Nigerian quarterly journal of hospital medicine最新文献

Background: Large babies have attracted immense attention as they present obstetric problems with associated increase in perinatal morbidity and mortality. The major risk of fetal macrosomia is trauma to the fetus and mother during vaginal delivery.

Objective: To compare the outcome of macrosomic babies with babies of normal birth weights.

Methods: This was a retrospective comparative study of deliveries over a period of two years from 1 "August 2005 to 31st July 2007.

Results: There were 198 macrosomic babies (6.9%) out of a total of 2,879 deliveries that occurred within the study period. Majority of the mothers were multiparous; para 2 to 4 (47.5% in the study group and 33.7% in the control group). Emergency Caesarean Section (EMCS) rate in the study group was 44.4% while it was 25.3% in the control group and this was statistically significant (p value <0.001). In this study the maternal injuries in the study group were not significantly higher than the control group. The fetal morbidity and mortality in the study group was significantly higher than the control group both with p values <0.001.

Conclusion: Fetal macrosomia is associated with high morbidity and mortality in this centre, there is a need to identify pregnant women at risk as well as adequate counseling of possible interventions and outcomes.

Background: Gastrointestinal surgery has been at the forefront of advances in minimally invasive surgery (MIS). In the low resource settings of the developing countries, despite the benefits of MIS, its uptake in sub-Saharan African countries has been slow.

Objective: The present study reports the process of developing a minimally-invasive surgery service line as well as surgical outcomes in LASUTH. METHODS. We reviewed medical records of all patients who underwent minimally invasive surgery at LASUTH between March 2011 and March 2012. During each of three training missions in LASUTH patients with Gastrointestinal and gynaecological surgical conditions were carefully selected, and prepared for surgery. All patients were admitted a day prior to surgery. A description of the surgical technique and the skills training used is also presented.

Results: A total of 24 laparoscopic procedures were performed between March 2011 and March 2012. There were more females 17(70.8%) than males 7(29.2%), with a female to male ratio of 2.5:1. The age range was from 18 yrs to 75 yrs with a peak in the age group between 21-30 yrs. The chief complaints were right hypochondrial pain in 9 cases (37.5%) and right iliac fossa pain in 6 cases (25%) whilst others were right groin swelling, dysphagia, infertility and intersex state.

Conclusion: The results presented in respect of conversion rate, length of post operative stay and complications rate are similar to the pattern in more established centers. The use of team training as done in LASUTH helps to accelerate the rate of learning and ensures sustainability.

Background: The use of exercise training in the management of individuals with chronic heart failure has not been widely accepted by health care providers especially in Sub-Saharan Africa because of the possibility that the failing hearts may have a negative response to the increased workload and stress of exercise.

Objective: The study aimed to evaluate the effects of exercise training (ET) on selected cardio-respiratory and body composition variables of Nigerians with chronic heart failure (CHF).

Methods: Thirty two Nigerians with CHF (male - 17), aged 30 to 71 years, mean age 54.2 ± 1.9 years and New York Heart Association Functional Class (NYHA) II-III recruited from Cardiology Clinic of Lagos University Teaching Hospital Nigeria participated in the study. They were randomized into exercise (EG) and control groups (CG). Exercise group performed 12-weeks of aerobic and resistance training for 60 minutes, three sessions per week. Selected cardio-respiratory and body composition variables were measured pre and post intervention in both groups. Data was analyzed using SPSS-17 package. Level of significance was set at 0.05.

Results: There was no significant difference in the measured variables between the groups at baseline (p > 0.05). Significant improvement was seen in EG in all the measured variables except the systolic (p = 0.29) and diastolic blood pressure (p = 0.45). No adverse effect was observed during the exercise training. No significant improvement was observed in the control group (p > 0.05).

Conclusion: Exercise training may improve cardiorespiratory and body composition variables in patients with chronic heart failure.

Background: Sexually transmitted infections (STIs) are a major public health issue. Adolescents and youth (15-24 years) are the age groups at the greater risk for acquiring them. Also a large percentage of new STIs occur in this age group with 7000 young people worldwide acquiring the infection every day. Sexually transmitted infections (STIs) are poorly recognized and inadequately treated in Nigeria despite the fact that they constitute a major risk factor for sexual transmission of HIV infection. The shortage of trained human resources is among the most important obstacles to strengthening health systems in low-income countries.

Objective: This study is to document the knowledge and practice of undergraduate students about gonorrhoea and other STIs as a baseline survey for future intervention work.

Methods: It was a questionnaire-based, cross sectional descriptive study of the knowledge and practice of STIs among students in the seven public tertiary academic institutions in Lagos State using list obtained from the Lagos State Ministry of Education. Thirty (30) students who agreed to be surveyed were conveniently selected from each school. Pre-tested, semi-structured, validated questionnaires were administered and collected back. Data was entered into Microsoft Excel and analysed using EPI Info, SPSS version 15 and Microsoft Excel. Results were considered to be statistically significant if p < 0.05.

Results: Majority of the respondents were of the 21 - 25 year age range (48%) and were mainly single (95%), Christian (61%) and Yoruba (81%). About 51% of the respondents had at least good knowledge of gonorrhoea and other STIs. Knowledge about symptoms and transmission was higher than knowledge of prevention, consequences and drugs. Among those that are sexually active 24% do not use condom while 10% reuse condom. Use of both modern and traditional medical practitioners (TMP) was documented among the students.

Conclusions: Awareness programs with key messages about gonorrhoea and other STIs should be developed and circulated widely in tertiary institutions in the state to improve students' practice. Also strategies to embrace TMP for STI management should be evolved.