Health-related quality of life in patients with dyspepsia presenting at the University of Benin Teaching Hospital, Benin City, South-South Nigeria: a cross-sectional study.

Introduction: Health-related quality of life (HRQoL) examines the impact of the symptoms of dyspepsia on the daily life of sufferers. There are a few published studies related to HRQoL of persons with dyspepsia in Africa. Methods: this was a hospital-based cross-sectional study involving 324 dyspeptic patients referred for upper gastrointestinal endoscopy to the University of Benin Teaching Hospitals (UBTH) The ROME IV criteria were used to recruit patients with dyspepsia. The short form Nepean Dyspepsia Index (SF NDI) was used to assess HRQoL in all participants. Upper gastrointestinal endoscopy was performed on all 324 dyspeptic patients. Results: the mean age of patients was 47.6 ± 15.6 years. Three hundred (92.6%) patients had significantly impaired HRQoL with an SF NDI mean score of 31.3 ± 9.1. Interference with daily activities and eating and drinking subdomains were more impaired than other subdomains of HRQoL (p < 0.001). There was no statistical difference between the impaired HRQoL in patients with functional dyspepsia and organic dyspepsia (p = 0.694). Among patients with organic dyspepsia, those with upper gastrointestinal cancers had significantly worse HRQoL SF NDI mean (sd) scores (39.7 ± 5.9) compared with patients with gastritis, peptic ulcer disease and GERD with (30.3 ± 9.2, 31.5 ± 9.7 and 32.9 ± 7.1 respectively) (p = 0.01). Conclusion: health-related quality of life is significantly impaired in patients with dyspepsia and those with upper gastrointestinal cancers having overall worse scores. The physical, social and psychological well-being of a majority of patients with dyspepsia in South-South Nigeria is negatively affected by dyspepsia.

Preparedness and response of a tertiary hospital to the COVID-19 pandemic in Nigeria: challenges, opportunities and lessons.

Africa was the last continent to be affected by the COVID-19 pandemic. Much of the discourse on Africa's response captured in scientific journals revolves around nations, public health agencies and organizations, but little is documented about how individual healthcare facilities have fared. This article reports the challenges faced in a tertiary hospital in Nigeria, including space constraints, diagnostic challenges, shortages in personal protective equipment and health worker infections. The opportunities and strengths that aided the response are also highlighted. The lessons learned will be useful to similar facilities. More information about health facility response at various levels is needed to comprehensively assess Africa's response to the pandemic.

The rheological profile of chronic liver disease patients in Nigeria.

BACKGROUND: In chronic liver diseases, liver function is adversely affected and the consequent alterations in blood constituents are known to affect vascular and rheological parameters. The aim of the study was to analyze the rheological profile in chronic liver disease (CLD) patients in Nigeria. PATIENTS AND METHODS: Seventy consecutive CLD patients attending the Gastroenterology Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria were studied prospectively over an 8 month period (May-December, 2007). Fifty apparently healthy age-and-sex matched individuals who were prescreened and found serologically negative to HIV 1 and 2, HBsAg and HCV were used as controls. Diagnosis of CLD was based upon histological findings of chronic parenchymal liver disease in the presence of stigmata of CLD. Plasma fibrinogen level was determined by the clot-weight technique. Plasma viscosity, erythrocyte sedimentation rate, haematocrit and platelet count were analysed. Clinico-demographic features, treatment modalities and the complications were analyzed. RESULTS: A total of 120 subjects comprising 70 CLD patients (50 males (71.4%) and 20 females (28.6%)) and 50 controls were studied. Alcoholic cirrhosis (44.3%) was the main risk factor closely followed by viral hepatitis (41.4%). Haematocrit and platelet count of CLD patients were significantly lower than the controls (p<0.001). Plasma fibrinogen concentration and plasma viscosity in CLD patients were significantly lower compared to the controls (p<0.001). CONCLUSION: CLD patients had low blood viscosity and low fibrinogen level (hypofibrinogenamia) when compared to controls. This may have contributed to the hypocoagulable state and therefore the bleeding tendency encountered in these patients.

Multiple myeloma: a ten year study of survival and therapy in a developing nation.

OBJECTIVE: To analyze the survival related to therapeutic modalities and haematological indices at presentation with outcome performed on records of all multiple myeloma (MM) patients'. METHODS: A prospective study was conducted in the University of Benin Teaching Hospital, Nigeria from 1993 to 2003. Thirty patients were identified with diagnosis confirmed on the basis of atypical plasmacytosis (=30% in the bone marrow), monoclonal component in the serum or urine and radiological evidence of the typical skeletal lytic lesions. RESULTS: Males (n = 20) outnumbered the females (n = 10), with a median age of 54 years. The mean duration of survival of all patients was 7 months (median 3 months; P < 0.0001) with only 13.3% of the patients surviving at two years. The mean duration of survival of 10 patients on either therapy of vincristine, adriamycin, dexamethasone (VAD) or 8 patients on melphalan, prednisolone (MP) was 3 months, significantly shorter than 21 months for the 5 patients on a combination of both forms of therapy at different times (COMB) (P = 0.0067). The Kaplan-Meier estimates of survival showed survival probability was least in those without definitive therapy (NONE) as expected. CONCLUSION: Late presentation and inadequate treatment from poor compliance with therapy in a setting of poverty and ignorance are suggested as factors contributing to the poor survival of the patients studied

The pattern of fetal hemoglobin changes in patients with malignancy on chemotherapy.

OBJECTIVE: Production of fetal proteins by malignant tissue is a recognized phenomenon seen in many neoplastic disorders. Hence, the aim was to determine if there is a positive correlation between administration of chemotherapy and reduction in fetal hemoglobin (HbF) levels. METHODS: In a prospective study at the University of Benin Teaching Hospital, Nigeria, 50 cancer patients at various stages of the disease and 50 controls for 10 months period (March to December, 2005), HbF was determined in pre- chemotherapy (n = 23) and post-chemotherapy (n = 27) cancer patients. Fetal hemoglobin was estimated by the modified Betke's method. RESULTS: A total of 20 patients (40%) comprising 10 pre-chemotherapy and 10 post-chemotherapy patients presented with increased HbF which was statistically significant (p < 0.0001). There was also a significant decrease in post- chemotherapy result when both pre and post-chemotherapy values were compared (p = 0.0073). CONCLUSION: The results presented indicate that during recovery of erythropoiesis some erythroblasts synthesized HbF and there was a reduction following administration of chemotherapy.