Background: Dialysis remains the most common modality of renal replacement therapy for managing end-stage kidney disease. Optimisation of various measures is needed for its efficient delivery. Inadequate dialysis is common in many low-income nations, and there could be inter-centre differences in the delivered dose. Aim: We assessed the dialysis adequacy and factors associated with inter-centre variation. Materials and Methods: This was a two-centre comparative study. Participants' sociodemographic and examination findings were documented and dialysis was prescribed. Pre- and post-dialysis blood for electrolytes, urea and creatinine were taken, and urea reduction ratio and fractional urea clearance as a function of its distribution volume (Kt/V) were calculated. Results: Two hundred and thirty-two participants had 1248 dialysis sessions. Participants' mean age was 49.9 ± 4.6 years. More males participated in the study, and males also received more sessions per participant. A greater proportion of the participants had tertiary education and had hypertensive nephropathy as the cause of kidney disease. The internal jugular access was used for dialysis in majority (60.6%) of the dialysis sessions. Dialysis dose (DD) was adequate in only 115 (9.2%) sessions. The mean DD was 1.02 ± 0.4; in the two centres, it was 0.86 ± 0.2 and 1.11 ± 0.5. Conclusion: DD is low in many low-income nations including Nigeria. The DD was directly related to the blood flow rate, dialysis duration and frequency of erythropoietin use. In addition to other factors, inability to afford prescribed dialysis regimen is a major contributor to the low DD in low-income settings.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The role of the anatomical pathologist is very crucial in the investigation of deaths in suspicious circumstances. It entails thorough dissection, scrutiny of organ changes and sound intellectual processes to guide legal authorities to take proper decisions based on medicolegal reports of autopsies. Aims and Objectives: The aim of this study was to establish the presence of pre-morbid conditions in deceased persons during medicolegal autopsies and to ascertain the contributions of pre-morbid diseases to the process of death. Materials and Methods: A retrospective analysis of medicolegal autopsy records over eleven years (2007-2017) was done and the data was analyzed by simple descriptive statistical methods. The inclusion criteria were disorders that predated the medicolegal event resulting in death. Conditions known to be pathophysiological components of the medicolegal event were excluded from the study. Results: A total of 246 cases were considered but only 10 cases met the inclusion criteria. The manner of death in four of the cases within the inclusion criteria were accidental deaths, including three cases of road traffic accident and one case of aircraft crash. There were three cases of infective illness, one case of gunshot injury to the head, one case of death from occupational hazard and one case of death due to injuries from machete cuts. The pre-medical conditions in most of the cases on strict morphological assessment were incidental findings and were not deemed to be contributory in any way to the process of death. Conclusion: It is very important for the anatomical pathologist to probe meticulously for the cause of death and explain the role of every lesion seen at autopsy in the process of death. This is necessary so as to avoid doubts, the insinuations of incomplete autopsies and unnecessary controversies in medicolegal cases.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Current discourses on healthcare environments' design suggest that qualitative healthcare is directly linked with the state and quality of the environment, making reference not only to the physical but also to the ambient and social environments. These conclude that in giving qualitative care to patients, who are the primary targets of these facilities, it is advocated that the healthcare environments are consciously humanised. Methods: The study is a literature review citing the Nigerian scenario as a case study among developing countries. Results: This review reveals that even though humanisation is crucial, as a driver for change in healthcare environments, its definition varies contextually. The paper further maintains that culture is central to whatever the definitions given to the concept of humanisation and attempts to initiate a discussion on the definition for 'Humanisation' in healthcare environments in Nigeria. It also emphasises the need for and the benefits of evidence-based designs in ensuring the design of well-humanised healthcare environments. In addition, the study finds that there is a dearth of the literature on healthcare environments' design in Nigeria. Conclusion: Currently, there are no commonly identifiable definitions for humanistic designs in healthcare environments in Nigeria. Recommendations are that more healthcare design research should be conducted to support these observations with empirical evidence and uncover how humanisation is defined in the country.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The integration of eye care services into the primary health-care (PHC) system and the accessibility and quality of eye health in the community is hugely dependent on available resources. Objective: The aim was to assess the resources available for eye care delivery in public PHC facilities in Obokun Local Government Area (LGA), Osun State, Nigeria. Methodology: This was a descriptive cross-sectional study of public PHC facilities and workers in Obokun LGA, Nigeria. A PHC facility checklist was used to obtain data on available infrastructure, material resources, primary eye care (PEC) services, and human resources during a tour and inspection of each facility. Further data on human resources were obtained with a semi-structured questionnaire administered to PHC workers. Data included information on the age, sex, cadre, duration of service, PEC practices, and training of PHC workers. Results: There were 4 (10.0%) primary health (PH) centres, 19 (47.5%) PH clinics and 17 (42.5%) health posts. The number and distribution of PHC facilities, material resources, and PEC services were below-recommended guidelines. There were 12 (11.2%) nurses, 4 (3.7%) community health officers, 19 (17.8%) community health extension workers (CHEWs), 7 (6.5%) health technicians, 8 (7.5%) junior CHEWs, and 57 (53.3%) health assistants. There was a sufficient number of PHC workers and community services to build capacity for PEC delivery. Conclusions: Resources were available for PEC in Obokun LGA; however, some were insufficient or unevenly distributed. Further training of PHC workers in PEC and the provision of the minimum required infrastructure and material resources are recommended.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Alcohol is a socially acceptable substance that plays a key traditional role in the African setting. Family factors such as dysfunctional family background may increase the risk of alcohol use disorder (AUD) among university students. Objective: This study assessed the prevalence of AUD and its association with family factors among undergraduates of a Nigerian university. Methods: This descriptive cross-sectional survey involved 360 consenting undergraduates recruited from Obafemi Awolowo University, Ile-Ife. Demographic variables were obtained with a questionnaire, whereas AUD was measured with AUD Identification Test. Family factors assessed were family structure, family socioeconomic status, family functioning, parenting styles and perceived social support (PSS). Results: The mean age of respondents was 21.12 years (standard deviation = 2.37) and 223 (61.9%) were males. The prevalence of AUD was 16.7%. Factors significantly associated with AUD were demographic variables – being male (P < 0.001) and traditional religion (P = 0.024) and family factors – low socioeconomic class (P = 0.023), dysfunctional family (P < 0.001) and father use of alcohol (P = 0.001). Respondents with AUD reported significantly lower mean score on all the PSS subscales: family (P = 0.001), friend (P < 0.001) and significant other (P < 0.001) and authoritative parenting style of father (P < 0.001) and mother (P < 0.001). Predictors of AUD were male sex, father use of alcohol, father authoritative parenting style and high PSS from friends. Conclusion: AUD is prevalent among Nigerian undergraduates with male sex and some family factors associated with it. The results of this study have significant implications for both primary and secondary prevention efforts.

[ABSTRACT]  [FULL TEXT]  [PDF]