Nigerian Medical Practitioner <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. en-US Copyright belongs to the journal. (Prof O A Sofola) (Prof. S. A. Ogun) Mon, 23 Aug 2021 09:47:56 +0000 OJS 60 Clinical Audit of Low Dose Magnesium Sulphate Regimen in Management of Severe Pre-Eclampsia in a Tertiary Hospital in Sagamu South-West Nigeria <p>Pre-eclampsia contributes significantly to maternal and perinatal mortality and morbidity.&nbsp; Magnesium sulphate (MgSO4) is the anticonvulsant of choice in the prevention of convulsion in severe pre-eclampsia. Low dose regimen was conceived due to the concern of toxicity and cost in our environment. The aim of the study is to compare the clinical outcome of this low dose regimen to pritchard regimen. This was a retrospective study conducted in Olabisi Onabanjo University Teaching Hospital (OOUTH) among pregnant women managed for severe pre-eclampsia. A total of 72 and 68 women were managed for severe pre-eclampsia using pritchard regimen and low dose regimen respectively. The results show that there was no episode of convulsion and no clinical evidence of toxicity. There was no significant difference in APGAR scores, perinatal mortality and maternal complications. There was no maternal death. A randomized double blinded placebo control trial will be required to compare the efficacy.</p> O.I. Odelola Copyright (c) Mon, 23 Aug 2021 00:00:00 +0000 Haematological Parameters of Patients Attending the Geriatric Clinic of Lagos State University Teaching Hospital, Lagos, Nigeria <p>Normal aging process is related to a decline in the functional reserve of multiple organ systems which increases the probability of disease. Full blood count (or complete blood count) is one of the commonest laboratory investigations requested worldwide, and has numerous uses in the diagnosis and monitoring of different morbidities. Available literature suggest that an inverse relationship exists between most haematological parameters and age. It has been documented that aging leads to a decline in haemoglobin (Hb), packed cell volume (PCV), white blood cells (WBC) and platelet (PLT); and this suggest a reduction in bone marrow reserves. The aim of this study was to estimate the reference ranges for commonly used haematological parameters in patients attending the geriatric clinic in a Nigeria tertiary hospital. This was a descriptive cross-sectional study involving 100 geriatric patients with mean age of 71.3 + 74 years attending the Geriatric clinic of the Lagos State University Teaching Hospital. All participants' blood samples were collected and their full blood count was determined. The mean Hb concentration for the entire group was 11.43 ± 1.79g/dl with a mean of 11.84 ± 2.08 g/dl in males and 11.17 ± 1.54 g/dlin females. All these values were below the accepted reference ranges. However, the WBC and PLT counts were all within normal reference values. The mean Hb was higher in males than females and this difference was statistically significant (P= 0.01). In conclusion, evidence of lowered Hb level and normal WBC and PLT levels in the geriatrics population suggests aging may not affect all haematological indices production.</p> F.O. Olowoselu, E.I. Uche , O.O. Kalejaiye , T.A. Ekwere , R.A. Bamiro, O.A. Kareem, B. Augustine, A. Suleiman, H.A. Odebiyi , A. Balogun , A. Akinbami Copyright (c) Mon, 23 Aug 2021 00:00:00 +0000 Transcranial Electrical Nerve Stimulation for Dementia: A Systematic Review of Randomized Control Trials <p>Non-invasive brain stimulation is recently gaining interest in brain modulation but transcranial electrical stimulation is yet to receive wide acceptance as a means of managing dementia among the aged. This study reviewed transcranial electrical nerve stimulation and its effectiveness in managing patient with dementia.&nbsp; The study was carried out over a three months period beginning from April 13th to July 4th, 2020 PubMed, Cochrane, Science direct, Pedro and Google scholar&nbsp; were searched using keywords including “Transcranial Direct Current Stimulation”, “tDCS”,&nbsp; “dementia”, “cognitive impairment”. Separate searches was conducted in the same database by replacing Transcranial Direct Current Stimulation (tDCS) with Transcranial Alternating Current Stimulation (tACS). Out of the search hit of 321, 12 germane studies that met the inclusion criteria were pooled and appraised and information therein was synthesized. Out of the 10 papers on tDCS, 7 are on Alzheimer dementia and 4 of the 7 studies supported its efficacy in Alzheimer dementia with clinically important significant improvement observed in cognitive functions. The prefrontal context is the common stimulation area in managing Alzheimer and other type of dementia using tDCS at a current intensity of 1.5 to 2.0 mA. The other three studies out of the 10 papers on tDCS found improvement in cognitive functions including communicating intention processes in vascular and behavioural variant of frontotemporal dementia. One of the two studies on tACS found improvement in biomarkers of Alzheimer's disease at 40Hz (gamma range), and another found improvement in cognitive functions in patients with dementia related to Parkinson's disease at the frequency of 30Hz (Theta range), and this affect is attributable to enhancement in endogenous brain oscillation. This review suggests that Transcranial Electrical Nerve Stimulation is effective in remediating symptoms in mild to moderate dementia as a stand alone or as adjunctive treatment.&nbsp;</p> T. Adeniji , A.Y. Oyeyemi Copyright (c) Mon, 23 Aug 2021 00:00:00 +0000 Medical Migration/Brain Drain among Early Career Doctors (ECDs) in Nigeria <p>Medical migration is an unrelenting global trend. While it may be beneficial to destination countries by helping them sustain their health systems, it may negatively affect the health systems of source countries. Early Career Doctors make up a significant proportion of the health workforce of a country. They are also more mobile and, therefore, more likely to engage in medical migration. In this commentary, we examine the magnitude of the problem, the determining factors, and the impact of this phenomenon with respect to Early Career Doctors in Nigeria to proffer recommendations to alleviate this problem.</p> H.I. Monye , Y.F. Hassan, L.Q. Olajide , D.Y. Buowari , U.U. Enebeli , T. Selowo, V.I. Ogbonna, O.O. Omolawal, O.O. Adesoye , O. Agaja, T. Olalere , O. Uyilawa , O. Adebayo Copyright (c) Mon, 23 Aug 2021 00:00:00 +0000