OUTCOME OF HIV/AIDS ADMISSIONS IN THE MEDICAL WARDS OF A TERTIARY HEALTH FACILITY, SOUTH EAST NIGERIA: A 10 -YEAR REVIEW.

Introduction: About 9% of all persons living with HIV infection (PLWH) the world over were resident in Nigeria as of 2014 and Nigeria had the second largest HIV disease burden in the world after South Africa. Despite the introduction of antiretroviral therapy (ART) for the treatment of HIV infection, PLWH was frequently admitted to the medical wards on account of opportunistic infections, advanced HIV disease, and other complications. Objective: The objective of this study was to determine the HIV/AIDS treatment outcome in the medical wards of the only teaching hospital in Abia State, which in 2019, had a disease prevalence of 2% behind Akwa Ibom, Benue, and Rivers States in Nigeria. Methodology: This was a 10-year retrospective descriptive study in which data about patients admitted for HIV/AIDS was extracted from the Admission/Discharge registers in the male and female medical wards. Data collected from each patient's record included - age, gender, definitive diagnosis, duration of hospital stay, and outcome during admission. In this study, the outcome measures were improved and discharged home, died, discharged against medical advice (DAMA) or transferred to another specialty. Relevant data thus obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: A total of 6587 medical admissions were seen within the study period; 852 (12.9%) were admitted because of HIV/AIDS-related complications, made up of 365 (42.8%) males and 487 (57.2%) females. Young people (20-39 years) and the middle-aged population (40-59 years) were the predominant age groups admitted at 55.5% and 36.2% respectively Mortality among the HIV/AIDS admissions was 32.7% while only 45.9% improved and were discharged home. The mean duration of hospitalization was 8.48±7.08 with a range of 1-50 days and most deaths (77.1%) occurred within the first ten days of hospitalization. Conclusion: HIV/AIDS contributes significantly to medical admissions in Aba, Nigeria. Mortality from HIV/AIDS is high despite scaled-up ART enrollment within the period under review. Public health measures aimed at preventing HIV infections are advised as prevention of HIV infection is much more cost-effective than attempting to treat HIV advanced disease.

The Impact of telemedicine during the COVID-19 pandemic in Nigeria: A review

Background: Telemedicine practice is a rapidly evolving aspect of medicine in developed countries, though resource-limited countries like Nigeria are yet to embrace it fully. Moreover, the COVID-19 pandemic has limited patients' visits to hospitals in addition to the social distancing measures deployed by the government. In addition, with the challenges of a limited number of doctors, among other difficulties, it has become important that a radical approach to patient care and treatment should be explored. Methods: A comprehensive literature review of original articles was done using an internet search. Words such as Telemedicine, COVID-19, Pandemic, Requirements, History, Benefits, and Challenges were searched on Google scholar, EMBASE, PubMed, Medline, Web MD, and Scopusto check for various articles published or any probable link. The references of the relevant articles were searched. Results: The practice of telemedicine has evolved over the years. Also, the global telemedicine market has grown exponentially and is expected to grow even further in the next five years. Unfortunately, this exciting narrative is not obtainable in developing countries like Nigeria. Indeed, some healthcare providers in Nigeria need to prepare for this new technological advancement, and consequently, they struggle to evolve their practice to adopt this new technology. Furthermore, there is disinterest from most of the end users, particularly the patients. Conclusion: Modifications must involve telemedicine services with a view of getting ready and well-organized in the event of any future pandemic such as COVID-19, in addition to harnessing the benefits of this service in the future.

Hyperglycaemic Emergencies in a Tertiary Health Facility in South-Eastern Nigeria.

BACKGROUND: Patterns of hyperglycaemic emergencies (HE) include diabetic ketoacidosis, (DKA), hyperglycaemic hypero-smolar state, (HHS), normo-osmolar non-ketotic hyper-glycaemic state, (NONKHS), or the mixed/indeterminate form. Certain factors are predictive of adverse HE outcome. There is a paucity of literature on the patterns and poor prognostic factors of HE in the South East (SE) region of Nigeria, hence, the need for this study. MATERIALS AND METHODS: This was a prospective observa-tional study done to assess the pattern of prognostic factors for HE managed at the Federal Medical Centre, (FMC), Umuahia, South East, Nigeria. Consecutively recruited adult patients managed for HE at FMC, Umuahia between July 2015 and March 2016 were studied. Patterns of HE were determined via biochemical tests while prognostic factors were determined from biodata, precipitating illnesses, clinical presentations and other comorbid illnesses. Analysis of data was done using SPSS 20.0 and the level of statistical significance was set at p < 0.05. RESULTS: A total of 110 subjects were recruited, made up of 46 (42%) males and 64 (58%) females. Death from HE occurred in 10% of the subjects with case fatality rates of 3.6%, 2.7%, and 0.9% for the mixed type, DKA/NONKHS and HHS respectively. Mixed/indeterminate form was the commonest pattern followed by DKA and then NONKHS. The correlates of HE death included stroke, diastolic hypotension and presence of complication(s) attributable to HE but the independent risk factors for death from HE were diastolic hypotension and stroke Cerebrovascular Accident (CVA) only. CONCLUSION: Mixed form of HE and DKA were the most common presentations of HE in this facility and the independent risk factors for death from HE were diastolic hypotension and stroke (CVA).

Selfmonitoring of blood glucose practices by people living with diabetes who use their personal glucometers in Port Harcourt, Niger Delta Region, Nigeria

Self-monitoring of blood glucose (SMBG) assists persons living with diabetes with the day-to-day behavioral and therapeutic adjustments to their diabetes care. It is a cheaper and more available alternative to glycated haemoglobin (HbA1c) in Nigeria for monitoring glycaemic control. Information on SMBG practices of Nigerians living with diabetes using their personal glucometers is scanty. The aim of the study is to assess the intensity and frequency of SMBG by glucometer owners, and the extent the patients and/or the health care providers (HCP) utilize SMBG to achieve personalized treatment goals via behavioral/treatment adjustments. This was a cross sectional study carried out among persons living with diabetes that accessed diabetes care at the diabetes clinic of the University of Port Harcourt Teaching Hospital (UPTH) and using their personal glucometers. They were consecutively recruited. Data obtained by using interviewer-administered questionnaires were analyzed using SPSS version 20.0, and pvalue <0.05 was considered significant. A total of 128 persons living with diabetes participated in the study of which 40 (31%) were males and 88 (69%) were females; the mean age of the subjects was 52.05 ± 11.24 years with a range of 26­70 years. The majority of the study subjects (72%) were in the active working age group (25­60years). The highest frequency of glucometer use was in the 26 subjects (20%) who checked their blood glucose every morning while 62 (48%) of the subjects checked their blood glucose any morning they felt like. Most of the subjects (60%) did not have any recording device. Glucometer owners were not just the insulin-requiring people living with diabetes as more than half of the subjects, 66 (52%) were on oral anti diabetic drugs (OAD) only. Glucometer ownership was mainly by those that were in the working age group. SMBG protocol (frequency) was variable and SMBG data were not maximally utilized