Annals of Ibadan postgraduate medicine最新文献

Background: A substantial increase in Type 1 Diabetes Mellitus (T1DM) has been reported globally among children following the discovery of COVID-19. This study reports a similar trend among Nigerian children.

Methods: A twelve-year (2010-2021) retrospective review of T1DM cases admitted in the Paediatric wing of a tertiary hospital in South-East Nigeria.

Results: During the twelve-year study, 21 T1DM patients were seen: 9 (43%) males and 12 (57%) females. Approximately 60% of these cases presented during the pandemic (2020-2021). The mean age of subjects with T1DM was 10.5 ± 4.1 years, with females being slightly older than the male subjects (11.6 ± 3.7 years vs 9.2 ± 4.3 years respectively; p=0.176). Prior to the pandemic, females were significantly older than males (11.6 ± 3.7 years vs 4.5 ± 2.1 years respectively; p=0.042), but no age difference was observed during the pandemic (11.6 ± 4.1 years vs 10.4 ± 3.9 years respectively; p=0.597). 80% of all males in this study were seen during the pandemic and were older than the males seen before the pandemic (10.4 ± 3.9 years vs 4.5 ± 2.1 years; p=0.078). Following adjustments for age and gender, older children and males had an increased odd of developing T1DM during the pandemic but this was not statistically significant.

Conclusion: This study highlights the need for increased awareness and high index of suspicion of T1DM among children during this pandemic. In the interim, more robust multi-centre studies are required to investigate the underlying relationship between COVID-19 and T1DM.

Background: Resident doctors' health and wellbeing has recently become the focus of international concern, as they are very important members of the healthcare system. The medical workplace is a complex environment where the doctors respond differently.

Objective: The objective of this study was to assess workplace stress among the resident doctors, examine their perceived health status, and determine the effect of workplace stress on their perceived health status.

Methods: The study was a cross-sectional study conducted among resident doctors at University College Hospital (UCH), Ibadan, Nigeria across all the specialties over a three-month period, from 1^st March to 31^st May, 2019. Two hundred and thirty-two eligible and consenting resident doctors were selected by stratified random sampling and data was collected using interviewer-guided selfadministered questionnaire. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.

Results: The result showed that 144 (62.1%) of the resident doctors experienced workplace stress and 108 (46.6%) resident doctors perceived their health as poor. Workplace stress, years in residency program, designation, and work hours on least busy day at work were all significantly associated with perceived health status of the resident doctors, however, only workplace stress could independently predict poor perceived health status of the resident doctors.

Conclusion: It is therefore important to prevent and manage workplace stress in order to improve the perceived health status of resident doctors.

Systemic candida infections in the neonatal population are commonly seen especially in low birth weight, preterm neonates admitted to the Neonatal Intensive Care Unit. Albicans spp is the most commonly isolated but in more recent times, fluconazole resistant spp such as Candida krusei have been reported to cause healthcare associated infections. This is a case of a 12-day old, term, low birth weight (2.45 kg), male neonate delivered to a 32-year-old $P_2^{+0}$ through elective caesarian section (CS) at term. He was well till the 12th day of life when he developed respiratory distress and sub-optimal oxygen saturation requiring supplemental oxygen. Chest x-ray showed prominent vascular markings with no active focal lung lesion and he was managed for suspected Aspiration Pneumonitis until a blood culture on the 10th day of admission yielded Candida krusei . He had a monotherapy of intravenous fluconazole, made progressive clinical improvement and was discharged on oral fluconazole to complete a 6 weeks course on outpatient basis.

Background: Cardiomyopathies contribute about 18.2-40.2% (average- 21.4%) to the global burden of heart failure of which dilated cardiomyopathy (DCM) is a major cause. DCM is the second commonest cause of heart failure in Ibadan. The gender differences in the clinical profile has not been described in our setting.

Objective: In this study, we set out to describe the gender differences in the pattern and presentation of DCM at the University College Hospital, Ibadan, Nigeria.

Methods: This was an analysis of a prospectively collected data over a period of 5 years (August 1, 2016 to July 31, 2021).

Results: A total of 117 subjects, 88 males (75.3%) and 29 females (24.8%) aged 50.30 ± 14.7 years (range, 17 to 86 years). Males had significantly achieved a higher educational level than females (p = 0.004). Males were more likely to be employed and had more monthly income compared to females. Males were significantly more likely to use alcohol and smoke cigarette (p = 0.0001 and 0.001 respectively). Females were more likely to be in NYHA class III/IV. There was no statistically significant difference in the relationship between any medication and gender of participants (p > 0.05).

Conclusions: DCM is a disease of young and middle-aged adults in our population. The commonest age group was 20-39 years and there was male preponderance. There were some gender differences in the clinical profile of the disease in our environment.

Professor Isaac Adetayo Grillo was born on January 15, 1931, in Lagos. He had both his elementary and secondary school education at Baptist Academy, Lagos. His autobiography recorded that he excelled brilliantly at the school. He earned the Doctor of Medicine at the University of Kansas in 1960. He completed his residency training in General Surgery and Cardiothoracic Surgery, passing the American Board of General Surgery and the American Board of Thoracic Surgery examinations in 1966 and 1967 respectively. He returned to Nigeria in 1968. Of particular note, Professor Grillo led a team that performed the first open heart Surgery in Nigeria by a group of all Nigerian Doctors and Nurses in 1978. He lived an illustrious life. Always wanting to excel and do his very best, he became Nigeria's most famous Cardiothoracic Surgeon during his time. Professor Grillo passed on after a brief illness on the 4th of April, 2022.

Background: Violent acts perpetrated by young people can cause physical and psychological harm to others and is of serious public health concern. This study was conducted to determine the prevalence of childhood trauma, and to assess the relationship between adverse childhood experiences and other predicting factors, and the perpetration of violence among young adults in Delta state prisons.

Methods: A descriptive cross-sectional study design was conducted amongst 293 youths who were convicted prison inmates in Delta State Correctional facilities. Three out of the five facilities in Delta State were selected using simple random sampling, after which a total sampling of incarcerated inmates from the three selected facilities was carried out. Data were collected using the; Childhood Trauma Questionnaire (CTQ) to measure adverse childhood experiences, and a proforma to classify the offence of the inmate (whether violent or non-violent).

Results: The mean age of the respondents was 28.4 ± 5.4 years. The overall prevalence of childhood trauma was 5.1%. The most common abuse/neglect experienced while growing up was physical neglect with 26.3% followed by emotional neglect (20.5%), physical abuse (7.2%), emotional abuse (2.4%) and sexual abuse (1%).The prevalence of violent offences was 46.1%. Age, (OR=0.3; CI= 0.2-0.6, p=0.001), attaining primary education (OR=3.4; CI= 1.5-7.8, p=0.004) and having witnessed violence while growing up (OR=2.0; CI= 1.2-3.3, p=0.007) were all significant predictors of the perpetration of violence.

Conclusion: The overall prevalence of childhood trauma was low; however, the perpetuation of violence was found to be high in this study. Further research is required to develop study instruments for childhood trauma that are more context specific bearing in mind local sociocultural practices.

Background: Shade matching presents a complex and multidimensional process that involves the cognitive ability of the operator. Hence, dental professionals need to have high shade matching skill.

Objective: To compare the shade matching ability among three categories of dental professionals and assess the inter-examiner reliability of the visual shade selection.

Methods: This was a cross sectional study involving conventional visual tooth shade selection by three categories of dental professionals. Twenty four patients that met the selection criteria were included in the study and Ethical approval duly obtained. Visual shade selection using vital classical shade guide was done by calibrated 3 categories of the dental professionals. Data collected was analysed using IBM SPSS with statistical significance placed at p ≤0.05.

Results: There were 9 (37.5%) male and 15 (62.5%) female participants with mean age ±SD of 39.9 ± 18.47 years. In the shade selection, the dental surgery technician and the house officer agreed in 2 (7.7%) teeth, dental surgery technician and consultant in 6 (23.1%) teeth while the house officer and consultant did so for 8 (30.8%) teeth. The three examiners agreed on shades selected for only 1 (3.8%) tooth. Inter-examiner reliability was 0.11. Shades selected by the consultant matched that of the spectrophotometer in 3 of the 26 teeth (11.5%) being the best.

Conclusion: Inter-examiner reliability was very low in the conventional visual shade selection. Experience and training in colour science and shade selection may play a role in correct tooth shade selection.

Background: Puerperal sepsis is one of the leading causes of pregnancy-related maternal morbidity and mortality in developing countries. This study explored the complications, treatment modalities, and management outcomes of puerperal sepsis.

Methods: A 10-year retrospective review of women managed for puerperal sepsis at University College Hospital, Ibadan, Nigeria between January 2009 and December 2018. Information on their socio-demographic and obstetrics characteristics, presenting complaints, treatment modalities, complications, and outcomes were obtained from the medical records. Data was analyzed with SPSS version 20. Descriptive statistics was done and results were presented in tables and chart.

Results: The prevalence of puerperal sepsis during the period reviewed was 0.83%. The mean age of the women was 29.0±6.7 years. The primiparous women 53(33.5%) were mostly affected. Klebsiella spp 25(15.8%) was the most common organism isolated and most sensitive to the third generation of Cephalosporin and Quinolones. Anaemia 90(56.8%) was the most common complication and all the women had intravenous antibiotics while about half (46.5%) of those with abdominopelvic collections were managed surgically via laparotomy. The case fatality rate was 16.5%.

Conclusion: Despite the low prevalence of puerperal sepsis within the period reviewed, a high case fatality was recorded. Cephalosporin and Quinolones should be considered in managing puerperal sepsis in our facility but more importantly prevention of maternal sepsis is essential.

Background: Gunshot related injuries to the face are relatively rare in peacetime. This study reported the pattern of presentation and management of orofacial civilian gunshot injuries at a Nigerian tertiary hospital.

Methodology: Medical records of 25 patients who sustained gunshot injuries to the face and were managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife between 2010 and 2019 were reviewed. Patients' demographics, wounding mechanisms, clinical presentations and treatment administered were retrieved from the patients' case record. Patient records with incomplete information were excluded. Data generated were inputed into IBM-SPSS version 26 and analysed.

Results: A total of 2,847 patients were admitted through our department over the study period and 28 of them sustained orofacial gunshot injuries, giving a prevalence of 0.98%. Twenty-five out of the 28 retrieved case files met the inclusion criteria. There were 22 males and 3 females; with a male to female ratio of 7.3:1. The mean age was 37.60 ± 11.86 years with highest prevalence at fourth decade of life. About two-thirds of these injuries were intentionally inflicted by others with the use of Dane guns on highways. Majority (64%) of these injuries involved the middle third of the face. Definitive treatments ranged from simple to complex reconstructive procedures to restore pre-injury form and functions.

Conclusion: Gunshot injury involving the maxillofacial region is uncommon during peace time. The male gender was predominantly affected and the middle third facial skeleton was the most involved anatomic site. Most of the injuries were intentionally inflicted by others using Dane gun.