Open prostatectomy for benign prostatic hyperplasia: A critical analysis of patient presentation and surgical outcomes in a contemporary series.

Background: Open prostatectomy (OP) is still a valid treatment option for benign prostatic hyperplasia (BPH), but it needs to be constantly reevaluated in the context of minimally invasive treatments (MITs). Aim: Our purpose is to present contemporary data on patient presentation and surgical outcomes of OP with which other OP series and MITs can be compared. Methods: A retrospective study of all OP was carried out in our institution from January 2011 to December 2020. All patients had a thorough preoperative workup and optimization of comorbidities before surgery. Data were collected in a predesigned pro forma and analyzed. Results: The mean age of the 148 patients studied was 66.2 (±7.9) yrs. The mean duration of symptoms before surgery was 32.2 (±33.7) mos. The mean preoperative prostate volume was 118.0 (±67.1) cm3. There was a 54.4% comorbidity rate with diabetes mellitus (DM) topping the list (16.0%). An incidental prostate cancer rate of 6.1% was found. The overall complication rate was 45.3%. Perioperative hemorrhage requiring blood transfusion (BT) was the most common complication (26.1%). There was no significant difference in age, duration of surgery, and prostrate volume between subjects with and without BT (P > 0.05). Wound infection was significantly associated with diabetes (P = 0.043, OR = 3.507, 95% CI = 1.042-11.805). The reoperation rate was 1.4%, and mortality rate was 0.7%. The International Prostate Symptom Score (IPSS), quality-of-life (QOL) score, and post-void residual urine (PVR) volume were significantly improved (P < 0.001). Conclusion: OP was found to be a safe and effective procedure for the relief of bladder outlet obstruction (BOO) secondary to BPH. However, it was associated with high morbidity and low reoperation rate.

Physical Activity among Healthcare Workers in a Major Tertiary Hospital, Southeast Nigeria.

BACKGROUND: Physical inactivity (PIA) is the fourth leading risk factor in an estimated global death of 3.2 million annually. To reverse this negative impact of PIA, there is a need to increase physical activity (PA). This could be achieved through creation of awareness, promotion, and good practice of PA by healthcare workers. OBJECTIVE: To evaluate physical activity among healthcare workers (HCW) in a major tertiary hospital, southeast Nigeria. METHODS: The Global Physical Activity Questionnaire (GPAQ) was researcher-administered to investigate PA level among consenting HCW who met the inclusion criteria. Participants were recruited from their workstations in the hospital. The questionnaire recorded age, anthropometrics, demographics, and physical activity. Data were summarized with descriptive statistics of frequency and percentages. The spearman rank correlation test was used to assess for the relationship between PA and socio-demographic factors. RESULTS: There were 209 participants with 93 (44.5%) males and 116 (55.5%) females. The mean age was 34.32±9.88 years. Amongst different professions, Nurses were 53(25.3%), Doctors, 31 (14.8%), and Dietitians, 21 (10%), Accountants, 19 (9.1%). The majority of the participants 100 (47.8%) had physical activity level that was high (extra sufficient), 31 (14.8%) had a moderate PA level while 78 (37.3%) had a low physical activity level. There was a significant negative relationship between PA and age, marital status, number of children, and other dependents respectively, whereas there was no significant relationship between PA and gender, income, and family type. CONCLUSION: HCWs have the minimum required PA in a week. About 63% met the minimum required PA in a week. Age, marital status, and having children or dependents reduce participation in PA. However, there is a need for conscious awareness and practice of PA among HCW in the hospital.

CONTEXTE: L'inactivité physique (AIP) est le quatrième facteurde risque dans une mortalité mondiale estimée à 3,2 millions de personnes par an. Pour inverser cet impact négatif du PIA, il est nécessaire d'augmenter l'activité physique (AP). Cela pourrait être réalisé par la sensibilisation, la promotion et les bonnes pratiques de l'AP par les travailleurs de la santé. OBJECTIFS: Évaluer l'activité physique chez les travailleurs de la santé (HCW) dans un grand hôpital tertiaire, au sud-est du Nigeria. METHODES: Le questionnaire global sur l'activité physique (GPAQ) a été administré par des chercheurs pour étudier le niveau d'activité physique chez les travailleurs de la santé consentants qui répondaient aux critères d'inclusion. Ils ont été recrutés à partir de leurs postes de travail à l'hôpital. Le questionnaire enregistrait l'âge, l'anthropométrie, la démographie et l'activité physique. Les données ont été résumées avec des statistiques descriptives de fréquence et de pourcentages. Lacorrélation du rang de lanceur pour le test de la relation entre l'AP et les facteurs sociodémographiques. RESULTATS: Il y avait 209 participants avec 93 (44,5 %) hommes et 116 (55,5 %) femmes. L'âge moyen était de 34,32 ± 9,88 ans. Parmi les différentes professions, les infirmières étaient 53 (25,3%), les médecins, 31 (14,8%), et les diététiciens, 21 (10%), les comptables, 19 (9,1%) etc. La majorité des participants 100 (47,8%) avaient des problèmes physiques niveau d'activité élevé (extra suffisant), 31 (14,8%) avaient un niveau d'AP modéré tandis que 78 (37,3 %) avaient un niveau d'activité physique faible. Il y avait une relation négative significative entre l'AP et l'âge, l'état matrimonial, le nombre d'enfants et d'autres personnes à charge, respectivement, alors qu'il n'y avait pas de relation significative entre l'AP et le sexe, le revenu et le type de famille, respectivement. CONCLUSION: les travailleurs de la santé ont l'AP minimale requise en une semaine. 62,6 % ont atteint l'AP minimale requise en une semaine. L'âge, l'état matrimonial et le fait d'avoir des enfants ou des personnes à charge réduisent la participation à l'AP. Cependant, il existe un besoin de sensibilisation consciente et de pratique de l'AP parmi les travailleurs de la santé à l'hôpital. Mots-clés: Inactivité physique, Facteurs de risque, Nigéria, Questionnaire global sur l'activité physique, Équivalent métabolique.

Seroprevalence of Hepatitis B, and C Viruses and HIV Infections among Antenatal Women in a Secondary Health Facility in Lagos, Nigeria.

BACKGROUND: Hepatitis B and C viruses and HIV infections contribute a significant proportion to maternal and perinatal morbidity and mortality in low and middle-income countries. While the burden of hepatitis B and C viruses is higher in low and middle-income countries, Nigeria also has the second largest burden of HIV. OBJECTIVES: To determine the seroprevalence of hepatitis B and C viruses and HIV infections among antenatal women who sought care at a secondary health facility in Lagos. METHODS: This was a retrospective review of patients managed in the antenatal clinic of 68 Nigerian Army Reference Hospital over one year. A study proforma was used to collect relevant data which were entered and analyzed using the IBM Statistical Package for Social Sciences (SPSS Statistics) Version 23. RESULTS: A total of 347 women attended prenatal care during the study period, however, only 329 cases with complete data were included in the final statistical analysis. The prevalence of HIV in our study was 6.4%, while HBV and HCV accounted for 6.2% and 1.8% respectively. Hepatitis B, and hepatitis C viruses and HIV Infections occurred in 3 (0.9%) of our patients, 6 (1.8%) of the women had HIV-HBV co-infection while 1 (0.3%) was infected with HIV-HCV. CONCLUSION: Our study re-emphasizes the public health importance of HBV, HCV and HIV screening in our antenatal clinics. This knowledge is very important for the implementation of effective prevention and control measures that will further decrease the mother-to-child transmission of these viruses.

CONTEXTE: Les virus de l'hépatite B et C et les infections par le VIH contribuent pour une part importante à la morbidité et à la mortalité maternelles et périnatales dans les pays à revenu faible et intermédiaire. Alors que le fardeau des virus de l'hépatite B et C est plus élevé dans les pays à revenu faible et moyen, le Nigeria a également le deuxième plus grand fardeau du VIH. OBJECTIFS: Déterminer la séroprévalence des virus de l'hépatite B et C et des infections par le VIH chez les femmes en période prénatale qui ont consulté dans un établissement de santé secondaire de Lagos. MÉTHODES: Il s'agit d'une étude rétrospective des patientes prises en charge dans la clinique prénatale de 68 références de l'armée nigériane sur une période d'un an. Un formulaire d'étude a été utilisé pour recueillir les données pertinentes qui ont été saisies et analysées à l'aide du progiciel statistique pour les sciences sociales IBM (SPSS Statistics) version 23. RÉSULTATS: Un total de 347 femmes ont suivi des soins prénataux pendant la période d'étude, cependant, seuls 329 cas avec des données complètes ont été inclus dans l'analyse statistique finale. La prévalence du VIH dans notre étude était de 6,4%, tandis que le VHB et le VHC représentaient respectivement 6,2% et 1,8%. Les virus de l'hépatite B et de l'hépatite C ainsi que le VIH étaient présents chez 3 (0,9%) de nos patientes, 6 (1,8%) des femmes avaient une co-infection VIHVHB tandis qu'une (0,3%) était infectée par le VIH-VHC. CONCLUSION: Notre étude souligne à nouveau l'importance pour la santé publique du dépistage du VHB, du VHC et du VIH dans nos cliniques prénatales. Ces connaissances sont très importantes pour la mise en œuvre de mesures de prévention et de contrôle efficaces qui permettront de diminuer davantage la transmission mère-enfant de ces virus. Mots clés: Hépatite B, VIH, Hépatite C, Séroprévalence, Coinfection, Lagos.

Urological emergencies in a Nigerian teaching hospital: Epidemiology and treatment.

BACKGROUND: Urological emergencies constitute a significant part of emergency presentations in various referral centers. Data on the prevalence of these emergencies in West African sub-region are sparse. OBJECTIVE: The study is aimed at determining the pattern of urological emergencies in our center and is geared towards bridging the gap in knowledge of the epidemiology of urological emergencies in this sub-region as a means of achieving efficient use of scarce resources. SUBJECTS AND METHODS: It was a retrospective study of all urological emergency cases that presented over six years in a Federal University Teaching Hospital in Nigeria. Data were collected from emergency register and theatre logs. Data analysis was done using SPSS version 25. RESULTS: A total of 267 patients presented with urological emergencies during the period of study with 258 (96.6%) men and 9 (3.4%) women. The mean age of the patients was 50.6 ± 20.8 years. Urinary retention was the most common urological emergency accounting for 159 (59.6%) cases followed by Fournier's gangrene 23 (8.6%) and testicular torsion 23 (8.6%). Bladder and ureteral injuries accounted for 5 (55.6%) of the urological emergency presentations in women while both injuries accounted for only 4 (1.6%) in men (P = 0.000). Urethral catheterization was the most commonly performed procedure 139 (52.1%), followed by percutaneous suprapubic cystostomy (SPC) 31 (11.6%). CONCLUSION: Urological emergencies have varying presentations in both sexes. Urinary retention, and acute scrotum were the most common urological emergencies in our facility. This knowledge can be used in emergency preparedness planning which involves personnel training and resource allocation.

Pharmacodynamics of diclofenac from novel Eudragit entrapped microspheres.

Effective clinical utilization of non-steroidal anti-inflammatory drugs such as diclofenac sodium (DS) is significantly limited by their ulcerogenic potential and poor bioavailability after oral administration, thus necessitating the need for a better carrier to minimize these obvious limitations. The objective of this study was to evaluate Eudragit® RS100/RL100 microspheres formulated by the solvent-evaporation technique for improved delivery of diclofenac. Three batches of (DF1, DF2 and DF3) microspheres were prepared using different ratios of Eudragit RS-100 and RL-100 polymers based on the solvent-evaporation method. The microspheres were characterized based on morphological properties, particle size analysis and encapsulation efficiency (EE%). In vitro release of DS was investigated in both 0.1 N HCl (pH 1.2) and phosphate-buffered saline (pH 7.4), while anti-inflammatory studies were evaluated in the rat model. Maximum EE% of 86.61 ± 0.11, 88.14 ± 0.16 and 85.50 ± 0.21 was obtained for DF1, DF2 and DF3, respectively. Discrete, smooth and brownish microspheres of size range 437 ± 0.01-479 ± 0.21 µm were obtained. Release of DS from the formulation depends on the polymer ratio. All the batches exhibited good anti-inflammatory activities. Microsphere formulations based on Eudragit® polymers would likely offer a reliable and alternative means of delivering DS orally.

Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu.

An overview of health and social issues is presented here regarding Native Hawaiian transgenders. Perhaps due to relatively greater tolerance of gender diversity among Polynesian cultures, approximately 70% of all male-to-female transgenders in Hawai'i are Native Hawaiian. However, the overall climate is one of discrimination and harassment such that transgenders--who tend to be under-educated, under-employed, and medically underserved--may be the most severely impacted of all Native Hawaiians. Lei Anuenue, human immunodeficiency virus (HIV) prevention program for Native Hawaiians, has provided a variety of services for transgenders, including outreach, educational workshops, support groups, HIV testing, and case management. All services are provided by peer leaders who are employed by the program. Data for this article are based on case management, including client self-disclosures and reports of peer staff who knew details of clients' lives having shared with them both generic experiences and specific activities. Information from 100 transgender clients and their case managers indicated that the transgender health profile is far more serious than that of mainstream Native Hawaiians. For example, 74% smoke, 31% use illegal drugs (excluding marijuana), more than 50% have been involved in street or domestic violence, and few individuals over age 50 have been found during three years of outreach. To some extent, employment options limit transgenders to prostitution, drug dealing, and minimum-wage jobs. In addition, a lifestyle of multiple sex partners and lack of opportunities for stable relationships place transgenders at much greater risk for HIV, sexually transmitted diseases (STD), and other infectious and non-infectious diseases as compared to the mainstream Native Hawaiian community. Clients in this study were from O'ahu, primarily from downtown Honolulu, Chinatown, and Wai'anae. Future studies should compare the results of this sample to transgenders from the neighbor islands (especially in rural Hawaiian areas), as well as utilize a structured prospective longitudinal approach.