Fixed-prosthodontics in Nigerian private practice settings

Context: Private practice dentistry is predominant in Nigeria. Audits of fixed-prosthodontic practice in these settings are rare and will highlight capacity and guide training. This study aimed to assess the scope and quality of fixed-prosthodontic practice in such settings in Nigeria. Objectives: The study sought to assess: Participants' sociodemographic and their diagnostic and preoperative practices. The quality of impression making and operative technique, reviews and maintenance, temporization practices and communication with the laboratory.The range of treatments given and provision of advanced treatments. Materials and Methods: An adapted questionnaire was administered electronically on Nigerian dentists practicing fixed-prosthodontics in private practice settings. Retrieved data underwent descriptive statistics and associations were tested with the Fischer's Exact and Chi-Square tests using IBM SPSS Statistics version 21. Statistical significance was set at p≤0.05. Results: A total of 100 valid responses with a male:female ratio of 2.1:1 from 16 states wereretrieved. Fifty-nine participants had only first degrees and mean experience was 14.3±9.5 years. There were 27 adequate responses with regards to range of treatments offered. Sixty-three participants practiced direct temporization. Twenty-one and 14 participants regularly practiced implantology and CAD/CAM dentistry respectively. Direct temporization was significantly associated with increasing education (X2=6.03, p=0,05) and experience (X2=13.2, p=0.03). Conclusion: Only a few Nigerian dentists in private practice gave an adequate range of treatment. Most of them prefer direct temporization. Implantology and CAD/CAM dentistry practice are improving, but are still not very common.

Appendicectomy in private practice in Kwazulu-Natal Province, South Africa

Background. The treatment of appendicitis is regarded as a bellwether procedure that can be used to describe the delivery of essential surgical care. Little has been published on clinical outcomes in the private sector in South Africa (SA), and this study attempts to address this deficiency.Objectives. To extend our understanding of the outcomes of acute appendicitis in the public and private sectors in SA.Methods. Data on patients covered by a leading medical aid who underwent appendicectomy in 26 private hospitals in Durban and Pietermaritzburg, KwaZulu-Natal Province, during the period 2010 - 2015 were obtained and compared with existing data from a recent study of patients with appendicitis treated in the Pietermaritzburg academic complex.Results. Between January 2010 and December 2015, 397 patients covered by the medical aid underwent appendicectomy in private hospitals. Their mean age was 29.7 years (range 3.7 - 87.6), the mean length of stay 4.6 days (range 1 - 41) and the mean operation time 70.6 minutes (range 24.0 - 335.0). Of the procedures 66.5% were laparoscopic. A total of 33 patients (8.3%) required intensive care unit (ICU) admission, and 38 (9.6%) were readmitted. While there was no information on the reasons for readmission, this is a proxy marker for possible complications. The mean total event cost per patient was ZAR38 934. A total of 134 open operations were performed (33.8%). In the state sector, a total of 1 004 patients were documented. The mean patient age was 20.2 years (difference not statistically significant), mean length of stay was significantly longer at 7.3 days (p=0.02, one-tailed t-test), and 10% of patients required ICU admission. In the state hospitals only 3% of the operations were laparoscopic. None of the private sector patients but 40% of the state patients required further surgery. Conclusions. Medical aid data provide useful information on disease profiles and outcomes in private practice. The outcome of acute appendicitis in the private sector appears to be significantly better than in the state sector. Further work is required to fully elucidate the reasons for this, although late presentation in the state patients almost certainly contributes to their poor outcome. In terms of cost, SA private practice appears to be highly efficient and is relatively inexpensive in comparison with international equivalents

South African Private Practising Clinical Dietitians' Perceptions of the Relevance of Service-Specific Healthcare Marketing Principles and Communication Elements

"Background: South African dietitians are confronted with the challenge of effectively marketing themselves as a sound source of information on nutrition to both the public and other health professionals. The marketing initiative should focus on the promotion of both the profession itself and individual practices. The aim was to assess the perception of South African private practising clinical dietitians of the relevance of service-specific healthcare marketing principles and communication elements (within the ambit of Act 53 of 1974). The design was a descriptive cross-sectional survey in the quantitative domain. Convenience sampling was used (n = 79). Method: Data were collected by means of an electronic questionnaire. The response rate was low (16.8); and the results could not be generalised. Results: The dietitians seemed more focused on the science of nutrition; than on marketing their profession and individual practices. There was an overall awareness of the need for marketing in the dietetic private sector; but the importance and implementation thereof did not receive the amount of attention that it justifies. A number of service-specific healthcare marketing principles received ""slightly relevant"" or ""not relevant"" ratings.Conclusion: For the dietetic profession to reach its full potential in South Africa; and for dietetic private practices to be successful on all levels; dietitians need to focus more of their time and energy on business-related aspects such as marketing. By integrating the theory from the literature with the findings from the study; a profession-specific marketing flow diagram and recommendations could be proposed."

Day case adenotonsiletomy: experience of two private clinics in Nigeria

Background: adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy. Methodology: All pediatrics cases requiring adenoidectomy; tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery- ASA grade I or II for general Anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others. Results: A total number of 144 patients requiring adenoidectomy; Tonsillectomy or both were seen at the study centers with only sixty six (45.8) meeting the inclusion criteria. Adenoidectomy constituted 47of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5) of the patient. the other complications Were non-persistent vomiting 13 (19.7); low grade fever 5 (7.6) and pain at time of discharge 23 (34.8). There were no fatalities. Conclusion: The complication rates were low. Day-case Adenoidectomy/tonsillectomy or denotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/ post recovery as this as this had a soothing/calming effect on the patient/s