RESUMO
Background and Aim: The deleterious effects of Resident Doctors' (RDs') long duty hours are well documented. Driven by concerns over the physician's well-being and patient safety, the RDs' duty hours in many developed countries have been capped. However, in Nigeria and many African countries, there are no official regulations on work hours of RDs. This study evaluated the work schedule of Nigerian RDs and its impact on their wellbeing and patient safety. Subjects and Methods: A national survey of 1105 Nigerian RDs from all specialties in 59 training institutions was conducted. With an electronic questionnaire designed using Google Forms, data on the work activities of RDs were obtained and analyzed using the IBM SPSS software version 24. The associations were compared using Chi-squared test with the level of significance set at < 0.05. Results: The mean weekly duty hours (h) of the RDs was 106.5 ± 50.4. Surgical residents worked significantly longer hours than non-surgical residents (122.7 ± 34.2 h vs 100.0 ± 43.9 h; P < 0.001). The modal on-call frequency was two weekday on-calls per week (474, 42.9%) and two weekend on-calls per month (495, 44.8%), with the majority of RDs working continuously for up to 24 hours during weekday on-calls (854, 77.3%) and 48-72 hours during weekend on-calls (568, 51.4%), sleeping for an average of only four hours during these on-calls. The majority of RDs had post-call clinical responsibilities (975, 88.2%) and desired official regulation of duty hours (1,031, 93.3%). Conclusion: The duty hours of Nigerian RDs are currently long and unregulated. There is an urgent need to regulate them for patient and physician safety.
Assuntos
Internato e Residência , Carga de Trabalho , Humanos , Nigéria , Admissão e Escalonamento de Pessoal , Inquéritos e QuestionáriosRESUMO
Aplasia cutis congenita (ACC) is a rare developmental disorder that is not fully understood. It often occurs in isolation but can also be syndromic. Usually, there is an absence of the epidermis and dermis. It may be limited to the skin alone but may involve deeper structures. Research has identified a heterogeneous predisposition including genetic factors. Among patients with ACC, scalp involvement is common, however large scalp defects with the involvement of the skull is not common. We present a preterm neonate with a large scalp ACC with a wide skull defect.
L'aplasie cutanée congénitale (ACC) est un mal du développement rare qui n'est pas entièrement compris. Elle survient souvent de manière isolée mais peut également être syndromique. Habituellement, il y a une absence d'épiderme et de derme. Elle peut être limitée à la peau seule mais peut impliquer des structures plus profondes. La recherche a identifié une prédisposition hétérogène incluant des facteurs génétiques. Chez les patients atteints d'ACC, l'atteinte du cuir chevelu est fréquente, mais de grandes anomalies du cuir chevelu avec atteinte du crâne ne sont pas courantes. Nous présentons un nouveau-né prématuré avec un grand CCA du cuir chevelu avec un large défaut du crâne.
