Type 2 diabetes mellitus risk assessment among doctors in Ondo state.

Introduction: Diabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State. Methods: This was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant. Results: One hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13-26.33; p = <0.001); BMI ≥25kg/m2 (AOR:11.41; CI:4.14-31.45; p = <0.001); family history of DM (AOR:9.93; CI:3.25-30.39; p = <0.001); abdominal obesity (AOR:6.66; CI:2.08-21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable (AOR:3.11;CI:1.03:9.37: p = 0.04). Conclusion: There was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.

Recalling the universal health coverage vision and equity in the COVID-19 vaccine distribution plan.

The COVID-19 pandemic has changed the world in so many ways since 2019 when the first case was recorded. COVID-19 pandemic has impacted negatively on economy, health, education and infrastructure globally. COVID-19 vaccine was developed with the aim of stopping the pandemic and allowing the rebuilding of our societies and economies. The vaccine was rolled out in December 2020 and the distribution plan appears to be skewed in favour of high income countries. This paper highlights the need for consideration of the principles of equity and universal health coverage in the distribution plan of the vaccine. It emphasizes the need to ensure that the interests of citizens of developing and low income countries are well protected. The paper concludes that issues of disparity in economic status of countries entering agreement with the vaccine manufacturing companies, absence of logistic support among others should not be a barrier to ensuring equitable access to vaccine for all consistent with the sustainable development goal 3.7.

Legal perspectives on liability for medical negligence and malpractices in Nigeria.

Medical practice usually involves different activities which if not professionally handled, may give rise to liabilities on the part of the medical practitioner. These liabilities may arise in tortious claims and in some other cases, may go beyond the realm of civil liabilities to criminal liabilities. This review focuses on liabilities that amount to negligence both under the civil and criminal laws in Nigeria, other instances of malpractices which may not amount to negligence but may suffice to give rise to a successful cause of action in other branches of substantive law including claims for breach of fundamental human rights; contract; and fiduciary relationship. The review concludes by emphasizing the need for caution and the need to ensure that justice is seen to be done not only to the victims but also to the medical practitioners who deserve all legal protection in the exercise of their professional duties.

Assessment of knowledge of chronic kidney disease among non-nephrology nurses in Akure, South-West Nigeria.

Health workers require adequate knowledge of chronic kidney disease (CKD) to be able to play their role in reducing the burden of CKD. Most previous studies focused on assessing knowledge of doctors on CKD; however, nurses are also important in primary, secondary, and tertiary prevention of CKD. This study assessed the knowledge of non-nephrology nurses on CKD with the aim of identifying areas of knowledge gaps which will be targets for future educational programs. This was a cross-sectional descriptive study carried out among nurses in Akure, Southwest Nigeria during their mandatory continuing professional development program required for practicing license renewal. Knowledge of CKD was assessed using self-administered pretested questionnaires. P <0.05 was taken as significant. One-hundred nurses participated in the study with a male:female ratio of 1:3.7. The mean duration of their nursing experience was 14.5 ± 9.1 years. Only 15% had nephrology posting during their training. Six (6%) of the respondents had good knowledge of CKD, 55 (55%) had fair knowledge, and 37 (37%) had poor knowledge. Only 5% was aware of renal care policy in Nigeria. Junior and intermediate cadre nurses had better knowledge of CKD than senior cadre nurses (P = 0.004). Nurses who had nephrology posting during their training had significantly higher mean knowledge score than others (14.38 ± 2.25 vs. 12.93 ± 3.10, P = 0.036). There were significant deficiencies in the knowledge of CKD among non-nephrology nurses who participated in the study. Junior and intermediate cadre nurses and those who had nephrology postings had better knowledge of CKD.

Assessment of iron status in predialysis chronic kidney disease patients in a Nigerian Tertiary Hospital.

Anemia in chronic kidney disease (CKD) is associated with poor overall outcome if not promptly managed with erythropoietin when indicated. This study assessed iron status and associated factors in predialysis CKD patients in Southern Nigeria. This was a cross-sectional study that assessed and compared iron status in 100 predialysis CKD patients and 90 healthy controls. Mean age of the CKD patients was 49.39 ± 14.84 years. Iron deficiency was present in 14% of CKD patients compared to 3% of the controls (P = 0.021). Among CKD patients with ID, 11 (85.7%) had functional iron deficiency while three (14.3%) had absolute iron deficiency. Serum ferritin was significantly higher in the predialysis CKD patients (P = 0.001). There was no significant gender difference in iron indices among the CKD patients. Functional iron deficiency was present in 11 (11%) of the CKD patients compared to none among the control group (P = 0.003). There was no significant association between iron deficiency and age, gender, etiology, and stage of CKD. Functional iron deficiency was the predominant form of iron deficiency in our predialysis CKD patients, and there was no significant association with age, gender, stage, or etiology of CKD.