Sleep health among medical students in Abakaliki Nigeria: A descriptive study.

Background: Sleep health focuses on those measurable characteristics of sleep that are most clearly associated with physical, mental, and neurobehavioral well-being, and not necessarily the absence of sleep disorder. Sleep health is characterised by subjective satisfaction, appropriate timing, adequate duration, high efficiency, and sustained alertness during waking hours. Adequate and restful sleep is particularly crucial for medical students, who face unique challenges due to the demanding nature of their academic and clinical responsibilities. There is limited data on sleep health among medical students in Nigeria. Objectives: This research study investigated the pattern of sleep health among medical students in Abakaliki Nigeria. Methods: This cross-sectional observational study was undertaken among the medical students of 2 public institutions in Abakaliki Nigeria from 16th to 23rd June 2023. Results: Out of the 288 medical students (males- 53.1 %, females- 46.9 %), good sleep health was recorded in 6.6 %. The mean SATED sleep score was 4.9 ± 1.7 (male- 4.9 ± 1.8, female- 4.9 ± 1.6) (p-value = 1) and it was significantly lower among the final-year students. Age difference, sex difference, and presence of chronic headache did not significantly affect the SATED sleep score. The mean sleep duration was 6.1 ± 1.5 hours (male- 6.1 ± 1.6, female- 6.0 ± 1.4). Sleep duration (54.5 %) had the best rating while sleep efficiency (44 %) had the lowest rating among the assessed sleep domains. Conclusion: Sleep health is poor among medical students in Abakaliki Nigeria and significantly poorer among final-year medical students.

Stroke units in Nigeria: a report from a nationwide organizational cross-sectional survey.

Introduction: stroke is one of the leading causes of death and disability in Nigeria. Stroke unit care is crucial for reducing mortality and morbidity in stroke. This study describes the stroke units' structure, organization, and care process in Nigerian tertiary hospitals. Methods: this study is a cross-sectional descriptive organizational survey-based study using an online structured questionnaire to collect information on the stroke units. Results: five (8.6%) out of 58 hospitals had a stroke unit. The number of beds ranged between 10 and 27 with the coverage of hospital stroke patients ranging from 24% to 100%. All the centers had a multidisciplinary team for their unit. The basic required investigations like computerized tomography and electrocardiography were available in the centers. Thrombolytic therapy coverage was suboptimal in all the centers due to prolonged onset-to-arrival times and inaccessibility of thrombolytic medications. Conclusion: there has been some progress in stroke unit availability since the country´s first stroke unit was established over a decade ago. However, there is still the need to create more stroke units in Nigeria and improve reperfusion therapy coverage.

Awareness, Treatment, and Control of Hypertension in Primary Health Care and Secondary Referral Medical Outpatient Clinic Settings at Enugu, Southeast Nigeria.

Essential hypertension is the most common noncommunicable disease (NCD), affecting more than half the adult population in many countries and being the major NCD contributor to the double burden of disease in developing countries. We undertook a survey of the hypertension awareness, treatment, and control in primary and secondary referral health care clinics in Enugu, Nigeria, and compared these data with those obtained in local community surveys. The prevalence of hypertension in the primary care clinic (9.2%) was lower than in a previously reported community survey (42.2%), while, in the referral clinic, 70.3% of patients attending were hypertensive. Hypertension awareness rates were 91.9%, 29.4%, and 93.2% in these respective health care settings. Treatment and control rates (89.9% and 72.9%) were better in the secondary care clinic than in the primary care centre (87.7% and 46.0%). (Chi-square analysis confirmed statistically significant differences between these rates (p < 0.05).) These data may form a useful index of health care system effectiveness in Nigeria. Possible reasons for the differences observed and effective strategies to address the waxing pandemic of hypertension are discussed.

Pattern of neurological admissions in the tropics: experience at Abakaliki South-Eastern Nigeria.

BACKGROUND: The pattern of neurological admissions varies amongst different regions of the world and this depends on many factors including the regional burden of neurological disorders. This study determined the pattern of neurological admissions in a tertiary health centre in Abakaliki South Eastern Nigeria and compared it with that from other parts of the country. METHODOLOGY: A review of admissions into the medical wards of the Federal Teaching Hospital Abakaliki south- eastern Nigeria from July 2012 to June 2013 was done using the register of admissions and discharges. RESULTS: Out of 1247 patients admitted in medical ward over the study period, 267 (21%) had neurological disorders with mean age of 55.1 ± 20.2 years. There were 154 (58%) males and 113 (42%) females, with a sex ratio of 4:3. Seventy two percent of the patients were between 30 and 69 years. Stroke accounted for 62% (166) of the neurologic admissions. Others were central nervous system (CNS) infections, seizure disorders, hypertensive encephalopathy. myelopathies, CNS tumors and neurodegenerative disorders in descending order of frequency. CONCLUSIONS: The burden of neurological disorders is high with male preponderance in Abakaliki south-eastern Nigeria affecting mainly the productive population. Stroke and CNS infections were the most prevalent neurological disorders identified which are both largely preventable.There should be good health planning that will address the enormous neurological disease burden with emphasis on preventive health.

The prognosis of acute stroke in a tertiary health centre in south-east Nigeria.

BACKGROUND: Stroke is a common neurologic disorder and it is the third leading cause of mortality worldwide after ischaemic heart disease and cancer.This study determined the prognosis of acute stroke in Federal Teaching Hospital Abakaliki (FETHA) South-East Nigeria. METHODOLOGY: It was a retrospective, descriptive and hospital based study conducted in a tertiary health centre in Abakaliki south-east Nigeria. The stroke register of the neurology unit was reviewed and relevant data were extracted and analyzed. RESULTS: Stroke accounted for 12% of medical death with 24 hour, 7 day and 30 day mortality rates of 5%, 10% and 15% respectively. Factors associated with stroke mortality include advanced age, female sex, extremes of blood pressure, loss of consciousness and haemorrhagic stroke. CONCLUSION: There should be regular health education with emphasis on primary prevention of stroke. Also, stroke patients should be referred early to a stroke unitfor adequate management.

Ischaemic stroke in hyperthyroidism without cardiac arrhythmia. A case report from south east Nigeria.

BACKGROUND: The relationship between hyperthyroidism and stroke is well established in the setting of atrial fibrillation. However there is limited literature for ischaemic stroke occuring in hyperthyroidism without cardiac arrhythmia. No such case had been described in South East Nigeria. METHOD: This report highlights a case of ischaemic lacunar infarction in an elderly Nigerian woman with reemergent thyrotoxicosis, without atrial fibrillation. RESULT: A 75- year old retired female teacher presented with a painless goiter of 3 years duration and right sided hemiplegia of 2 months duration. She had sub-total thyroidectomy 32 years ago for thyrotoxicosis with subsequent good outcome and had been managed for diabetes mellitus for 13 years with good glycaemic control. She was not a known hypertensive. She was thyrotoxic on examination with a large non-tender goiter. There was sinus tachycardia. She had a right sided facial nerve palsy and ipsilateral spastic hemiplegia. Sensations were spared. Results of investigations confirmed hyperthyroidism while brain CT scan was unremarkable except for cerebral atrophy. She had no other associated risk factor associated with hyperthyroidism. Within two weeks of admission she was stabilized on anti-thyroid and anti-diabetic medications, her motor functions significantly recovered and she was independent. She was discharged to be followed up at the out-patients' clinic. CONCLUSION: Ischaemic stroke may present in hyperthyroid patients without atrial fibrillation. This possibility needs to be entertained despite the absence of cardiac arrhythmia or other well established factors for cardioembolic stroke. There is a need for more studies on this relationship.

The use of the radial recurrent fasciocutaneous flap in interposition arthroplasty of elbow ankylosis case report and review of literature.

Elbow ankylosis and its management remain a challenge in the developing countries like Nigeria because of many factors, including the absence of elbow replacement surgery. Current operative management, which is interposition arthroplasty with fascia lata or arthrodesis in a more functional position, is commonly complicated with donor site morbidity and restricted functionality, respectively. We report the use of the regional radial recurrent fasciocutaneous flap of the arm as an interposition material for an ankylosed elbow after excision of the bone block, with no donor site morbidity and improved range of elbow motion. At 4 years postoperatively, patient is very satisfied with functionality. Additionally, this method of managing elbow ankylosis uses a vascularized and durable flap, is cheap, and has less operation time, and thus is highly recommended.