ABSTRACT
Background: Tissue necrosis from pentazocine abuse is becoming a burden in our environment. Pentazocine is an opioid of the benzomorphan class. It is commonly used for post-traumatic and postoperative pain and vaso-occlusive pain of sickle cell disease (SCD). Its prolonged use can lead to addiction and may result in severe injection site necrosis, often worsened by infection due to a lack of aseptic principles during administration. Although pentazocine is a controlled drug in our environment, it is readily available. Objectives: To review patients with tissue necrosis from pentazocine injection, share the challenges in their management, and proffer solutions. Materials and Methods: Clinical summaries of patients with tissue necrosis and ulcers due to pentazocine addiction were reviewed. Results: Twenty-five patients, comprising nine females and 16 males aged 22-61 years, were recorded. Twenty had SCD, while five had other underlying conditions. The duration of abuse was 1-16 years, while the average maximum daily dose was 348.75 ± 346.04 mg. Most patients used multiple sites for injection. Lesions included abscesses, tissue necrosis with ulcers, lymphoedema, exposed necrotic bones, and osteomyelitis. Most had multidisciplinary care. The outcome of wound care was good in two. Three had major limb amputations, four died, three signed against medical advice, six were still receiving care while seven were lost to follow-up. None was completely weaned from the drug at the time of this report. Conclusion: Rising cases of tissue necrosis from pentazocine abuse are disturbing. Treatment is frustrating. Concerted efforts at prevention should be made to stem the tide.
ABSTRACT
Background: This study ascertained the level of distraction attributable to cell phone by drivers in Enugu. Methodology: This study was conducted in Enugu, Nigeria using a validated structured questionnaire randomly administered to drivers in different locations in the city. Study period was 2 months and different forms of distraction while driving were tested. Result: There were 500 participants in the study. 306(61.2%) were males and 194(38.8%) were females. The mean age of respondents was 43.85±9.89 years. Ninety-nine percent of respondents were aware of the ban on use of cell phones while driving but as much as 97.8% of the drivers still use cell phones while driving. Conclusion: Level of distracted driving in Enugu is quite high and this has the potential to cause serious road crashes which can impact negatively on the lives of the people. The need for concerted effort to educate people on the dangers of cell phone use while driving cannot be over emphasized. Key Lessons: - There is a paucity of literature on distracted driving in Nigeria even with the high incidence of Road Traffic Accident.- Awareness of laws on distracted driving is not the challenge rather it is compliance. There is need for ways of enforcing the existing laws on distracted driving as mere knowledge of the provisions of the law does not ensure compliance.- Enforcement of laws on distracted driving will play a preventive role in reducing the incidence of RTAs and its associated health implications.
ABSTRACT
BACKGROUND: It has been reported by some studies that the desire to be involved in decisions concerning one's healthcare especially with regard to obtaining informed consent is related to educational status. The purpose of this study, therefore, is to assess the influence of educational status on attitude towards informed consent practice in three south-eastern Nigerian communities. METHODS: Responses from consenting adult participants from three randomly selected communities in Enugu State, southeast Nigeria were obtained using self-/interviewer-administered questionnaire. RESULTS: There were 2545 respondents (1508 males and 1037 females) with an age range of 18 to 65 years. More than 70% were aged 40 years and below and 28.4% were married. More than 70% of the respondents irrespective of educational status will not leave all decisions about their healthcare to the doctor. A lower proportion of those with no formal education (18.5%) will leave this entire decision-making process in the hands of the doctor compared to those with tertiary education (21.9%). On being informed of all that could go wrong with a procedure, 61.5% of those with no formal education would consider the doctor unsafe and incompetent while 64.2% of those with tertiary education would feel confident about the doctor. More than 85% of those with tertiary education would prefer consent to be obtained by the doctor who will carry out the procedure as against 33.8% of those with no formal education. Approximately 70% of those who had tertiary education indicated that informed consent was necessary for procedures on children, while the greater number of those with primary (64.4%) and no formal education (76.4%) indicated that informed consent was not necessary for procedures on children. Inability to understand the information was the most frequent specific response among those without formal education on why they would leave all the decisions to the doctor. CONCLUSION: The study showed that knowledge of the informed consent practice increased with level of educational attainment but most of the participants irrespective of educational status would want to be involved in decisions about their healthcare. This knowledge will be helpful to healthcare providers in obtaining informed consent.
