Exploring artificial intelligence in the Nigerian medical educational space: An online cross-sectional study of perceptions, risks and benefits among students and lecturers from ten universities.

Background: The impact of artificial intelligence (AI) has been compared to that of the Internet and printing, evoking both apprehension and anticipation in an uncertain world. Objective: This study aimed to explore the perceptions of medical students and faculty members from ten universities across Nigeria regarding AI. Methods: Using Google Forms and WhatsApp, a cross-sectional online survey was administered to clinical year medical students and their lecturers from ten medical schools representing all the six geopolitical zones of Nigeria. Results: The survey received 1003 responses, of which 708 (70.7%) were from students and 294 (29.3%) were from lecturers. Both groups displayed an average level of knowledge, with students (Median:4, range -5 to 12) significantly outperforming lecturers (Median:3, range -5 to 15). Social media (61.2%) was the most common form of first contact with AI. Participants demonstrated a favourable attitude towards AI, with a median score of 6.8 out of 10. Grammar checkers (62.3%) were the most commonly reported AI tool used, while ChatGPT (43.6%) was the most frequently mentioned dedicated AI tool. Students were significantly more likely than lecturers to have used AI tools in the past but <5% of both groups had received prior AI training. Excitement about the potential of AI slightly outweighed concerns regarding future risks. A significantly higher proportion of students compared to lecturers believed that AI could dehumanise health care (70.6% vs. 60.8%), render physicians redundant (57.6% vs. 34.7%), diminish physicians' skills (79.3% vs. 71.3%) and ultimately harm patients (28.6% vs. 20.6%). Conclusion: The simultaneous fascination and apprehension with AI observed among both lecturers and students in our study mirrors the global trend. This finding was particularly evident in students who, despite possessing greater knowledge of AI compared to their lecturers, did not exhibit a corresponding reduction in their fear of AI.

Developing a Low-resource Approach to Trauma Patient Care - Findings from a Nigerian Trauma Registry.

BACKGROUND: Trauma is a worldwide problem that results in significant morbidity and mortality in developing countries. OBJECTIVE: This study looks at the demography of trauma from data abstracted from a Nigerian trauma registry and considers the peculiarities of a low-resource setting from this perspective. METHODS: Trauma registry data from January 2013 to June 2014 were analyzed. RESULTS: A total of 542 patients were included in the study. The mean age of the patients was 33.43 ± 12.79 years; the median time from injury to arrival at the hospital was 3 h (interquartile range IQR 1 - 5.1 h); three-quarters of the patients sustained their injuries on the road-tricycles were rarely involved in road traffic injuries (RTIs) (6.9% of RTIs) but were used in transporting a third of the patients whose data on means of transportation were captured. There were 15 (2.7%) deaths in the first 24 h period postinjury covered by the study - 13 (86.7%) of these patients had head-and-neck injury. About half of the assault injury (50.5%) was from persons known to the victim. The shock indices suggested that a majority of the patients were not at a high risk of mortality. CONCLUSION: Most of the trauma patients at our hospital were in low- to middle-income categories. The median time to arrival of injured patients was 3 h (IQR 1 - 6 h). Most injuries occurred on the road because of RTIs. The involvement of tricycles in accidents was uncommon, but they were used fairly commonly by lay responders in transporting the injured victim to hospital. A high proportion of assailants were known to the victim. The use of trauma registries provides essential data for prioritizing limited resources and can guide a contextualized approach to reducing trauma and improving trauma patient care.

Computed Tomographic Imaging Appraisal of Traumatic Brain Injury in a Tertiary Hospital in South-South Nigeria: A 6-Year Review.

BACKGROUND: Computed tomography (CT) remains the gold standard in imaging evaluations of traumatic brain injury (TBI). TBI on its own has become a major concern in developing countries with its untoward effects. OBJECTIVES: The objective was to appraise the craniocerebral computed tomograms of patients who had TBIs. MATERIALS AND METHODS: A retrospective study of patients who underwent craniocerebral CT on account of head injury in the University of Uyo Teaching Hospital, Uyo, Nigeria, from November 13, 2013 to May 31, 2019 was done. The duration was regardless of the disjointed periods of service interruption. Patients' demographic and CT features were evaluated with application of simple analysis of data. RESULTS: Two hundred and thirty-two patients were evaluated with minimum and maximum ages of 6 months and 78 years, respectively. Males were predominant with a ratio of 2.74: 1. Most affected age ranges were 30-39 years (23.27%) and 20-29 (22.84%). Normal brain CT was seen in 44 patients (18.97%). The most frequent lesion in patients with abnormal CT was intracranial hemorrhages (n = 188, 81.03%). Here, extra-axial hemorrhages (n = 100, 53.19%) supersede intracerebral hemorrhages (n = 88, 46.81%). Half of the intracerebral hemorrhages were multiple. Calvarial fractures were seen in 34.48% (n = 80) of patients. The most common localization was the facial bones (n = 24, 30.00%), whereas the least site was the occipital bone (n = 4, 5.00%). Fifteen percent of the patients had multiple fractures which also included base of the skull. CONCLUSION: TBIs commonly occur among young active males. The most frequent lesion is intracranial hemorrhages with extra-axial bias.

Prevalence and predictors of low back pain in a Southern Nigerian hospital.

Background: Low back pain (LBP) is the most common musculoskeletal disease in adults. The data on LBP from Sub-Saharan Africa are inadequate. The aim of this study was to assess the prevalence and analyze the predictors of LBP among hospital staff in a Nigerian tertiary hospital. Materials and Methods: The study participants were recruited using an opt-in approach, with the aim of including representative numbers from each professional cadre. Each participant gave formal consent. Ethical clearance was obtained. Results: Five hundred and sixty-three participants with the mean age of 36.0 ± 8.3 years and 62% female were interviewed. The point prevalence of LBP was 234 (42% [95% confidence interval [CI]: 37%-45%]). Profession was a significant predictor of LBP (P = 0.001) - nurses (53% [95% CI 43%-63%]), administrative officers (49% [95% CI 40%-59%]), engineers (50% [95% CI 24%-76%]), and health information staff (50% [95% CI 26%-75%]) had the highest prevalence. In univariate regression, female gender, increasing age, body mass index ≥25 kg/m2, and frequently adopting a bending posture, were significantly associated with LBP, while in multivariate regression, only the female gender was a significant predictor. Conclusion: The pattern of both the professions at risk, due to the well-known mechanisms of poor ergonomics, and the marked risk for the female gender, in the hospital setting, suggest underresourced work and societal environments as the underlying factors-more research is needed.

RésuméContexte: La douleur dans le bas du dos est la maladie musculeux-squelettique la plus commune parmi les adultes. Les données sur la douleur dans le bas du dos de l'Afrique sub-saharienne ne sont pas adéquates. Le but de cette communication était est d'évaluer la prévalence et d'analyser les indicateurs de la douleur dans le bas du dos parmi les travailleurs dans l'hôpital tertiaire au Nigeria. Methodes: Les participants de l'étude ont été sélectionnés à travers l'approche opt-in, pour bien représenter les gens de chaque niveau professionnel. Chaque participant a donné son consentement. L'autorisation éthique a été obtenue. Resultats: Cinq cents soixante-trois participants de l'âge moyen de 36.0 ± 8.3 et 62% de femelles ont été interviewés. Le point de prévalence de la douleur dans le bas du dos était 234 [42% (95% CI 37 ­ 45%)]. La profession est un indicateur important de la douleur dans le bas du dos (P - 0.001) ­ les infirmiers [53% (95% CI 43 ­ 63%)], les directeurs administratifs [49% (95% CI 40 ­ 59%)], les ingénieurs [50% (95% CI 24 ­ 76%)] et les travailleurs de l'information de santé [50% (95% CI 26 ­ 75%)] ont eu la plus prévalence. Dans la régression univariée, sexe féminin, l'âge croissant, IMC ≥ 25kg/m2 et adoptant fréquemment une posture de flexion, ont été associés à la douleur dans le bas du dos, tandis que dans la régression multivariée, seulement le sexe féminin était un indicateur important. Conclusion: Le schéma des deux professions sont à risque dû aux mécanismes bien reconnus de pauvres ergonomiques, et le risque marqué pour le sexe féminin, en milieu hospitalier, suggère un travail sous financé et les environnements de société en tant que facteurs sous-jacents - plus de recherche est nécessaire.

Prevalence and predictors of low back pain in a Southern Nigerian hospital

Background: Low back pain (LBP) is the most common musculoskeletal disease in adults. The data on LBP from Sub-Saharan Africa are inadequate. The aim of this study was to assess the prevalence and analyze the predictors of LBP among hospital staff in a Nigerian tertiary hospital. Materials and Methods: The study participants were recruited using an opt-in approach, with the aim of including representative numbers from each professional cadre. Each participant gave formal consent. Ethical clearance was obtained. Results: Five hundred and sixty-three participants with the mean age of 36.0 ± 8.3 years and 62% female were interviewed. The point prevalence of LBP was 234 (42% [95% confidence interval [CI]: 37%­45%]). Profession was a significant predictor of LBP (P = 0.001) ­ nurses (53% [95% CI 43%­63%]), administrative officers (49% [95% CI 40%­59%]), engineers (50% [95% CI 24%­76%]), and health information staff (50% [95% CI 26%­75%]) had the highest prevalence. In univariate regression, female gender, increasing age, body mass index ≥25 kg/m2, and frequently adopting a bending posture, were significantly associated with LBP, while in multivariate regression, only the female gender was a significant predictor. Conclusion: The pattern of both the professions at risk, due to the well-known mechanisms of poor ergonomics, and the marked risk for the female gender, in the hospital setting, suggest underresourced work and societal environments as the underlying factors-more research is needed

Students' perceptions of the learning environment in two Nigerian medical schools offering different curricula.

OBJECTIVE: Compare the results of administering the DREEM questionnaire in two Nigerian medical schools offering traditional and student-centred curricular respectively, to identify any differences in the learning environment and appreciate advantages of the more modern curriculum. METHODS: A survey design was used. Data was analysed using the DREEM scoring rubric. The independent t-test was used to compare results. SETTING: The DREEM questionnaire was administered to final year medical students at two participating centres. PARTICIPANTS: Final year students of a teacher-centred and a student-centred medical school. RESULTS: There were 138 respondents - 50 (96.2% of the final year students) from the teacher centred school and 88 (59.1% of the final year students) from the student-centred school. The mean total DREEM score was 117+22.3 in the former and 119 +23.6 in the latter (p = 0.798). Mean age of students in the teacher centred school was 28 ± 5.28 years, while that of the student-centred school was 23 ± 1.83 years (p < 0.05). CONCLUSION: The mean total DREEM score proximity between the schools suggests that the younger students using a more student-centred curriculum have less of an appreciation of their improved learning environment than is expected. Thus, the hidden curriculum could be lagging behind the written one. The older students in the teacher centred environment have a more mature appreciation of their learning climate. FUNDING: Personal sources.

The Uyo Trauma Registry-developed for sustainable audit of trauma care and cause in Nigeria.

The Cape Town Trauma Registry (CTTR) was developed as a minimum data set for low-resource settings and was applied in a southern Nigerian tertiary hospital. Based on the outcome of the study, the CTTR was modified to produce the Uyo Trauma Registry. Using the CTTR, data was obtained prospectively from injured patients who presented to the Accident and Emergency Department of the University of Uyo Teaching Hospital over a 7 week period in June and July 2012. The final data set was determined based on the ease of capture of each item and its relative importance to injury surveillance. The goal for satisfactory data capture was chosen as ≥ 80%. The Uyo Trauma Registry has 19 patient-variable items and may be the first locally relevant hospital based injury surveillance tool in Nigeria. The Uyo Trauma Registry has provided the resource constrained setting in Nigeria with a simplified tool in order to sustainably obtain trauma data and thus engage in objective locally relevant efforts at injury prevention and improved care of the injured patient.

Pre-internship Nigerian medical graduates lack basic musculoskeletal competency.

PURPOSE: Our aim was to assess the basic musculoskeletal competency of pre-internship graduates from Nigerian medical schools. METHODS: We administered the Freedman and Bernstein basic musculoskeletal competency examination to 113 pre-internship graduates from seven Nigerian medical schools over a three year period from 2008 to 2010 at the University of Uyo Teaching Hospital. Five specialist residents took the examination to test criteria relevance. RESULTS: All graduates failed this test, obtaining scores ranging from 7% to 67%. The duration of the orthopaedic posting, and observation of operative fracture fixation, were not significant determinants of the score. The two final-year specialist residents each had a marginal pass in the examination. CONCLUSION: Basic musculoskeletal competency among pre-internship Nigerian medical-school graduates is inadequate.

Patterns of Spinal Injury in a New Neurosurgical Centre: A 2-Year Prospective Study

Background: Spinal injury is a major cause of morbidity and mortality worldwide. Road traffic accident is the main aetiologic factor; affecting mostly the male gender in the 15 - 40-year age group. The aim of this study was to establish our local hospital patterns of spinal injury and compare them with published reports. Methods and Patients: A prospective study of all spinal injury patients treated in our service in the two-year period; April 21; 2006 - April 20; 2008 was undertaken. Data collection was done using a structured proforma from the time of admission into our service to the time of discharge; and subsequent follow-up in the few cases that kept to their appointment. Data was then collated and simple data analysis done. Results: Spinal injury was diagnosed in 62 of our 826 patients; mostly males; aged 15-40years 28 (45.2); and road traffic accident was the main aetiologic factor with an unusually high case incidence from motorcycles. There were neurological deficits in 49(79) and cervical cord injuries were the most common. Evaluation of the injuries was mostly with plain radiography; and treatment was non-operative in all cases. omplete cord injuries remained without improvement; and complications were mostly pressure ulcers; with no incident of deep venous thrombosis. Mortality was 13(21). Conclusion: Spinal injury was an important indication for neurosurgical consultations in our service. Complete cord injuries were more common than incomplete injuries contrary to other previous reports; and the case incidence from motorcycles was remarkably high

Plating of Femoral Shaft Fractures: the Experience in an African Teaching Hospital.

BACKGROUND: Femoral shaft fractures are common presentation in our trauma units. It is obvious that all these fractures cannot be treated conservatively due to the pressure on trauma beds and thus a suitable method of internal fixation that is feasible in the environment has had to be adopted. OBJECTIVE: This study is a report of our experience with plate fixation of femoral shaft fracture in our environment. DESIGN: A retrospective hospital based study. PATIENT AND METHOD: All patients with femoral shaft fractures stabilized with plates and screws between 1997 and 2004 at the University College Hospital were reviewed. The case notes were retrieved and data extracted from them; all case notes entry gave sufficient information. RESULTS: The fracture pattern showed 56 cases (35.4%) of Type 32-A, 45 cases (28.5%) of Type 32-B and 57 cases (36.1%) of Type 32-C using AO classification. The outcome of treatment was excellent to good in 125 fractures (77.2%). The average time of healing was 20 weeks (range 16-48). Fracture related complications occurred in nine fractures (5.7%) which included deep infection in four fractures (2.5%) and implant failure in five fractures (3.2%). CONCLUSION: Femoral shaft plating gives good result if the principles of fixation is carefully followed and in developing countries where initial cost of procurement of equipments for closed nailing may not be forth coming, it thus provide a safe efficient and low cost method of fixation of femoral shaft fracture.