Knowledge, awareness and practice of infection control by health care workers in the intensive care units of a tertiary hospital in Nigeria.

BACKGROUND: Hospital-acquired infections (HAIs), one of the leading causes of, morbidity and mortality, are common in developing countries. Methicillin-resistant staphylococcus aureus (MRSA), commonest cause of HAIs, has been isolated from the hands of more than half of health care workers. Practice of hand hygiene may help in the control of nosocomial infections. We evaluated the practice of infection control among health care workers in the intensive care unit (ICU) of our hospital. MATERIALS AND METHODS: This is a descriptive cross-sectional study. Information on knowledge, awareness and practice of infection control in the ICU were obtained from health care workers with the aid of a structured questionnaire. RESULTS: Sixty nine out of the 80 (86%) respondents had good knowledge that a hand is the most common vehicle of transmission of infection. However, 53.8% and 32.5% of the respondents had knowledge of movement of hand hygiene and practiced six steps of the hand washing technique respectively. Though, physicians accounted for 68 (85%) of the respondents, only 28% of them practiced the six steps of the hand washing technique with resident doctors constituting a large proportion of hand washing technique defaulters. Only 13.9% of non-physician and 7.5% of physician respondents had ever attended a training program on infection control respectively. CONCLUSION: Knowledge and awareness of infection control among the health care workers in our ICU is good but the practice is poor. Training workshop on infection control should be organized for all ICU health care workers to reduce noso-comial infections.

Fluoroscopic-guided supra-scapular nerve block in the management of shoulder pain in a Nigerian Teaching Hospital: Report of five cases.

Shoulder pain complaints are common in our environment. The disorder can occur among the young active age group or in the older patients as a result of degenerative changes with its attendant limitations of the function of the affected upper limb, hindrance of the performance of activities of daily living, and reduced quality of life. The traditional oral analgesics, physiotherapy, and intra-articular corticosteroid injections are seldom ineffective at providing the desired pain relief and functional improvement at the shoulder joint. We investigated the role of fluoroscopic-guided supra-scapular nerve blocks (SSNBs) in patients with shoulder pain who failed to respond to the routine conservative management. With the patient lying prone and the C-arm fluoroscope placed in anterior-posterior position, the scapula notch was visualized and a 22G spinal needle was directed toward the nerve. The mixture of local anesthetic agent and steroid was injected as close to the nerve as possible after negative aspiration. Fluoroscopic-guided SSNB can produce substantial pain relief and improved range of movement in patients with painful shoulders. The procedure is safe, well tolerated, and can be done on a day-case basis.

Serial pathologic fractures of five long bones on four separate occasions in a patient with primary hyperparathyroidism, challenges of management in a developing country: a case report.

Multiple pathologic fractures secondary to parathyroid adenoma is rarely recognized and reported in the tropics. Inadequate evaluation causes worsened disability and increased psychological stress. We present a 27-year-old Nigerian male student with recurrent unexplained pathological fractures of the long bones. Primary Hyperparathyroidism was later diagnosed and he benefited from a unilateral parathyroidectomy. Primary hyperparathyroidism secondary to parathyroid adenoma is difficult to diagnose and needs a high index of suspicion. Surgery and good post-operative biochemical control of serum calcium produce satisfying outcomes.