Factors affecting routine medical screening among health workers in a tertiary hospital in Delta State.

Background: Routine medical screening usually involves periodic history taking, physical examination, and laboratory tests on a regular basis for asymptomatic individuals for continuing self-health care. Aim: This study aimed to determine the knowledge, practice, and factors affecting practice of routine medical screening among health workers in Delta State University Teaching Hospital, Oghara. Subjects and Methods: The study population comprised all staff of the hospital. The sample size was determined using the Yamane formula; n = N/1 + N (e) = 295. A structured questionnaire was distributed among the various staff of the hospital that consented to participate in the study by agreeing to complete the questionnaire. Permission for the study was obtained from Ethics committee of the hospital. Data analysis was by SPSS version 22 (IBM). Results: About 297 participants completed their questionnaires. Female respondents (53.20%) participated more than males (46.80%). Nurses made up 25.5%, 18.8% were doctors, and 16.4% were administrative staff. Among the respondents, knowledge score was good in 58.3%, fair in 25.1%, and poor in 25.1%. The perception score among the respondents was good in 187 and poor in 110. The main reasons for not doing routine medical screening in the last one year were attributed to cost of tests (36.4%). The main reasons for doing a medical test in the past one year were mainly because of illness (60.0%). The practice of routine medical screening score was good in (26.2%) and poor in (73.7%). There was statistically significant association between sex and practice of routine medical screening, females had better practice of routine medical screening compared to men, P = 0.004. The main factors that affected routine medical screening were sex, being managed for a medical condition, and cost of the medical screening. Conclusion: The practice of routine medical screening by the health care workers in our region is poor despite the demonstration of a good knowledge. The major factors affecting uptake of routine medical screening were sex, history of being managed for a health condition, and financial constraint. Staff of the hospital should be better enlightened on the use and importance of the Contributory Health Scheme in routine medical screening.

Gastrointestinal Lesions in a Nigerian Tertiary Care Centre: A Histopathological Study.

BACKGROUND AND OBJECTIVE: Gastrointestinal diseases account for significant morbidity and mortality across the world. The study aims at establishing the epidemiological profile of gastrointestinal diseases in a Nigerian tertiary care center. METHODS: This is a descriptive retrospective study of all gastrointestinal specimens, submitted to the histopathology department of Delta State University Teaching Hospital (DELSUTH) for diagnosis. The age, sex, and histological diagnosis were extracted from the archives of the department. These were re-reclassified into diagnostic groups, analyzed using Excel spread sheet 2007 and summarized in tables. RESULTS: The study involves 570 patients (290 males and 280 females) with gastrointestinal tract (GIT) diseases within the age range of 10 days to 99 years, and of a mean age of 48.4 years. Congenital, inflammatory, benign neoplasms, malignant neoplasms and vascular diseases accounted for 1.6%, 77.5%, 2.6%, 18.1% and 0.18% of the cases respectively. These lesions were domiciled in the esophagus (1.4%), stomach (53.3%), small intestine (7.9%), appendix (10%), colorectum (25.4%) and anus (2%). The peak incidence corresponded to the 5th decade with 72.5% of cases affecting patients of 30-69 years. Malignant lesions were found in the esophagus (5.8%), stomach (14.6%), small intestine (4.9%), colorectum (72.8%) and anus (1.9%) and were mostly adenocarcinomas. CONCLUSION: The study showed that GIT lesions were slightly more common among males. Majority of cases were inflammatory diseases (gastritis, appendicitis) with GIT cancers (colorectal and gastric cancer) being the next most common. The preponderance of GIT lesions among the productive age calls for action to ameliorate the trend. Preventive public enlightenment campaign on GIT cancer risk factors and population-based screening programmes especially for Helicobacter pylori infection and colorectal cancer is highly recommended.

Post-burn pruritus: need for standardization of care in Nigeria.

It is generally agreed among burn care specialists that pruritus (itching) is a very common and distressing complication of burn injuries that results in extreme discomfort. There is no consensus on treatment modality worldwide but there are generally accepted methods of managing amelioration. This survey aims to study the knowledge, attitudes and practices of Nigerian burn specialists who manage various degrees of burn injuries in our environment. The purpose is to find out whether there are any uniform modalities of care for these patients, with the view of possibly providing standardization. To this end, a structured questionnaire was designed and distributed to plastic surgeons from across Nigeria. Findings showed that 88.6% of the plastic surgeons had no form of assessment tool or method for evaluating post-burn pruritus, leaving only 11.4% believing they had a method of assessing the severity of post-burn pruritus. With regard to treatment, 57.1% would use oral medications as first-line treatment, 22.9% would use injectables, 8.6% would use topical agents, 5.7% would only reassure the patients and another 5.7% would use a combination of oral and topical agents together. 85.7% of these plastic surgeons and burn care specialists did not have any form of anti-pruritic regimen, as only 14.3% indicated having this. Hence, there is no standardization in the management of pruritus in Nigeria and there is an urgent need for a management protocol.

Il est généralement admis parmi les spécialistes du traitement des brûlures que prurit (démangeaisons) est une complication très fréquente et douloureuse des brûlures qui se traduit par une gêne extrême. Actuellement, il n'ya pas de consensus globale sur les modalités de traitement, mais il y a des méthodes de gestion de l'amélioration généralement acceptées. Cette enquête vise à étudier les connaissances, attitudes et pratiques des spécialistes des brûlures nigérians qui gèrent divers degrés de brûlures dans notre environnement. Le but est de savoir s'il existe des modalités uniformes de soins pour ces patients, en vue de fournir éventuellement normalisation. À cette fin, un questionnaire structuré a été conçu et distribué aux chirurgiens plasticiens à travers le Nigeria. Un total de 88,6% des chirurgiens plasticiens n'avait aucune forme d'outil d'évaluation ou d'une méthode d'évaluation de prurit consecutif aux brûlures tandis que seulement 11,4% d'entre eux croyaient qu'ils avaient une méthode d'évaluation de la gravité de prurit suite aux brûlures. En ce qui concerne le traitement, 57,1% utiliseraient médicaments par voie orale comme traitement de première ligne, 22,9% utiliseraient injectables, 8,6% utiliseraient des agents topiques, 5,7% ne feraient que rassurer les patients, et un autre 5,7% utiliseraient une combinaison d'agents oraux et topiques ensemble. 85,7% de ces chirurgiens plasticiens et spécialistes des brûlures n'ont pas toute forme de traitement anti-prurigineux, puisque seulement 14,3% ont indiqué qu'ils avaient une certaine régime. Par conséquent, il n'existe pas de normalisation dans la gestion du prurit au Nigeria et il ya un besoin urgent d'un protocole de gestion.

DONOR SITE MORBIDITY FOLLOWING HARVEST OF SPLIT-THICKNESS SKIN GRAFTS IN SOUTH EASTERN NIGERIA.

BACKGROUND: Split-thickness skin grafting is a very common procedure. Few documentation of its complications exist in the literatures especially in our sub-region where excessive scarring is a major issue. OBJECTIVE: The objective of the study was to document the common complications observed at the donor site for split thickness skin grafts. METHODS: This is a prospective study carried out at the National Orthopaedic Hospital, Enugu, Nigeria over a six month period. All patients with wounds requiring split-thickness skin grafts, who gave consent, were recruited. An observer administered questionnaire was opened for each patient. Any donor site complication was noted on inspection and documented. Analysis of the results was done using SPSS with frequencies, mean and test of significance. RESULTS: A total of 120 patients were recruited for the study. Males accounted for 59.2% of the patients while females made up 40.8%. Donor site complications noted were pain which was exaggerated after 24 hours, itching, infection, dyschromia, hypo-pigmentation, hyper-pigmentation, and hypertrophic scars. At 1 month post-operative period, dyschromia was the commonest complication (39.2%), followed by itching (22.5%), hypo-pigmentation (19.2%), infection (17.5%), and exaggerated pain (1.7%). However, by 3 months, hyper-pigmentation was most common (55.4%), followed by dyschromia (37.5%), hypertrophic scar (3.6%) and itching (3.6%). Whereas by 6 months most patients had hyper-pigmentation (96.0%) while 4.0% had hypertrophic scars. The exaggerated pain was treated successfully with analgesics and was no longer present in any patient after the first month. While infection was also treated successfully following wound swab culture and sensitivity, appropriate antibiotic therapy and local wound care. Pigmentation changes were in keeping with previous studies as hyper-pigmentation was an invariable event following healing of a partial thickness wound. CONCLUSION: Donor site morbidity can be a big problem especially with regard to infection which increases duration of admission and therefore cost of management.

Burn Injuries in Enugu, Nigeria - Aetiology and Prevention. A Six-year Retrospective Review (January 2000 - December 2005).

Background.Burn injuries frequently occur in our homes and workplaces and during travels. They are a common presentation at the National Orthopaedic Hospital, Enugu, Nigeria, which is a regional centre for burns care and for plastic surgery, orthopaedic surgery, and trauma patients. Most burn injuries are preventable, and campaigns to arouse greater awareness are necessary to reduce the number of occurrences. Objectives.The objectives of this study are to highlight the causes of burn injuries and to characterize age and sex incidences, as also the severity of burn injuries. It is hoped that formidable preventive measures will be suggested to aid public enlightenment campaigns in fighting the scourge of burn injuries. Materials and method. A retrospective review of patient's folders from Jan. 2000 to Dec. 2005 showed that 414 cases of burn-injured patients were treated at the emergency unit of the National Orthopaedic Hospital, Enugu. Results. Flame burns accounted for 48.3% of burn injuries followed by scalds with 40.6%; chemical burns accounted for 6.3%, while electrical and friction burns accounted for 4.6% and 1.0% respectively. Males made up 60.4% of the cases and females 39.6% (ratio, 1.5:1). The age group most commonly affected was that of children aged between 0 and 10 yr, accounting for 37.2% of cases, followed by the 21-30 yr age group with 22.7%. Altogether, 95.0% of the patients were aged less than 50 yr. With regard to flame burns, 51.5% were due to petrol flames (premium motor spirit), while 33.0% were due to kerosene. Cooking gas explosions accounted for 7.5% of the cases and diesel (automotive gas oil) 1.0%. Of the scalds, hot water accounted for 89.3% and hot oil 7.7%. As to chemical burns, 84.6% were due to acids, with alkalis, corrosive creams, and others making up the rest. With regard to electrical injury, current passage accounted for 63.2% of cases and flash burns for 36.8%.

Burns in epileptics: experience from enugu, Nigeria.

We present burn injuries sustained by epileptics and managed in our burns centre over a period of 10 years. There were a total of 18 patients who sustained burns as a result of epileptic attacks during the study period. This constituted 3.7% of the 485 burn patients seen during the period. There were 10 males and 8 females. Sixteen of them (88.9%) were known epileptics, while two had their first seizures when they sustained the burn injuries. Only seven of the patients (38.9%) had attempted any form of treatment for epilepsy prior to the burn injuries - four of these were on native herbal medications while three had seen orthodox medical practitioners but did not comply with their medications. Sixteen of the patients (88.9%) had flame burns and two (11.1%) had scald injuries. The burn surface areas ranged between 5 and 80%, with a mean of 21.0%. Most of the injuries were full thickness, necessitating wound cover. One patient had amputation of the right hand digits, while another had an above-elbow amputation. We submit that sociocultural beliefs about epileptics and epilepsy constitute a significant problem in this group of patients in our environment. Education of the people will reduce burn injuries in such patients.