ABSTRACT
Background:The practice of inflicting cuts (incisions) on the anterior abdominal wall to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis (especially inchildren who are the major targets); massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients. This practice is a long-termpractice of the Esan people of the central part of Edo State Nigeria. This study aims to identify the factors that continue to make this practice attractive to members of the community, the common complications encountered, and how to develop an advocacy tool for health education and promote the health-seeking behavior of the populace.Methods:This was a prospective community based cross-sectional descriptive study that was conducted in all the 5 Esan speaking local government areas of Edo State where this practice is very common. The study was done between January 2017 and June 2018. Participants were interviewed using a structured questionnaire by previously trained researchers, after pretesting and validation. The questionnaire was administered on 700 adults, however, 500 were returned. The data obtained were summarized as frequencies and percentages.Results:The majority of the participants were middle-aged. Ninty-five percent (95%) of respondents were aware of the practice of abdominal scarification and 80% of them think itis effective. It was mainly carried out by herbalists in 95% of the respondents. Half of the respondents were unaware of any complications associated with the procedure. Conclusion:Abdominal scarification is a common practice among the Esan people of south-south Nigeria. They believe it's effective, affordable, and risk-free. This is despite the availability of effective alternatives in orthodox medicine. There is, therefore, a need for advocacy and health education considering the dangers and complications associated with the practice
ABSTRACT
Background: Cutaneous diseases are common in patients with HIV/AIDS however there are few documented reports of these lesions from some parts of world such as Nigeria and West Africa. Objective: The aim of this study was to identify cutaneous pathologies in patients attending an adult outpatient (HIV/AIDS) clinic department in a rural/suburban centre in the south geopolitical zone of Nigeria. Additionally it also aims to determine if there are differences in the pattern of presentation as compared to patients seen in other parts of the country and the world. Methods/Design: This is a prospective observational study conducted in the adult antiretroviral (ART) clinic of Irrua Specialist Teaching Hospital Irrua Edo StateNigeria over a 12 month period involving HIV positive patients. All patients with skin complaints are included in the study while other patients without skin complaints are generally excluded. Results: A total of 9460 patients were seen during this period in the clinic including old, new and repeat visits. Four hundred and ninety patients had various dermatologic complaints at various times giving a 5.18% prevalence of the cutaneous pathology. The mean age of the patients was 38±10 years with a male: female ratio of 1:1.4(140:350). For easy of analysis these lesions were grouped into infective and non-infective pathologies. Infective pathologies dominated the main manifestation (viral- 37.1%, fungal 24.3% and bacterial 2.9%) and non-infective mainly neoplasms 5.7%, drug reactions 11.4% and others 18.6% (comprising post inflammatory hypopigmentation and hyperpigmention, pruritic eruptions of HIV, and papularurticaria (insect bite reactions). Lesions are generally more florid and widespread in these patients particularly at lower CD4 counts. Conclusion: Cutaneous manifestations of HIV infection are common even when not deliberately sought out for. They range from infections to neoplasms and drug reactions. They can be the main reason for initial presentation to the clinic and without prompt recognition and treatment patients care will be incomplete.
ABSTRACT
Nosocomial infection is a recognized public health problem world-wide with a prevalence rate of 3.0-20.7and an incidence rate of 5-10. It has become increasingly obvious that infections acquired in the hospital lead to increased morbidity and mortality which has added noticeably to economic burden. However; after about three decades of nosocomial infection surveillance and control world-wide; it still remains an important problem for hospitals today. Studies have shown that most hospitals in developing countries especially Africa; have no effective infection control programme due to lack of awareness of the problem; lack of personnel; poor water supply; erratic electricity supply; ineffective antibiotic policies with emergence of multiply antibiotic resistant microbes; poor laboratory backup; poor funding and non-adherence to safe practices by health workers. It is recommended that the cost of hospital infection control programme should be included in the health budget of the country and fund allocated for the infection control committee for routine control purposes and to bear the cost of outbreaks. There is need for adequate staffing and continuous education of staff on the principles of infection control; especially hand washing which is the single most important effective measure to reduce the risks of cross infection
Subject(s)
Cross Infection/prevention & control , Hospitals , Lakes , Nigeria , Risk Factors , Socioeconomic FactorsABSTRACT
Background: The study was designed to find out the radiation protection practices of radiologists and other staff involved in the first extra-corporeal shock wave lithotripsy in Nigeria, performed at Igbinedion Hospital and Medical Research Centre, Okada. Methodology: Some members of staff who were present when the extra-corporeal shock wave lithotripsy (ESWL) was used in the hospital at Okada were interviewed between November 2002 and August 2003. Radiology records of the hospital were studied. Literature search involved available publication on the procedure in local and international journals with interest in precautions to reducing radiation exposure. Results: Only lead apron and lead gloves were used by the radiologists for radiation protection and shielding during fluoroscopy procedures. The fluoroscopy was the screen type with TV monitor. Multiple sessions were used in several patients with multiple pre- and post- treatment radiographic studies including contrast studies with average of two sessions per patient. All the patients were adults aged between 26 and 65 years with mean age of 42.5 years. 627-6000 shock waves were delivered over 45-135 minutes at intensity of 143-19KV depending on patients build and the size of the stones. The sizes of the patients varied from very obese with large bulk to slim built. Radiation monitoring of the staff and patients was not done. Staff believed that radiation effect from the lithotripsy procedure was low therefore adequate radiation monitoring and radiation reducing alteration in the procedure was rarely adopted. Conclusion: Extended fluoroscopy time, multiple fluoroscopy examinations, multiple treatment sessions and multiple x-ray examinations which increased both the patients/' and staff/'s radiation exposures were noted. Proper radiation protection and monitoring of patients and staff are necessary to avoid the risks from low-level exposure to radiation such as in ESWL