Nigerian Hospital Practice

The Pattern of Acute kidney Injury in the Intensive Care Unit of a Low Resource Economy.

Olatosi JO, Oladimeji MA, Adekola OO — Wed, 23 Apr 2025 00:00:00 +0000

Summary:

Acute kidney injury (AKI) is characterized by sustained rise in creatinine levels and reduction in urine output. This is accompanied by retention of nitrogen products and electrolyte derangement. The incidence varies between 36% to 67% among critically ill patients with associated mortality of 50% to 70%. We determined the pattern and clinical outcome of AKI among critically ill patients. This was a retrospective, observational, cohort study on the pattern and outcomes of acute kidney injury in the intensive care unit over an 18 month period. Data were collected from case files on admission and daily during ICU hospitalization until discharge or death. Kidney Diseases: Improving Global Outcomes (KDIGO) criteria using creatinine, urine output and renal replacement therapy were used to diagnose AKI. A total of 177 patients were recruited, the incidence of AKI was 34.5%, however, only 12.9% developed AKI in the course of their ICU admission. The mean onset and duration of AKI were 2.6 ± 1.2 days and 7.9

±4.5 days respectively. The 30-day mortality rate for ICU and AKI patients were 42.4% and 85.3% respectively. Only 36.6% had renal replacement therapy. Factors mitigating against early RRT were protracted hypotension (63%), lack of funds (18%), delayed screening for HIV & Hepatitis B (18%) and lack of dialysis bed space 15.7%. Acute kidney injury is common in the intensive care unit, it is associated with high mortality rate, renal dysfunction and various adverse outcomes. Renal replacement therapy with heparin for anticoagulation and femoral vein for vascular access was the most common method for RRT at our center.

Modern Teaching Methods, Technology and Student Satisfaction in Medical Education: A Study of Year Four Medical Students in Southern Nigeria.

Otokunefor O, Ewong Ememobong K. — Wed, 23 Apr 2025 00:00:00 +0000

Summary:

Training and producing quality medical doctors is crucial for the overall health of a population. The world is rapidly evolving. Medical practice as well is evolving with virtual wards and online consultations taking place. Therefore, the training methods need to adapt to the changes. Use of PowerPoints has replaced dictating of notes. The current Gen-Z students and their trainers need to evolve and adapt to the present realities while at the same time optimizing assimilation. The aim of the study was to ascertain the effectiveness of the current teaching pattern of the year four students based on the student's satisfaction and establish how it can be modified for better efficacy. This was a descriptive cross-sectional study carried out among students who just passed the fourth-year professional medical examination in a public university in Southern Nigeria. Purposive sampling technique was utilized while an online semi-structured questionnaire was used to collect data. Results were recorded and analysed using SPSS version
23. Data was analysed through descriptive statistics. Frequencies and percentages were used. A P-value equal to or less than 0.05 was taken as significant. Sixty-four students filled the form. Most of the respondents were 23 years and above (52.4%) and most were females (57.1%). 66.7% were content with the class, 87.3% affirmed that use of PowerPoint aided comprehension. Most (58.7%) of the students attended tutorials at least 75-95% of the time, 79.4% found tutorials and the informal assessments helpful. Moving forward, most of the students, (73%) stated that online visual demonstrations, and official study groups (61.9%) would be beneficial to students. The use of PowerPoint presentation was found to be adequate, however it can be improved by visual demonstrations and establishing of official study groups. The use of PowerPoint notes is an effective tool for lecturing. Fortifying this with informal assessments. Future students will benefit from establishing official study groups and visual demonstrations.

Pattern of Sociodemographic and Clinical Attributes of Patients with Depression in Diabetes Mellitus in a University Teaching Hospital in Nigeria

Maigari JM — Wed, 23 Apr 2025 00:00:00 +0000

Summary:

Improved knowledge of the sociodemographic and clinical characteristics of patients with depression in diabetes mellitus can assist patients, carers and policy makers in the prevention and care of these patients leading to better overall outcome for subjects with diabetes mellitus. This was a cross sectional descriptive study of 250 patients with diabetes mellitus who were recruited by simple random sampling via ballotting, administered the socio-demographic/clinical Questionnaire, then screened with the General Health Questionnaire 12. They were then administered with the Schedule for Clinical Assessment in Neuropsychiatry (Depression module) administered to generate diagnoses of depression. They also had the WHO Disability Assessment Schedule II Questionnaire. Prevalence rate of depression in the sample was 24.4 %. The mean age of depressed subjects was 49.97 ±11.044 years while it was 52.23 ±9.81 years for subjects not depressed. There was statistically significant association between medication adherence and not developing depression in diabetes mellitus (p= 0.048). Development of disability and depression in diabetes mellitus was also statistically significant (p=0.001). Depression is very prevalent in adult diabetes mellitus patients and requires close attention, identification and treatment. Medication adherence protects subject from developing depression in diabetes mellitus. Subjects with depression in diabetes mellitus are more likely to have disability.

Aquaporin 4-Positive Neuromyelitis Optica Presenting with Diencephalic Syndrome and Spinal Cord Sparing: A Rare Presentation

Nwazor E, Ogbamgba S, Tomba Martyns-Yellowe — Wed, 23 Apr 2025 00:00:00 +0000

Summary:

Neuromyelitis Optica Spectrum Disorder (NMO) is a rare autoimmune-mediated disorder of the central nervous system characterized by severe inﬂammation and demyelination of the brain, optic nerves, and spinal cord. We report a rare case of a 17-year-old male who presented with bilateral visual loss, quadriparesis, and diencephalic syndrome, with normal spine MRI. Serum aquaporin-4 (AQP4) antibodies were positive, confirming the diagnosis of NMO. The patient's presentation with diencephalic syndrome and spinal cord sparing is unusual and highlights the heterogeneity of NMO presentations. This case report highlights the importance of considering NMO in the differential diagnosis of patients presenting in the neurology clinic with optic neuritis and brainstem symptoms, even in the absence of spinal cord involvement. Early diagnosis and treatment are crucial to prevent long-term disability and improve outcomes in patients with NMO.