Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: a cross-sectional study.

BACKGROUND: One of the global issues facing the nursing profession is work-related stress because it interferes with care quality and organisational competency. These kinds of stressful situations can cause damage to the mental ability of the affected individual resulting in low job productivity. In a Nigerian healthcare setting, patient safety is under-researched. AIM: This study aimed to assess the influence of work-related stress on patient safety culture among nurses in a tertiary hospital. MATERIALS AND METHODS: The study adopted a descriptive cross-sectional survey. The Population of the study was nurses who are currently serving as employees at Federal Medical Center Birnin-Kebbi. Proportional and systematic sampling methods were used in the selection of the sample of the study. The tools used for this study were adapted Hospital Survey on Patient Safety (HSOPS) and Nurses' Occupational Stressor Scale. Ethical approval was obtained from the research ethical committee of the hospital. RESULTS: The moderate stress experience was having the highest percentage (45.0%). The highest percentage of the nurses (69.9%) practised a moderate safety culture. There were weak or very weak significant negative correlations (P < 0.01) between patient safety culture practices and occupational stress across all the subscales of the nurses' occupational stressors scale except in the occupational hazards subscale in which there was extremely weak and non-significant negative correlation. Work-family conflict was a significant predictor of patient safety culture, t (208) = -2.341, P < 0.05. Difficulty in taking leave was a significant predictor of patient safety culture, t (208) = -2.190, P < 0.05. CONCLUSION: There was a significant negative correlation between stress and safety practice which implies that as stress increased safety practice decreased. These study findings can be used to develop ongoing strategies and targeted interventions in addressing work-related stress.

MEDICAL OUTREACH AND IMPROVED ACCESS TO SPECIALIST SERVICES FOR THE RURAL COMMUNITY OF BAUCHI STATE, NIGERIA: THE REQUIREMENTS FOR SUSTAINABILITY.

Introduction: The West African College of Physicians (Nigeria) conducted its Annual General and Scientific Meeting (AGSM) in Bauchi State, Nigeria on 11th-15th of July, 2023. The theme of the AGM is HEALTH-RELATED SDGs IN NIGERIA: THE PROGRESS SO FAR. The sub- themes included challenges of health care in the face of Disaster and the menace of brain drain on health care manpower and medical education. Part of the activities for the AGSM was a medical outreach conducted at Durum community of Bauchi LGA, Bauchi State on Saturday, 8th July, 2023 between 8:00AM to 5:00PM at Durum primary school premises. Objectives: We examined the role of specialist medical outreach in supporting primary health care services and overcoming the barriers to health care faced by the rural dwellers and also examined issues affecting sustainability. Methods: Durum community was chosen from the list of 3 rural communities submitted to the Local Organizing Committee (LOC). A community entry was conducted to the relevant stakeholders. A descriptive cross-sectional design was used for the study. A semi-structured data form was used to collect information from 1062 participants. The activities included health talk and consultations on common health problems in the community as well as referral services. Relevant screenings tests for HBV, HCV, DM, Kidney diseases (Urinalysis), HIV and Tuberculosis were conducted. Medications for common diseases affecting the community were prescribed by the Doctors and dispensed during the outreach. The data were analyzed using SPSS version 26 at 5% significance level and 95% confidence interval. Results: A total of 1,062 filled forms were retrieved. The results show that majority of the participants are females 615(58%) while 447(42%) are males. Half of the respondents are illiterate 526(50%) and only 1%(11) attended tertiary institution. Majority are unemployed 646(61%) and only 1%(13) are civil servants. The commonest existing chronic medical conditions among the participants are hypertension 43(4%) and diabetes 15(1%). The commonest presenting complaints of the respondents are fever 404(38%), headache 170(16%), cough 53(%), dizziness 53(5%), skin rashes 43 (4%), abdominal pain 159 (15%), diarrhoea 53(5%) and vaginal discharge 127(12%). Regarding medical check-up, 481(45%) of the respondents have never ever had a medical check-up. 44(4%) had a check-up in the last preceding month, 41(4%) had check-up in the last preceding week, 40(4%) had check up in the last 6 months, while 34(3%) had check-up in the last one year. 84(42%) and 81(41%) among those tested had positive results for hepatitis B and C respectively and were counseled and referred. None tested positive for Tuberculosis and 1(1%) tested positive for HIV among those screened. 301(80%) among those tested had positive results for malaria and were counseled and offered treatment. The commonest health problems in the community were malaria (41%), enteric fever (26%), PUD/Dyspepsia (19%), UTI (9%) and skin diseases (5%). Conclusions: The study found out that half of the participants are illiterate and unemployed. The commonest health problems in the community were malaria, enteric fever, PUD/Dyspepsia, UTI, skin diseases, Hepatitis B & C. Thus, we recommend that the Primary Health Care Centre in the community should continue to provide the basic health services to the community. The Drug Revolving Fund (DRF) of the facility should be upgraded with relevant drugs and medical consumables at an affordable cost and a Doctor should be posted to the centre on temporary basis. These require the support of Ward Development Committee, Department of Primary Health Care of Bauchi Local Government Area, Bauchi State Primary Health Care Development Agency and the Bauchi State Ministry of Health. In addition, the State Government should improve the allowances for the health care personnel working in the rural areas and support the community in educational enrollment and poverty alleviation as well as collaborating with health institutions like the WACP in providing quality services to the State.

First report of compounds from an Ancistrocarpus species: Triterpenoids from A. densispinosus Oliv. (Malvaceae).

The stem bark of Ancistrocarpus densispinosus Oliv. exhibited triterpenoids, including the rare fernane-type, fern-9(11)-ene-2α,3ß-diol (1) a possible chemotaxonomically distinct biomolecule for the genus. Other triterpenoids that were isolated from this plant include the ursane-type ursolic acid (2) and corosolic acid (3), friedelane-type friedelin (4) and canophyllol (5), lupane-type lupeol (6), betulin (7), betulinic acid (8) and hennadiol (9), oleanoic acid (10), maslinic acid (11) and taraxerol (12) and three sterols. This is the first report of the chemistry of a plant of the Ancistrocarpus. The structures of the compounds were elucidated based on their NMR, IR and MS techniques and by comparisons of their experimental data with those reported. The twelve triterpenoids 1-12 were found to be inactive against five bacterial strains Escherichia coli, Bacillus subtilis, Pseudomonas agarici, Micrococcus luteus and Staphylococcus warneri; inactive against KB-3-1 cervix carcinoma cancer cell line and inactive as antioxidants in the DPPH assay.

Dressed chicken as potential vehicle for spread of methicillin-resistant Staphylococcus aureus in Sokoto, Nigeria.

AIM: To evaluate the role of dressed chicken in the spread of methicillin-resistant Staphylococcus aureus (MRSA) in Sokoto, Nigeria. MATERIALS & METHODS: 190 chicken carcass rinsates were subjected to culture and biochemical analyses to isolate and identify MRSA. PCR was used to amplify mecA gene that is responsible for methicillin resistance. RESULTS & CONCLUSION: Culture and molecular analysis showed 19.5% (37/190) of the rinse had MRSA on oxacillin-resistance screening agar base (ORSAB) with 7.9% (15/190) possessing the mecA gene. Significant association (p = 0.044) exist between local-chicken and presence of MRSA, being twice more likely to have MRSA compared to exotic-chickens (odds ratio [OR] = 2.132). Results indicate possible role of dressed-chicken in the spread of MRSA. Authorities should regulate the sale and use of antibiotics by farmers, and enhance hygienic practices at slaughterhouses.

Sonographic assessment of the portal vein diameter in apparently healthy adults in a Northern Nigerian population.

BACKGROUND: Sonography is a valuable tool in the assessment of porto-systemic pathologies. This study aimed at determining the mean portal vein diameter based on age, gender and anthropometric variables. METHODS: A cross sectional study conducted among 201 apparently healthy adults in Bauchi Metropolis. Participants were recruited from the school of nursing AbubakarTafawa Balewa Teaching Hospital (ATBUTH), Bauchi. Ultrasound machine ALOKA SSD-1000, (IP-1233EV, SN-57324, Japan) with curvilinear transducer with frequency of 3-5MHz was used for a period of four months, (December 2015 to April 2016). Participants' heights were measured while standing against a meter rule with the head in Frankfurts' position and weight measured using a weighing scale. Data analysis was done using SPSS version 22.0. Descriptive statistics (mean, standard deviation), and Pearson's Correlation were used. RESULTS: The mean portal vein diameter was 9.60 ± 1.41mm for both sexes. The mean value for males was 9.71 ± 1.42mm, and 9.35±1.46mm among females. There was a positive correlation correlation between the PV diameter and Body Mass Index (P ≤ 0.01). CONCLUSION: This study found the mean values of PV diameter in apparently healthy adults in our environment to be 9.60 ± 1.41mm and that PV diameter positively correlates with anthropometric variables.

Antinociceptive activity of a synthetic oxopyrrolidine-based compound, ASH21374, and determination of its possible mechanisms.

This study was carried out to determine the antinociceptive activity of a novel synthetic oxopyrrolidine-based compound, (2R,3R,4S)-ethyl 4-hydroxy-1,2-dimethyl-5-oxopyrrolidine-3-carboxylate (ASH21374), and to elucidate the involvement of the opioid, vanilloid, glutamate, and nitric oxide - cyclic guanosine monophosphate (NO/cGMP) systems in modulating the observed antinociception. ASH21374, in the doses of 2, 10, and 100 mg/kg body mass, was administered orally to mice 60 mins prior to exposure to various antinociceptive assays. From the results obtained, ASH21374 exhibited significant (P < 0.05) antinociceptive activity in the abdominal constriction, hot-plate, and formalin tests that was comparable with 100 mg/kg acetylsalicylic acid or 5 mg/kg morphine, respectively. ASH21374 also attenuated capsaicin- and glutamate-induced paw licking. Pre-treatment with 5 mg/kg naloxone significantly (P < 0.05) inhibited the activity in all assays, while pretreatment with 10 mg/kg ß-funaltraxamine, 1 mg/kg naltrindole, or 1 mg/kg nor-binaltorphimine significantly (P < 0.05) reversed the activity in the abdominal constriction test. l-Arginine, N(G)-nitro-l-arginine methyl esters (l-NAME), methylene blue, and their combinations, failed to inhibit the ASH21374 antinociceptive activity. In conclusion, ASH21374 demonstrated antinociceptive activities on the peripheral and central nervous systems, mediated through the activation of opioid receptors, inhibition of the glutamatergic system, and attenuation of vanilloid-mediated nociceptive transmission. Further studies have been planned to determine the pharmacological potential of ASH21374.

Human dicrocoeliasis presenting as a subcutaneous mass.

Human infection by Dicrocoelium dendriticum, a zoonotic liver fluke, is uncommon and soft tissue manifestation is extremely rare. The infection has no specific clinical signs or symptoms and diagnosis may be missed completely, thus treatment may be delayed. Diagnosis in humans is by identification of the eggs in the stool, while a living or dead fluke is rarely seen. The present report concerns the case of a 7-year-old child who presented with recurrent right flank subcutaneous nodules containing a live fluke on excision, and tissue histology showed characteristic brown operculated ova of D dendriticum. This is the first extraintestinal soft tissue presentation in such a setting. It is important to know the life cycle and natural habitat of this rare human parasite in order to make a correct diagnosis and institute early treatment in patients who have become infected.