Nigerian Medical Practitioner https://www.ajol.info/index.php/nmp <em>The Nigerian Medical Practitioner</em>, a monthly Journal publishes clinical and research articles in medicine and related fields which are of interest to a large proportion of medical and allied health practitioners. It also publishes miscellaneous articles-hospital administration, business practice, accounting, law-for health practitioners. Case reports and letters about published papers are welcome. SAME Ventures en-US Nigerian Medical Practitioner 0189-0964 Copyright belongs to the journal. Correlates of Compliance to IPC Protocol among Healthcare Workers during Covid-19: Survey of A Rural Health Facility in Ogun State, Nigeria https://www.ajol.info/index.php/nmp/article/view/221305 <p>Globally, millions of people are affected by hospital acquired infections (HAIs), which are completely avoidable. Effective infection, prevention and control (IPC) procedures lead to more than 30% reduction in hospital acquired infection rates. This study sought to assess the knowledge of IPC among healthcare workers, evaluate availability and access to IPC materials at the facility and level of compliance with IPC guidelines.This was done at a comprehensive model primary health centre (PHC), Pakoto, Ogun State.This cross-sectional self-administered survey among all the healthcare workers sought to obtain data to determine the knowledge level of compliance, and correlates of compliance to the IPC policy. Data was analysed with SPSS version 21 and presented as frequency tables. Respondents were mostly female (71.6%) with a mean age of 36.8 + 6.8 years. Majority (71.6%) knew there was an IPC policy, 67.6% knew the IPC nurse and 54.9% knew there was a COVID-19 triage area. Majority (85.3%) correctly indicated that suspected patients should be kept in the triage area and the Disease Surveillance Notification Officer (DSNO) informed. Compliance with IPC protocols was high (88.0%). IPC materials like surgical facemasks, gloves, hand washing items like liquid soap, disinfectants or detergents and running water were available between 65.7% and 89.2% of the time.Gaps in knowledge, availability of IPC materials and compliance to protocols need to be addressed in order to reduce chances of COVID-19 transmission.</p> A.A. Roberts E.O. Olufela A.A. Usinoma B.A. Maduafokwa Copyright (c) 2022-02-11 2022-02-11 80 1-6 3 11 A Guide to Obstetric Risk Assessment and Referral Cascade in the Primary and Secondary Healthcare Settings in Nigeria https://www.ajol.info/index.php/nmp/article/view/221307 <p>Obstetric risk assessment and referral cascade are two interdependent and indispensable aspects of obstetric practice used to identify high risk pregnancies with subsequent referral to a higher level of care. The aim of the study was to formulate a practice guideline for obstetric risk assessment and referral cascade from primary and secondary healthcare settings to tertiary care facilities for specialised care. It was of mixed design – observational descriptive and a systematic review carried out at the Rivers State University Teaching Hospital (RSUTH). Four groups of obstetric risk factors on which obstetric referral cascade depend were clearly defined, namely intra-partum risk factors necessitating referral to tertiary centres, medical conditions indicating increased risk suggesting antenatal care and planned birth in tertiary centres, factors and medical conditions indicating increased risk suggesting referral for booking and planned delivery in tertiary centres but for joint antenatal care at all settings of obstetric care and lastly, risk factors with known timing of occurrence and outcome necessitating referral to tertiary centres when complications occur. The urgent need for structured retraining of obstetric Practitioners and equipping primary and secondary healthcare facilities with medical instruments was also emphasised. In conclusion, four obstetric risk groups necessitating referral to tertiary health facilities were identified and the need for structured retraining of antenatal/birth Attendants and adequate equipment of healthcare facilities was highlighted.</p> M. Abbey O.A. Oloyede C.I. Akani Copyright (c) 2022-02-11 2022-02-11 80 1-6 12 18 Practical Approach to Sub-specialty Training in Maternal Foetal Medicine (MFM) in Nigeria https://www.ajol.info/index.php/nmp/article/view/221311 <p>The heavy burden of maternal and perinatal morbidities and mortalities in Nigeria, most of which are MFM-related has stimulated the introduction of subspecialty training in MFM. Unfortunately in the available curriculum, less attention was paid to the ultrasound-related aspect of the training and also there was less clarity on the order of navigation through the various modules of the training. The objective of the present study therefore was to design a sub-specialty training curriculum in MFM with practical approach to its execution, taking into consideration the Nigerian ethno- cultural peculiarities, its disease topography and the level of its economic development. It was of mixed design study, with both observational and review components. A literature search and telephone communication with MFM specialists in tertiary health institutions in Nigeria on the subject were carried out. There was no structured training program in MFM in Nigeria. A competency-based modular training framework whereby acquisition of ultrasound-based competencies intertwined with the maternal medicine components of the training was proposed. The ultrasound modules to be covered were as following: first trimester scan at 11+0 to 13+6 weeks, the 20 + 0 to 23 + 6 weeks scan, growth and doppler ultrasound, cervical assessment, foetal echocardiography, application of ultrasound in the management of labour, screening for and diagnosis of placenta accrete spectrum and invasive procedures. Successful completion of the training modules, including rural posting, rotation in allied disciplines will earn the trainee an exemption from the dissertation component of the part II fellowship examination and award of fellowship or diploma in MFM, depending on whether the trainee completed the invasive module or not.</p> M Abbey OA Oloyede KI Green E Nonye-Enyidah K Okagua NJ Kwosah P Kua PA Awoyesuku R.S. Iwo-Amah B.O. Altraide S.C. Amadi L. Sapira-Ordu J. Dickson J. Ikimalo S.A. Uzoigwe C.I. Akani Copyright (c) 2022-02-11 2022-02-11 80 1-6 19 26 COVID -19 and its Perceived Environmental Risk Factors in Patients with Respiratory symptoms https://www.ajol.info/index.php/nmp/article/view/221315 <p>Diseases that involve the respiratory tract often manifest with respiratory symptoms such as cough, fever and difficulty in breathing. We evaluated the symptoms and some perceived environmental risk factors associated with COVID-19 in patients with respiratory symptoms. This was an observational record-based study, longitudinal in design. Records of 431 patients that presented with respiratory symptoms that were managed from 14th March to 14th October 2020 in Federal Medical Centre, Nguru were used for this study. Out of the 431 study participants, 62 (14.4%) had COVID -19. The mean age of the studied participants was 46.23 ± 19.37 (95% CI 44.4 – 48. 06). The mean age of the COVID-19 cases was 46.97 ± 17.22, it was similar to 46.15&nbsp; ± 19.23 in others condition manifesting with respiratory symptoms (P = 0.75). Coryza was more common in COVID-19, than other conditions (p &lt; 0.001). Contact with confirmed COVID-19 case (s), OR = 5.63, 95% CI (2.91 – 10.94) was significantly associated with COVID-19. Multiple respiratory symptom &gt; 4 was associated with COVID -19, df = 4, x2 = 11.1, P = 0.025).&nbsp; COVID -19 detection rate in patients with respiratory symptoms obtained in this study is 14.4%. It was particularly seen in those that presented early, with multiple symptoms and contacts with patients with laboratory confirmed SARS-CoV-2.</p> C.B. Akawu B.A. Denue N. Sepu A.A. Abdullahi A.M. Musa Copyright (c) 2022-02-11 2022-02-11 80 1-6 27 31 Reasons for Seeking Post Exposure Prophylaxis for HIV in A Paediatric Infectious Diseases Clinic in Owerri, Nigeria https://www.ajol.info/index.php/nmp/article/view/221316 <p>Post exposure prophylaxis (PEP) for Human immunodeficiency virus(HIV) includes amongst others drug intervention to help prevent&nbsp; infection in a person exposed to the risk of infection. Where indicated PEP should be started&nbsp; within 72 hours and adherence to a full 28-day course of antiretrovirals is critical to the effectiveness of the intervention. This study&nbsp; sought to identify the reason(s)&nbsp; on account of which&nbsp; patients&nbsp; presented at the&nbsp; Paediatric infectious diseases clinic of the Federal medical centre ,Owerri&nbsp; for HIV&nbsp; Post exposure prophylaxis. It involved the retrospective analysis of medical&nbsp; records of&nbsp; patients who presented for PEP for HIV&nbsp; between January 2012 and June 2020.&nbsp; A total of 190 patients presented during the study period for PEP for HIV. Their&nbsp; ages ranged&nbsp; from 3 to 18years. Mean Age (Mean ± SD) = 12.23 ± 4. There were 178(92.7%)&nbsp; females and 12(6.3%) males.&nbsp; The major reason for seeking PEP by patients was on account of rape , others were human bite and needle prick. About a third of the patients&nbsp; presented beyond&nbsp; 72 hours after the exposure occurred. There was a statistically significant association between age&nbsp; of the patient&nbsp;&nbsp; and&nbsp; reason for seeking PEP (p = 0.01)&nbsp; but the relationship between the reason for&nbsp; seeking PEP&nbsp; and interval between time of exposure and time of presentation was not statistically significant. (p = 0.394). The major reason for seeking HIV Post exposure prophylaxis&nbsp; in the&nbsp; clinic was rape&nbsp; and a third of the patients presented to the clinic beyond&nbsp; 72 hours&nbsp; after&nbsp; exposure to the risk event.</p> E. Nwolisa U. Ikejiaku K. Odinaka U. Nwigwe S. Anthony-eweputanna P. Anozie O. Adimora Copyright (c) 2022-02-11 2022-02-11 80 1-6 32 34