were lower (p <0.001) among substance abuse users as compared with the control while mean cell volume (MCV) was significantly higher (p <0.001) among substance abuse user. The mean erythrocyte sedimentation rate (ESR) among substance abuse users was significantly higher (p <0.001) than the control group. Protein C, D-Dimer, prothrombin time (PT) and activated partial thromboplastin test (APTT) were higher (p <0.001) among substance abuse users whereas fibrinogen was lower (p<0.001). Conclusion: Substance abuse seems to impact deleterious effects on haematological and haemostatic parameters among Nigeria population on substance abuse. Keywords:: Substance abuse, haematological parameters, haemostatic parameters, D-dimer, Protein C, Red cell indices.
Background: Evaluation of a palpable breast mass requires a systematic approach to the history, physical examination, and radiographic imaging studies to ensure a correct diagnosis. Palpable breast masses are common and usually benign, but efficient evaluation and prompt diagnosis are necessary to rule out malignancy. A thorough clinical breast examination, imaging, and tissue sampling are needed for a definitive diagnosis.Aim: To study the distribution and pattern of breast masses in secondary health facility in Lagos.Method: This study was carried out in two hospitals in Lagos over a period of 5 years January 2010 to December2014. The hospitals are General Hospital, Ikorudu and General Hospital, Orile-Agege. All patients with palpable breast masses were evaluated with history, physical examination, ultrasonography, mammography, Fine Needle Aspiration cytology (FNAC) and/or trucut biopsy in cases that required such investigation. Excisional Biopsy was done for benign masses and histology was obtained in all cases.Results: In this study 193 patients were seen with different types of breast masses. Histological diagnosis was obtained for all cases. The age range was 10years to 70years. Fibroadenoma was the most common diagnoses accounting for 126 (65.28%) of all cases, breast cancers accounted for 49 (25.38), cystosarcomaphyloides and fibrocystic diseases accounted for 5 patients (2.6%) each respectively, breast lipoma accounted for 3 (1.6%) while breast abscesses and ductal papillomas accounted for 2 (1%) each respectively. Tubular adenoma accounted for 1(0.5%).Conclusion: Fibroadenoma and breast cancinoma are the most common breast masses seen. Hence histological evaluation is very important. Key words Pattern, Distribution, Breast masses
Olanzapine is an effective pharmacologic treatment of psychosis. However, its use is commonly associated with metabolic side effects. This study was designed to investigate the possible mechanisms of olanzapine-induced blood glucose dysregulation in rats. Olanzapine (10 mg/kg, i.p.), or co-administration of olanzapine (10 mg/kg) and metformin (500 mg/kg), respectively, to rats, acutely or chronic for 28 consecutive days. Fasting glucose and insulin levels, were measured, followed by a 2h glucose tolerance test. Then, blood samples were collected for estimation of biochemical and haematological parameters. The liver, kidney and brain were harvested to estimate the level of oxidative/nitrosative stress status. Subacute administration of olanzapine did not affect body weight but decreased insulin secretion (P<0.05), induced glucose intolerance in OGTT test and enhanced insulin-blood glucose reduction in insulin tolerance test (P<0.001). Both acute treatments with olanzapine and metformin increased insulin secretion but no significant change were seen in subacute study. Conversely, acute injection of olanzapine induced hypoglycemia with concomitant increase in insulin secretion by 1.9 fold (P<0.01) with no significant change in body weight. Sub-chronic olanzapine induced 1.2 fold increase in ALT (P<0.01), 2.1 fold increase in ALP(P<0.01) and 1.8 fold increase in bilirubin (P<0.01) concentration, while decreasing creatinine and urea levels by 1.1 fold (P<0.05) compared with vehicle-treated control. Olanzapine injection decreased anti-oxidant activity (GSH, P<0.05) in the brain by 1.9 fold and in the liver by 17.6 fold (GSH, P<0.0001) with increase in lipid peroxidation by 1.6 fold (P<0.05) and increased nitrosative stress (P<0.05). In contrast, there was an increase in kidney antioxidant level (GSH, P<0.05) by 2.4 fold and increase in lipid peroxidation by 2.5 folds (MDA, P<0.05). Sub-chronic administration of olanzapine induced metabolic syndrome (glucose intolerance, increased TG, reduced HDL), hepatotoxicity, and anemia through induction of oxidative stress. ABSTRAITL'olanzapine est un traitement pharmacologique efficace de la psychose. Cependant, son utilisation est generalement associee a des effets secondaires metaboliques. Cette etude a ete concue pour etudier les mecanismes possibles de la deregulation de la glycemie induite par l'olanzapine chez le rat. L'olanzapine (10 mg / kg, ip), la metformine (500 mg / kg) ou la coadministration d'olanzapine (10 mg / kg) et de metformine (500 mg / kg), respectivement, ont ete administres a des rats, de maniere aigue ou pendant 28 jours consecutifs. traitements de jours. Les taux d'insuline et de glucose a jeun ont ete mesures, suivis d'un test de tolerance au glucose de 2h. Ensuite, des echantillons de sang ont ete recueillis pour l'estimation des parametres biochimiques et hematologiques. Le foie, les reins et le cerveau ont ete recoltes pour estimer le niveau de stress oxydant / nitrosatif. L'administration subchronique d'olanzapine n'a pas eu d'incidence sur le poids corporel, mais a diminue la secretion d'insuline (p <0,05), induit une intolerance au glucose dans le test OGTTet une reduction accrue de la glycemie dans le test de tolerance a l'insuline (p <0,001). Les deux traitements aigus avec l'olanzapine et la metformine ont augmente la secretion d'insuline, mais aucun changement significatif n'a ete observe dans l'etude subchroniqueune reduction du nombre d'hemoglobine et de globules rouges (P <0,05). Inversement, une injection aigue d'olanzapine a provoque une hypoglycemie avec une augmentation concomitante de la secretion d'insuline de 1,9 fois (P <0,01) sans modification significative du poids corporel. L'olanzapine subchronique a induit une augmentation de 1,2 fois de l'ALT (P <0,01), de 2,1 fois de la PAL(P <0,01) et de 1,8 fois de la concentration en bilirubine (P <0,01), tout en diminuant les taux de creatinine et d'uree de 1,1 fois (P <0,05) par rapport au temoin traite avec le vehicule. L'injection d'olanzapine a diminue l'activite anti-oxydante (GSH, p <0,05) dans le cerveau de 1,9 fois et dans le foie de 17,6 fois (GSH, p <0,0001) avec une augmentation de la peroxydation lipidique de 1,6 fois (p <0,05) et une augmentation de la nitrosation stress (P <0,05). en revanche, le niveau d'antioxydant dans les reins (GSH, p <0,05) a augmente de 2,4 fois et celui de la peroxydation lipidique de 2,5 fois (MDA, p <0,05). Administration subchronique du syndrome metabolique induit par l'olanzapine (intolerance au glucose, TG accrue, HDLreduit), une hepatotoxicite et une anemie, probablement a cause de l'induction d'un stress oxydatif.
Background: Orthodontic brackets and wires provide extra surfaces for plaque and calculus accumulation, and can alter the balance of the oral microbiologic ecology thus making maintaining a good oral hygiene a challenging task.These alterations may in turn lead to gingivitis, gingival bleeding, gingival enlargement around the brackets, dental caries, as well as white spot lesions. Maintaining high levels of daily plaque removal by effective tooth brushing and other adjuncts, is therefore very important in patients undergoingfixed orthodontic therapy. Objective: The aims of this study were to assess the oral hygiene practices of patients undergoing fixed orthodontic therapy, as well as identify any pathological oral changes among such patients. Materials and methods: This was a cross sectional study conducted via self-administered questionnaires. A total of 114 patients undergoing orthodontic treatment at the Lagos State University Teaching Hospital, and the University of Port Harcourt Teaching Hospital were recruited for this study. Results: About half (57.6%) of the participants in this study brushed twice daily. Only 3 remembered to brush after every meal, 26.3% flossed and 37.7% used mouth rinses as an adjunct to tooth brushing. Majority (64.9%) reported episodes of bleeding gums during orthodontic treatment. Majority of the respondents were fully aware that tooth brushing is very important during orthodontic treatment, but only half knew that braces could lead to tooth decay. Conclusion: The participants in this study appear to have a good knowledge about general oral hygiene practices, but not of the peculiarities of wearing braces, nor the changes to the oral environment during orthodontic treatment. Orthodontists should therefore properly educate their patients on the importance of maintaining an excellent oral hygiene while undergoing orthodontic treatment. Keywords: Oral hygiene, orthodontic treatment, fixed appliance therapy.
Background: The emergence of carbapenem resistant Klebsiella pneumoniae (CRKP) is of great concern because of the limited options for treatment. While carbapenem resistant Klebsiella pneumoniae is increasingly identified worldwide, limited data is available in Africa. This study was undertaken to determine the prevalence of CRKP in LUTH and to provide phenotypic characterisation of the resistancemechanisms. Methods: Across sectional study with 153 isolates of Klebsiella pneumoniae obtained from clinical cultures of inpatients identified using Microbact 12A and 12B. All isolates were subjected to antimicrobial susceptibility testing using the Modified Kirby Bauer method and interpreted according to the CLSI guidelines. The modified Hodge test was used to detect carbapenemase production. Results: The prevalence of carbapenem resisant Klebsiella pneumoniae was 5.2% and carbapenamase producing K. pneumoniae was2.6%. Most of the K. pneumoniae isolates had high rates of antibiotic resistance to Cefotaxime 78.4%, Ceftazidime 67.3%, Genticin 71.9%, Ciprofloxacin 59.5%, Cefepime 10.5% and Amikacin 13.7%. Conclusion: There was a high rate of carbapenem resistance in Klebsiella pneumoniae. The K. pneumoniae isolates were also multi- drug resistant. There is need for antibiotic stewardship. Keywords: Carbapenem resistance, Kelbsiella pneumoniae, prevalence
Background: The emergence of carbapenemresistant Gram-negative bacilli (GNB) represents a serious public health threat which requires implementation of antimicrobial stewardship programs to reverse conditions that favour the emergence of multidrug-resistant GNB within the hospital (increased use of carbapenems), thereby reducing morbidity/mortality and healthcare costs. The prevalence of Carbapenem resistant GNB causing infections at LUTH and their resistance pattern to other classes of antimicrobial agents were determined.Methods: The bacterial isolates were recovered from various clinical specimens in LUTH between January and October 2015. Antimicrobial susceptibility testing was done using the Modified Kirby-Bauer disc diffusion and gradient diffusion methods andinterpreted using EUCAST 2014 breakpoints tables, version 4.0 and CLSI 2013 guidelines Carbapenem resistance was defined as resistance to any of imipenem (10µg), meropenem (10 µg) or ertapenem (10 µg).Result: Four hundred and two Gram- negative bacilli were isolated. Seventy one (17.7%) were carbapenem resistant, comprising 16 (59.3%) of the 27 Acinetobacter baumanii, 26 (17%) of the 153 Pseudomonas aeruginosa, and 29 (17%) of the 222 Enterobacteriaece. All carbapenem resistant isolates were multidrug-resistant except one. Most isolates were susceptible to colistin (88 – 100%), polymixin B(88.5% for Pseudomonas aeruginosa), and tigecycline (44.1% for Enterobacteriaece). Four hundred and two Gram- negative bacilli wereisolated. Seventy one (17.7%) were carbapenem resistant, comprising 16 (59.3%) of the 27 Acinetobacter baumanii, 26 (17%) of the 153Pseudomonas aeruginosa, and 29 (17%) of the 222 Enterobacteriaece. All carbapenem resistant isolates were multidrug-resistant except one. Most isolates were susceptible to colistin (88 – 100%), polymixin B (88.5% for Pseudomonas aeruginosa), and tigecycline (44.1% for Enterobacteriaece).Conclusions: There was a high rate of carbapenem resistance among GNB most of which were multi drug resistant. Antimicrobial stewardship should be instituted with the restricted use of carbapenems. Spread of these multi drug resistant organisms should be prevented with infection control practices like hand hygiene and contact based precaution.
Background: In the outpatient pharmacy setting, waiting time is the main indicator for assessing quality of service delivery. Long waiting times affect the efficiency of the pharmacy and cause patients' dissatisfaction.Method: The study employed a combination of work flow analysis and a survey involving administration of questionnaires to 123 ambulatory patients in Family Medicine/General Outpatient department of LUTH.Results: The workflow analysis revealed a total patient waiting time of 79.24min with the process component accounting for 7.9 min (9.97%) and delay component responsible for 71.34 min (90.03%). The results of the survey indicated that more than half of therespondents felt that the queue in the pharmacy was long. In spite of this excessive delay, 80% of the respondents still felt satisfied with the services received.Conclusion: Significant reduction in waiting time can be made by facilitating service delivery at the prescription validation and assessment point. The excessive patient waiting time underscored the need to employ more pharmacists to improve on the performance. It was recommended that payment point be sited within the vicinity of the pharmacy unit and that patient waiting time be effectively managed by using the waiting area as an avenue to disseminate drug information and provide educational materials to the patients. Keywords - Ambulatory Pharmacy, Waiting time, Service Delivery, Patient Satisfaction
