ABSTRACT
Burnout among physicians is a global phenomenon which has been under-reported in middle and low-income economies. The importance of burn-out on the physicians' well-being, patient care and overall health care system cannot be overemphasized. In Nigeria, few studies are specific to burnout, with most of the available studies exploring psychosocial issues at physicians' workplace stress and job dissatisfaction. This present review of literature is assessing burnout among Nigerian Physicians. This review is designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The review identified observational, review, longitudinal and experimental studies on Nigerian physicians between 1970- 2017, which have the full text in the English language. The articles were searched from online databases such as PUBMED, Directory of Open Access Journals (DOAJ), African Journals Online (AJOL) and Google Scholar by researchers. The keywords used include "Physician", "Nigeria", "burn-out" syndrome. The prevalence of 23.6% to 51.7% burnout was reported among physicians in the selected studies, with young age being a strong predictor for burnout. High burden of emotional exhaustion, depersonalization and personal accomplishment were reported in the study carried out among resident doctors who are early career doctors. The prevalence of burnout reported from these studies in Nigeria is very high, although they are within the globally reported range of physician burnout. Nevertheless, there is a dearth of information on the subject matter among Nigerian Physicians. There is a need to carry out more studies on burnout among Nigerian Physicians
Subject(s)
Burnout, Psychological , Nigeria , PhysiciansABSTRACT
Introduction: Staphylococcus aureus is the etiological agent for a wide range of human infections, and its pathogenicity largely depends on various virulence factors associated with adherence, evasion of the immune system and damage of the host. This study determined the prevalence of methicillin-resistant S. aureus (MRSA) and some selected virulence genes in clinical isolates of S. aureus from South-Western Nigeria. Materials and Methods: The antibiotic susceptibility of 156 S. aureus isolates to various antibiotics was determined. Moreover, polymerase chain reaction detection of the mecA gene was performed including SCCmec typing, and the isolates were screened for selected genes (alpha hemolysin [hla], intracellular adhesion A [icaA], Panton-Valentine leukocidin [PVL], fibronectin binding protein A [fnbA], bone sialoprotein binding protein [bbp], exfoliative toxin A [eta], exfoliative toxin B [etb], and collagen binding adhesion [cna]) associated with virulence. Results: The prevalence of mecA gene was 42.3% (66 out of 156 S. aureus), and SCCmec typing showed that 24 (36.4%) carried the SCCmec II element, 4 (6.1%) with type III, 10 (15.2%) with SCCmec IV, and 28 (42.4%) harbored type V. The proportion of S. aureus with the following genes was ascertained: Hla (55.1%), icaA (42.3%), PVL (34.6%), fnbA (8.3%), bbp (4.5%), and eta (3.8%). All the isolates were etb and cna negative. The prevalence of the PVL gene in methicillin susceptible Staphylococcus aureus (MSSA) was 53.3% compared with 9.1% of MRSA. An association between virulence genes (eta and icaA) and mecA positive S. aureus; and significant difference in the distribution of virulence genes in in-patients and out-patients were found. The MRSA strains in South-Western Nigeria were dominated by SCCmec II and SCCmec V. Conclusion: The study concluded that there is a high prevalence of MRSA in Nigeria with association of eta and icaA genes with mecA gene in S. aureus isolates.
ABSTRACT
Jatropha gossypifolia has been known to thrive well in tropical climate, most importantly in Nigeria where they are found to grow naturally on dumpsites. The potential use of this robust tropical plant in phytoremediation technology should be advocated especially for developing countries. This study investigates the effect of enhanced phytoextraction on the accumulation of the following heavy metals; (Cd, Cr, Fe, Mn, Pb, Zn, Ni, Cu, Co and Sn) by J. gossypifolia cultivated on soil collected from dumpsites in Ekiti state, South Western Nigeria, with application of 1g/kg EDTA (Experiment) and without (control). Application of 1g/kg EDTA did not adversely affect plant growth, except at preflowering stage where were yellowing of leaves. The concentration of heavy metals in tissues of plant were higher in the experiment than control, with concentration of Pb (376.0, 350.0, 355.2 and 328 mg/kg; experiment, 184.0, 180.0, 169.0 and 159.0 mg/kg; control), Cu ( 962.0, 958.0, 898.0 and 818.0; experiment, 650.0, 526.0 464.2 and442.0 mg/kg; control) and Cd (416.8, 418.2, 399.0 and 377.5; experiment, 167.3, 164.2, 147.8 and 142.2 mg/kg) at Aba Egbira, Atikankan, Igbehin and Moshood street dumpsites respectively in the shoot of the plant. Highest concentrations of heavy metals were obtained in leaves of the plant. Notably, concentration of Pb, Cu and Cd were greater than the threshold value of 100mg/kg, indicative of the fact that J. gossypifolia could be a good candidate for Pb, Cu and Cd-phytoextraction. Bioaccumulation factor (BF), translocation factor (TF) and remediation ratio (RR) values greater than one also revealed the effectiveness of the plant to translocate Pb, Cu and Cd to their harvestable portion and phytoextraction efficiency under the chelant-assisted phytoremediation. However, the concentration of heavy metals did not vary significantly at p<0.05, least significant difference (LSD test) in all dumpsites investigated. Therefore, the use of J. gossypifolia is advocated as a candidate plant for restoring dumpsites polluted with heavy metals.
ABSTRACT
This study compared the efficacy and safety of Lispro insulin and regular insulin in the management of hyperglycemic emergencies (HE). Fifty patients who presented in HE to the Emergency unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife participated in the study. Hyperglycaemic emergency was diagnosed when plasma glucose level was >17 mmol/L (300 mg/dl) in the presence of polyuria and polydipsia that warrants emergency hospital admission. Subjects in the Lispro insulin group had a statum dose of 0.3 IU/kg, while those in the regular insulin group had a statum dose of 20 IU equally split between the intravenous and intramuscular routes. Further insulin therapy was by the intramuscular route. Data was analysed using the Statistical package for social sciences (SPSS) version 11. Hyperglycaemia resolved within the first 8 hours in 60 and 40% percent of subjects in the lispro and regular insulin treated groups respectively. The time taken for resolution of hyperglycaemia was similar in both treatment groups, 6.6 +/- 0.8 hours for the lispro insulin group and 7.4 +/- 0.8 hours for the regular insulin group p = 0.51. The number of episodes of hypoglycaemia and hypokalemia in the two treatment groups did not differ statistically (p = 1.0 and 0.38 respectively). Eight (16%) subjects died. Lispro insulin is a safe and efficacious alternative to regular insulin in the treatment of HE