PUSK AND PULL FACTORS OF EMIGRATION AMONG PHYSICIAN IN NIGERIA.

Background: Physician emigration is increasing exponentially in developing countries. In Nigeria, with the last decade's unprecedented brain drain, it has gained the popular moniker 'japa syndrome'. Aim: This study aimed to determine push and pull factors affecting physician migration in Nigeria, to provide evidence-backed recommendations for physician retention policies. Materials/Methods: A cross-sectional study was conducted among attendees at the 2022 Abuja Cardiovascular Symposium hosted by Limi Multispecialty Hospital and the Nigerian Cardiac Society. Convenience and snowball sampling were used, and 295/400 responded to comprehensive self-administered questionnaires (73.7% response rate). Data was analysed using SPSS v.26. Results: Most participants (79.4%) were aged 20-39 years (Mean 35 years SD ±10.17); female (58.6%); married (58.4%) and had family size below six (73.6%). About 85.8% were employed, and 55.9% worked in private establishments. Solely basic medical degrees were possessed by 64.4%, and 63.7% earned N300,000-N399,999 (USD 396.82-USD 527.78) monthly. Top destinations were UK (50.5%), Canada (43.3%), and USA (37.9%), with low remuneration (71.2%), insecurity (62.7%), and difficult working environments (55.9%) most frequent push factors. Postgraduate-training frustrations (38.6%), and limited educational opportunities for oneself (37.6%), children (26.4%), or spouse (19.7%) were the least. High earning potential (76.6%), career growth opportunities (70.8%), and high-level equipment/technology (54.9%) were frequent pull factors. Conclusion: Physician emigration threatens Nigeria's health system and should be addressed multi-sectorally to boost physician remuneration and improve work environments and societal security. Additionally, innovative education and digital technology would encourage health workforce retention.

Accidental kerosene oil ingestion in under-five age children in Nigeria - The need for vigilance in primary care settings in low- and middle-income countries (LMICs).

Four children aged between 15 months and two years presented in several different out-patient emergency departments with a history of recent ingestion of kerosene. Majority of the patients lived in crowded domestic settings, and they all presented with varying degrees of respiratory distress, different presentations of respiratory clinical symptoms and signs, after being subjected to various potentially dangerous home remedies to counter the effect of the kerosene. Majority of the children presented late, but all recovered following appropriate management. The presented cases demonstrate the vital importance of prompt emergency management in primary care settings, family counseling on childcare and domestic safety, and community enlightenment on reducing the complications and frequency of childhood poisoning in increasingly overcrowded and less affluent communities.

Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria.

BACKGROUND: Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes. AIM: This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja. SETTING: The study was conducted in Abuja, the Federal Capital Territory, Nigeria. METHODS: This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation. RESULTS: Patients' median age was 39.3 years (interquartile range [IQR]: 26-52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5-19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%. CONCLUSION: Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.

Coronavirus disease (COVID-19) and acute nonicteric hepatitis: A case report from Asokoro, Nigeria.

We report our first case of Coronavirus disease (COVID-19) infection with hepatitis B co-infection who presented with fever, catarrh, headaches, fatigue, and loss of smell. He had a history of chronic hepatitis B infection which appeared to be inactive given a history of normal outpatient liver tests prior to admission for COVID-19. Following the positive nasopharyngeal polymerase chain reaction diagnosis with COVID-19, liver function tests revealed evidence of hepatitis with elevated bilirubin and liver enzymes and deranged full blood count findings.