DEMOGRAPHICS OF COLLABORATORS INVESTIGATING THE NIGERIAN MEDICAL AND DENTAL INTERNS: A MEDICAL INTERNSHIP TRAINING IN NIGERIA (MINTING) STUDY COLLABORATION.

Introduction: The internship period is a peculiar time in a doctor's career, and some have described it as a "nuisance year" during which the junior doctor assumes many roles at the same time. Junior doctors especially house officers are faced with many unique challenges; this is even more pronounced in poor resource settings like Nigeria. This study aimed to unravel and improve understanding of the challenges faced by medical and dental interns in Nigeria. Methodology: A nine-member House officers Research and Statistics Committee (HRSC) was immediately set up to include three senior colleagues - Senior Registrars and Registrar. To carry out her responsibility efficiently the committee created the House Officers Research Collaboration Network (HRCN), a 103- member team comprising medical and dental interns from across Nigeria under a collaborative - Medical INternship Training in Nigeria (MINTING) study. Results: Out of a total of the 103 House Officers Research Collaboration Network, 80 of them participated in this survey giving a 78% response rate. Ten of the intern Collaborators had additional qualification and seven of them had BSc as an initial degree. About 66 % of the Collaborators have never authored any publication. Of the 27 that have published an article; three collaborators are said to have published 15, 13, 16 articles respectively. Male collaborators where more likely to have published at least one article in the past. Thirty one of the 80 Collaborators have never been in a research collaborative group prior to this MINTING collaborative. Conclusion: This commentary is set out to describe in detail Nigerian House Officers initiative in terms of the structure, functions, operational modalities, and to investigate the demographics of the HRCN collaborators which showed that over two third of collaborators have never authored any publication and about a third of them have never been involved in collaborative research. We also believe the findings will serve as policy guide and benchmark in training the critical medical health force.

NON-COMMUNICATING HYDROCOELE OF THE CANAL OF NUCK: A RARE FINDING IN A RURAL-DWELLING NIGERIAN WOMAN.

Background: The surgical condition termed hydrocoele of the canal of Nuck is one of the rarest clinical entities in the female group. It occurs due to the failure of obliteration of the derivative of the peritoneum, the processus vaginalis. It usually presents with painless inguinal swellings and is sometimes associated with features of intestinal obstruction if there is hernia coexisting with it that has become obstructed. Abdominopelvic ultrasonography and magnetic resonance imaging provide the basis for diagnosis, where these imaging modalities are available. However, a definite diagnosis may only be made during surgery. Definitive treatment includes groin exploration and excision of the cyst with high ligation of the neck of the sac up to the peritoneal pouch, along with repair of the inguinal hernia, if present. Case Presentation: We present a rare case of a 34-year-old woman who presented with clinical features of a left inguinolabial swelling post-surgery, and diagnosed as left recurrent irreducible inguinal hernia. Intraoperatively, a cystic swelling with serous collection was observed. She had hydrocoelectomy and repair of the left groin surgical wound. Conclusion: Hydrocoele of the canal of Nuck may be misdiagnosed as inguinal hernia because of its rarity, lack of adequate knowledge regarding the entity and paucity of literature on the subject matter. This report is to furthermore increase our level of awareness of this condition especially after a previous groin surgery.

Cardiovascular Findings in Adult Patients with Sickle Cell Anaemia in Steady State seen in Calabar, Nigeria.

BACKGROUND: Sickle cell anaemia (SCA) is associated with significant morbidity and mortality linked to multi-systemic complications. With recent improvements in healthcare globally, it is expected that SCA patients in Nigeria will live longer. The cardiovascular complications may thus become prevalent. SUBJECTS AND METHODS: Fifty-two patients with sickle cell anemia in steady state and 52 controls were recruited. The assessment included history, physical examination, 12-lead resting electrocardiography, 2D, M-Mode and Doppler echocardiography, six-minute walk test and NTerminal pro Brain Natriuretic Peptide (NT-pro BNP) assay. RESULTS: The mean age of the sickle cell patients was 28.87±7.89 years and most were post-secondary or tertiary institutions. They had faster pulse rates (84.69±9.48 vs75.48±10.35 beats/minute, p=0.000), lower blood pressure (Systolic 112.56 ±10.87 mmHg vs 115.42 ± 14.75mmHg; Diastolic 70.79±9.03mmHg vs 71.27±9.23 mmHg) and lower Body Mass Index (21.55±3.51 vs 24.94±4.56kg/m2; p=0.000). Mean left ventricular (LV) internal diameters in systole and diastole were (3.19 ±0.57cm vs 2.81±0.45 cm; p=0.000) and (4.99±0.69cm vs 4.29±0.56 cm; p=0.00) respectively. Left and right ventricular systolic functions were normal. None of the patients with SCA met the criteria for pulmonary hypertension while 88.89% of those screened using Natriuretic peptide were at risk of developing pulmonary hypertension (NT-proBNP levels ≥ 160pg/ml). Functional status assessed by sixminute walk test was normal (373.00 ±60.40m vs 403.83±72.87 m; but significantly lower than in controls (p= 0.021). CONCLUSION: The cardiovascular system is adversely affected in persons with sickle cell anaemia especially as they grow older. Despite the presence of left ventricular remodeling, the patients with SCA in this study maintained good functional status. Regular cardiovascular assessment is advised.

CONTEXTE: La drépanocytose (SCA) est associée à une morbidité et une mortalité importantes liées à des complications multisystémiques. Avec les récentes améliorations des soins de santé dans le monde, on s'attend à ce que les patients atteints d'ACS au Nigeria vivent plus longtemps. Les complications cardiovasculaires pourraient donc devenir prévalentes. SUJETS ET MÉTHODES: Cinquante-deux patients atteints de drépanocytose à l'état d'équilibre et 52 témoins ont été recrutés. L'éva lua tion c om prena it l'histoire, l'exa m en physique, l'électrocardiographie de repos à 12 dérivations, l'échocardiographie 2D, M-Mode et Doppler, un test de marche de six minutes et un test d'apnée du sommeil. le dosage du NTerminal pro Brain Natriuretic Peptide (NT-pro BNP). RÉSULTATS: L'âge moyen des patients drépanocytaires était de 28,87±7,89 ans et la plupart étaient issus d'établissements post-secondaires ou tertiaires. Ils avaient un pouls plus rapides (84,69±9,48 vs75,48±10,35 battements/minute, p=0,000), une pression artérielle plus basse (Systolique 112,56 ±10,87 mmHg vs 115,42 ± 14,75 mmHg ; diastolique 70,79±9,03 mmHg vs 71,27±9,23 mmHg) et un indice de masse corporelle plus faible (21,55±3,51 vs 24,94±4,56kg/m2 ; p=0,000). Les diamètres internes moyens du ventricule gauche (VG) en systole et en diastole étaient de (3,19 ±0,57 cm vs 2,81±0,45 cm ; p=0,000) et (4,99±0,69 cm vs 4,29±0,56 cm ; p=0,00) respectivement. Les fonctions systoliques des ventricules gauche et droit étaient normales. Aucun des patients atteints d'ACS ne répondait aux critères d'hypertension pulmonaire, tandis que 88,89 % des patients dépistés à l'aide du peptide natriurétique étaient à risque de développer une hypertension pulmonaire(taux de NT-proBNP ≥160pg/ml). L'état fonctionnel évalué par le test de marche de six minutes était normal (373,00 ±60,40 m vs 403,83±72,87 m ; mais significativement plus faible que chez les témoins (p= 0,021). CONCLUSION: Le système cardiovasculaire est affecté de manière négative chez personnes atteintes de drépanocytose, en particulier lorsqu'elles vieillissent. Malgré la présence d'un remodelage ventriculaire gauche, les patients atteints d'ACS dans cette étude ont conservé un bon état fonctionnel. Une évaluation cardiovasculaire régulière est conseillée. MOTS CLÉS: Fonction ventriculaire, Drépanocytaires adultes, État d'équilibre, Hypertension pulmonaire.

Prevalence and Pattern of Smoking among Health Science Students in Nnamdi Azikiwe University Nigeria.

BACKGROUND AND OBJECTIVE: Cigarette is a Group 1 carcinogen and a major global health concern. The morbidity and mortality attributable to cigarette smoking are preventable. Health workers and health professional students are presumed to be well informed about smoking and are, therefore, absolved from the menace of smoking: The objective of this study was to determine the prevalence and pattern of smoking among preclinical and health professional students, the knowledge they had of the health consequences of smoking and the reasons why they smoked. METHODS: This was a cross-sectional study of 277 students in which self-administered semi-structured questionnaire was used. The variables addressed were age, gender, academic level, departments, smoking or non-smoking status, age at first smoking, tried smoking even puffing, smoking duration, reasons for smoking, thought of smoking as having health benefit, adduced reasons for presuming smoking health benefit, awareness of dangers of smoking (dangers like asthma, COPD, hypertension, diabetes mellitus), reasons for not smoking, and reasons for stopping smoking. Analysis of the variables was doneusing descriptive statistics. RESULTS: The number of subjects studied were 277. The subjects' mean age was 21.47±2.34 years; 161(58.3%) were female subjects, and majority of them were in their 2nd year. Eighty-five percent of the students were in the departments of Medicine, Physiology, Medical Laboratory Science and Physiotherapy. Seven [2.5%, (females 2(0.7%), males 5(1.8%)] of the respondents were current smokers. However, 35[12.6%, females 12(4.3%), males 23(8.3%)] smoked previously but stopped. The mean age of the respondents when they smoked for the first time was 15.78 ± 5.02 years. The main reasons why the respondents smoked were peer pressure (35%), stress (25%) and depression (20%). Furthermore, 15(5.4%) respondents reported that smoking had some health benefits whereas 84% of the students had good knowledge of the health dangers of cigarette smoking and this was the major reason for quitting smoking or not smoking. CONCLUSION: The prevalence of smoking was low among health science students in this study. Stress, depression and peer pressure were the main reasons for smoking, and majority of them had sound knowledge of the health outcomes of smoking. There is a need for further creation of awareness of the dangers of smoking by health institutions to further reduce the prevalence of smoking among health professional students.

CONTEXTE ET OBJECTIF: La cigarette est un cancérogène du groupe 1 et un problème de santé mondial majeur. La morbidité et la mortalité attribuables au tabagisme sont évitables. Les agents de santé et les étudiants en professionnels de la santé sont supposés être bien informés sur le tabagisme et sont donc dispensés de la menace du tabagisme : eu des conséquences sur la santé du tabagisme et des raisons pour lesquelles ils fumaient. MÉTHODES: Il s'agissait d'une étude transversale de 277 étudiants dans laquelle un questionnaire semi-structuré auto-administré a été utilisé. Les variables abordées étaient l'âge, le sexe, le niveau scolaire, les départements, le statut de fumeur ou de non-fumeur, l'âge au début du tabagisme, l'essai de fumer même en bouffant, la durée du tabagisme, les raisons du tabagisme, la perception du tabagisme comme bénéfique pour la santé, les raisons invoquées pour présumer du tabagisme bienfaits pour la santé, sensibilisation aux dangers du tabagisme (dangers comme l'asthme, la MPOC, l'hypertension, le diabète sucré), les raisons de ne pas fumer et les raisons d'arrêter de fumer. L'analyse des variables a été effectuée à l'aide de statistiques descriptives. RÉSULTATS: Le nombre de sujets étudiés était de 277. L'âge moyen des sujets était de 21,47 ± 2,34 ans ; 161 (58,3%) étaient des sujets féminins, et la majorité d'entre eux étaient dans leur 2e année. Quatre-vingt-cinq pour cent des étudiants étaient dans les départements de médecine, physiologie, sciences de laboratoire médical et physiothérapie. Sept [2,5 % (femmes 2 (0,7 %), hommes 5 (1,8 %)] des répondants étaient des fumeurs actuels. Cependant, 35 [12,6 %, femmes 12 (4,3 %), hommes 23 (8,3 %)] ont déjà fumé. mais arrêté. L'âge moyen des répondants lorsqu'ils ont fumé pour la première fois était de 15,78 ± 5,02 ans. Les principales raisons pour lesquelles les répondants ont fumé étaient la pression des pairs (35 %), le stress (25 %) et la dépression (20 %). , 15 (5,4 %) répondants ont déclaré que le tabagisme avait des effets bénéfiques sur la santé alors que 84 % des étudiants avaient une bonne connaissance des dangers pour la santé du tabagisme et c'était la principale raison d'arrêter de fumer ou de ne pas fumer. CONCLUSION: La prévalence du tabagisme était faible chez les étudiants en sciences de la santé de cette étude. Le stress, la dépression et la pression des pairs étaient les principales raisons du tabagisme, et la majorité d'entre eux avaient une bonne connaissance des effets du tabagisme sur la santé. Il est nécessaire de sensibiliser davantage les établissements de santé aux dangers du tabagisme afin de réduire davantage la prévalence du tabagisme chez les étudiants en professionnels de la santé. Mots-clés: Tabagisme, Raisons du tabagisme, étudiants en professionnels de la santé.