Cancer pain control in a Nigerian oncology clinic: treating the disease and not the patient.

INTRODUCTION: inadequate pain control negatively impacts the quality of life of patients with cancer while potentially affecting the outcome. Proper pain evaluation and management are therefore considered an important treatment goal. This study assessed the prevalence of pain, the prescribing patterns, and the efficacy of pain control measures in cancer patients at the Radiation Oncology Unit of the Lagos University Teaching Hospital, Lagos. METHODS: this was a longitudinal study design recruiting adults attending outpatient clinics. Participants were assessed at initial contact and again following six weeks using the Universal Pain Assessment Tool developed by the UCLA Department of Anaesthesiology. RESULTS: among the patients reviewed, 34.0% (118 of 347) were at the clinic, referred for initial assessment following primary diagnosis. All respondents had solid tumours; the most common was breast cancer. The prevalence of pain at initial assessment was 85.9% (298 of 347), with over half of respondents, 74.5% (222 of 347) characterising their pain as moderate to severe. Over a quarter, 28.9% (100 of 347) of patients were not asked about their pain by attending physicians, and none of the patients had a pain assessment tool used during evaluation. In 14.4% (43 of 298) of patients, no intervention was received despite the presence of pain. At six weeks review, 31.5% (94 of 298) of patients had obtained no pain relief despite instituted measures. CONCLUSION: under-treatment of cancer pain remains a significant weak link in cancer care in (Low-to-middle-income country) LMICs like Nigeria, with a significant contributor being physician under-evaluation and under-treatment of pain. To ensure pain eradication, the treatment process must begin with a thorough evaluation of the patient's pain, an explicit pain control goal and regular reevaluation.

Factors Affecting Undergraduates' Participation in Medical Research in Lagos.

BACKGROUND: The current situation regarding the scope and contribution of undergraduate medical research to the health space in Nigeria is still largely unreported in formal literature. This study examined the knowledge, attitudes, and the perceived barriers faced by medical students in Lagos toward research. MATERIALS AND METHODS: A cross-sectional study design was conducted among all medical students in 200-600 levels of study at the College of Medicine, University of Lagos. With the aid of Self-administered questionnaires, we examined their knowledge of research and the analytical tools used in research, their attitudes and the perceived barriers to their participation in research. RESULTS: The data were obtained from 221 medical students, of whom 52.9% had prior involvement in research and 14.0% and 6.3% had presented or published their research, respectively. The overall knowledge of medical research was low (21.3%) and reported barriers included lack of funding for research' (79.6%), "lack of research and biostatistics curriculum" (76.0%), "inadequate training in research methodology" (74.7%), "insufficient time allocation to undergraduate research" (73.3%), "lack of professional supervisors and proper mentoring" (58.8%), and "lack of equipped laboratory facilities to conduct research" (77.8%). CONCLUSION: Our results highlight the need for more mentored supervision and training to improve their knowledge of the principles and techniques of clinical research to increase involvement.